Podcast
Questions and Answers
What is the main assumption behind the 'sick role' theory?
What is the main assumption behind the 'sick role' theory?
What is the most important factor in patient adherence to medical advice?
What is the most important factor in patient adherence to medical advice?
According to the 'Stages of Change' model, what is the critical point for patient motivation?
According to the 'Stages of Change' model, what is the critical point for patient motivation?
What is the primary responsibility of physicians regarding adherence issues?
What is the primary responsibility of physicians regarding adherence issues?
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What is the percentage of patients who fully adhere to management recommendations?
What is the percentage of patients who fully adhere to management recommendations?
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What is the primary factor in whether patients sue their doctors?
What is the primary factor in whether patients sue their doctors?
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What is the primary goal of good physician-patient communication?
What is the primary goal of good physician-patient communication?
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What is the ideal arrangement during a physician-patient interview?
What is the ideal arrangement during a physician-patient interview?
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What is the recommended approach to asking patients about embarrassing or fear-provoking issues?
What is the recommended approach to asking patients about embarrassing or fear-provoking issues?
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What is the primary goal of the initial stage of the physician-patient interview?
What is the primary goal of the initial stage of the physician-patient interview?
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Who decides how and when to inform an ill child about their diagnosis?
Who decides how and when to inform an ill child about their diagnosis?
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What type of questions are used in emergency situations or with seductive or overly talkative patients?
What type of questions are used in emergency situations or with seductive or overly talkative patients?
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What is the purpose of using open-ended questions in a physician-patient interview?
What is the purpose of using open-ended questions in a physician-patient interview?
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What is a criticism of the sick role theory?
What is a criticism of the sick role theory?
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When interviewing young children, what is the first step the physician should take?
When interviewing young children, what is the first step the physician should take?
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What type of questions should be used when interviewing young children?
What type of questions should be used when interviewing young children?
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What is the purpose of asking questions in the third person when interviewing young children?
What is the purpose of asking questions in the third person when interviewing young children?
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What is the primary purpose of the clinical interview?
What is the primary purpose of the clinical interview?
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What is the ideal way to establish trust and rapport with a patient?
What is the ideal way to establish trust and rapport with a patient?
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What should the physician do if the patient appears dangerous or threatening?
What should the physician do if the patient appears dangerous or threatening?
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What percentage of Americans with symptoms seek medical care?
What percentage of Americans with symptoms seek medical care?
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What is a major factor that influences a patient's behavior when seeking medical care?
What is a major factor that influences a patient's behavior when seeking medical care?
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What is a common correlation found in patients who need psychiatric attention?
What is a common correlation found in patients who need psychiatric attention?
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What is a major reason why many patients fail to seek psychiatric help in the United States?
What is a major reason why many patients fail to seek psychiatric help in the United States?
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What is a factor that contributes to the patient's decision to file a malpractice suit against the physician?
What is a factor that contributes to the patient's decision to file a malpractice suit against the physician?
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What is a common consequence of not seeking psychiatric help?
What is a common consequence of not seeking psychiatric help?
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What is a factor that influences a patient's expectations of physicians?
What is a factor that influences a patient's expectations of physicians?
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What is a characteristic of patients who do not seek medical care?
What is a characteristic of patients who do not seek medical care?
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What is a common reason why patients seek medical care?
What is a common reason why patients seek medical care?
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What is a factor that affects a patient's decision to seek psychiatric care?
What is a factor that affects a patient's decision to seek psychiatric care?
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What is the primary goal of the initial stage of the physician-patient interview?
What is the primary goal of the initial stage of the physician-patient interview?
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What type of questions are used in emergency situations or with seductive or overly talkative patients?
What type of questions are used in emergency situations or with seductive or overly talkative patients?
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When interviewing young children, what is the recommended approach?
When interviewing young children, what is the recommended approach?
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What is the purpose of using open-ended questions in a physician-patient interview?
What is the purpose of using open-ended questions in a physician-patient interview?
