Good Physician Research Articles

Segmented assimilation trajectories of physician trust among internal migrants in Shanghai, China: A cross-sectional study

Physician trust is necessary for improving physician–patient relationships and maintaining an effective health-care system. Most studies on the theory of segmentation assimilation have mainly focused on comparing immigrants in different countries and few studies have applied segmented assimilation to clarify physician–patient relationships, especially physician trust among internal migrants in the context of Chinese megacities. A random sample of 1200 internal migrants was collected through an online questionnaire conducted in Shanghai from August to December 2021. An exploratory K-means cluster analysis and multivariate logistic regression models were employed to identify patterns of segmented assimilation and examine their relationships with physician trust, as well as the factors influencing physician trust among internal migrants in Shanghai. Results show four main patterns were revealed, namely first-generation classic assimilation, first-generation integrative assimilation, first-generation segmentation, and second-generation underclass assimilation, supporting the theory of segmented assimilation. Association between assimilation pattern and physician trust was observed. A relationship was found between assimilation patterns and trust in physicians. Migrants belonging to the first-generation classic and integrative assimilation groups exhibited a higher level of trust in doctors compared to those in the segmented assimilation groups. Additionally, undergraduate and postgraduate education attainment, an annual income of <400 000 yuan, visiting the physician ≥2 times in the past year, and self-rated health status before and after population floating were significant contributing factors for good physician trust. The government can implement corresponding measures to maintain physician trust, improve cultural adaptability instead of only at the economic level among internal migrants, achieving the facilitation of their understanding of the health system and health service utilization to increase physician trust.

Which social accountability competencies make a good physician? A qualitative investigation of the patient perspective on social accountability

Objective Social accountability is an emerging theme in health care education. In previous literature, the perspectives of patients regarding the competencies that they think are required for physicians to demonstrate in this domain are scarce. This study aims to get insight into the competencies in the domain of social accountability that, according to patients, should be demonstrated by physicians. Methods Online semi-structured interviews with 18 patients in the Netherlands were conducted as part of an exploratory qualitative study. Snowballing and convenience sampling techniques were used to recruit participants. The grounded theory method was used to qualitatively analyze the interviews. Results and conclusion Patients identified five competencies of a physician in the domain of social accountability: (1) Taking patient’s characteristics into account and tailoring care to the individual patient, (2) Taking the broader community into account, (3) Balancing between care for the individual patient versus concern for society, (4) Providing guidance to patients in the navigation within the health system, and (5) Taking climate impact into account. Patients stated that the importance of these competencies are dependent on the specialism. Practice implications The formulated competencies can be used to better align medical education focussing on social accountability to the expectations of patients.

Dark triad traits, study and power motives among medical students–A cross-sectional study at a German medical faculty

BackgroundA good physician should be empathic and altruistic, among other qualities. Therefore, the levels of socially undesirable personality traits (Dark Triad) as well as implicit motives of achievement, affiliation and power (Multi-Motive Grid) among medical students as future physicians were analyzed at two different points in their medical training. MethodsThis study includes 380 medical students in their first year and 217 in their third year in Germany. All participants completed the Dirty Dozen (DD) and Multi-Motive Grid (MMG) questionnaires at the end of two different classes as paper-and-pencil tests. Relevant differences of the Dark Triad traits between the medical students and reference sample and the two different cohorts, as well as their implicit motives, the associations of Dark Triad traits and MMG components and gender differences of the Dark Triad traits were calculated. ResultsThere were no significant group differences between year one and year three medical students in narcissism, psychopathy and Machiavellianism (Dark Triad). There were no significant differences between the medical students and reference sample except in psychopathy. Male students scored significantly higher in the Dark Triad traits than female students. In the MMG, first-year students scored significantly higher levels in Fear of Rejection, and lower levels in Hope of Success and Hope of Power than the third-year students. Some associations were found between narcissism and Machiavelliansim with Hope of Success, Hope of Power and Fear of power. ConclusionsDark Triad traits already appear to exist before the commencement of medical studies. These traits do not differ significantly between the medical students and reference sample; only a few MMG components seem to differ at different stages of their studies. This lack of differences between the medical students and validation cohort indicates that tests based on (undesirable) personality traits are not suitable criteria for the admission selection of medical students.

