As I’ve reviewed my year’s postings, I’ve identified a few themes, and one of them is the focus on what we do as clinicians, and how this influences the people we work with and for. Here are links to the posts from 2010 on this topic – and yes, there will be more of these in 2011!
Looking at you, looking at me – It’s not just the match between patient and provider communication behaviour, it’s the direction of that match
It takes more than knowledge to teach self management – system support is also needed, an example from implementation of the Flinders Self Management Programme in New Zealand
I Don’t Know: Three words we might not be saying enough – being honest, and gentle with that honesty, might be important for our patients
Taking a closer look at health encounters – Stomski and colleagues summarise the state of play in ways to measure chronic pain consultation quality.
Essential skills for pain clinicians – my list of the skills needed by pain clinicians is to really listen first, and let the person you’re working with know that you’ve heard
Clinicians and graded exposure – working with your uncomfortable feelings while conducting graded exposure therapy
On being both a scientist and a human – blending the rigour of science with the warmth of being human is, I think, one of the key skills for a clinician
How well do we really communicate? – researchers in Norway and Denmark carry out an interesting study of video-recorded interactions between clinicians and patients where the patients were being informed of the results of MRI of their back. Who do you think got the most information about biomedical aspects of their problem?
Is reassurance reassuring? – it’s important for clinicians to demonstrate that they’re listening and really answering the specific concerns of the patient, rather than just giving general information or patients will experience the information as a lack of understanding of the legitimacy of the complaint, and respond by asserting the complaints more forcefully.
Intuition and other failings in clinical reasoning – In clinical reasoning, there is a real risk of having our very human cognitive reasoning biases kick in before we can even draw a breath, and the worst thing is – we won’t even know it!
Talking pain, seeking validation – ‘Fixing’ the problem by making suggestions can reinforce passivity, acknowledging and working alongside the person while they identify their ‘next best step’ might be more helpful.
People with high risk factors for disability get more biomedical information – Shaw and colleagues identify that while clinicians may recognise the presence of yellow flags, and understand that this needs more assessment and management, but revert to what they know best, ie biomedical advice and explanation, rather than exploring lifestyle and psychosocial factors.
Here’s looking at us – This study looks at the use of the Pain Attitudes and Beliefs Scale with GP’s, or primary care providers.
How long does it take to get there? – no, not kids in cars, but a look at the delays in referral for chronic pain management.
Rules for doctors – and probably other health professionals – A repost of a wonderful set of instructions written by a doctor!
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