The Politics of Medical Encounters

The Politics of Medical Encounters

Author: Howard Waitzkin

Publisher: Yale University Press

Published: 1991-01-01

Total Pages: 332

ISBN-13: 9780300055115

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The complaints that patients bring to their doctors often have roots in social issues that involve work, family life, gender roles and sexuality, aging, substance use; or other problems of nonmedical origin. In this book, physician/sociologist Howard Waitzkin examines interactions between patients and doctors to show how physicians' focus on physical complaints often fails to address patients' underlying concerns and also reinforces the societal problems that cause or aggravate these maladies. A progressive doctor-patient relationship, Waitzkin argues, fosters social change. Waitzkin provides a pathbreaking analysis of medical encounters, applying perspectives from structuralism, post-structuralism, and critical literary theory to transcripts of recorded conversations between doctors and patients. He demonstrates how doctors unintentionally maintain dominance in their dealings with patients, encourage conforming social behavior and attitudes, and marginalize patients' concerns with social problems. Waitzkin urges physicians to attend to the social as well as the medical problems that emerge from patients' narratives and suggests ways to restructure the manner in which patients and doctors communicate with each other. Physicians and patients, for example, should work together to demystify medical discourse, should refrain from medicalizing social problems through medications or reassurances that dull socially caused pain, and should be prepared to call on advocacy organizations seeking to change the social conditions that create personal distress. This book will influence and challenge physicians scholars, and students in the social sciences and humanities, as well as anyone concerned about the present problems and future direction of medicine.


Unequal Treatment

Unequal Treatment

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-02-06

Total Pages: 781

ISBN-13: 030908265X

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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.


Communication in Medical Care

Communication in Medical Care

Author: John Heritage

Publisher: Cambridge University Press

Published: 2006-07-06

Total Pages: 445

ISBN-13: 1139455400

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This 2006 volume provides a comprehensive discussion of communication between doctors and patients in primary care consultations. It brings together a team of leading contributors from the fields of linguistics, sociology and medicine to describe each phase of the primary care consultation, identifying the distinctive tasks, goals and activities that make up each phase of primary care as social interaction. Using conversation analysis techniques, the authors analyze the sequential unfolding of a visit, and describe the dilemmas and conflicts faced by physicians and patients as they work through each of these activities. The result is a view of the medical encounter that takes the perspective of both physicians and patients in a way that is both rigorous and humane. Clear and comprehensive, this book will be essential reading for students and researchers in sociolinguistics, communication studies, sociology, and medicine.


The Ceremonial Order of the Clinic

The Ceremonial Order of the Clinic

Author: Robert Dingwall

Publisher: Routledge

Published: 2019-11-11

Total Pages: 0

ISBN-13: 9781138735460

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This title was first published in 2001. A classic ethnographic study of the interactions between paediatricians and parents of children thought to be neurologically handicapped. Strong used this work to systematize the often chaotic ideas of Erving Goffman, to explore the connections between micro and macro analysis in sociology and to reflect on the nature of medical practice in modern liberal societies. The book stands as a testament to Strong's pursuit of methodological rigour in qualitative sociology.


The Medical Interview

The Medical Interview

Author: Mack Jr. Lipkin

Publisher: Springer Science & Business Media

Published: 2012-12-06

Total Pages: 559

ISBN-13: 1461224888

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Primary care medicine is the new frontier in medicine. Every nation in the world has recognized the necessity to deliver personal and primary care to its people. This includes first-contact care, care based in a posi tive and caring personal relationship, care by a single healthcare pro vider for the majority of the patient's problems, coordination of all care by the patient's personal provider, advocacy for the patient by the pro vider, the provision of preventive care and psychosocial care, as well as care for episodes of acute and chronic illness. These facets of care work most effectively when they are embedded in a coherent integrated approach. The support for primary care derives from several significant trends. First, technologically based care costs have rocketed beyond reason or availability, occurring in the face of exploding populations and diminish ing real resources in many parts of the world, even in the wealthier nations. Simultaneously, the primary care disciplines-general internal medicine and pediatrics and family medicine-have matured significantly.


