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DiscussionReflections

Physical Distancing With Social Connectedness

David Bergman, Christina Bethell, Narangerel Gombojav, Sandra Hassink and Kurt C. Stange
The Annals of Family Medicine May 2020, 18 (3) 272-277; DOI: https://doi.org/10.1370/afm.2538
David Bergman
1Stanford University, Stanford, California
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Christina Bethell
2Johns Hopkins University, Baltimore, Maryland
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Narangerel Gombojav
2Johns Hopkins University, Baltimore, Maryland
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Sandra Hassink
3Nemours Children’s Health System, Wilmington, Delaware
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Kurt C. Stange
4Case Western Reserve University, Cleveland, Ohio
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  • For correspondence: kcs@case.edu
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Abstract

In light of concerns over the potential detrimental effects of declining care continuity, and the need for connection between patients and health care providers, our multidisciplinary group considered the possible ways that relationships might be developed in different kinds of health care encounters.

We were surprised to discover many avenues to invest in relationships, even in non-continuity consultations, and how meaningful human connections might be developed even in telehealth visits. Opportunities range from the quality of attention or the structure of the time during the visit, to supporting relationship development in how care is organized at the local or system level and in the use of digital encounters. These ways of investing in relationships can exhibit different manifestations and emphases during different kinds of visits, but most are available during all kinds of encounters.

Recognizing and supporting the many ways of investing in relationships has great potential to create a positive sea change in a health care system that currently feels fragmented and depersonalized to both patients and health care clinicians.

The current COVID-19 pandemic is full of opportunity to use remote communication to develop healing human relationships. What we need in a pandemic is not social distancing, but physical distancing with social connectedness.

Key words
  • primary care issues
  • continuity of care
  • primary care issues
  • clinician-patient communication/relationship
  • relationship-centered care
  • telehealth
  • telemedicine
  • investing in relationship
  • COVID-19
  • Received for publication November 22, 2019.
  • Revision received March 22, 2020.
  • Accepted for publication March 24, 2020.
  • © 2020 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 18 (3)
The Annals of Family Medicine
Vol. 18, Issue 3
May/June 2020
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Physical Distancing With Social Connectedness
David Bergman, Christina Bethell, Narangerel Gombojav, Sandra Hassink, Kurt C. Stange
The Annals of Family Medicine May 2020, 18 (3) 272-277; DOI: 10.1370/afm.2538

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Physical Distancing With Social Connectedness
David Bergman, Christina Bethell, Narangerel Gombojav, Sandra Hassink, Kurt C. Stange
The Annals of Family Medicine May 2020, 18 (3) 272-277; DOI: 10.1370/afm.2538
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  • Article
    • Abstract
    • CHALLENGING THE CONTINUITY TENET
    • A THOUGHT EXPERIMENT
    • SURPRISES
    • LOOKING BELOW THE SURFACE
    • NO EXCUSE
    • COVID-19: A NEW OPPORTUNITY TO REINVENT INVESTMENT IN RELATIONSHIP
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Subjects

  • Core values of primary care:
    • Continuity
    • Personalized care
    • Relationship
  • Other topics:
    • Health informatics
    • COVID-19
    • Communication / decision making

Keywords

  • primary care issues
  • continuity of care
  • clinician-patient communication/relationship
  • relationship-centered care
  • telehealth
  • telemedicine
  • investing in relationship
  • COVID-19

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