Physician Patient Relationship Law and Legal Definition | USLegal, Inc.
Who counts as a patient is a complex legal question that has major Dr. Eddingfield was not considered obligated to provide care for Ms. Burk because “ the State In this case, the court decided that a patient-physician relationship had been. Summary. The legal duties of a doctor attending a “difficult” patient with a serious condition do not end at the last consultation, especially in a. Doctor-patient relationships, laws, clinical guidelines, best practices, are not considered to be legally qualified to practice medicine in that.
This article examines the foundations and features of the doctor—patient relationship, and how it may be affected by managed care. A robust science of the doctor—patient encounter and relationship can guide decision making in health care plans.
We know much about the average doctor's skills and knowledge in this area, and how to teach doctors to relate more effectively and efficiently. We describe problems that exist and are said to exist, we promulgate principles for safeguarding what is good and improving that which requires remediation, and we finish with a brief discussion of practical ways that the doctor—patient relationship can be enhanced in managed care.
The medical interview is the major medium of health care.Reaffirming the Doctor-Patient Relationship - Stephen Sanders - TEDxSaintLouisUniversity
Most of the medical encounter is spent in discussion between practitioner and patient. The interview has three functions and 14 structural elements Table 1. For example, a patient who does not trust or like the practitioner will not disclose complete information efficiently. A patient who is anxious will not comprehend information clearly.
The relationship therefore directly determines the quality and completeness of information elicited and understood. It is the major influence on practitioner and patient satisfaction and thereby contributes to practice maintenance and prevention of practitioner burnout and turnover, and is the major determinant of compliance.
Effective use gives patients a sense that they have been heard and allowed to express their major concerns, 17 as well as respect, 18 caring, 19 empathy, self-disclosure, positive regard, congruence, and understanding, 20 and allows patients to express and reflect their feelings 21 and relate their stories in their own words.
Other aspects important to the relationship include eliciting patients' own explanations of their illness, 2324 giving patients information, 2526 and involving patients in developing a treatment plan.
The accessibility of personnel, both administrative and clinical, and their courtesy level, provide a sense that patients are important and respected, as do reasonable waiting times and attention to personal comfort.
The availability of covering nurses and doctors contributes to a sense of security. Reminders and user-friendly educational materials create an atmosphere of caring and concern. Organizations can promote a patient-centered culture, 29 or one that is profit- or physician-centered, with consequences for individual doctor—patient relationships.
Organizations as well as whole health care systems can promote continuity in clinical relationships, which in turn affects the strength of in those relationships. For instance, a market-based system with health insurance linked to employers' whims, with competitive provider networks and frequent mergers and acquisitions, thwarts long-term relationships. These suggestions are based on paragraph 3.
The steps suggested could be adopted in any case where a doctor—patient relationship has ended, regardless of the reason — a difficult, non-compliant or threatening patient, or the doctor's cessation of employment, relocation or retirement, taking account of the possible impact on the patient if the relationship has ended. Ensuring a patient's continuing care The above steps may not always resolve the issues.
There may be no other doctor or specialist in an isolated rural area to whom the patient can be referred; or the doctor may be concerned about how such a referral should be made. Where a patient may present a serious risk to the new doctor, the doctor's duty of confidentiality may be outweighed by the need to protect the new doctor's safety.
However, that is not the case in other circumstances, and the referring doctor would ordinarily be required not to reveal the reason for the referral if it relates to the patient although the new doctor may guess what it is.
The initial doctor may therefore feel obliged to continue treating the patient, perhaps seeking assistance from a more distant colleague, if that is possible. If it is necessary to terminate the clinical relationship, the treating doctor may take comfort from the fact that any litigation or other risk in such circumstances can be minimised by telling the patient that they should terminate their clinical relationship, and by ensuring that what happens afterwards is in accordance with what the doctor perceives to be the patient's best interests especially in regard to facilitating transfer of care.
Doctors should include in the notice a brief explanation for ending the relationship, such as the patient failing to comply with advice or to keep appointments.
This is especially necessary if the patient may have a serious or life-threatening condition that needs urgent attention; or the patient has a non-English speaking background.
