Changing How We Think about Difficult Patients

Changing How We Think about Difficult Patients PDF Author: Joan Naidorf
Publisher:
ISBN: 9780996663212
Category :
Languages : en
Pages : 128

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Book Description
Physicians enter their professions with the highest of hopes and ideals for compassionate and efficient patient care. Along the way, however, recurring problems arise in their interactions with some patients that lead physicians to label them as "difficult." Some studies indicate that physicians identify 15% or more of their patients as "difficult." The negative feelings that physicians have toward these patients may lead to frustration, cynicism. and burnout. Changing How We Think about Difficult Patients uses a multi-tiered approach to bring awareness to the difficult patient conundrum, then introduces simple, actionable tools that every physician, nurse, and caregiver can use to change their mindset about the patients who challenge them. Positive thoughts lead to more positive feelings and more effective treatments and results for patients. They also lead to more satisfaction and decreased feelings of burnout in healthcare professionals. How does this book give you an advantage? Caring for difficult patients poses a tremendous challenge for physicians, nurses, and clinical practitioners. It may contribute significantly to feelings of burnout, including feelings of exhaustion, cynicism, and lost sense of purpose. In response, Dr. Naidorf offers a pragmatic approach to accepting patients the way they are, then provides strategies for providers to find more happiness and satisfaction in their interactions with even the most challenging patients and families. Here are just some of the topics the author discusses in detail: What Makes a "Good" Patient? The Four Core Ethical Principals of the Clinician-Patient Relationship The Four Models of the Physician-Patient Relationship What Challenges Anybody with Illness or Injury? How "Good" Patients Handle the Challenges of Illness and Injury Six Common Reactions to Illness and Hospitalization On "Taking Care of the Hateful Patient" Standards for Education in Medical Ethics De-escalation Strategies Cultural, Structural, and Language Issues Types of Patients Who Tend to Challenge Us The Think, Feel, Act Cycle Recognizing Our Preconceived Thoughts Three Common Thought Distortions About Patients Asking Useful Questions Getting Out of the Victim Mentality Guiding our Thoughts Through a Common Scenario Show Compassion, Feel Compassion If you're a healthcare provider or caregiver, Changing How We Think about Difficult Patients will give you the benefit of understanding your most challenging patients, and a roadmap to positively changing your mindset and actions to better deliver care and compassion for all.

Field Guide to the Difficult Patient Interview

Field Guide to the Difficult Patient Interview PDF Author: Frederic W. Platt
Publisher: Lippincott Williams & Wilkins
ISBN: 9780781747745
Category : Medical
Languages : en
Pages : 328

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Book Description
Written by physicians skilled at coaching colleagues in physician-patient communication, this pocket guide presents practical strategies for handling a wide variety of difficult patient interviews. Each chapter presents a hypothetical scenario, describes effective communication techniques for each phase of the interaction, and identifies pitfalls to avoid. The presentation includes examples of physician-patient dialogue, illustrations showing body language, and key references. This edition includes new chapters on caring for physician-patients, communicating with colleagues, disclosing unexpected outcomes and medical errors, shared decision making and informed consent, and teaching communication skills. Other new chapters describe clinical attitudes such as patience, curiosity, and hope.

The Difficult-to-Treat Psychiatric Patient

The Difficult-to-Treat Psychiatric Patient PDF Author: Mantosh J. Dewan
Publisher: American Psychiatric Pub
ISBN: 1585627887
Category : Medical
Languages : en
Pages : 460

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Book Description
Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.

Behavioral Medicine A Guide for Clinical Practice 5th Edition

Behavioral Medicine A Guide for Clinical Practice 5th Edition PDF Author: Mitchell D. Feldman
Publisher: McGraw Hill Professional
ISBN: 1260142698
Category : Medical
Languages : en
Pages : 641

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Book Description
The #1 guide to behavioral issues in medicine delivering thorough, practical discussion of the full scope of the physician-patient relationship "This is an extraordinarily thorough, useful book. It manages to summarize numerous topics, many of which are not a part of a traditional medical curriculum, in concise, relevant chapters."--Doody's Review Service - 5 stars, reviewing an earlier edition The goal of Behavioral Medicine is to help practitioners and students understand the interplay between psychological, physical, social and cultural issues of patients. Within its pages readers will find real-world coverage of behavioral and interactional issues that occur between provider and patient in everyday clinical practice. Readers will learn how to deliver bad news, how to conduct an effective patient interview, how to care for patients at the end of life, how to clinically manage common mental and behavioral issues in medical patients, the principles of medical professionalism, motivating behavior change, and much more. As the leading text on the subject, this trusted classic delivers the most definitive, practical overview of the behavioral, clinical, and social contexts of the physician-patient relationship. The book is case based to reinforce learning through real-world examples, focusing on issues that commonly arise in everyday medical practice and training. One of the significant elements of Behavioral Medicine is the recognition that the wellbeing of physicians and other health professionals is critically important to caring for patients.

Every Patient Tells a Story

Every Patient Tells a Story PDF Author: Lisa Sanders
Publisher: Harmony
ISBN: 0767922476
Category : Biography & Autobiography
Languages : en
Pages : 305

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Book Description
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.

