Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement

Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement

by Lucia Siegel Sommers
     
 

View All Available Formats & Editions

This is a book about primary care clinicians and the clinical uncertainty endemic to their work. Even when seemingly straightforward, each patient raises unique questions regarding how best to listen to their complaints, empathize with their suffering, or respond to their silences. This book is also about addressing uncertainty in primary care practice and engaging

Overview

This is a book about primary care clinicians and the clinical uncertainty endemic to their work. Even when seemingly straightforward, each patient raises unique questions regarding how best to listen to their complaints, empathize with their suffering, or respond to their silences. This book is also about addressing uncertainty in primary care practice and engaging it. Engagement requires knowledge, explicit and tacit, placed in the service of a single patient's problem. It also requires carefully managed communication, facilitating dialogue with the patient and encouraging shared problem-solving. Most importantly, this book is about collaborative engagement with case-based uncertainty in the setting of small groups of clinicians. Sommers and Launer contend that the medical profession's tradition of working independently should be augmented with an explicitly shared, collegial one of jointly creating wisdom through practice-based learning. An international panel of expert clinicians and educators provides:
• Perspectives on clinical uncertainty in the medical literature
• A taxonomy of clinical uncertainty with patient examples
• Analysis of the educator role to support clinicians in engaging uncertainty
• A compendium of small group methods for collaborative engagement with clinical scenarios
• Analysis of the special challenges of collaborative engagement A mind-opening manifesto, Clinical Uncertainty in Primary Care will equip primary care clinicians, educators, public health and behavioral health professionals with resources for infusing practice with meaning through collegial collaboration. From the Foreword: "Lucia Sommers and John Launer, with the accompanying inputof their contributing authors, have done a deeply insightful and close to exhaustive job of defining clinical uncertainty. They identify its origins, components, and subtypes; demonstrate the ways in which and the extent to which it is intrinsic to medicine...and pre

Editorial Reviews

Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This book outlines a collaborative engagement strategy for primary care clinicians.
Purpose: The foreword speaks to developing small groups of primary care physicians, oriented around issues of medical uncertainty. This approach brings young and more experienced clinicians together to discuss in generalities cases with which they are not sure how to proceed. This may be a reasonable approach in the U.K., but with the demand for services and the financial constraints in the U.S., this simply does not appear to be a reasonable time investment for American primary care clinicians. The emphasis on evidence-based practice also brings into question the value of this collaborative engagement strategy, as evidence-based medicine is focused on moving away from the biases of individual senior clinicians to strategies based on reproducible data.
Audience: The book is directed mainly at U.K. general practitioners. The editors include an educator and health services researcher and a U.K. GP.
Features: This is a collection of a number of essays, with an emphasis on Balint groups, a method of exploring the emotional conflicts that come with physicians wanting to show empathy while "doing the right thing" and a few success stories of how this technique has been useful in Canada and Sweden.
Assessment: This is a nice theoretical approach to helping inexperienced clinicians mature, but does not conform to the current generally accepted manner of approaching the emotional maturation of young physicians.
Doody's Review Service
Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: This book outlines a collaborative engagement strategy for primary care clinicians.
Purpose: The foreword speaks to developing small groups of primary care physicians, oriented around issues of medical uncertainty. This approach brings young and more experienced clinicians together to discuss in generalities cases with which they are not sure how to proceed. This may be a reasonable approach in the U.K., but with the demand for services and the financial constraints in the U.S., this simply does not appear to be a reasonable time investment for American primary care clinicians. The emphasis on evidence-based practice also brings into question the value of this collaborative engagement strategy, as evidence-based medicine is focused on moving away from the biases of individual senior clinicians to strategies based on reproducible data.
Audience: The book is directed mainly at U.K. general practitioners. The editors include an educator and health services researcher and a U.K. GP.
Features: This is a collection of a number of essays, with an emphasis on Balint groups, a method of exploring the emotional conflicts that come with physicians wanting to show empathy while "doing the right thing" and a few success stories of how this technique has been useful in Canada and Sweden.
Assessment: This is a nice theoretical approach to helping inexperienced clinicians mature, but does not conform to the current generally accepted manner of approaching the emotional maturation of young physicians.

Product Details

ISBN-13:
9781461468110
Publisher:
Springer New York
Publication date:
06/30/2013
Edition description:
2014
Pages:
306
Product dimensions:
6.10(w) x 9.25(h) x 0.04(d)

Meet the Author

Lucia SiegelSommers is an educator and health services researcher with a 40-year history of working with clinician small groups. She holds an undergraduate degree from the University of Pennsylvania; a masters in social work from Bryn Mawr University; a doctorate in public health from the University of California, Berkeley; and completed a 2-year fellowship in health services research at Stanford University. From 1994 through 2001, Lucia was a full-time faculty member in the Internal Medicine Residency Program at St. Mary’s Medical Center in San Francisco and Associate Program Director from 1997 to 2001. She is currently an assistant professor in the Department of Family and Community Medicine at the University of California San Francisco where she has taught medical students since 1996. Her published research includes studies focused onthe effectiveness of medical audit, nurse-physician collaboration to improve care and reduce costs in hospitals, and interdisciplinary care for the frail elderly in the primary care office setting.

John Launer is a family physician, family therapist, educator and writer. He graduated in English at Cambridge before studying medicine at London University. After obtaining Membership of the Royal College of General Practitioners with distinction in 1983, he worked for 22 years as a GP in Edmonton, north London, and continues to work as a part-time GP. In 1994 he completed training at the Tavistock Clinic as a family therapist and joined the senior staff there as honorary consultant in general practice and primary care. Since then his teaching and clinical work has drawn together ideas from family medicine and family therapy, with a focus on narrative and clinical supervision.John is an Associate Dean for Postgraduate Medical Education at London University, and has published five previous books as author or editor, including ‘Narrative-Based Primary Care: A Practical Guide.’ He has lectured and run workshops internationally, including in the USA, Canada, Scandinavia, Israel and Japan.

Customer Reviews

Average Review:

Write a Review

and post it to your social network

     

Most Helpful Customer Reviews

See all customer reviews >