axelrod review Flashcards
how many people in the US have alzheimer’s?
4 million
what is the chance of developing alzheimers after age 85
20-40%
abdominal pain accounts for what percent of ER visits?
5-10%
What is the prevalence of domestic violence?
36.5%
6% of women per year
what is the prevalence of chronic kidney disease
13%
what is the best treatment option for endstage renal disease
transplant (dialysis is only temporary)
does racial profiling occur with dispensing of pain meds?
yes. opioids are more often withheld from AA patients
what are the risk factors for kidney disease
HTN, diabetes
what is the biggest risk factor for breast cancer?
family history or previous hx of breast ca
definition of empathy in the context of patient care
empathy is a predominantly cognitive (rather than emotional) attribute which involves an understanding (rather than feeling) of experiences, concerns, and perspective of the pt, combined w/ a capacity to communicate this understanding, and an intention to help
empathy vs sympathy
- empathy is entering into sufferer’s mind and understanding his pain from within as if the pain were ours, but remains his own
- sympathy is sharing feelings together w/ the pt as if the pain is ours and remains so
- overabundance of sympathy can be overwhelming in pt care, thus impeded the clinician’s performance, whereas empathy needs no restraining boundaries
- “compassion fatigue” and “detached concern” are applicable to sympathetic involvement, not empathetic engagement in pt care
jefferson scale of empathy
3 factors: perspective taking, compassionate care, walking in pts shoes
- physician empathy is a multidimensional concept
- can be operationally defined and quantitatively measured
are empathy scores significantly correlated with global rankings of clinical competence in med school?
yes
are empathy scores correlated with performance on standardized exams?
no
are women or men more likely to receive higher empathy scores
women
T/F: physicians in people-oriented specialties have higher empathy scores than procedure/tech-oriented
True
higher jefferson scale of empathy scores associated with…
higher sociability and lower agressive/hostility
- more likely to be nominated by classmates for professionalism attributes
- higher empathy ratings on osce
- higher level of satsifaction in early relationship with mother
T/F: pts perceptions of physician empathy is highly correlated with patient satisfaction and patient compliance
True
T/F: empathy scores of medical students did not decline during the 3rd year
False; empathy scores do decline in 3rd year
what are some reasons that medical students and doctors lose empathy?
inappropriate role models, lack of attention to “art of medicine”, “hidden agenda”, time pressure, sleep deprivation, work load, overly demanding pts, fear of malpractice, lack of autonomy, overreliance on technology
2 key empathy studies
- jefferson study: patients of doctors with high empathy scores were more likely to have good HbA1c and LDL control
- Italian study: patients of doctors with high empathy scores had fewer acute metabolic complications of diabetes
why is physician empathy associated with better patient outcomes?
- psychosocial level: trusting relationship, more accurate dx and compliance
- bio-neurological: activate pro-social peptides/hormones; “mirror-neuron system”
worldwide how many women experience intimate partner violence? in the US?
worldwide: 1 in 3
US: 1 in 4
consequentialist ethics:
utilitarianism: the ends justify the means
limiations: codones potentially harmful actions
