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
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共 182 条
[11]   Can patient-centered attitudes reduce racial and ethnic disparities in care? [J].
Beach, Mary Catherine ;
Rosner, Mary ;
Cooper, Lisa A. ;
Duggan, Patrick S. ;
Shatzer, John .
ACADEMIC MEDICINE, 2007, 82 (02) :193-198
[12]   Developing a quality measure for clinical inertia in diabetes care [J].
Berlowitz, DR ;
Ash, AS ;
Glickman, M ;
Friedman, RH ;
Pogach, LM ;
Nelson, AL ;
Wong, AT .
HEALTH SERVICES RESEARCH, 2005, 40 (06) :1836-1853
[13]   Hypertension in multicultural and minority populations: Linkin communication to compliance [J].
Betancourt J.R. ;
Carrillo J.E. ;
Green A.R. .
Current Hypertension Reports, 1999, 1 (6) :482-488
[14]   Becoming a physician: Cultural competence - Marginal or mainstream movement? [J].
Betancourt, JR .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (10) :953-955
[15]  
Bierman A S, 2001, Health Serv Res, V36, P90
[16]   Addressing the unique challenges of inner-city practice:: a direct observation study of inner-city, rural, and suburban family practices [J].
Blankfield, RP ;
Goodwin, M ;
Jaén, CR ;
Stange, KC .
JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE, 2002, 79 (02) :173-185
[17]  
Blumenthal D, 1999, J FAM PRACTICE, V48, P264
[18]   Who is accountable for racial equity in health care? [J].
Blustein, Jan .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2008, 299 (07) :814-816
[19]   Patient self-management of chronic disease in primary care [J].
Bodenheimer, T ;
Lorig, K ;
Holman, H ;
Grumbach, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (19) :2469-2475
[20]   The teamlet model of primary care [J].
Bodenheimer, Tbomas ;
Laing, Brian Yoshio .
ANNALS OF FAMILY MEDICINE, 2007, 5 (05) :457-461