This book fills not only a gap but a wide cavern....I can not think of a better way for neophyte nurses to engage the human experiences and perspectives of their patients, nor can I think of a more relevant and comprehensive explanation of the philosophy and methods of existential phenomenology for seasoned researchers, scientists, and theoreticians.-- Jacquelyn H. Flaskerud, PhD, RN, FAAN, UCLA School of Nursing. While addressing a wide readership, this book focuses particularly on the nurse clinician and student, demonstrating how a humanistic philosophy and research methodology has the potential to illuminate the deeper meanings of health crises and universal human experiences like pain and spiritual distress.
From the fictional portrayal of Dr. Gregory House to Jerome Groopman's bestseller How Doctors Think, both medical professionals and the general public recognize that there is more to the doctor's job than technical practice. Yet why do so many patients come away from their doctors' offices feeling dissatisfied with their interactions? In this welcome addition to the growing field of narrative medicine, physician Loreen Herwaldt uses the illness narratives of two dozen writer-patients to teach listening skills to medical students, residents, physicians, and other health care providers. Herwaldt skillfully pares each narrative down to its most basic elements, rendering them into powerful found poems that she has used successfully in her role as a teacher and in her own practice. Drawing from narratives by writers who are both emerging and well known, including Oliver Sacks, Richard Selzer, and Mary Swander, each poem reveals the experience of illness and treatment from the patient's perspective. Patient Listening includes a detailed general introduction and a how-to guide that will prove invaluable in the classroom and in clinical practice. This book will inspire thoughtfulness in everyone who reads it. It is also designed to foster discussions about all aspects of the patient experience from ethics to stigmatization to health insurance. Patient Listening is not just about bedside manner but also about how health care providers can gain the most from their interactions with patients and in turn offer more appropriate treatments, develop more cooperative and responsive relationships with their patients, and thus become better doctors.
Can refocusing conversations between doctors and their patients lead to better health? Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things. Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.
Discusses how to avoid harmful medical mistakes, offering advice on such topics as working with a busy doctor, communicating the full story of an illness, evaluating test risks, and obtaining a working diagnosis.
Do you feel that your doctor doesn't pay attention to what you say? Does your doctor cut you off when you try to explain how you feel? Do you think your doctor could remember your name without referring to your chart? Does your doctor seem to be in such a hurry that you don't even get a chance to ask your most important questions? Do you spend more time waiting than actually talking to your doctor? Do you understand what your doctor says? At one time or another, we have all had these complaints. This book will teach you how to ask the right questions, understand the answers, and show you how to take more control of your visits to the doctor and your own health. This is the first book in which communication pioneer Barbara M. Korsch, M.D., reveals what she has learned about the doctor-patient relationship dilemma during almost half a century of investigation. In clear, simple language, Dr. Korsch answers most of our common questions: How do I know when I'm sick enough to go to the doctor? How do I know if it's serious enough to go to the emergency room? What do I do if I can't follow the advice my doctor gives me? She walks us through a typical visit to the doctor, showing us how to prepare ourselves so we don't forget the question that has been worrying us for weeks as soon as we walk through the doctor's door. She gives important tips on how to survive the dreaded hospital experience. And she offers insight into the doctor's side of the relationship, showing how doctors are trained to be task-oriented and how their natural human sympathy is discouraged throughout their careers. Finally, she offers patients useful strategies for humanizing the relationship. Korsch's helpful, commonsense recommendations are extensively illustrated with real-life doctor-patient conversations which she recorded on audio and video tape over the course of the last thirty years. She was one of the first medical professionals to emphasize the importance of teaching doctors how to talk to patients as part of their medical training. She serves as consultant and lecturer to medical schools, hospitals, and medical practices throughout the world to help the next generation of doctors communicate with their patients. Above all, after years of research, she has found abundant evidence that the relationship patients form with their doctors directly determines the quality of the care they receive. This is a vital book for anyone who is concerned about their health and who wants to take control of their medical care. So much depends upon asking the right questions and on finding a doctor who will listen to you. This book gives you the tools and the confidence to do just that.
A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it—on some level—restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory—making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment—only to have their symptoms mysteriously return. A young woman lies dying in the ICU—bleeding, jaundiced, incoherent—and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness—the diagnosis—revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.
A riveting first-hand account of a physician who's suddenly a dying patient, In Shock "searches for a glimmer of hope in life’s darkest moments, and finds it.” —The Washington Post Dr. Rana Awdish never imagined that an emergency trip to the hospital would result in hemorrhaging nearly all of her blood volume and losing her unborn first child. But after her first visit, Dr. Awdish spent months fighting for her life, enduring consecutive major surgeries and experiencing multiple overlapping organ failures. At each step of the recovery process, Awdish was faced with something even more unexpected: repeated cavalier behavior from her fellow physicians—indifference following human loss, disregard for anguish and suffering, and an exacting emotional distance. Hauntingly perceptive and beautifully written, In Shock allows the reader to transform alongside Awidsh and watch what she discovers in our carefully-cultivated, yet often misguided, standard of care. Awdish comes to understand the fatal flaws in her profession and in her own past actions as a physician while achieving, through unflinching presence, a crystalline vision of a new and better possibility for us all. As Dr. Awdish finds herself up against the same self-protective partitions she was trained to construct as a medical student and physician, she artfully illuminates the dysfunction of disconnection. Shatteringly personal, and yet wholly universal, she offers a brave road map for anyone navigating illness while presenting physicians with a new paradigm and rationale for embracing the emotional bond between doctor and patient.
For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.
This textbook is a practical guide to the application of the philosophy and principles of Integrative and Functional Medical Nutrition Therapy (IFMNT) in the practice of medicine, and the key role nutrition plays in restoring and maintaining wellness. The textbook provides an overview of recent reviews and studies of physiological and biochemical contributions to IFMNT and address nutritional influences in human heath overall, including poor nutrition, genomics, environmental toxicant exposures, fractured human interactions, limited physical movement, stress, sleep deprivation, and other lifestyle factors. Ultimately, this textbook serves to help practitioners, healthcare systems, and policy makers better understand this different and novel approach to complex chronic disorders. It provides the reader with real world examples of applications of the underlying principles and practices of integrative/functional nutrition therapies and presents the most up-to-date intervention strategies and clinical tools to help the reader keep abreast of developments in this emerging specialty field. Many chapters include comprehensive coverage of the topic and clinical applications with supplementary learning features such as case studies, take-home messages, patient and practitioner handouts, algorithms, and suggested readings. Integrative and Functional Medical Nutrition Therapy: Principles and Practices will serve as an invaluable guide for healthcare professionals in their clinical application of nutrition, lifestyle assessment, and intervention for each unique, individual patient.
Miscommunication between patient and physicians is a common problem, resulting in costly and harmful outcomes. Patients are increasingly misdiagnosed as their physicians focus on identifying symptoms rather than the unique manifestation of those symptoms in the individual. Listening for What Matters: Avoiding Contextual Errors in Health Care covers ten years of research based on hundreds of recorded doctor visits, which revealed a widespread disregard of patients' individual context during diagnosis. The aim of this book is to open up a dialog between patients, physicians, policy makers, and medical educators to bridge this disconnect in current medical practice.