The Physician in Flight: The Moral and Legal Responsibilities of Physicians When Present for In-Flight Medical Emergencies

A physician boards the plane and sits down. Does that physician face risk beyond a plane crash? If there is a medical emergency in-flight, does the physician face moral/ethical/legal risk by acts of commission or omission in relation to the medical emergency? That may depend on whether the flight is within the United States or is an international flight. This uncertainty prompts the question: Do we need broader coverage for physicians in-flight and would legislation similar to the on-the-ground Good Samaritan law protect physicians who are passengers on a plane?

Perception of good physicians in patient’s face-to-face consultations: Evidence from a Chinese platform

Abstract Objective: This article aimed to offer insights into patients’ expectations regarding the traits of physicians, with the goal of helping physicians gain a better understanding of patient needs and provide better care. Method: This study used a Python crawler script to collect patients’ comments from haodf.com, a major online consultation platform in China, to examine the expected character traits of physicians by patients. A total of 83,315 comments were obtained. We selected positive comments from patients, performed text segmentation using Jieba, and utilized the TextRank algorithm to identify high-ranking words based on the Index of Relative Importance (IRI) within these comments. To make the findings comprehensible and practical for physicians and medical educators, we utilized a word cloud to visualize the results. We classified the high-ranking words into 4 dimensions—professional competence, communication attitude, communication ability, and character traits—based on the categorization of positive physician qualities found in the relevant literature. Results: Key findings from the study included: (1) The top 23 high-ranking words for traits of good physicians (in descending order) were patient, meticulous, proficient, precise, kind, moderate, successful, gentle, rigorous, explicit, clear, effective, humorous, sincere, skilled, kindhearted, modest, awesome, practical (and not flashy), unhurried, experienced, clean, and excellent; (2) patients placed the highest value on the professional competence of physicians, followed by their communication attitude, communication ability, and character traits; (3) despite the highest IRI score for professional competence, it was exceeded by the combined scores of communication attitude and communication ability. This underscored the significance of effective communication in medical encounters. Conclusions: Drawing from these findings, recommendations are proposed for physicians and medical educators to enhance the quality of medical encounters. These suggestions include implementing narrative medicine training to improve communication awareness and skills as well as encouraging lifelong continuing medical education to maintain professional competence among practitioners. This study contributes to the establishment of positive physician-patient relationships in both telemedicine and face-to-face medical interactions.

The effects of physicien attire on consultation outcomes in primary health care, National Guard, Riyadh

Introduction A good Physician- patient relationship is the core of a successful primary health care. It is characterized by a two way interactions between the physician and the patient, where the patient is involved in the decision making(1) . The relationship between the physician and the patient can interfere significantly with the treatment adherence(2) . So it is necessary for the physician to work on building and preserving a good relationship from the first moment. The first impression is important to optimize healthcare outcomes(3) . Physician appearances, gender, nationality, age, speech and posture were found to affect patient’s first impression(3) . Also, it is found that once the first impression been developed, it will remain unchanged – most of the times- (3) . Gender preferences found to increase patient satisfaction in some settings(4) . For the intimate, and psychosocial issues, it is found to be preferred to have a physician of the same gender as a patient (4) . For the age preference, some studies found that patients preferred the physician to be between 30- 50 years (5) . Physician appearances is also an important factor affecting patient perception of the care provided (1)

Visual Intelligence Education as a Tool for Enhancing Medical Students' Self-Perception of Communication Skills.

Visual arts-based exposure and training are effective tools to enhance medical education. The visual arts can increase emotional intelligence and critical thinking skills. This study, conducted at Georgetown University School of Medicine (GUSoM) and the National Gallery of Art (NGA) in Washington, DC, was designed to measure the effect of a visual arts elective course on medical students' self-perception of their communication skills. This 6-week course involved lessons at the NGA and GUSoM for16 second-year medical students. The intervention students were age and gender-matched to14 second-year medical student control participants who took different elective courses. Prior to and following the intervention, the participants completed the Communication Skills Attitude Scale (CSAS). Statistical analysis was performed with either the 2-sided t-test or 2-sided Wilcoxon rank-sum test. There were no statistically significant differences in the presurvey scores between the groups. However, there were 6 CSAS questions in the postsurveys that had statistically significant differences between the 2 groups. Within each group, there were also numerous statistically significant differences between their presurvey and postsurvey responses, with positive changes occurring in the intervention group (IG) and primarily negative changes occurring in the control group (CG). The NGA course improved the self-perception of communication skills, with students reporting stronger views on the importance of communication skills in teamwork and patient rapport. The CG, on the other hand, did not have as many improved perceptions of communication skills and had stronger opinions regarding not needing the ability to communicate well to be a good physician. This study indicates that medical student communication skills can benefit from exposure to visual arts activities and experiences. Future physicians must become effective communicators, and this study paves the way for research investigating the relationship between visual arts education and the development of a physician's communication skills.

