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Medical encounters are interactional/interpersonal processes taking place within contexts shaped by macro-level social structures. In the case of sexually transmitted diseases (STDs), medical encounters occur at a stigmatized crossroads of social control and gendered norms of sexual behavior. When women are diagnosed and treated for chronic STDs, practitioner demeanor has an important impact on how patients will view not only their health status but also their moral status. This chapter draws on in depth interviews with 40 women diagnosed with genital infections of herpes and/or human papillomavirus (HPV – the cause of genital warts) to explore three models of patient–practitioner interaction. The analysis focuses on the relationship between gender, construction of illness, and practitioner interaction style. In a broader context, the health risks posed by particular interaction styles to female STD patients shed light on larger public health implications of combining morality with medicine for the broader range of patients with stigmatizing diagnoses.

Managed care organizations use physician incentives to control costs and ensure their financial viability. While the efficacy of incentives may be questioned, substantial challenges exist for physicians who must balance the well-being of their patients and the focus of their professional training with organizational financial concerns. Many physicians experience difficulty in discussing incentive pay with patients (Pearson & Hyams, 2002), even though patients want to know (Pereira & Pearson, 2001) and tend to trust physicians more who are forthright about the issue (Levinson, Kao, Kuby, & Thisted, 2005). Of interest here are patients’ perceptions of the ethicalness of commonly used physician pay incentives. The results of our findings suggest that patients may view these incentives from a different perspective than health policy experts and physician executives. Specifically, our findings indicate that patients perceive incentives based upon patient satisfaction and clinical efficiency more ethically than incentives based upon revenue generation. These views are significantly related to physician visits. We offer suggestions for future research in light of recent pay disclosure regulations.

Patient engagement has been a focus of patient-centered care in recent years, encouraging health care organizations to increase efforts to facilitate a patient's ability to participate in health care. At the same time, a growing body of research has examined the impact that social determinants of health (SDOH) have on patient health outcomes. Additionally, health care equity is increasingly becoming a focus of many organizations as they work to ensure that all patients receive equitable care. These three domains – patient engagement, SDOH, and health care equity – can intersect in the implementation of social needs screenings among health care organizations. We present a case study on a two-phase social needs screening implementation project and describe how this process focuses on equity. As health care organizations seek to increase patient engagement, address SDOH, and improve health equity, we highlight the need to move away from a siloed approach and view these efforts as interrelated. By approaching efforts to address these challenges and barriers as the duty of all those involved in the patient care process, there may be larger strides made toward equitable health care.

This study illustrates that differences across health-related websites, as well as different Internet usage patterns, have significant implications for how individuals view and interact with their health care providers.

We rely on a qualitative study of three health-related websites and an ordinary least squares regression analysis of survey data to explore how websites with different organizational motives frame health-related issues and how variations in Internet usage patterns affect patients’ perceptions of the patient-doctor interaction.

Results reveal differences across three health-related websites and show that both the number and the type of websites patients visit affect their perceptions of physicians’ responses. Specifically, visiting multiple websites decreased perceptions of how well doctors listened to or answered patients’ questions, whereas using nonprofit or government health-related websites increased evaluations of how well doctors listened to and answered questions.

This study suggests that practitioners and scholars should look more closely at how patients use the Internet to understand how it affects doctor-patient interactions. Future research could expand the analysis of website framing or use methods such as in-depth interviewing to more fully understand on-the-ground processes and mechanisms.

This study highlights the importance of fleshing out nuances about what it means to be an Internet-informed patient given that varying patterns of Internet use may affect how patients perceive their physicians.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

The authors have previously validated a design of the health-care supply chain which treats patients as inventory without loss of respect for the patients. This work continues examination of patients as inventory while addressing the dual objectives of reducing redundancy in services and creating greater efficiency in the health-care supply chain. Historical data is used to forecast health care needs in light of the increasingly specialized health-care professionals, which have resulted in much more flexible and expensive supply chains. The lack of common data storage, or electronic medical records (EMRs), has created a need for redundancy (or rework) in medical testing. The use of EMR will also enhance our ability to forecast needs in the future. We perform simulations using SigmaFlow software to address our goals relative to the resource constraints, monetary constraints, and the overall culture of the medical supply chain. The simulation outcomes lead us to recommendations for data warehousing as well as providing mechanisms, like inventory postponement strategies, to establish structures for more efficiency, and reduced flexibility in the supply chains.

Health professionals are in an ethical dilemma. The patients should be assumed as competent. Involuntary treatment is a violation of human rights. Therefore incompetent patients should be protected. However, one cannot determine a patient's incompetency without testing him/her, which is a violation of the assumption of competency. Thus, we propose two different types of uses for competency tests. One is to measure the appropriateness of information disclosed,but with a poor test result the information should be repeated. Another is to measure the competency of the patients when making major decisions. A poor test result will be followed by the designation of a proxy so that incompetent patients can be protected.

In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend these ideas specifically to how we might think about reducing seemingly intractable problems in health care such as patient safety, patient falls, hospital acquired infection, and the rise of chronic illness and obesity. I suggest that such changes will require managers and providers to view health care organizations and patients as complex adaptive systems and include patients as full participants in co-producing their health care.

Fostering the development of professional character in student physicians remains the most essential, yet challenging and sometimes elusive goal of those in medical education. Current understandings and contemporary approaches to learning and teaching can provide perspectives that may inform our thinking. In this chapter, learning with and from others is explored along with approaches that form the foundation for the development of professional character that integrates moral conduct into professional practice. The implications for both teaching and learning and the importance of the learning environment are discussed. Education as a moral endeavor and values-based practice is emphasized.

As a key component of the American health care system, the physician office could be the front line in a bioterrorist attack. Nationally and locally, the primary focus on this subject appears to be from a hospital preparedness and public health agency perspective, with little attention devoted to primary physician providers in their own offices, and those specialists to whom patients may be referred. While unrelated to bioterrorism, the recent SARS outbreak also brings to the forefront the need for physicians offices to be able to clinically, operationally, and managerially respond to illnesses that mirror the symptoms of known illnesses, but may be more virulent new organisms or hybrids of existing organisms. If the face of bioterrorism is subtle and slow in its presentation, physicians, in their own offices, could be the first providers of care. Will they be prepared, or will they be among the first fatalities in a bioterrorist attack?