This paper advocates a philosophical and methodological approach to the medical conversation between doctor and patient. It engages the issue of subjectivity in medicine, focusing on the dialogue between patient and physician regarding health choices and subjective experience. A performatory approach to training physicians to communicate with their patients (rather ...

Pagers, personal data assistants (PDAs) and other devices that have wireless connectivity are becoming a popular method for delivering patient related information to medical decision makers. Although medical informatics research has emphasized the design, and implementation of pagers as event notification mechanisms, researchers have not paid as much attention to ...

The basic concepts of medical consultation have been reviewed. The referring physician and the consultant both have responsibilities to fulfill in order to maximize the effectiveness of the consultation in improving patient care. The reasons for and urgency of the consultation need to be communicated to and understood by the ...

An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are ...

It can be expected that the differential diagnosis problem of decompression sickness will increase in the future due to the increasing number of divers. During the last 30 years, 232 divers were treated for decompression sickness (DCS) at the Naval Medical Institute (NMI) in Split, Croatia. In 66 cases (28%), ...

Videoconferencing between patients and their physicians can increase patients' access to healthcare. Unscheduled videoconferencing can benefit patients with acute medical problems but has not been studied extensively. We conducted a clinical trial of unscheduled, nighttime videoconferencing in a nursing home, where on-call physicians usually provide care by telephone from remote ...

Within the context of primary-care, physician-patient visits, researchers have documented both patients' low levels of communicative participation (e.g., question asking) and the advantages of such participation to healthcare (e.g., improved physical health and satisfaction). Prior research has offered a variety of partial, non-exclusive explanations for patients' low levels of participation. ...

PURPOSE: Previous studies have shown that physicians often have poor knowledge of the medical restriction on fitness to drive, or submit poor quality medical reports. To determine the reliability of physicians' reports on fitness to drive, the medical data provided on the standard medical fitness form was compared with the ...

In this article we will examine the relation between physicians and (representatives of) the pharmaceutical industry. More in particular we want to discuss the appropriateness of some of the gifts that are given to physicians by companies in the pharmaceutical (and medical equipment) industry, since there has been growing concern ...

Internet use by physicians has played a vital role in medical practices for many years. A number of related studies have emerged to examine the impact of Internet use on medical practice. However, there is yet to be a comprehensive study on the impact of Internet use by physicians on ...

A plethora of agents have been proposed to combat atherosclerosis, and many of these come from outside mainstream medicine. The majority have anti-oxidant properties, which is the scientific basis for their supposed action. Some of these agents have been evaluated carefully in randomized, double-blinded studies, whereas others have gained popularity ...

The author applauds the paradigm shift in medical education and practice toward evidence-based medicine. However, he maintains that an important part of this shift should be a careful consideration of its implications for the physician's legal and ethical obligations to sufficiently inform patients about the nature of proposed medical interventions. ...

Of the various factors that serve as the ingredients for a healthy and successful medical group, none is more important than the people. In a medical group practice, physicians are the key to ensuring that the culture is grounded on a set of values and principles that promote teamwork and ...

Medical professionalism encourages physicians to place their patients interests above self-interest. In recent years, many medical organizations, including the American Board of Internal Medicine (ABIM), Association of American Medical Colleges (AAMC), and the American Medical Association (AMA), have developed initiatives to strengthen medical professionalism. By emphasizing professionalism, supporters of these ...

Physicians' relationships with industry derive from the moral imperative to advocate and work for the best interests of patients. Private industry generally operates to satisfy the best interests of the stockholders or owners. Conflicts arise between these interests and are magnified by the inequality of the financial positions of physicians ...

OBJECTIVE: To determine if the medical record might overestimate the quality of care through false, and potentially unethical, documentation by physicians. DESIGN: Prospective trial comparing two methods for measuring the quality of care for four common outpatient conditions: (1) structured reports by standardised patients (SPs) who presented unannounced to the ...

Medical professionalism includes expert knowledge, self-regulation and fiduciary responsibility to place the needs of patients ahead of the self-interest of physicians. In teaching medical professionalism to our medical students only the behavioural elements are dealt with. One of the challenges facing medical educators today is how medical professionalism can be ...