Why Medical Error is Killing You (And Everyone Else)

In 2000, the infamous report To Err is Human rocked society with its focus on the pervasive danger of medical error. More than two decades later, medical error rates remain high and pose a consistent danger to patients. Today, medical error ranks as the fourth leading cause of death behind heart disease, cancer, and COVID-19. Medical error reflects the vulnerabilities of the healthcare process and may be diagnostic in nature. A large concern in responding to medical error is an overemphasis on blame and the idea that good physicians do not make mistakes. Our perspective on how to address medical error is flawed. The successful reduction of error will require rethinking how we respond to error and creating a culture of openness and transparency. Changing how we address error benefits all patients but is particularly important for racial and ethnic minorities, women, and the LGBTQ+ population, whose healthcare needs have historically been overlooked. This Article reviews what we know about medical error and the disproportionate effects of harm it can cause. I consider issues leading to the persistence of medical error and emphasize the need to improve patient safety, address harm to vulnerable communities, and decrease medical malpractice litigation. Successfully addressing error requires a multi-pronged approach that embraces different disciplines. First, the healthcare industry should emphasize restorative justice strategies and institute legal safeguards, such as increased protections for apologies and information disclosure from healthcare institutions. Second, communication theory and high reliability organizations offer model methodologies to both address and prevent harm from medical error. Third, error response should shift away from a culture of blame and instead emphasize developing a Just Culture that encourages the acceptance of responsibility under collective accountability. Finally, the healthcare field should work to be more patient focused, with patients at the center of care and decision-making. Medical error presents a real and deep concern for patients and their families. Reducing the widespread effects of medical error will require a multidisciplinary approach extending to fields far beyond medicine, and even the law, to see real change.

A Crucial Study on Dead Body Preservation

Abstract: A medical student who never stepped in the cadaveric laboratory on his institute during the first year can neither be a good physician or surgeon in his medical career .so dissection plays a very important role in learning anatomy completely. Anatomy is the branch of medicine where study of structures of human body is done at the level of first year of academic course of every medical profession. For learning anatomy there must be a dead body for better knowledge and study. Dissection is a long-lasting procedure which is carried out in every medical teaching institute This process of preservation of human dead body is called embalming

Sanat Temelli Özel Çalışma Modülü: Tıp Öğrencilerinin Görsel Düşünme ve İletişim Becerilerinin Geliştirilmesi

Aim: Visual arts have been incorporated into medical education in different ways. The arts have been successfull in enhancing tolerance for ambiguity, fostering, empathy, and holistic views of medical students of all levels. Physical examination is a fundamental part of clinical diagnosis. A proper observation can provide critical information for the diagnostic evaluation and accuracy of treatment. The Special Study Module (SSM) is an educational method in which students are given the opportunity to study, research, and have experience in their own areas of interest. This training method places emphasis on changing students' attitudes towards self-learning techniques and other skills such as teamwork, problem solving, observation, communication, and presentation. In this study, we aimed to investigate the relationship between art and the skills to be a good physician, such as the development of observational skills in medical education. Methods: This is a survey-based prospective study. Second-year medical students enrolled in the "Medicine and Art History" Special Study Module (SSM), were included in the study. Demographic data was collected. Before and after the SSM period (24 weeks), students completed a survey on the impact of art on medical education. Groningen Reflection Ability Scale (GRAS) and Communication Skills Attitude Scale (CSAS) were administered. Data were analyzed using the statistical program SPSS v.22. Results: While the total GRAS score was 75 before the SSM, it increased to 79 after the SSM. The rate of students who completely agreed with the statement "I must have good communication skills to be a good doctor" was 50% before the SSM, and it increased to 80% after the SSM. Before the SSM, 80% of the students stated that they did not use art regularly to learn medical concepts, 20% stated that they were undecided. After the SSM, 60% of the students stated that they would use art regularly to learn medical concepts. Conclusions: In conclusion, the results of this innovative study are encouraging. All students considered art to be a valuable tool to learn medicine. Art-based medical education contributed significantly to students' communication skills, and observation skills when the pre- and post-module surveys were compared. Reflection ability and observational skills are essential in providing professional collaboration and working in a team. We believe that art can help medical students to become better clinical observers and improve personal and professional development as well as to be an empathetic person.

