Annals of family medicine
-
Annals of family medicine · Sep 2022
Physicians' and Patients' Interruptions in Clinical Practice: A Quantitative Analysis.
Physicians' interruptions have long been considered intrusive, masculine actions that inhibit patient participation, but a systematic analysis of interruptions in clinical interaction is lacking. This study aimed to examine when and how primary care physicians and patients interrupt each other during consultations. ⋯ Most interruptions in clinical interaction are cooperative and may enhance the interaction. The nature of physicians' and patients' interruptions is the result of an interplay between role, gender, and consultation phase.
-
Many years have passed since I visited Donny in the hospital, where he was admitted with a newly diagnosed and terminal lung cancer. Despite years of separation, his wife Rose took him back into her home and cared for Donny at the end of his life. In the months after his death, I learned more about their relationship; Donny's drinking and infidelities, the emotional and verbal abuse that Rose put up with. ⋯ It was an arid time and place on my interior journey and the activity felt forced and inauthentic. Although Rose died more than 5 years ago, I still think of her and reflect on my life as a physician practicing in the shadow of the COVID-19 pandemic. As she looks at me, my uncertainties scatter and her image draws down and stirs divine wellsprings in me.
-
Annals of family medicine · Sep 2022
Effective Facilitator Strategies for Supporting Primary Care Practice Change: A Mixed Methods Study.
Practice facilitation is an evidence-informed implementation strategy to support quality improvement (QI) and aid practices in aligning with best evidence. Few studies, particularly of this size and scope, identify strategies that contribute to facilitator effectiveness. ⋯ Facilitation strategies that differentiate more and less effective facilitators have implications for enhancing facilitator development and training, and can assist all facilitators to more effectively support practice changes.
-
During medical school and residency, we are taught to always keep boundaries with our patients. I took this lesson to heart and considered my patients merely as "diseases" during training. As I transitioned into the role of an early career attending physician, I realized my lack of meaningful patient relationships, and the concomitant burnout that it had caused. ⋯ There is so much joy, but grief exists simultaneously. Bad outcomes and patient losses are more heartbreaking than ever before. In this essay I reflect upon my journey of finding a path to the humanistic side of medicine and highlight my struggle to find the balance between the joy of connecting to patients and the vulnerability to pain and loss that accompanies it.