Aesthetic Applications of Intense Pulsed Light

Aesthetic Applications of Intense Pulsed Light PDF Author: Lucian Fodor
Publisher: Springer Science & Business Media
ISBN: 1849964564
Category : Medical
Languages : en
Pages : 148

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Book Description
The book is structured into eight chapters: 1. Skin anatomy. This chapter is intended to describe the pertinent anatomy related to IPL applications. In addition to the described main structural elements of the skin, the chapter has important points about skin aging and histological aspects which gives the reader a better understanding of the etiology of skin lesions and the need for Intense Pulsed Light (IPL) treatment. 2. Light-tissue interaction. This chapter describes the interaction between IPL and different skin structures. Target skin structures (chromophores) are described in detail. The results of this interaction are detailed as being important to understanding the goals and principles of IPL treatment. 3. IPL safety and legal issues. This chapter describes the needs of the environment for a safe treatment. The necessary equipment and things to avoid pitfalls which may lead to lawsuits are detailed. Several aspects of IPL legal issues are also described: how to avoid medical liabilities and how to manage them are also included in this chapter. 4. Patient selection. This chapter describes the pearls and pitfalls in selecting patients for IPL treatment. This is not an easy task and proper patient selection is extremely important to have satisfied patients. Problematic patient types are also described here. 5. Skin rejuvenation. This chapter starts with a description of skin aging. Intrinsic and extrinsic mechanisms are detailed. The most common skin lesions related to aging that can benefit from IPL treatment for rejuvenation are detailed. The chapter continues with treatment protocols which describe strategies for achieving optimal results. A review of the literature is included, presenting the treatment parameters of different studies and their results. 6. Hair removal. This chapter starts with a description of the hair follicle cycle, hair types and important structures for treatment. Treatment strategies are emphasized and detailed, starting from choosing the right parameters to post-treatment recommendations. A literature review is presented regarding treatment parameters and results according to different authors. 7. Vascular lesions treatment. This chapter describes the types of vascular lesions that can benefit from IPL treatment. The treatment protocol is emphasized and all the steps for performing this application are described in detail. A literature review is presented and different results are compared regarding treatment parameters. 8. Complications. It is inevitable that any medical treatment can end with complications. The possible complications of the most common IPL applications (skin rejuvenation, hair removal, pigmented and vascular lesion treatment) are detailed. The way to avoid them and how to handle them is also described. At the end of each chapter, there is a section on the practical points highlighting the most important points of the chapter. An extensive literature review of this technology is presented alongside numerous illustrations, tables and color pictures. The book will benefit any doctor or healthcare professional who uses IPL for cosmetic purposes, such as plastic surgeons, dermatologists, ophthalmologists, maxillofacial surgeons and otolaryngologists dealing with aesthetics of the face, as well as residents interested in learning the subject.

The Clinical Interview Using DSM-IV

The Clinical Interview Using DSM-IV PDF Author: Ekkehard Othmer
Publisher:
ISBN: 9780880488259
Category : Diagnostic and statistical manual of mental disorders
Languages : en
Pages : 0

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Book Description
The authors seek to transform their professional clinical experience into clear, concise, practical and learnable clinical skills. The work demonstrates its multidimensional approach using numerous DSM-IV case studies. It also shows how to modify clinical interviewing techniques for patients with different major psychiatric and personality disorders. Updated to include information from the DSM-IV, the guide contains vignettes that illustrate the strategies, techniques and underlying principles of clinical interviewing. Designed for both practitioners and trainees, it is intended to be used as a reference on how to approach the clinical interview.

Patient-Centered Healthcare

Patient-Centered Healthcare PDF Author: Eldo Frezza
Publisher: CRC Press
ISBN: 0429629532
Category : Medical
Languages : en
Pages : 311

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Book Description
Patient-centered care is a way of thinking and doing things that considers patients partners in the development of a healthcare plan designed to meet their specific needs. It involves knowledge of the individual as a person and integrates that knowledge into their plan of care. Patient-centered care is central to the discussion of healthcare at the insurance and hospital-level. The quality of the service is evaluated more deeply from all the healthcare components, including insurance payments. It is the start of a new client- and patient-centered healthcare, which is based on a profound respect for patients and the obligation to care for them in partnership with them. Healthcare has been lacking a strategy to teach patients how to take care of themselves as much as they possibly can. In countries with socialized healthcare, patients don’t go to the emergency room unless it is necessary; they have a physician on call instead. This affords more personalized care and avoids patients getting lost in the hospital system. This book advocates the critical role of patients in the health system and the need to encourage healthy living. We need to educate patients on how to be more self-aware, giving them the tools to better understand what they need to do to achieve healthy lifestyles, and the protocols and policies to sustain a better life. Prevention has always been the pinnacle of medical care. It’s time to highlight and share this approach with patients and involve them as active participants in their own healthcare. This is the method on which to build the new healthcare for the next century.

When Doctors Become Patients

When Doctors Become Patients PDF Author: Robert Klitzman
Publisher: Oxford University Press
ISBN: 0195327675
Category : Medical
Languages : en
Pages : 344

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Book Description
For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.

Caring for Patients

Caring for Patients PDF Author: Allen Barbour
Publisher: Stanford University Press
ISBN: 9780804731539
Category : Medical
Languages : en
Pages : 428

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Book Description
An experienced and compassionate physician questions the prevailing medical model of patient care?that every illness has a physical cause that can be identified and treated medically?and argues for the necessity of taking the psychological and social situation of the patient into account in the process of diagnosis and treatment.