Examining Critical Health Policy Issues within and beyond the Clinical Encounter: Patient-Provider Relationships and Help-seeking Behaviors

Abstract

Among notable issues in health care policy and practice over the past 50 years have been those centered on the changing dynamics in clinical encounters, predominantly the relationship between physicians and patients and access to health care. Patient roles have become more active, diverse, long-term, and risk-based, while patient-provider relationships are multifaceted, less paternalistic, and more pivotal to health outcomes. Extensive literatures on help-seeking show how much social influences affect both undertreatment and inappropriate high utilization of health care. The challenge in trying to contain the growth of health care costs is two-fold: developing better ways of defining need for care and promoting better access for those who could benefit most from health care. Both of these strategies need to be considered in the context of addressing racial, ethnic, socioeconomic, and health status disparities. Rebuilding the primary care sector as a sociologically informed strategy and a key component of health care reform may optimize both health care delivery and patient outcomes.

The patient is in: patient involvement strategies for diagnostic error mitigation

“…Consistent with the trend of patients being more proactive and involved in their own healthcare,30 becoming a more knowledgeable consumer may reduce the risk of diagnostic error 31. Patients may become more informed through second opinions or the internet, but the vastness of the internet also poses a risk for information overload, contradictory information, misinformation from unreliable/unverified sources, or misuse of the information to self-diagnose instead of seeking professional help.…”

Strategies for Reducing Potentially Avoidable Hospitalizations for Ambulatory Care-Sensitive Conditions

“…Previous studies have explored help-seeking behavior by focusing on issues based on sex of the patient, 28 ethnicity, 29 or the physician-patient relationship. 30 Delayed help seeking Identification of patients at high risk for hospitalization for ACSCs by complementing predictive modeling with assessment of patients' social situation, medication adherence, and self-management capabilities Regular medication review (what medication is taken and how? ), easy-to-read medication schedules, and shared treatment plan among patients, caregivers, and physicians to improve adherence Regular (telephone-) monitoring of symptoms and treatment adherence in highrisk patients Self-management training of patients and caregivers (eg, should enable them to manage acute deterioration or to seek timely help of primary care resources) Identification of existing social support systems (eg, family, friends, neighbors) and community resources Health technology systems (eg, recall system for monitoring, updated links to community resources and ambulatory services, shared medical records between primary care practices and hospitals/after-hours care) Enhanced communication between physicians across sectors (eg, treating physicians and external physicians in after-hours care, admission and discharge management, easy access to colleagues to ask for advice in case of diagnostic uncertainty)…”

“It Is Like That, We Didn't Understand Each Other”: Exploring the Influence of Patient-Provider Interactions on Prevention of Mother-To-Child Transmission of HIV Service Use in Rural Tanzania

“…Interactions between health care providers and their patients are widely recognised to play an important role in determining the uptake of health services [1]. The providers' role in influencing medication adherence, health-seeking behaviour, and satisfaction with health services has been documented [2], [3], with studies on patient-provider interactions focussed predominantly on the developed world primary care setting and treatment of chronic conditions such as cancer [4].…”