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Description
In-depth philosophical analysis of conceptual issues and challenges in the clinical encounter
The Clinical Encounter enables readers to better understand the many facets of the clinical encounter, the challenges faced by its participants, and what it means to clinicians, patients, and the community. In approaching the clinical encounter as a social activity, the text examines how practical tasks of care interact with the experiences and values of participants, the environment of care, and healthcare policy.
Questions raised in The Clinical Encounter include:
- What do we mean by quality of care?
- How do we determine care to be effective?
- What is communicated in the encounter and how is it communicated (including presentation of risk and management of care options)?
- Who is (or ought to be) involved in decision-making about care and what are their perspectives and responsibilities?
- What is the role and impact of technology?
Intended for a broad audience, The Clinical Encounter is an essential thought-provoking resource for clinicians, students, managers, and researchers seeking to study and improve patient care, and for patients navigating the healthcare system.
Table of Contents
Acknowledgments vii
1 Introduction 1
2 The Clinical Encounter 9
2.1 The Clinical Encounter: What Is It? 9
2.2 Who Is Involved in the Clinical Encounter? 12
2.3 What Are the Goals of the Clinical Encounter? 14
2.4 Where Does the Clinical Encounter Take Place? 17
2.5 What Are the Activities That Take Place During the Clinical Encounter? 19
2.6 Conclusion 21
3 The Patient and the Clinician 23
3.1 Why the Individual Patient Matters 24
3.2 Person-Centered Care 28
3.3 The Clinician and Their Responsibilities 30
3.4 Supplier-Induced Demand 33
3.5 Conclusion 36
4 Diagnosis 37
4.1 What Do We Mean by Diagnosis and What Is Its Purpose? 37
4.2 The Diagnostic Process 40
4.3 Sources of Evidence in Determining a Diagnosis 47
4.4 Implications of a Diagnosis 51
4.5 Conclusion 53
5 Effectiveness of Care 54
5.1 What Do We Mean by “Effective”? 54
5.2 Sources of Evidence 56
5.3 Evidence-Based Medicine 62
5.4 Clinical Practice Guidelines 64
5.5 Conclusion 67
6 Communication 69
6.1 What Is Communicated (and how)? 70
6.2 Factors Affecting Communication 74
6.3 Presenting Risk 77
6.4 Management of Care Options 82
6.5 Decision Aids 85
6.6 Conclusion 88
7 Clinical Judgment and Clinical Reasoning 89
7.1 Decision Making Under Uncertainty 90
7.2 Models of Clinical Judgment and Clinical Reasoning 93
7.3 Conclusion 103
8 Decision Making 105
8.1 Models of Decision Making 106
8.2 Which Model Is Used and How Is That Determined? 112
8.3 Shared Decision Making 119
8.4 Conclusion 125
9 Technology in the Encounter 126
9.1 Artificial Intelligence 127
9.2 The Virtual Encounter 131
9.3 Consumer Products, Smartphones, and Wearable Technology 135
9.4 Social Media, Discussion Boards, and Websites 139
9.5 Conclusion 142
10 Quality of Care 143
10.1 How Do We Define Quality Care? 144
10.2 How Is Quality of Care Measured? 147
10.3 Quality Indicators and Benchmarking Care 155
10.4 Conclusions 161
11 A “Final” Word on the Clinical Encounter 162
References 167
Index 185
