Seeing Patients


Book Description

“A powerful and extraordinarily important book.” —James P. Comer, MD “A marvelous personal journey that illuminates what it means to care for people of all races, religions, and cultures. The story of this man becomes the aspiration of all those who seek to minister not only to the body but also to the soul.” —Jerome Groopman, MD, author of How Doctors Think Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. While race relations have changed dramatically since then, old ways of thinking die hard. In this blend of memoir and manifesto, Dr. White draws on his experience as a resident at Stanford Medical School, a combat surgeon in Vietnam, and head orthopedic surgeon at one of Harvard’s top teaching hospitals to make sense of the unconscious bias that riddles medical care, and to explore how we can do better in a diverse twenty-first-century America. “Gus White is many things—trailblazing physician, gifted surgeon, and freedom fighter. Seeing Patients demonstrates to the world what many of us already knew—that he is also a compelling storyteller. This powerful memoir weaves personal experience and scientific research to reveal how the enduring legacy of social inequality shapes America’s medical field. For medical practitioners and patients alike, Dr. White offers both diagnosis and prescription.” —Jonathan L. Walton, Plummer Professor of Christian Morals, Harvard University “A tour de force—a compelling story about race, health, and conquering inequality in medical care...Dr. White has a uniquely perceptive lens with which to see and understand unconscious bias in health care...His journey is so absorbing that you will not be able to put this book down.” —Charles J. Ogletree, Jr., author of All Deliberate Speed




When Doctors Become Patients


Book Description

For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.




Medical Management of Vulnerable & Underserved Patients: Principles, Practice, Population


Book Description

No other book on the subject Chronic diseases, especially those associated with poor nutrition, obesity, and addiction have grown to epidemic proportion in many poor and minority populations Covers all essential topics, including Navigating Language Barriers, Understanding Disability, Patient Education, Substance Abusers, the Care of Gay and Lesbian Patients, Reproductive Issues in Poor Women, and much more




The Patient Will See You Now


Book Description

The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation's top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.




Talking with Patients


Book Description

In the twelve years since the first edition of Talking With Patients was published, contributions from relational psychoanalysis and from neuroscience have been integrated into much of the work done by self psychologists. The relational focus on the impact of the treatment relationship on the psychoanalytic process, while implicit in self psychology, is made explicit in this new edition. Additionally, the concept of implicit memory, a contribution from neuroscience, has opened the door to new ways of understanding and dealing with patients who were severely abused as children. In the second edition of Talking with Patients, the author discuss how we are guided by non-verbal cues as much as by verbal ones, and continues to expand on the idea that therapists learn how to do therapy as much from their patients as from supervisors or theories.




Smith's Patient Centered Interviewing: An Evidence-Based Method, Third Edition


Book Description

A comprehensive, evidence-based introduction to the principles and practices of patient communication in a clinical setting Endorsed by the American Academy on Communication for Healthcare Updated and expanded by a multidisciplinary team of medical experts, Smith’s Patient-Centered Interviewing, Third Edition presents a step-by-step methodology for mastering every aspect of the medical interview. You will learn how to confidently obtain from patients accurate biomedical facts, as well as critical personal, social, and emotional information, allowing you to make precise diagnoses, develop effective treatment plans, and forge strong clinician-patient relationships. The most evidence-based guide available on this topic, Smith’s Patient-Centered Interviewing applies the proven 5-Step approach, which integrates patient- and clinician-centered skills to improve effectiveness without adding extra time to the interview’s duration. Smith’s Patient-Centered Interviewing covers everything from patient-centered and clinician-centered interviewing skills, such as: Patient education Motivating for behavior change Breaking bad news Managing different personality styles Increasing personal awareness in mindful practice Nonverbal communication Using computers in the exam room Reporting and presenting evaluations Companion video and teaching supplement are available online. Read details inside the book.




Registries for Evaluating Patient Outcomes


Book Description

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.




What Patients Teach


Book Description

Being a patient is a unique interpersonal experience but it is also a universal human experience. The relationships formed when we are patients can also teach some of life's most important lessons, and these relationships provide a special window into ethics, especially the ethics of healthcare professionals. This book answers two basic questions: As patients see it, what things allow relationships with healthcare providers to become therapeutic? What can this teach us about healthcare ethics? This volume presents detailed descriptions and analyses of 50 interviews with 58 patients, representing a wide spectrum of illnesses and clinician specialties. The authors argue that the structure, rhythm, and horizon of routine patient care are ultimately grounded in patient vulnerability and clinician responsiveness. From the short interview segments, the longer vignettes and the full patient stories presented here emerge the neglected dimensions of healthcare and healthcare ethics. What becomes visible is an ethics of everyday interdependence, with mutual responsibilities that follow from this moral symbiosis. Both professional expressions of healthcare ethics and the field of bioethics need to be informed and reformed by this distinctive, more patient-centered, turn in how we understand both patient care as a whole and the ethics of care more specifically. The final chapters present revised codes of ethics for health professionals, as well as the implications for medical and health professions education.




Unequal Treatment


Book Description

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.




Caring for Patients


Book Description

An experienced and compassionate physician questions the prevailing medical model of patient care?that every illness has a physical cause that can be identified and treated medically?and argues for the necessity of taking the psychological and social situation of the patient into account in the process of diagnosis and treatment.