An anatomy of conflicts in primary care encounters: a multi-method study

Family Practice
M WeingartenJeffrey M Borkan

Abstract

Medical consultations are replete with conflicts, particularly in the current era of explicit and implicit rationing practices in health care organizations. Although such conflicts may challenge the doctor-patient relationship, little is known about them or their consequences. To systematically describe the nature of doctor-patient conflicts in medical encounters and the strategies physicians use when faced with conflicts. Analysis of 291 videotaped routine encounters with 28 general practitioners, using a novel adaptation of the Roter interaction analysis system software, provided quantitative empirical data on the conflicts and on the communication process. Seven focus groups (56 GPs) provided qualitative insights and guided the analysis. Conflicts were identified in 40% of consultations; 21% of these were related to the rationing of health care resources. In conflictual encounters, both the opening and closing phases of the encounter were shorter than in non-conflictual encounters. In coping with resource rationing, the commonest strategy was to accept the dictates of the system without telling the patients about other options. When conflict of this type occurred, doctors showed more opposition to the patients rather than em...Continue Reading

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Citations

May 3, 2012·The American Journal of Bioethics : AJOB·George F Blackall, Michael J Green
Jan 17, 2012·Family Practice·Alex WalterStephen Harrison
Jul 4, 2012·Social Science & Medicine·Geva GreenfieldNadav Davidovitch
May 31, 2011·Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen·Talya Miron-ShatzGlen M Doniger
Jun 12, 2014·Revista da Associação Médica Brasileira·Carla M Pires, Afonso M Cavaco
Nov 1, 2016·ANS. Advances in Nursing Science·Mary Kate Falkenstrom
Oct 7, 2011·Nursing Ethics·Alice GaudineLinda Thorne

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