Although shared decision making (SDM) in general practice continues to be promoted as a highly desirable means of conducting consultations it is rarely observed in practice. The aim of this study is to identify the discursive features and... more
Although shared decision making (SDM) in general practice continues to be promoted as a highly desirable means of conducting consultations it is rarely observed in practice. The aim of this study is to identify the discursive features and conversational strategies particular to the negotiation and sharing of treatment decisions in order to understand why SDM is not yet embedded into routine practice. Consultations from Scottish general practices were examined using discourse analysis. Two themes were identified as key components for when the doctor and the patient were intent on sharing decisions: the generation of patient involvement using first-person pronouns, and successful and unsuccessful patient requesting practices. This article identifies a number of conversational activities found to be successful in supporting doctors’ agendas and reducing their responsibility for decisions made. Doctor’s use of ‘partnership talk’ was found to minimize resistance and worked to invite cons...
This study draws from Grice's conversational implicatures and uses Discourse analysis to explore interactions of doctors and patients during consultations in private clinics. It advances the claim that effective use of communication... more
This study draws from Grice's conversational implicatures and uses Discourse analysis to explore interactions of doctors and patients during consultations in private clinics. It advances the claim that effective use of communication strategies facilitates common ground as participants get involved in mutual discussion of treatment options, goals, and roles in health management. Extracts from eight transcripts of the audio-recorded interactions serve as data. Results show that communicative strategies of doctors include instances of bureaucratic negotiation and casual inserts, frequent repetitions and explanations, and codeswitching while patients preferred brief answers, asking for confirmation, and giving more information than requested. These strategies promote effective doctor-patient interaction and communication central to doctors' clinical competence and patients' health status, satisfaction, and health care.
In this paper, we do a literature review on electronic health records (EHR) and patient involvement. It seems that patients are not included as much as one would presume. After our analysis of both literature and ethical nature, we... more
In this paper, we do a literature review on electronic health records (EHR) and patient involvement. It seems that patients are not included as much as one would presume. After our analysis of both literature and ethical nature, we suggest that research on why this is so and whether they should be included needs to be done.
This study draws from Grice’s conversational implicatures and uses Discourse Analysis to explore interactions of doctors and patients during consultations in private clinics. It advances the claim that effective use of communication... more
This study draws from Grice’s conversational implicatures and uses Discourse Analysis to explore interactions of doctors and patients during consultations in private clinics. It advances the claim that effective use of communication strategies facilitates common ground as participants get involved in mutual discussion of treatment options, goals, and roles in health management. Extracts from eight transcripts of the audio-recorded interactions serve as data. Results show that communicative strategies of doctors include instances of bureaucratic negotiation and casual inserts, frequent repetitions and explanations, and codeswitching while patients preferred brief answers, asking for confirmation, and giving more information than requested. These strategies promote effective doctor-patient interaction and communication— central to doctors’ clinical competence and patients’ health status, satisfaction and health care.
CC BY-NC-ND This invited talk presented a new model (Tractenberg, et al. in review 2016) of developing *patient-centered* patient reported outcomes (PC-PROs), contrasting it with typical PROs, and integrated this type of model with Dr.... more
CC BY-NC-ND This invited talk presented a new model (Tractenberg, et al. in review 2016) of developing *patient-centered* patient reported outcomes (PC-PROs), contrasting it with typical PROs, and integrated this type of model with Dr. Tractenberg's method for the analysis of change in Likert-rated items, Qualified Change.