Learning and assessment strategies to develop specific and transversal competencies for a humanized medical education.

Introduction: Medical education should promote the development of skills and abilities that can be applied to real-world work performance. The aim of this study is to evaluate technical and methodological knowledge, as well as physician-patient communication skills, as one of the most important transversal competencies that a good physician should acquire; all this in a reliable, accurate and objective way. Methods: We present a rubric specifically designed and implemented for the evaluation of specific and transversal competencies in the physiology practical sessions, during the second year of the medical degree. The assessment consists in two evaluation tests: 1) a theoretical test that consists of multiple-choice questions. Students must demonstrate that they have acquired adequate theoretical knowledge (specific competency "to know"); 2) a practical test, in which students are evaluated by the rubric through the simulation of a medical consultation. Thus, demonstrating their ability to execute/apply what they have learned in class (specific competency "to know how to do"). They are also evaluated on the transversal competencies that we call "communication with the patient" (transversal competency "to know how to be there") and "dealing with the patient" (transversal competency "to know how to be"). Results: We evaluated whether there were differences in the grades obtained by students when the transversal competencies were not assessed (academic years 2017-2018 and 2018-2019; n = 289), and when the transversal competencies were assessed by applying the rubric in the academic years 2019-2020, 2021-2022, and 2022-2023 (n = 526). Furthermore, we present a student perception that supports the use of clinical simulation and our rubric as a good method within the competency learning process. Discussion: The acquisition of these competencies, starting from the first courses of undergraduate education, helps to raise the students' awareness in the development of a more humanized medicine, allowing a better response to the patients' needs. Our rubric, which clearly indicate the performance criteria, have become an excellent method to carry out the assessment of competencies, both for students and teachers, since they allow to obtain clear evidence of the level of acquisition and application of knowledge.

Self-governance from the perspective of the chamber of physicians

The self-government of physicians in Germany is an enormous privilege for the profession. The core tasks of medical associations are the design of the professional framework, specialist and continuing education, and quality assurance. A look at history reveals important developments within the profession and its changing relationships with politics and also the different systems of government and constantly changing professional policy orientations, which are continuously changing and must be permanently shaped by the medical profession. In particular, the relationship to health insurance companies, to the economy, and to politics should be mentioned here. What is new, on the other hand, are the changing expectations in the medical profession, the shortage of skilled workers, management and care structures, and new types of ownership, for example, in centers providing medical care. The basic ethical code of physicians-scientific knowledge, experience, personal attitude, and human compassion-continue to be of utmost importance. Taking into account the rapid developments within modern medicine and the increasing expectations of society, additional qualifications that go beyond the historically traditional characteristics of the "good physician" are needed today and in the future. These new demands complement and deepen the relationship between patients, society, and the medical profession. In order to practice personalized medicine, the profession needs to be free from all sociopolitical directives.

What Makes a 5-Star Orthopaedic Sports Medicine Surgeon? An Analysis of Positive Online Patient Reviews.

