A guide to the first step of patient evaluation - interviewing medical students. Section I is a guide to the medical interview and to oral and written case presentation. Section II provides interview strategies for example, treating distraught patients, ways to share bad news and how to elicit information on sexual history or alcohol abuse.

The encounter between patient and physician may be characterized as the focus of medicine. As such, the patient-physician relationship, or more accurately the conduct of patients and physicians, has been the subject of considerable comment, inquiry, and debate throughout the centuries. The issues and concerns discussed, apart from those more specifically related to medical theory and therapy, range from matters of etiquette to profound questions of philosophical and moral interest. This discourse is impressive with respect both to its duration and content. Contemporary scholars and laypeople have made their contribution to these long-standing discussions. In addition, they have actively addressed those distinctively modern issues that have arisen as a result of increased medical knowledge, improved technology, and changing cultural and moral expectation. The concept of the patient-physician rela tionship that supposedly provides a framework for the conduct of patients and physicians seemingly has taken on a life of its own, inviolable, and subject to norms particular to it. The essays in this volume elucidate the nature of the patient-physician relationship, its character, and moral norms appropriate to it. The purpose of the collection is to enhance our understanding of that context, which many consider to be the focus of the entire medical enterprise. The con tributors have not engaged in apologetics, polemics, homiletics, or em piricism.

The Clinical Interview offers a new perspective on the patient encounter. Interpreting decades of evidence-based psychotherapy and neuroscience, it provides 60 succinct techniques to help clinicians develop rapport, solicit better histories, and plan treatment with even the most challenging patients. This book describes brief skills and techniques for clinical providers to improve their patient interactions. Although evidence-based psychotherapies are typically designed for longer specialized treatments, elements of these psychotherapies can help clinicians obtain better patient histories, develop more effective treatment plans, and more capably handle anxiety-provoking interactions. Each chapter is brief and easily digestible, contains sample clinical dialogue, and provides references for further reading. These skills help clinicians practice more effectively, more efficiently, and with greater resilience. Whatever your clinical specialty or role, whether you are a trainee or an experienced clinician, The Clinical Interview offers practical wisdom and an entirely new way to think about the clinical encounter. The Clinical Interview will be of great use to any student in a health-related field of study or a healthcare professional interested in refining their interviewing skills. It will help anyone from emergency medical technicians, nurses, and physician assistants, to nurse practitioners and physicians to build more meaningful patient relationships.

The foundational knowledge and practical actions you need to effectively address your patients’ emotions—and manage your own Emotions are ever-present in the context of illness and medical care and can have an enormous impact on the well-being of patients and healthcare providers alike. Despite this impact, emotions are often devalued in a medical culture that praises stoicism and analytical reasoning. Featuring the latest theories and research on emotion in healthcare, this much-needed resource will help you build the necessary skillset to navigate the extraordinary emotional demands of practicing medicine. Emotion in the Clinical Encounter will help you: Learn the science of emotion, as it relates to clinical care Understand the role of emotion in illness Recognize the connection between clinical response to patient emotions and care outcomes Develop effective strategies for emotion recognition Build strong emotional dialogue skills for medical encounters Identify biases that may shape clinical interactions and subsequent outcomes Understand emotion regulation in patients, providers, and in the clinical relationship Address challenges and opportunities for clinical emotional wellness Identify a new path forward for delivering emotion-based medical school curricula “How did we manage for this long in healthcare without this textbook? This is an essential guide to help both trainees and established clinicians sharpen their skills. Our patients will only benefit when we bring our full set of skills to the bedside." —Danielle Ofri MD, PhD, Clinical Professor of Medicine, New York University, Editor-in-Chief of Bellevue Literary Review, and author of What Doctors Feel: How Emotions Affect the Practice of Medicine “This is a unique contribution that deeply explores the role of emotions in clinical medicine, drawing on a wide range of disciplines and presenting both scholarly paradigms and practical applications. It should be essential reading for medical educators, clinicians and patient advocates who all aim to better navigate today’s frustrating healthcare system.” —Jerome Groopman MD, Recanati Professor Harvard Medical School, and author of How Doctors Think “Emotion in the Clinical Encounter is a must-read book for clinicians. It would be especially helpful if medical students start their careers by reading this invaluable volume to gain a deeper understanding of human emotion. The book is evidence-based and detailed enough to be perhaps the definitive guide to emotions for the clinician.” —William Branch, MD, MACP, FACH, The Carter Smith, Sr Professor of Medicine, Emory University

In Suffering and Sacrifice in the Clinical Encounter, the authors identify the ways in which some patients seek to create what Freud termed a "private religion" and unconsciously substitute sacrificial enactments of scapegoat surrogates to protect them against the pain of separation, mourning, and loss of primary figures of attachment. They investigate the function of sacrifice and its relationship to the breakdown of psychic structure and the development of manic defenses and pathological narcissism. Such treatments are complex, the "reversed roles" of victim and perpetrator central to the sacrificial process when enacted in therapy can trigger feelings of shame, guilt and inadequacy in the therapist. Perverse, vengeful, and sadistic transference distortions are explored to enable the therapist to appreciate the true nature of the patient's hidden traumatic experience, with the necessity for the working-through of genuine separation and grieving highlighted. Useful methods are detailed to counter the tendency to become overly active and inappropriately involved when working with patients who have deadened their desire to improve. This book is unique in utilising the dynamic concepts of the effects of trauma and sacrifice, the role of the scapegoat, and the distinctions between the experience of pain and the accomplishment of suffering in order to develop a foundational understanding of such patients. It is a must-read for all practising and trainee therapists.

Efforts to evaluate the clinical encounter in terms of autonomous agents governed by rationally justified moral principles continue to be criticised. These essays, written by physicians, ethicists, theologians and philosophers, examine various models of the clinical encounter emerging out of these criticisms and explore the prospects they offer for theological and religious discourse. Individual essays focus on the reformulation of covenant models; revisions of principles approaches; and topics such as power, authority, narrative, rhetoric, dialogue, and alterity. The essays display a range of conclusions about whether theology articulates generally accessible religious insights or is a tradition-specific discipline. Hence the volume reflects current debates in theology while analysing current models of the clinical encounter. Students, professionals, and scholars who find themselves at the intersection of theology and medicine will welcome these voices in an ongoing conversation.

This innovative volume provides fresh perspectives on how medical students and patients construct identities in relation to each other, using stories of their clinical encounters. It explores how paying attention to medical students’ and patients’ stories in clinical teaching encounters can encourage empathy and the formation of professional identities that embody desirable values such as integrity and respect. Written by an experienced clinician and based on original, rigorous research combining ethnography and dialogic narrative analysis, Storytelling Encounters as Medical Education: Crafting Relational Identity includes patient stories alongside those of students and clinical teachers. This is an important contribution for all those interested in medical education, narrative medicine, person-centred care and identity formation in healthcare. It will also be of value to scholars in a range of other disciplines, who are using a dialogic approach.

This open access book is a unique resource for health professionals who are interested in understanding the philosophical foundations of their daily practice. It provides tools for untangling the motivations and rationality behind the way medicine and healthcare is studied, evaluated and practiced. In particular, it illustrates the impact that thinking about causation, complexity and evidence has on the clinical encounter. The book shows how medicine is grounded in philosophical assumptions that could at least be challenged. By engaging with ideas that have shaped the medical profession, clinicians are empowered to actively take part in setting the premises for their own practice and knowledge development. Written in an engaging and accessible style, with contributions from experienced clinicians, this book presents a new philosophical framework that takes causal complexity, individual variation and medical uniqueness as default expectations for health and illness.