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What should the physician do if the patient appears dangerous or threatening?
What should the physician do if the patient appears dangerous or threatening?
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What is the ideal arrangement during a physician-patient interview?
What is the ideal arrangement during a physician-patient interview?
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What type of questions are used with young children?
What type of questions are used with young children?
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What is the purpose of asking questions in the third person when interviewing young children?
What is the purpose of asking questions in the third person when interviewing young children?
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What is the primary purpose of the clinical interview?
What is the primary purpose of the clinical interview?
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When interviewing young children, what is the first step the physician should take?
When interviewing young children, what is the first step the physician should take?
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What is a primary expectation of individuals assuming the 'sick role'?
What is a primary expectation of individuals assuming the 'sick role'?
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What is a key factor in determining whether a patient will adhere to medical advice?
What is a key factor in determining whether a patient will adhere to medical advice?
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Why is it important to ask patients about embarrassing or fear-provoking issues?
Why is it important to ask patients about embarrassing or fear-provoking issues?
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What is the primary purpose of the clinical interview?
What is the primary purpose of the clinical interview?
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What is a common criticism of the sick role theory?
What is a common criticism of the sick role theory?
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What is the purpose of telling relatives about a patient's illness?
What is the purpose of telling relatives about a patient's illness?
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What is a key factor in a patient's decision to seek medical care?
What is a key factor in a patient's decision to seek medical care?
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What is the primary reason for using open-ended questions in a physician-patient interview?
What is the primary reason for using open-ended questions in a physician-patient interview?
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What is a potential consequence of not establishing a strong doctor-patient relationship?
What is a potential consequence of not establishing a strong doctor-patient relationship?
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What is a characteristic of patients who are motivated to change their behavior?
What is a characteristic of patients who are motivated to change their behavior?
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What is the primary reason why many patients in the United States fail to seek help for psychiatric illnesses?
What is the primary reason why many patients in the United States fail to seek help for psychiatric illnesses?
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What is the significance of the correlation between psychological illness and physical illness?
What is the significance of the correlation between psychological illness and physical illness?
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What is the consequence of not seeking help for psychiatric illnesses?
What is the consequence of not seeking help for psychiatric illnesses?
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What influences a patient's behavior when seeking medical care?
What influences a patient's behavior when seeking medical care?
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What is a characteristic of patients who fail to seek medical care?
What is a characteristic of patients who fail to seek medical care?
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What is a factor that influences a patient's expectations of physicians?
What is a factor that influences a patient's expectations of physicians?
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What is a common reason why patients seek medical care?
What is a common reason why patients seek medical care?
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What is the significance of the patient's decision to file a malpractice suit against the physician?
What is the significance of the patient's decision to file a malpractice suit against the physician?
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What is a common consequence of not seeking medical care?
What is a common consequence of not seeking medical care?
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What is a factor that affects a patient's decision to seek psychiatric care?
What is a factor that affects a patient's decision to seek psychiatric care?
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Study Notes
Medical Practice
- A patient is more likely to file a malpractice suit against a physician if they believe the doctor missed a diagnosis or have poor communication with the doctor.
- A patient's behavior when seeking medical care is influenced by their culture, previous experiences, physical and mental conditions, personality styles, and coping skills.
Seeking Medical Care
- Only about one-third of Americans with symptoms seek medical care, while most people self-medicate with over-the-counter medications and home management.
- Patients may fail to seek help due to stigma, but it is essential to seek help as there is a strong correlation between psychological illness and physical illness.
The "Sick Role"
- The "sick role" includes exemption from usual responsibilities and expectation of care by others, as well as working toward becoming healthy and cooperating with healthcare personnel.
- Critics argue that the sick role theory applies only to middle-class patients with acute physical illness and emphasizes the power of the physician.
Telling Patients the Truth
- Adult patients are generally told the complete truth about their diagnosis, management, and prognosis.
- Information must be given directly to the patient, and not relayed through relatives, unless the patient permits.