Following a catalogue of serious, highly publicized medical misdemeanours, the General Medical Council (GMC) has introduced plans for a new system of medical licensing in the UK called 'revalidation'. Under this, the onus will fall on individual doctors, including occupational physicians, to demonstrate their continuing fitness to practice. Doctors will ...

OBJECTIVE: We wanted to characterize patient accompaniment to medical encounters and to explore the rationale and influence of the companion on the primary care medical encounter. STUDY DESIGN: This was a descriptive study. POPULATION: Academic general internal medicine physicians, patients, and patient companions participated. OUTCOMES MEASURED: We measured the frequency ...

The author critiques the long-standing belief that there will be too many physicians, particularly specialists, a view put forth by the Bureau of Health Professions and the Council on Graduate Medical Education in the 1990s and held by many medical organizations, including the Association of American Medical Colleges. He cites ...

Military physicians are expected to complete a routine outpatient appointment within fifteen minutes. However, data collection delays today compromise the quality of physician-patient interaction. Specifically, administrative and medical data collection tends to be time-consuming and resource-intensive. And, collection of patient information from sources other than the patient tends to be ...

An emerging consensus supports online communication between patients and physicians in an existing relationship to improve the quality, timeliness, and efficiency of medical care. Patients are also seeking medical care online from physicians they have never met, ranging from one-time interactions for a second opinion to psychotherapy. These practices call ...

BACKGROUND: Access to a well-trained workforce is one of many factors underscoring the global health divide that separates industrialized and developing nations. This paper describes the distribution and physician output of the world's medical schools, compares regional physician to population ratios, examines population trends and points out potential mismatches between ...

An ethnographic study was undertaken to observe in vivo medical encounters between oncology physicians and breast cancer patients. The aim of the study was to gain an inside view of how physicians and patients conceptualize the decision making process during cancer diagnosis and treatment. The confluence of the changes in ...

The participation of sports physicians in the "doping" of athletes with banned drugs can be documented as far back as the 1890s. Concern about the ethics and safety of doping elite athletes appeared during the 1920s and 1930s as sport became an increasingly important form of popular culture. While organized ...

Whether acknowledged or not, spirituality is part of the human condition of physicians as well as patients, and of the distinctive work that doctors do. This paper presents a first-hand sociological account of a group of 20 academic physicians in a large, urban, East Coast academic medical center who met ...

BACKGROUND: Title VII predoctoral and departmental grants for departments of family medicine are intended to increase the number of family and primary care physicians in the United States and increase the number of practices in rural and underserved communities. This study assessed the relationships of Title VII funding with physicians' ...

OBJECTIVES: Existing clinical practice guidelines for ordering prothrombin time (PT) and partial thromboplastin time (PTT) tests in the emergency department (ED) include physician expectation of an invasive procedure as a criterion. This study sought to determine whether this criterion accurately identifies patients who undergo an invasive procedure and whether an ...

BACKGROUND: To determine why emergency department (ED) patients leave without being seen (LWBS) by a physician and to ascertain whether they receive alternative medical care. METHODS: A cross-sectional study was conducted of patients who left without being seen by a physician between January 1 and June 30, 1999 in a ...

Previous studies of after-hours calls to family physicians focused on caller demographics, medical triage skills, and patient satisfaction, and were usually conducted for a limited time. We examined the frequency and nature of calls to a family practice residency over 1 year. Caller and patient information, date, time, and chief ...

It is commonplace today to deplore the dissatisfaction of patients with the physician-patient relationship. Furthermore, historical investigation shows that this problem is not really new. We investigated an important source of patients' views in the 18th century, namely the letters of patients received by the famous Swiss physician, Samuel Tissot, ...

Physicians are increasingly called upon to provide medical support for mass gatherings such as concerts, sporting events, political conventions, and other special events. Until recently, individuals planning such support have had little reliable information to assist them in determining what specific personnel and equipment are necessary to optimally support a ...

Head trauma is a very common and sometimes life-threatening medical condition that involves sports medicine physicians, emergency room physicians, neurologists, neurosurgeons, orthopedists, anesthesiologists, rehabilitation physicians, psychiatrists, and radiologists; as well as allied health care workers such as physical, occupational, and speech therapists, clinical psychologists, neuropsychologists, and many others. Head trauma ...

