PubMed · 15980737
Deal effectively with disciplinary action through a four-step process.
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John Olmstead. 2005. Four steps toward easing disciplinary actions.. https://doi.org/10.1097/00006247-200506000-00018
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This paper looks at aspects of doctor-patient communication and focuses on how prescribing decisions fit into the consultation within the context of the use (and non-use) of a technological clinical decision support system (CDSS) in the UK. Analysis of 6 simulated consultations filmed as part of the evaluation of a CDSS system indicated that the general practitioners (GPs) used their computers for a short time during consultations. The data showed that doctors' utterances, occurring at an early stage of the consultations, signalled the prescribing decision and eventual outcome of the consultation. The concept of 'verbal prescriptions' is used to describe these utterances of the GPs, and facilitates an understanding of how prescribing decisions are routinely achieved. Prescribing decisions can occur in the relatively early stages of the consultation, and both prior to and independently of the CDSS. Consequently, we suggest that the pattern of GP decision-making needs to be taken into account in CDSS design. However, this is not just an issue for CDSS design and implementation, as the verbal prescription phenomenon may impact upon patient involvement in decision-making, and even the appropriate use of evidence based medicine.
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This article explores the meanings associated with the motto used in a World No-Tobacco Day campaign to stimulate a discussion of the principal underlying messages in the field of health education in Brazil. The study focuses on the concept of vulnerability to contextualize and explore its interfaces with education in order to highlight the theoretical, practical, and political productivity of the link between health education and studies on vulnerability. In conclusion, the necessary renewal of health practices in general and health education practices in particular can benefit tremendously from the vulnerability reference, to the extent that it demarcates a new horizon for situating and linking risks, "causalities", and "determinations", drawing health--as well as the possibility of illness--into the field of real life, into the world of inter-subjective relations, where these processes gain unique meanings.