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An invaluable guide to becoming a competent and compassionate
physician. Medical students and physicians-in-training embark on a
long journey that, although steeped in scientific learning and
technical skill building, includes little guidance on the emotional
and interpersonal dimensions of becoming a healer. Written for
anyone in the health care community who hopes to grow emotionally
and cognitively in the way they interact with patients, On Becoming
a Healer explains how to foster doctor-patient relationships that
are mutually nourishing. Dr. Saul J. Weiner, a physician-educator,
argues that joy in medicine requires more than idealistic
aspirations-it demands a capacity to see past the "otherness" that
separates the well from the sick, the professional in a white coat
from the disheveled patient in a hospital gown. Weiner scrutinizes
the medical school indoctrination process and explains how it molds
the physician's mindset into that of a task completer rather than a
thoughtful professional. Taking a personal approach, Weiner
describes his own journey to becoming an internist and pediatrician
while offering concrete advice on how to take stock of your current
development as a physician, how to openly and fully engage with
patients, and how to establish clear boundaries that help defuse
emotionally charged situations. Readers will learn how to counter
judgmentalism, how to make medical decisions that take into account
the whole patient, and how to incorporate the organizing principle
of healing into their practice. Each chapter ends with questions
for reflection and discussion to help personalize the lessons for
individual learners.
The best clinicians take into account the life challenges of their
patients when planning their care, a process Drs. Weiner and
Schwartz refer to as "contextualizing care." Failures to
contextualize care, when they results in care plans that seem
appropriate from a narrowly clinical perspective but are
nevertheless unlikely to achieve their intended aims represent
"contextual errors." Prescribing a medication a patient cannot
afford when a less costly alternative is available would constitute
such an error. Drawing on two decades of research including
analysis of nearly 10,000 audio recorded medical encounters, the
authors document an unmeasured dimension of quality: the extent to
which clinicians attend to patient context, and its substantial
implications for health care outcomes and costs. Listening for What
Matters provides a comprehensive overview of research and quality
improvement efforts to address the problem of contextual error.
This second edition has been revamped and updated to include
studies testing clinical decision support tools in the electronic
medical record, medical student and resident trainee educational
interventions, and an audio-recording based quality improvement
program within the Department of Veterans Affairs. This book is a
must-read for physicians, other health care professionals,
policymakers and administrators, medical students, and medical
educators.
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