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Doctor Patient Relationship

Katie M Moynihan, Melanie A Jansen, Shih-Ning Liaw, Peta M A Alexander, Robert D Truog
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one of paternalism to more informed, shared decision-making. Unfortunately, there is an increasing trend for clinicians to avoid making recommendations, instead providing a "menu" of care options from which patients and families must choose. This seems to be underpinned by the belief that it is unacceptably paternalistic to give guidance as to which course of action may be best to take...
June 13, 2018: Pediatric Critical Care Medicine
Helmut A Schmelz, Max Geraedts
BACKGROUND: Growing numbers of patients in orthopaedic and trauma surgery are obese. The risks involved are e.g. surgical complications, higher costs for longer hospital stays or special operating tables. It is a moot point whether revenues in the German DRG system cover the individual costs in relation to patients' body mass index (BMI) and in which area of hospital care potentially higher costs occur. MATERIAL AND METHODS: Data related to BMI, individual costs and revenues were extracted from the hospital information system for 13,833 patients of a large hospital who were operated in 2007 to 2010 on their upper or lower extremities...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Andrea Dall'Asta, Tullio Ghi, Giuseppe Rizzo, Annalisa Cancemi, Filomena Aloisio, Domenico Arduini, Giuseppe Pedrazzi, Francesc Figueras, Tiziana Frusca
INTRODUCTION: Doppler ultrasound has recently been suggested to identify subclinical placental functional impairment among normal sized term fetuses. The objective of this study was to evaluate the relationship between cerebroplacental ratio (CPR) measured in early labor and perinatal and delivery outcomes in a cohort of uncomplicated singleton term pregnancies. METHODS: This was a multicentre, prospective, observational study involving three Tertiary Centres. Low risk term pregnancies, as defined by the absence of any maternal morbidity and pregnancy complication and normal ultrasound and clinical screening of the fetal growth in the third trimester, with spontaneous onset of labor were included...
June 13, 2018: Ultrasound in Obstetrics & Gynecology
Murugan Venkatesan, Amol R Dongre, Kalaiselvan Ganapathy
Context: Medication nonadherence is common among diabetics and it is one of the leading public health challenges. Aims: The aims of this study were to find the prevalence of nonadherence to diabetic medication and to identify various factors associated with it. Settings and Design: This study was conducted in 34 villages of the field practicing areas of rural health training center. This was a mixed method study design. Subjects and Methods: It was conducted among 328 type 2 diabetic patients...
April 2018: Indian Journal of Community Medicine
Guillaume Charbonneau
No abstract text is available yet for this article.
June 2018: Canadian Family Physician Médecin de Famille Canadien
Zachary R Paterick, Nachiket J Patel, Timothy Edward Paterick
On-call physicians encounter a diverse aggregate of interfaces with sundry persons concerning patient care that may surface potential legal peril. The duties and obligations of an on-call physician, who must act as a fiduciary to all patients, create a myriad of circumstances where there is a risk of falling prey to legal ambiguities. The understanding of the doctor-patient relationship, the obligations of physicians under the Emergency Medical Treatment and Labor Act, the meaning of medical informed consent and the elements of negligence will help physicians avoid the legal risk associated with the various encounters of being on call...
June 13, 2018: Postgraduate Medical Journal
Bernhard A Sabel, Jiaqi Wang, Lizbeth Cárdenas-Morales, Muneeb Faiq, Christine Heim
The loss of vision after damage to the retina, optic nerve, or brain has often grave consequences in everyday life such as problems with recognizing faces, reading, or mobility. Because vision loss is considered to be irreversible and often progressive, patients experience continuous mental stress due to worries, anxiety, or fear with secondary consequences such as depression and social isolation. While prolonged mental stress is clearly a consequence of vision loss, it may also aggravate the situation. In fact, continuous stress and elevated cortisol levels negatively impact the eye and brain due to autonomous nervous system (sympathetic) imbalance and vascular dysregulation; hence stress may also be one of the major causes of visual system diseases such as glaucoma and optic neuropathy...
