The Medical clinics of North America
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Motivational interviewing (MI) allows medical providers and patients to have more productive conversations about changing health behaviors. MI helps patients talk themselves into changing by evoking discussion around change, thus resolving natural ambivalence. MI practitioners cultivate a spirit of MI and use specific skills and strategies to develop discrepancy between the patient's current behavior and their goals or values. This article discusses the flow of MI, the spirit and method of MI including specific skills and strategies, and important considerations in implementing MI.
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Establishing goals of care (GOC) is a crucial component of a patient's treatment plan. The need for better physician-patient communication in this area has been recognized for decades, yet several gaps remain. Challenges exist for both physician and patient. Physicians should pursue a patient-led approach, exercise cultural competency, and use various communication techniques to guide patients when establishing GOC.
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Med. Clin. North Am. · Jul 2022
ReviewHealth Communication and Sexual Orientation, Gender Identity, and Expression.
The purpose of this article is to provide guidance on completing a thorough, competent, and culturally appropriate health history with details specific to the care of lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons and communities.
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The authors present models for patient care, reflecting on its modernization. A review of technology including electronic health records is provided, noting its benefits and constraints on the patient-clinician relationship. Keeping in mind the fact that patients are the "end users" of health care systems, several approaches to improving patient experience are shared.
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Difficult patient encounters are common in clinical practice, with many arising from patient hostility owing to a breakdown in communication and the health care alliance. Patient anger may be a manifestation of fear, grief, or discontent with prior experiences in the health care system, but there may also be contributions from specific patient, physician, or situational factors. Physicians may intervene with specific actions based on these individual factors, while focusing on self-reflection to better understand their part in creating a hostile physician-patient dyad.