So much to do, so little time - Care for the socially disadvantaged and the 15-minute visit

被引:136
作者
Fiscella, Kevin [1 ,2 ]
Epstein, Ronald M. [1 ,3 ]
机构
[1] Univ Rochester, Sch Med & Dent, Dept Family Med, Div Oncol,James P Wilmot Canc Ctr, Rochester, NY 14620 USA
[2] Univ Rochester, Sch Med & Dent, Dept Community & Prevent Med, Rochester, NY 14620 USA
[3] Univ Rochester, Sch Med & Dent, Dept Psychiat, Rochester, NY 14620 USA
关键词
D O I
10.1001/archinte.168.17.1843
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
There is so much to do in primary care, and so little time to do it. During 15-minute visits, physicians are expected to form partnerships with patients and their families, address complex acute and chronic biomedical and psychosocial problems, provide preventive care, coordinate care with specialists, and ensure informed decision making that respects patients' needs and preferences. This is a challenging task during straightforward visits, and it is nearly impossible when caring for socially disadvantaged patients with complex biomedical and psychosocial problems and multiple barriers to care. Consider the following scenario.
引用
收藏
页码:1843 / 1852
页数:10
相关论文
共 182 条
[1]  
ADAY LA, 1993, RISK AM HLTH HLTH CA
[2]   Mental and substance use disorders among medicaid recipients: Prevalence estimates from two national surveys [J].
Adelmann, PK .
ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH, 2003, 31 (02) :111-129
[3]   Benefits of telephone care over primary care for smoking cessation - A randomized trial [J].
An, LC ;
Zhu, SH ;
Nelson, DB ;
Arikian, NJ ;
Nugent, S ;
Partin, MR ;
Joseph, AM .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (05) :536-542
[4]  
[Anonymous], 1979, JAMA
[5]  
[Anonymous], 2001, ENV NAT HLTH CAR QUA
[6]   Adoption of patient-centered care practices by physicians - Results from a national survey [J].
Audet, AM ;
Davis, K ;
Schoenbaum, SC .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (07) :754-759
[7]   Primary care physicians who treat blacks and whites [J].
Bach, PB ;
Pham, HH ;
Schrag, D ;
Tate, RC ;
Hargraves, JL .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (06) :575-584
[8]  
Bajekal M, 2001, BRIT J GEN PRACT, V51, P451
[9]   Health literacy and mortality among elderly persons [J].
Baker, David W. ;
Wolf, Michael S. ;
Feinglass, Joseph ;
Thompson, Jason A. ;
Gazmararian, Julie A. ;
Huang, Jenny .
ARCHIVES OF INTERNAL MEDICINE, 2007, 167 (14) :1503-1509
[10]  
Batalden P B, 1997, Qual Manag Health Care, V5, P41