June 2018: EPMA Journal
Ningxi Yang, Yingnan Cao, Xiaoyan Li, Shiyue Li, Hong Yan, Qingshan Geng
BACKGROUND Doctors' empathy is closely related to patients' health. This study aimed to examine whether patients' stigma and self-efficacy play a mediating role in the relationship between doctors' empathy abilities and patients' cellular immunity in male patients with breast cancer. MATERIAL AND METHODS Doctors' empathy scores and patients' demographic data, disease condition, stigma, and self-efficacy were measured. Patient T cell subset was tested at admission and 3 months after the operation and was compared by paired t test...
June 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jaemyeong Shin, Yun Jeong Kim, Jong Kun Kim, Dong Eun Lee, Sungbae Moon, Jae Young Choe, Won Kee Lee, Hyung Min Lee, Kwang Hyun Cho
OBJECTIVES: Early retirement occurs when one's job satisfaction suffers due to employment mismatch resulting from factors such as inadequate compensation. Medical doctors report high levels of job stress and burnout relative to other professionals. These levels are highest among emergency physicians (EPs), and despite general improvements in their working conditions, early retirement continues to become more common in this population. The purpose of this study was to identify the factors influencing EPs intention to retire early and to develop a probability equation for its prediction...
May 2018: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Mikhail Golichenko, Sandra Ka Hon Chu
An inherent feature of drug control in many countries has been an excessive emphasis on punitive measures at the expense of public health. At its most extreme, this approach has reduced health services for people who use drugs to an extension of the drug control system. In these environments, health services are punitive rather than supportive for people who use drugs, especially those who are drug dependent. In Russia, the government's official policy towards drug use is one of "social intolerance," which seeks to legitimize and encourage societal ill treatment of people who use drugs...
2018: Public Health Reviews
Gianluca Castelnuovo, Emanuele Maria Giusti, Gian Mauro Manzoni, Donatella Saviola, Samantha Gabrielli, Marco Lacerenza, Giada Pietrabissa, Roberto Cattivelli, Chiara Anna Maria Spatola, Alessandro Rossi, Giorgia Varallo, Margherita Novelli, Valentina Villa, Francesca Luzzati, Andrea Cottini, Carlo Lai, Eleonora Volpato, Cesare Cavalera, Francesco Pagnini, Valentina Tesio, Lorys Castelli, Mario Tavola, Riccardo Torta, Marco Arreghini, Loredana Zanini, Amelia Brunani, Ionathan Seitanidis, Giuseppe Ventura, Paolo Capodaglio, Guido Edoardo D'Aniello, Federica Scarpina, Andrea Brioschi, Matteo Bigoni, Lorenzo Priano, Alessandro Mauro, Giuseppe Riva, Daniele Di Lernia, Claudia Repetto, Camillo Regalia, Enrico Molinari, Paolo Notaro, Stefano Paolucci, Giorgio Sandrini, Susan Simpson, Brenda Kay Wiederhold, Santino Gaudio, Jeffrey B Jackson, Stefano Tamburin, Fabrizio Benedetti
Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use...
2018: Frontiers in Neurology
Anne Herrmann-Werner, Rebecca Erschens, Barbara Schlisio, Christoph Nikendei, Robert Smolka, Stephan Zipfel, Caroline Rometsch-Ogioun El Sount
Teaching about chronic pain in psychosomatics courses - an overview of the situation in Germany and the Tübingen Model Objectives: When dealing with chronic pain patients it is crucial to take a bio-psycho-social approach. However, it is unclear how this approach is currently being taught to medical students, and how they judge its role and importance. METHODS: We carried out a qualitative study (questionnaire) asking (1) German psychosomatic departments about pain-related teaching and (2) medical undergraduates about pain-relevant issues...
June 2018: Zeitschrift Für Psychosomatische Medizin und Psychotherapie
Mohammed Senitan, Ali Hassan Alhaiti, James Gillespie
Purpose: This systematic review aims to explore patient satisfaction (PS) among patients who used Ministry of Health (MoH) primary care centres in Saudi Arabia, with a focus on their communication with physicians. Data sources: Medline, CINAHL, Embase, Global Health, the Saudi Medical Journal, Annals of Saudi Medicine, the Journal of Family and Community Medicine and Google Scholar. Study selection/Data extraction: The review focused on studies concerning PS in Saudi MoH primary care centres published between 2005 and 2017...