Doctors of Empire

Doctors of Empire

Author: Hoi-eun Kim

Publisher: University of Toronto Press

Published: 2014-07-31

Total Pages: 266

ISBN-13: 1442660481

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The history of German medicine has undergone intense scrutiny because of its indelible connection to Nazi crimes. What is less well known is that Meiji Japan adopted German medicine as its official model in 1869. In Doctors of Empire, Hoi-eun Kim recounts the story of the almost 1,200 Japanese medical students who rushed to German universities to learn cutting-edge knowledge from the world leaders in medicine, and of the dozen German physicians who were invited to Japan to transform the country’s medical institutions and education. Shifting fluently between German, English, and Japanese sources, Kim’s book uses the colourful lives of these men to examine the impact of German medicine in Japan from its arrival to the pinnacle of its influence and its abrupt but temporary collapse at the outbreak of the First World War. Transnational history at its finest, Doctors of Empire not only illuminates the German origins of modern medical science in Japan but also reinterprets the nature of German imperialism in East Asia.


Rethinking Causality, Complexity and Evidence for the Unique Patient

Rethinking Causality, Complexity and Evidence for the Unique Patient

Author: Rani Lill Anjum

Publisher: Springer Nature

Published: 2020-06-02

Total Pages: 252

ISBN-13: 3030412393

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This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.


Claiming Power in Doctor-Patient Talk

Claiming Power in Doctor-Patient Talk

Author: Nancy Ainsworth-Vaughn

Publisher: Oxford University Press

Published: 1998-06-25

Total Pages: 225

ISBN-13: 0195357256

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Nancy Ainsworth-Vaughn studied stories, topic control, "true" questions, and rhetorical questions in 101 medical encounters in US private-practice settings. In exceptionally lucid and accessible style, Ainsworth-Vaughn explains how power was claimed by and co-constructed for both patients and doctors (previous studies have focused upon doctors' power). The discourse varied along a continuum from interview-like talk to conversational talk. Six chapters are organized around data and include extended examples of actual talk in detailed transcription; four of these data-oriented chapters focus upon dynamic, moment-to-moment use of speech activities in emerging discourse, such as doctors' and patients' stories that co-constructed selves, and a patient's sexual rhetorical questions. Two more chapters offer non-statistical quantitative data on the frequency of questioning and sudden topic changes in relation to gender, diagnosis, and other factors. Contributing to discourse theory, Ainsworth-Vaughn significantly modifies previous definitions for topic transitions and rhetorical questions and discovers the role of storytelling in diagnosis. The final chapter provides implications for physicians and medical educators.


Appointments with Heaven

Appointments with Heaven

Author: Reggie Anderson

Publisher: Tyndale House Publishers, Inc.

Published: 2013

Total Pages: 337

ISBN-13: 1414380453

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When Dr. Reggie Anderson is present at the bedside of a dying patient, something miraculous happens. Sometimes as he sits vigil and holds the patient's hand . . . he can experience what they feel and see as they cross over. Because of these God-given glimpses of the afterlife--his "appointments with heaven"--Reggie knows beyond a doubt that we are closer to the next world than we think. Join him as he shares remarkable stories from his life and practice, including the tragedy that nearly drove him away from faith forever. He reveals how what he's seen, heard, and experienced has shaped what he believes about living and dying; how we can face the passing of our loved ones with the courage and confidence that we will see them again; and how we can each prepare for our own "appointment with heaven." Soul-stirring and hope-filled, Appointments with Heaven is a powerful journey into the questions at the very core of your being: Is there more to life than this? What is heaven like? And, most important: Do I believe it enough to let it change me?


Conflict of Interest in Medical Research, Education, and Practice

Conflict of Interest in Medical Research, Education, and Practice

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2009-09-16

Total Pages: 436

ISBN-13: 0309145449

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Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.