Search PubMed⌕ Search

Biomedical subjects

Leonard J Haas

Publications and source records attributed to Leonard J Haas.

7 recordsLinked to original sources
PubMed2006

Improving the effectiveness of the medical visit: a brief visit-structuring workshop changes patients' perceptions of primary care visits.

OBJECTIVE: To teach visit-structuring strategies to primary care clinicians with a 1.5-h experiential workshop and assess its effect on patient perceptions of their medical visits. METHODS: We developed and conducted a 90 min workshop for 75 clinicians from seven primary care clinics, and evaluated the effectiveness of the workshop by assessing changes in patients' ratings of visit qualities from 1 week prior (n=301) to 1 week after (n=322) the workshop. Patients rated their physicians' visit-structuring skills as well as satisfaction with their medical visits. RESULTS: Patients were highly satisfied with their visits both before and after the workshop. Post-workshop ratings of medical visits were more likely to indicate that all problems were addressed during the visit. CONCLUSIONS: A brief workshop had a positive measurable effect on patients' perception of their medical visits. Future research should address the utility of patient rated assessments of visit characteristics. PRACTICE IMPLICATIONS: Physicians' ability to establish and maintain a productive structure in primary care office visit is an important skill that can improve the quality of care, and some changes in physician visit-structuring behavior can be measured using patient perceptions.

Adolescent↗
PubMed2005

Management of the difficult patient.

All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders, personality disorders, and subclinical behavior traits. Physician factors include overwork, poor communication skills, low level of experience, and discomfort with uncertainty. Health care system factors include productivity pressures, changes in health care financing, fragmentation of visits, and the availability of outside information sources that challenge the physician's authority. Patients should be assessed carefully for untreated psychopathology. Physicians should seek professional care or support from peers. Specific communication techniques and greater patient involvement in the process of care may enhance the relationship.

Communication↗
PubMed1991

Hide-and-seek or show-and-tell? Emerging issues of informed consent.

This article reviews key philosophical and legal underpinnings of mental health professionals' obligation to obtain informed consent from consumers of their services. The basic components of informed consent are described, and strategies for clinically and ethically appropriate methods of obtaining informed consent are discussed. Emerging issues in informed consent involving duty to assess and protect against client dangerousness, obligations to third parties, and issues of deception are considered as well. The article proposes that part of the process of obtaining informed consent is the cultivation of a treatment environment that emphasizes beneficence and client autonomy.

Altruism↗
PubMedDate not supplied

Changing family physicians' visit structuring behavior: a pilot study.

OBJECTIVE: This study assessed the degree to which family physicians elicit patients' agendas and negotiate the agenda of the medical visit, related this behavior to late-arising patient concerns and satisfaction with the visit, and assessed the degree to which visit-structuring behavior can be modified by a brief workshop. METHODS: We reviewed 65 audiotaped clinic visits conducted by three experienced family physicians before (36 visits) and after (29 visits) a workshop on structuring outpatient visits. We also collected patient and physician satisfaction ratings through post-visit questionnaires. RESULTS: Patient concerns were explicitly elicited in 64% of pre-workshop visits and 90% of post-workshop visits. Significant increases occurred in agenda setting (14% of pre-workshop visits, 52% of post-workshop visits), agenda negotiating (0% of pre-workshop visits, 38% of post-workshop visits), and physician satisfaction with visits. CONCLUSIONS: A brief continuing medical education intervention improved family physicians' visit structuring.

Adult↗