May 10, 2018: International Journal for Quality in Health Care
Supriya Subramani
This paper illustrates and reflects on subtle micro-level events and practices that sustain and reproduce unequal relationships in healthcare encounters, and draws attention to their moral significance in two hospitals in the south Indian city of Chennai. Based on observational data and in-depth interviews with 16 surgeons, 11 nurses, and 36 patients and their family members between February 2016 and July 2017, it reveals how both victims and perpetrators normalize instances of micro-inequities, often failing to recognize or acknowledge them...
May 19, 2018: Social Science & Medicine
Tomoo Fujii, Manako Hanya, Masanori Kishi, Yuki Kondo, Marshall E Cates, Hiroyuki Kamei
Stigma associated with psychiatric disorders tends to be manifested as negative attitudes or behavior toward the mentally ill. It has negative influences, such as leading to difficulty in establishing trust-based relationships and interfering with medical treatment. In order to reduce such stigma, it is necessary to clarify its extent and characteristics in healthcare professionals. Considering this, an Internet-based questionnaire survey was conducted, involving doctors (n = 186), nurses (n = 161), and pharmacists (n = 192) in comparison with the general public (n = 331), and using the Whatley Social Distance Scale (WSDS) and Index of Attitudes toward the Mentally Ill (IATM) as stigma-related indices...
May 28, 2018: Asian Journal of Psychiatry
Monica Oliveira Bernardo, Dario Cecílio-Fernandes, Patrício Costa, Thelma A Quince, Manuel João Costa, Marco Antonio Carvalho-Filho
BACKGROUND: Empathy is a fundamental humanistic component of patient care which facilitates efficient and patient-centered clinical encounters. Despite being the principal recipient of physician empathy little work on how patients perceive/report receiving empathy from their physicians has been undertaken. In the context of doctor-patient interactions, knowledge about empathy has mostly originated from physicians' perspectives and has been developed from studies using self-assessment instruments...
2018: PloS One
Eileen F Hennrikus, Michael P Skolka, Nicholas Hennrikus
Problem: Medical school curriculum continues to search for methods to develop a conceptual educational framework that promotes the storage, retrieval, transfer, and application of basic science to the human experience. To achieve this goal, we propose a metacognitive approach that integrates basic science with the humanistic and health system aspects of medical education. Intervention: During the week, via problem-based learning and lectures, first-year medical students were taught the basic science underlying a disease...
January 2018: Journal of Medical Education and Curricular Development
Scott H Podolsky
Eric Topol's The Patient Will See You Now: The Future of Medicine is in Your Hands (2015) depicts a medical future in which the patient-doctor relationship is upended in the context of easily acquired and shared big data and the increasing computing power necessary to analyze such data. A chief obstacle to this future, in Topol's rendering, is the entrenched paternalism of the medical profession. But Topol's thought-provoking assessment misses other key potential obstacles to the rational and equitable implementation of this (or any) medical future and would benefit from a more nuanced telling of the history of attempts to empower patients in this country...
2018: Perspectives in Biology and Medicine
Matthew William McCarthy, Diego Real de Asua, Ezra Gabbay, Joseph J Fins
A growing demand for transparency in medicine has the potential to strain the doctor-patient relationship. While information can empower patients, unrestricted patient access to the electronic medical record may have unintended consequences. Medical documentation is often written in language that is inaccessible to people without medical training, and without guidance, patients have no way to interpret the constellation of acronyms, diagnoses, treatments, impressions, and arguments that appear throughout their own chart...
2018: Perspectives in Biology and Medicine
Simone Goebel, Dominik Mederer, H Maximilian Mehdorn
BACKGROUND: Neurosurgical brain tumour removal poses a unique threat for patients while also minimizing instrumental control. Thus, psychological processes utilized by patients in order to cope with surgery-related anxiety are of utmost importance. This is the first study to assess both nature and effectiveness of surgery-related coping efforts in neurooncological patients. METHOD: We included 70 inpatients with an intracranial tumour prior to neurosurgical treatment...
May 23, 2018: World Neurosurgery
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