60 Questions
What is the main assumption behind the 'sick role' theory?
That patients are exempt from their usual responsibilities
What is the most important factor in patient adherence to medical advice?
Strength of the doctor-patient relationship
According to the 'Stages of Change' model, what is the critical point for patient motivation?
When patients recognize their condition is problematic
What is the primary responsibility of physicians regarding adherence issues?
Dealing with adherence issues
What is the percentage of patients who fully adhere to management recommendations?
About one-third
What is the primary factor in whether patients sue their doctors?
Strength of the doctor-patient relationship
What is the primary goal of good physician-patient communication?
All of the above
What is the ideal arrangement during a physician-patient interview?
The physician and patient interact at eye level with no obstacles between them.
What is the recommended approach to asking patients about embarrassing or fear-provoking issues?
Asking open-ended questions
What is the primary goal of the initial stage of the physician-patient interview?
To establish trust and rapport with the patient.
Who decides how and when to inform an ill child about their diagnosis?
The parents
What type of questions are used in emergency situations or with seductive or overly talkative patients?
Direct questions.
What is the purpose of using open-ended questions in a physician-patient interview?
To encourage the patient to speak freely and obtain more information.
What is a criticism of the sick role theory?
It only applies to middle-class patients
When interviewing young children, what is the first step the physician should take?
Establish rapport by interacting with the child in a nonmedical way.
What type of questions should be used when interviewing young children?
Direct questions.
What is the purpose of asking questions in the third person when interviewing young children?
To avoid direct confrontation.
What is the primary purpose of the clinical interview?
To obtain physical, psychological, and social information about the patient.
What is the ideal way to establish trust and rapport with a patient?
By being at eye level with the patient and having no obstacles between them.
What should the physician do if the patient appears dangerous or threatening?
Obtain backup, such as hospital security.
What percentage of Americans with symptoms seek medical care?
One-third
What is a major factor that influences a patient's behavior when seeking medical care?
Culture of the patient
What is a common correlation found in patients who need psychiatric attention?
Higher morbidity rates and higher mortality rates
What is a major reason why many patients fail to seek psychiatric help in the United States?
Stigma associated with psychiatric illness
What is a factor that contributes to the patient's decision to file a malpractice suit against the physician?
Poor communication with the doctor
What is a common consequence of not seeking psychiatric help?
Higher morbidity rates and higher mortality rates
What is a factor that influences a patient's expectations of physicians?
Previous experiences with medical care
What is a characteristic of patients who do not seek medical care?
They tend to contend with illnesses at home with over-the-counter medications and home management
What is a common reason why patients seek medical care?
Because of symptoms that they are experiencing
What is a factor that affects a patient's decision to seek psychiatric care?
The stigma associated with psychiatric illness
What is the primary goal of the initial stage of the physician-patient interview?
To establish trust and rapport with the patient
What type of questions are used in emergency situations or with seductive or overly talkative patients?
Direct questions
When interviewing young children, what is the recommended approach?
First establish rapport by interacting with the child in a nonmedical way
What is the purpose of using open-ended questions in a physician-patient interview?
To encourage the patient to speak freely
What should the physician do if the patient appears dangerous or threatening?
Obtain backup, such as hospital security
What is the ideal arrangement during a physician-patient interview?
The physician and patient should interact at eye level, with no obstacle in between
What type of questions are used with young children?
Direct questions
What is the purpose of asking questions in the third person when interviewing young children?
To make the child feel more comfortable
What is the primary purpose of the clinical interview?
To obtain physical, psychological, and social information
When interviewing young children, what is the first step the physician should take?
First establish rapport by interacting with the child in a nonmedical way
What is a primary expectation of individuals assuming the 'sick role'?
Exemption from usual responsibilities
What is a key factor in determining whether a patient will adhere to medical advice?
The strength of the doctor-patient relationship
Why is it important to ask patients about embarrassing or fear-provoking issues?
To address the patient's concerns directly
What is the primary purpose of the clinical interview?
To gather information about the patient's symptoms
What is a common criticism of the sick role theory?
It is too focused on the doctor's power
What is the purpose of telling relatives about a patient's illness?
To relieve the relatives' fears
What is a key factor in a patient's decision to seek medical care?
The patient's recognition of their problematic behavior
What is the primary reason for using open-ended questions in a physician-patient interview?
To avoid leading the patient's responses
What is a potential consequence of not establishing a strong doctor-patient relationship?
The patient is more likely to sue the doctor
What is a characteristic of patients who are motivated to change their behavior?
They recognize that their behavior or condition is problematic
What is the primary reason why many patients in the United States fail to seek help for psychiatric illnesses?
Stigma associated with psychiatric illness
What is the significance of the correlation between psychological illness and physical illness?
It highlights the importance of seeking help for psychological illness
What is the consequence of not seeking help for psychiatric illnesses?
Morbidity rates and mortality rates increase
What influences a patient's behavior when seeking medical care?
Their culture, previous experiences, physical and mental conditions, personality styles, and coping skills
What is a characteristic of patients who fail to seek medical care?
They tend to rely on over-the-counter medications and home management
What is a factor that influences a patient's expectations of physicians?
Their culture, previous experiences, physical and mental conditions, personality styles, and coping skills
What is a common reason why patients seek medical care?
To address a specific medical concern
What is the significance of the patient's decision to file a malpractice suit against the physician?
It is influenced by the patient's coping skills and communication with the physician
What is a common consequence of not seeking medical care?
Increased symptoms
What is a factor that affects a patient's decision to seek psychiatric care?
The stigma associated with psychiatric illness
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.
A patient discovers a breast mass and wonders if her doctor missed it during a previous exam. Is the doctor liable for malpractice?
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