The increased focus on patient satisfaction has led to growth in the use of physician rating websites. To analyze the factors associated with online 5-star patient reviews for orthopaedic sports medicine surgeons. Cross-sectional study. A total of 70 orthopaedic sports medicine surgeons were randomly selected from the AOSSM website. A search was performed for these surgeons on Yelp.com. All reviews other than 5 stars (of a possible 5 stars) were excluded from the study. Each review was categorized as referring to a surgical or nonsurgical aspect of care, and each comment within the review was categorized as being clinically or nonclinically related. Comments were further subcategorized by specific features such as bedside manner, clinical outcomes, and patient education. Categorical variables were analyzed using the chi-square test. Overall, 400 five-star reviews were included in the study, comprising 1225 total positive comments. Of the 400 five-star reviews, 200 (50%) were from surgically treated patients, and 200 (50%) were from nonsurgically treated patients. Of the 1225 positive comments, 505 (41%) were clinically related, and 720 (59%) were nonclinical. The most common positive clinical comments were for clear treatment plans (191 reviews [48%]), good outcomes (173 reviews [43%]), and providing alternative treatment plans (55 reviews [14%]). The most common positive nonclinical comments were for good physician bedside manner (287 reviews [72%]), friendly/professional staff (194 reviews [49%]), and ease of scheduling (68 reviews [17%]). The majority of 5-star patient reviews left positive comments regarding nonclinical aspects of care such as physician bedside manner and friendly staff. The most common positive comments regarding clinical aspects concerned good outcomes and clear treatment plans. The overall most common positive comment, in both surgically and nonsurgically treated patients, referred to good bedside manner.

Investigating physician leadership competencies in rural and remote areas of the province of Aceh, Indonesia

BackgroundsGlobally, the most rural healthcare systems are lagging behind those of urban healthcare systems. Especially in rural and remote areas, the essential resources to provide principal health services are inadequate....

Assess the Relationship between the Emirates Medical Residency Entry Examination, Grade Point Average, and Multiple Mini Interview Scores and the Resident’s End-of-Year-One Performance in the UAE

Background: Emirates Medical Residency Entry Examination (EMREE), grade point average (GPA), and multiple mini interviews (MMIs) offer a framework for using independent tests to choose medical students for interviewing and employment, finding people who would do well as residents and become good physicians. However, no one indicator can be used to properly predict performance in residency. Purpose: The primary goal of this study was to measure the relationship between the EMREE score, GPA, and MMI and the performance of residents in year 1. Methods: During the months of September 2021 and July 2022, a quantitative, descriptive, and correlational investigation was conducted in the UAE. Convenience sampling of applicants who met the inclusion criteria was used for the purposes of the current study. Results: There were 106 participants in the current study. EMREE and end-of-year-one evaluation had a moderate positive relationship that was significant statistically (r = 0.599**, n = 106, p < 0.05), according to a Pearson correlation. Similar to this, there was a significant relationship (r = 0.665**, p < 0.05) between GPA and the end-of-year-one performance. Likewise, there was a statistically significant (r = 0.996**, p < 0.05) positive association between MMI the end-of-year-one performance. Conclusion: The present study discovered a significant relationship between resident performance and the EMREE at the conclusion of year one. Additionally, the MMI is indeed a helpful tool to help in the selection of medical students and predict future performance. Additionally, the performance of medical students during their first year of residency can be predicted using their GPA, which has a substantial correlation.

A great pediatrician and scholar devoting his whole life to pediatric infectious and digestive diseases—In memoriam of Professor Yongsui Dong

A great pediatrician and scholar devoting his whole life to pediatric infectious and digestive diseases—In memoriam of Professor Yongsui Dong

Cardiovascular Risk Scores: Great Tools... When Used by Good Physicians

“New developments in artificial intelligence may become a very useful future tool for risk stratification, but nowadays a good score combined with modulators, as those shown by Professor Daniel A. Siniawski’s team in his article, are the scientific basis for the management of our patients.”

Is the gender or age of the physician key to a good physician–patient with inflammatory bowel disease relationship?