Doctors should assist the patient as needed to find another doctor or specialist in the patient's vicinity to take over the patient's care. Doctors should offer to provide a report to the new doctor or to send copies of the patient's medical records to the new doctor, if the patient authorises that in writing.
Doctors should answer any questions that the patient raises and try as far as possible to maintain civil relations with the patient. What factors affect pre-clerkship changes in empathy? Students reported both negative and positive changes in empathy.
The Doctor–Patient Relationship
These changes occur due to time constraints, objective lessons in empathy, and a changing identity. Positive changes included an increased awareness of the impact of illness, and increased ability to read feelings. These changes result from increased exposure to patients, discussions surrounding the psychosocial impact of illness, and positive role models.
They collected more than student surveys over 4 years that focused on components of usefulness, enjoyment and facilitator effectiveness. A retrospective self-assessment of learning was used for both content knowledge of palliative care and knowledge of the other professions participating in the module. Medical students reported lower gains in knowledge than those in other programs.
Scores were moderately high for usefulness and facilitator effectiveness. Scores for enjoyment were very high. McKee et al concluded that there is strong theoretical and empirical evidence that PBL is a useful method to deliver IPE for palliative care education.
Paslawski, Kearney and White addressed the factors that contribute to tutor participation in PBL in a medical training program, examining tutor recruitment and retention within the larger scope of teacher satisfaction and motivation in higher education. Semi structured interviews approximately one hour in length were conducted with 14 people - 11 who had tutored in PBL and 3 faculty members who had chosen not to participate in PBL.
Thematic analysis was employed as the framework for analysis of the data. Seven factors were identified that affects the recruitment and retention of tutors in the undergraduate medical education program. They studied the use of ultrasonography, a method increasingly used for teaching physical examination in medical schools.
Surveying the opinions of involved educators, they identified potentially useful aspects ultrasonography: Examinations thought to be potentially most harmful included: Ma et al caution that when initiating an ultrasound curriculum for physical examinations, educators should weigh the risks and benefits of examinations chosen.
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Systematic Reviews In the first of two systematic reviews, Al Alawi, Al Ansari, Raees and Al Khalifa, focused on the use of multisource feedback to assess pediatricians.
Additionally evidence for content, criterion-related and construct validity was reported in all 6 studies. They concluded that multisource feedback is a feasible, reliable, and valid method to assess key competencies such as communication skills, interpersonal skills, collegiality, and medical expertise.
The second systematic review of educational resources for teaching patient handover skills to resident physicians and other healthcare professionals was done by Masterson, Richdeep, Turner, Shrichand, and Giuliani.
As the transfer of patient care is a time of heightened risk to patients, it is important to identify effective training models for handover skills. A number of such studies have now been published. Masterson et al found that physicians, residents and other healthcare practitioners should receive training in handover skills to improve patient care and thus reduce the risk of medical errors. Brief Reports In the first of three brief reports, Thomson, Harley, Cave and Clandinin studied the enhancement of medical student performance through narrative reflective practice NPR.
This process putatively helps medical students become better listeners. Employing 3rd-year University of Alberta medical students from the same class, they found that the group receiving NRP training scored higher 4. The second brief report focused on the Triple C curriculum for preparing residents for family practice. Residents perceived themselves as prepared to engage in most practice areas and their intentions to engage in various practice domains were positively correlated to their ratings of preparedness.
Residents perceived this program as comprehensive and relevant to their development as a family physician and they perceived a high degree of encouragement for inter-professional practice. These results provide some preliminary evidence that an integrated competency-based curriculum, with an emphasis on inter-professional practice, has the potential to effectively prepare residents for practice in family medicine.
The physician-patient relationship
There were no significant differences between the global scores of the Scholar stations showing that the overall knowledge and effort of the residents was similar across both stations 3.
No significant differences between senior residents and junior residents were detected or between internal medicine residents and non-internal medicine residents.
In this issue the major research contributions, systematic review papers, and brief reports each address some variant of improving medical practice and therefore improving patient care and safety.
In addition we are publishing commentaries and letters to the editor and two brief essays by students on the future of medical and health care education. The Oldest Code of Laws in the World: Lawbook Exchange, Ltd; History of Medicine, Volume II: Early Greek, Hindu, and Persian Medicine.