Sequencing: The patient caseload as an interactive system.

Abstract

The patient caseload is an interactional system. As providers we not only have an effect on our patients, but also are affected by them, and through us they have an effect on each other. The authors use personal experience and observation to explore the interactive nature of primary care.

Teaching housekeeping: Learning to manage the emotional impact of patient care.

“…Even with strong efforts to be professional, it is quite likely that doctors may carry with them the reactions they have from one patient into the exam room of the next or later patients. Seaburn and Harp (1988) described it this way:…”

“…A facilitated discussion completes the conference. In response to Seaburn and Harp's (1988) description, MegaClinic is designed to help the physician develop better punctuation skills. That is, in what ways can physicians better manage the inevitable emotional im-pact of the drama of patients' lives on themselves and on their work?…”

“…Seaburn and Harp (1988) described it this way: With each patient, one considers a variety of systemic approaches then intervenes and punctuates the encounter with some form of closure. One then moves on to the next patient.…”

A social constructionist approach to family medicine.

“…Surgeries are systems created jointly by practice members and by patients (9). Some of the typical features of surgery systems are shown in Tables 1 and 2, which analyze the two surgeries recorded in this study.…”