INTRODUCTION: The exact role of respiratory therapists (RTs) in patient assessment is not well defined. The purpose of this study was to identify local physician expectations of RTs for the application and interpretation of various assessment procedures. METHODS: A survey was developed that called for physicians to indicate on a ...

BACKGROUND AND OBJECTIVES: Patient anger because of a long wait is a common occurrence, but few studies have looked at how the anger should be addressed. This study determined patient levels of satisfaction, rating of importance, and preference for a variety of approaches for addressing anger being directed toward a ...

Physicians are increasingly grappling with medical liability issues as complementary and integrative health care practices are made available in conventional medical settings. This article proposes a framework in which physicians can assess potential malpractice liability issues in counseling patients about complementary and integrative therapies. The framework classifies complementary and integrative ...

This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician ...

In the face of rapid advances in technology, there has been a progressive deterioration of effective physician-patient communication. The American Academy of Orthopaedic Surgeons has identified that patients rate the orthopaedic profession as high in technical and low in communication skills. Poor communication, especially patient-interviewing skills, has been identified in ...

Managed care is cultivating a variety of new work careers within the medical profession, and it is worth asking whether they will function as long- or shorter-term career options for the individuals who participate in them. This paper uses the specific case of hospitalist physicians to explore how the surrounding ...

This paper describes the experiences of physicians-in-training at a public hospital in Nairobi, Kenya, where medical professionals practice in an environment characterized by both significant lack of resources and patients with HIV/AIDS in historically unprecedented numbers. The data reported here are part of a larger study examining ethical dilemmas in ...

Medical practice mergers provide one of the few remaining "clout-enhancing" strategies for physicians. Mergers can create significant benefits for the physicians involved. Achieving these benefits requires overcoming many obstacles and potential pitfalls. This article addresses the benefits to be gained and the difficulties to avoid, and provides an overview of ...

Birth control techniques were widely available in 19th-century Canada, despite the fact that they were illegal. Most physicians remained silent about contraception, with a small minority vocally opposed to the practice of birth control. Canadian physicians were influenced by the social, economic, legal, and political values of their time, and ...

Regina Salomea Rusiecki (later Pilsztynowa) was a young, poorly educated Polish Catholic woman in the 18th century who became well known in Eastern Europe and the Ottoman Empire because of her skill in the treatment of cataracts and some other medical problems. She was born in 1718, and at the ...

The purpose of this study was to identify communication styles and physician characteristics that correlate with improved patient adherence and satisfaction during geriatric healthcare interactions. A multiphase study design, incorporating the use of focus groups, socialization hours, educational seminars, and survey questionnaires, was used to discover the most effective methods ...

The 20th century witnessed phenomenal growth in scientific medical knowledge and technology, enabling physicians to more accurately diagnose and effectively treat a wide range of diseases. However, these advances led to longer and more complex training periods for physicians and increasing specialization and dependence on the new technology. An adverse ...

The efficacy of a medical treatment partly depends on the interpersonal context in which an intervention takes place. By identifying what factors in the medical encounter engender effect beyond that of the therapeutic intervention, treatment outcome is likely to increase. This study gives an overview of the most important literature ...

Cyril Clarke was an outstanding physician, medical scientist and lepidopterist. His career was unusual in that he developed a serious interest in medical research only after many years in clinical practice, a change of direction from the life of a busy consultant physician that was undoubtedly stimulated by his lifelong ...

Researchers and medical educators in the area of physician-patient communication encourage physicians to elicit patient narratives during medical encounters to facilitate data collection, rapport building, and patient satisfaction. These scholars, however, provide little information about the nature of the narrative, especially in the context of the medical interview. This article ...

The amount of published information on dietary supplements mushroomed in the 1990s. In fewer than 5 years, publications increased at least 100-fold in the medical literature alone. Dietary supplements are an uncharted territory that warrants complete and accurate exploration. One should not be surprised that disease and illness may respond ...

INTRODUCTION: Hypertension should be aggressively treated, especially in diabetic patients. But studies of physician prescribing habits reveal that physicians often delay making medication changes or initiating antihypertensive therapy. A chart-based reminder was designed to improve physician medication prescribing in this clinical situation. METHODS: A randomized controlled trial was conducted at ...