Thursday Review: “The Effect of Physician Behavior on the Collection of Data”

I love patient stories, and know how important they are to good care. The fact remains that patients are usually going to tell stories… badly. Physicians and other providers need to let them tell those ineffective stories, and be prepared for it.

Dr. Howard B. Beckman and Dr. Richard M. Frankel wrote an article in the Annals of Internal Medicine on how physicians’ verbal cues influence how and how much medical information is collected.

Beckman and Frankel help us realize how much control providers have over the patient encounter, and why narrative competence is so important.
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Thursday Review: “Soliciting the Patient’s Agenda: Have We Improved?”

What would a consultation look like if a patient were able to voice all of their concerns? Asked in a different way, how can we quantitatively demonstrate the benefits of a consultation where a patient is allowed to simply speak freely?

Writing in The Journal of the American Medical Association, Dr. M. Kim Marvel et al. give some rich detail and answers. They use a slightly different approach to “agenda” than Barry et al. did in their work on unexpressed patient agenda items. This paper, though, comes to the same general conclusion: that being intentional about hearing all that a patient has to say makes healthcare more effective, not less.

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Thursday Review: “Patients’ unvoiced agendas in general practice consultations: qualitative study”

In the discussions about how to bring the humanities into medicine, one essential feature often gets lost. The attempts to make care more human and more humane aren’t being done for the sake of warm fuzzies. There are concrete ways medical outcomes suffer when healthcare practitioners and patients aren’t communicating well.

Writing in The BMJ, Christine A. Barry, et al. provide one of the clearest discussions on medical outcomes suffering from ineffective communication, and why both patients and doctors are hesitant to change communication for the better.
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