A good patient–physician relationship in inflammatory bowel disease (IBD) is very important and physician empathy is its cornerstone. There is no evidence about if age and/or sex of physicians and patients could influence on perceived empathy by patients. The aim of the study was to assess the level of empathy of IBD specialist physicians perceived by their patients and if it varies according to the age and gender of the patient and the physician. We performed a national cross-sectional study based on voluntary online survey to IBD patients that included the Consultation and Relational Empathy (CARE) scale. Five hundred sixty one responses to the survey were received. After applying exclusion criteria, 536 patients were included in the analysis. Total median score of CARE scale was 44.5 (maximum possible score: 50 points). Most of the patients (99.1%) considered the contents of the questionnaire to be an important issue. There were no significant differences in CARE scale scores in function of patient/physician age range or gender [physician gender: males vs. females: median 46 vs. 44, p = 0.139; physician age: <40 years, 40–60 years, >60 years: 45.5 vs. 44 vs. 44, p = 0.328]. Spanish inflammatory bowel disease patients have a great physician empathy perception, which is the key to a good patient–physician relationship, and this fact is not influenced by age or gender of patients or inflammatory bowel disease specialist. Una buena relación médico-paciente con enfermedad inflamatoria intestinal (EII) es muy importante y la empatía del médico desempeña un papel clave para conseguirla. No hay evidencia sobre si la edad o el género de médicos y pacientes podría influir en la empatía percibida por los pacientes. El objetivo del estudio es evaluar el nivel de empatía del médico especialista en EII percibida por sus pacientes y si esta varía en función de la edad o el sexo del paciente y el médico. Estudio transversal nacional basado en la realización de encuestas voluntarias telemáticas por pacientes con EII, completando la escala Consultation and Relational Empathy (CARE). Se recibieron 561 respuestas a la encuesta. Tras aplicar los criterios de exclusión, 536 pacientes fueron incluidos en el análisis. La mediana de la puntuación total en la escala CARE fue de 44,5 (puntuación máxima posible 50 puntos). La mayoría de pacientes (99,1%) consideraron los contenidos del cuestionario como aspectos de alto interés. No se encontraron diferencias significativas en la puntuación de la escala CARE en función del rango de edad o el género de pacientes y médicos (género del médico: hombres vs. mujeres: mediana 46 vs. 44, p = 0,139; edad del médico: <40 años, 40-60 años, >60 años: 45.5 vs. 44 vs. 44, p = 0,328). Los pacientes españoles con EII han reportado unos altos niveles de empatía percibida, lo cual es clave para una buena relación médico-paciente, y este factor no está influido por la edad ni el género de los pacientes o el especialista en EII.

Influence of Role Models and Unstructured Relationship on Changes in Medical Student Character, Medical-Specific Empathy, and General Empathy

Purpose: Medical student empathy and character changes are of great interest with clear implications for patient interactions. With much focus on deleterious education culture, this study focuses more on what may bolster empathy and character. Building from interventions highlighting role models, the authors hypothesize the importance of informal relational connections within medical school may promote both modest empathy and character development. Materials and Method: This study uses unique secondary data that follows a cohort of medical students over time, with two surveys about a year apart. The data is unique not only in the inclusion of time, but also in various relational measures and both a medical-specific empathy as well as a general empathy measure. This allows for modeling change in medical student empathy. Results and Conclusion: First, general and medical-specific empathy appear to function different. At baseline, receiving positive character feedback from an attending/resident is positively related to medical empathy while negative feedback is inversely related to medical empathy and burnout is related only to general empathy. Over the next year, being around an admirable physician increased both types of empathy, seeing burnt out specialists increased medical empathy, and a sense of calling generally bolsters empathy. Second, exposure to morally admirable role models is broadly, although modestly, related to character development. It is positively associated with expectations for faculty to teach, shape, and train character, and with an increased sense that bad people may not make good physicians. Finally, exposure to these role models tends to increase one’s sense of calling to the profession. While not dramatic, informal relationships can be an important part of professionalization and may affect general and medical-specific empathy differently, and shift changes in student character.

The capability imperative: Theorizing ableism in medical education

Medical education programs profess commitments to justice, equity, and inclusion, seeking to diversify the profession and better serve patient populations. Although disability has more recently joined recognized categories of valued diversity, significant barriers remain for disabled learners in medicine. This paper develops the concept of the capability imperative, derived from a constructivist grounded theory study examining disability inclusion at four U.S. medical schools that analyzed technical standards policies and interviews with 19 disabled students and 27 school officials (faculty and administrators). Through three motifs (the selfless superhuman; the “real world” of medicine; and the malleable student), the capability imperative enforces the characteristics of a good physician, justifies institutional arrangements, and seeks to produce a learner who can conform to these expectations. Drawing on critical disability theories of ableism and crip theory, the paper argues that the capability imperative represents a context-specific manifestation of ableism that upholds a cultural logic of compulsory hyper-ablebodiedness and mindedness. This logic is antithetical to inclusive goals. Exploration of what constitutes a physician and whom this vision serves may help to shift the professional culture towards justice and unroot disabled peoples’ ongoing marginalization in the medical profession.