Special Situations
- Patients may be afraid to ask questions about embarrassing or fear-provoking issues, and physicians should ask about such issues openly and address them truthfully.
- Physicians have the primary responsibility for dealing with adherence issues and angry or complaining behavior by patients.
Adherence
- Adherence refers to the extent to which a patient follows the physician's recommendations.
- Patients need to recognize that their behavior or condition is problematic before they are motivated to change or seek medical care.
- The "Stages of Change" model refers to the point at which recognition and readiness to change occur.
Factors Affecting Adherence
- Adherence is not related to patient intelligence, education, sex, religion, race, socioeconomic status, or marital status.
- Adherence is most closely related to how well the patient likes the doctor.
The Clinical Interview
- Good physician-patient communication improves patient adherence to medical advice, detection of physical and psychological problems, and patient satisfaction.
- The physical setting for the interview should be private, with no obstacles between the physician and patient, and at eye level.
- The physician should establish trust and rapport with the patient, gather information, and educate the patient about the illness.
- The interview serves to obtain the patient's psychiatric history, including prior mental problems, drug and alcohol use, and sources of stress.
Interviewing Techniques
- Direct questions are used to elicit specific information quickly, while open-ended questions are more likely to aid in obtaining information about the patient.
- Open-ended questions give little structure to the patient and encourage them to speak freely.
- Examples of specific interviewing techniques are listed in Table 21.5.
Medical Practice
- A patient is more likely to file a malpractice suit against a physician if they believe the doctor missed a diagnosis or have poor communication with the doctor.
- A patient's behavior when seeking medical care is influenced by their culture, previous experiences, physical and mental conditions, personality styles, and coping skills.
Seeking Medical Care
- Only about one-third of Americans with symptoms seek medical care, while most people self-medicate with over-the-counter medications and home management.
- Patients may fail to seek help due to stigma, but it is essential to seek help as there is a strong correlation between psychological illness and physical illness.
The "Sick Role"
- The "sick role" includes exemption from usual responsibilities and expectation of care by others, as well as working toward becoming healthy and cooperating with healthcare personnel.
- Critics argue that the sick role theory applies only to middle-class patients with acute physical illness and emphasizes the power of the physician.
Telling Patients the Truth
- Adult patients are generally told the complete truth about their diagnosis, management, and prognosis.
- Information must be given directly to the patient, and not relayed through relatives, unless the patient permits.
Special Situations
- Patients may be afraid to ask questions about embarrassing or fear-provoking issues, and physicians should ask about such issues openly and address them truthfully.
- Physicians have the primary responsibility for dealing with adherence issues and angry or complaining behavior by patients.
Adherence
- Adherence refers to the extent to which a patient follows the physician's recommendations.
- Patients need to recognize that their behavior or condition is problematic before they are motivated to change or seek medical care.
- The "Stages of Change" model refers to the point at which recognition and readiness to change occur.
Factors Affecting Adherence
- Adherence is not related to patient intelligence, education, sex, religion, race, socioeconomic status, or marital status.
- Adherence is most closely related to how well the patient likes the doctor.
The Clinical Interview
- Good physician-patient communication improves patient adherence to medical advice, detection of physical and psychological problems, and patient satisfaction.
- The physical setting for the interview should be private, with no obstacles between the physician and patient, and at eye level.
- The physician should establish trust and rapport with the patient, gather information, and educate the patient about the illness.
- The interview serves to obtain the patient's psychiatric history, including prior mental problems, drug and alcohol use, and sources of stress.
Interviewing Techniques
- Direct questions are used to elicit specific information quickly, while open-ended questions are more likely to aid in obtaining information about the patient.
- Open-ended questions give little structure to the patient and encourage them to speak freely.
- Examples of specific interviewing techniques are listed in Table 21.5.
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Description
A patient discovers a breast mass and wonders if her doctor missed it during a previous exam. Is the doctor liable for malpractice?