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- Page navigation anchor for The Importance of ContextThe Importance of ContextShow More
I very much appreciate the comments of Reis, Scott, and Shapiro. All three point to the importance of "context" when making clinical decisions. In my view, it takes a long time- longer than a residency, certainly- to get really comfortable with this notion. Indeed, it takes courage to make decisions that don't jive with the latest evidence-based guidelines. Will the patient's family sue me if he or she dies? What will my...
Competing Interests: None declared. - Page navigation anchor for Narrative Based MedicineNarrative Based MedicineShow More
I just went to my Family Doc this week realizing I haven't checked my elevated cholesterol for a few years. I excused myself previously that in a few weeks, when I took a few more pounds off will be the right moment, which never came. And she is not Sally but Miriam and 93 years old and it is not COPD but …and mind you, I live and practice 10000 miles away and in a different language. In the real world of care, most of the...
Competing Interests: None declared. - Page navigation anchor for Chronic Illness Management in the Real WorldChronic Illness Management in the Real WorldShow More
I want Dr. Gianakos to be my doctor! His essay illustrates the doctor-patient relationship at its best. This experienced physician does not need to maintain “emotional distance” and he is not afraid to expose his own human failings to his patient, yet in no way does he compromise his professionalism. He respects Sally’s unique perspective about the management of her asthma, even though he would like her to do things...
Competing Interests: None declared. - Page navigation anchor for Weighty MattersWeighty MattersShow More
Stories like Dean Gianakos' "Pounds make me smile, because they reassure me that someone, somewhere, is still practicing family medicine the way I conceive it is meant to be practiced - with awareness and reflexivity, humility, compassion, negotiation, compromise, and humor. The tale of Sally, her asthma, and her self-reliant pride is grounded in the detailed personal knowledge her doctor has of her life, values, persona...
Competing Interests: None declared.