This article describes a simple in-class exercise in reading and writing that, by asking participants to write their own endings for a short narrative taken from the "Journal of the American Medical Association," prompts them to reflect on the problem of uncertainty in medicine and to apply the literary-critical techniques of close…

Introduction: The College of Physicians and Surgeons of Ontario, the regulatory authority for physicians in Ontario, Canada, conducts peer assessments of physicians' practices as part of a broad quality assurance program. Outcomes are summarized as a single score and there is no differentiation between performance in various aspects of care. In…

Using data from the National Institute of Mental Health Treatment for Depression Collaborative Research Program, the authors examined the impact on treatment outcome of the patient's perception of the quality of the therapeutic relationship and contribution to the therapeutic alliance. Shared variance with early clinical improvement was removed…

Context: In studying physician shortage issues, few studies have utilized individual interviews, allowing rural physicians to voice their own stories. Purpose: To explore rural physicians' unique characteristics affecting their decisions and satisfactions with practice in a rural area. Methods: A qualitative interview study with 11 Nebraska family…

The goal of this study was to produce an improved medical consent form. This form was designed to record the informed consent discussion between doctor and patient which should include an explanation of what procedure will be performed, by whom, why, the risks, and the alternatives. Patients, doctors, and hospitals may all benefit from the use of…

Examined relationship betwen attitude toward death and the terminal patient and communication with terminally ill in 103 medical students and 15 family physicians. Relationships were found between indices (Terminal Illness Questionnaire, Threat Index) and factors used in determining whether to reveal a terminal diagnosis. (Author/NRB)

Experimentally tests hypothesized biases influencing physicians' handling of child abuse cases, using a two-by-two factorial design in which patient socioeconomic status (lower versus upper-middle) and familiarity (new versus established-patient) were manipulated independently.(RH)

Introduces this special issue of the journal and highlights the contents, which focus mainly on text and talk in the context of healthcare and medicine. (Author/VWL)

Comments on the changing dynamics in work practices. Argues that such changes are not new but have become more visible due to the increased access by outsiders, such as researchers and the media to the increase in litigation claims that exert additional pressure on practitioners. (Author/VWL)

After a brief discussion of legal perspectives on informed consent, the present review examines the developmental literature on children and adolescents' capacities to make medical decisions that are informed, voluntary, and rational. The purposes and benefits of assent are identified. Remaining questions of how to evaluate capacity and balance…

Few researchers have studied how lesbians choose health and mental health care providers. This article reports on community focus groups in which 33 lesbians reported that decision making was based on their past experiences and their hopes for high quality care. They encountered a continuum of provider reactions consisting of five categories:…

Analysis of doctors' and patients' oral accounts and responses during medical interactions, from the perspective of an interactional strategy linking social structure to social interaction, demonstrates how the medical interview is characterized by a moment-to-moment battle that mirrors and largely sustains the institutional authority and status…

Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)

Presents, side by side, sections of the first author's (a psychotherapist) journal writing during and after her treatment for cancer, and the second author's (a medical doctor) "commentary" thoughts about her words and what they say about the subjective experience of life-challenging illness. Presents this as one way to humanize the encounter…

An old man, who experiences himself as deeply misunderstood by the medical profession, is interviewed. Analysis shows that doctors involved related, not to the patient, but to a biomedical image of him. His efforts to communicate were converted into instrumentally manageable disorders. Dialog medicine, a counseling model, is introduced.…