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Will the clinical encounter, family practice's signature concept, become truncated and distorted in the quest for cost-efficiency?
Quality-adjusted life-years signal two shifts in the locus of control and the nature of the clinical encounter. Formal expressions of community preferences and societal usefulness would counterbalance patient autonomy, and formal tools of resource allocation and applied decision analysis would counterbalance the use of clinical judgment.[9]
Into this complex field of misunderstanding comes Richard Zaner with Ethics and the Clinical Encounter. He brings remarkable qualifications to the task, having been trained as a phenomenological philosopher, going on to work extensively in the clinical context, and having considerable familiarity with the history of medicine.
NEW YORK -- The diagnosis of psychosis cannot be made on the basis of a single clinical encounter. "You have to look at the whole course" to distinguish among the various psychotic disorders and bipolar disorder, Ronald Rieder, M.D., said at a conference on schizophrenia sponsored by Columbia University.
Such divergences may not surface in a later clinical encounter. The actual events and interpretations may be forgotten by one, or both.
In addition to the possible harmful effects of promoting unproven mass screening, we have concerns that enthusiasts for PSA testing may not provide patients with a complete picture of the implications of PSA testing (clinical encounter number 1).
To most immediately correct problems listed during the clinical encounter, suggestions included hiring more clinic personnel, adding more clinic hours and space, and shortening the time that patients sit in the "waiting room" for their appointments.
The presumption has been that each clinical encounter is a self-contained moment and that the brief communication between a resident and unfamiliar patient is qualitatively similar to that which occurs between a patient and a physician who have known, cared for, and trusted each other for years.
Britt Anderson of the department of psychology, University of Waterloo, Ont., said he would find amyloid imaging results "useful in my clinical encounter" with patients, but it would not be the only tool used in making a diagnosis.
"They looked closely at the clinical encounter and felt that clinical uncertainty, bias, prejudice, and stereotyping may play a partial role, although clearly each of these were unconscious behaviors.
Care delivery organizations such as MSOs, PHOs and IPAs are required to provide clinical encounter data to health plans which roll up the information into the plan's HEDIS report.
Patient reactions were measured with a questionnaire that the patients completed after the clinical encounter.
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