Chapter 1

Question 1

Primary care

Answer 1

Care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any health concern such as outpatients clinics and primary health care centers.

Question 2

Secondary care

Answer 2

Medical care that is provided by a specialist and facility upon referral by a primary care physician and that requires more specialized knowledge, skill, or equipment than the primary care physician can provide such as specialized hospital.

Question 3

Primary care example

Answer 3

Outpatient clinics and primary health centers

Question 4

Secondary care examples

Answer 4

Specialized hospital

Question 5

Tertiary care

Answer 5

Specialized consultative health care, usually for inpatients and referral from primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment such as tertiary referral hospital.

Question 6

Tertiary care example

Answer 6

Tertiary referral hospital

Question 7

Clinical encounter

Answer 7

Medical clinical encounters or consultations usually occurs in
1. Outpatient clinics
2. Hospital wards
3. Emergency departments
4. Personal houses
5. House visits
6. Teleconsulations

Question 8

Teleconsultations

Answer 8

Interactions that happen between a clinician and a patient for the purpose of providing diagnostic or therapeutic advice through electronic means.

Question 9

Advantages of telepresence

Answer 9

Allows a patient to feel as if she or he were present without being physically in the same location.

Question 10

Patients and medical personnel interact virtually via

Answer 10

Technology

Question 11

Advantages of teleconsultations

Answer 11

1. Currently used in many countries.
2. Provides timely care that is easily accessible.
3. Teleconsultations agencies are growing rapidly.

Question 12

Services that can be done through Teleconsultations

Answer 12

1. Providing results of investigations.
2. Repeated prescriptions.
3. Request sick notes or claim notes.
4. Triage of emergency appointment requests.
5. Triage of home visit requests.
6. Health promotion Eg. Promoting immunization and smoking cessation services.
7. Effective healthcare delivery Eg. Follow up depressed or diabetic patients.

Question 13

Benefits of Teleconsultations

Answer 13

1. Convenience for patients: no time off work, no transport issues, and no childcare issues.
2. Convenience for doctors: tends to be shorter consultation and so provides better time management.
3. May reduce practice costs: more doctor time available for other patients.
4. Can overcome the issue of a lack of consultations rooms.
5. Can improve medical access for the disabled.

Question 14

Disadvantages of telecommunications

Answer 14

1. Absence of non-verbal cues and missed hidden agendas or fears.
2. No examination findings.
3. Deafness, accents, or language can be a big barrier to communication.
4. Reduced opportunity for health promotion: blood pressure management.
5. No opportunity for basic investigations: pregnancy test or urine dip test.
6. Issue of confidentially- who are you talking to and who may overhear.

Question 15

Teleconsultations use during the pandemic

Answer 15

A. Safe effective way to assess suspected cases and guide the patients diagnosis and treatment, minimizing the risk of disease transmission.
B. Enable many of the key clinical services to continue to operate regularly and uninterrupted.
C. Remote assistance and help with administrative management of patients, triage, follow up, meetings and technical discussions among physicians in different locations

Question 16

Teleconsultations in Kasr Al-Ainy hospitals

Answer 16

Phone triage service

Question 17

Patient centered care

Answer 17

Philosophy of care that encourages shared consultation, decisions about interventions or management of health problems with the patient. It focuses on the patient as a whole.

Question 18

Patient centered care involves

Answer 18

1. Transforming the relationship between the providers and patients from the traditional model in which a care provider prescribes the same treatment to patients with same diagnosis to patient provider relationship which considers treatment options based on patients unique preferences.
2. Treating patients as partners: planning and responsibly for their own health.
3. Patients active role in their own care.
4. Replaces disease oriented model by patients experience of illness, psychological, and decision making patients and family.

Question 19

Pickers 8 principles of patient centered care

Answer 19

1. Respect for patients preferences.
2. Coordination and integration of care.
3. Information and education.
4. Physical comfort.
5. Emotional support.
6. Involvement of family and friends.
7. Continuity and transition.
8. Access to care.

Question 20

Medical model patient role

Answer 20

Passive

Question 21

Medical model recipient of treatment

Answer 21

Doesn’t voice concerns.

Question 22

Medical model provider dominated decisions

Answer 22

Doesn’t offer options.

Question 23

Medical model disease centered

Answer 23

Dialysis is focus of patients life

Question 24

Medical model provider does most talking

Answer 24

Does not allow time for questions

Question 25

Medical model patient complies

Answer 25

No

Question 26

Patient-centered model patient role

Answer 26

Active
Patient asks questions

Question 27

Patient-centered model partner in treatment plan

Answer 27

Patients asks for information about options.

Question 28

Patient-centered model collaborative decisions

Answer 28

Pros and cons options

Question 29

Patient-centered model quality of life centered

Answer 29

Family life is focus of patients activities.

Question 30

Patient-centered model
Provider listens more and talks less

Answer 30

Allow Ike for discussion

Question 31

Patient-centered model patients follows treatment plan

Answer 31

Self manages diet and meds

Question 32

Methods of Patient-centered methods

Answer 32

1. Exploring both the disease and the illness experience.
2. Understanding the whole person.
3. Finding common ground.
4. Prevention and health promotion.
5. Patient-doctor relationship.
6. Being realistic.

Question 33

Dimension of disease

Answer 33

Theoretical terms of abnormality, structure, and function of body organ systems including physical and mental disorders.

Question 34

Dimension of disease traditional methods

Answer 34

1. History
2. Examination
3. Differential diagnosis
4. Investigations

Question 35

Empathy

Answer 35

Ability to experience the feelings of another person.

Question 36

Sympathy

Answer 36

Caring and understanding for the suffering of others.

Question 37

Dimension of illness

Answer 37

How patient feel about being ill.
Concerns, ideas, and impact.

Question 38

Understanding the whole person

Answer 38

Persons
1. History
2. Personality
3. Development
4. Methods of adaptation

Question 39

Finding common ground

Answer 39

Mutual definition of problem, priorities, goals of management of treatment, and roles.

Question 40

Being realistic

Answer 40

In time and availability of resources emotional and physical energy needed.

Question 41

Health enhancement

Answer 41

Doctor and patient monitor areas in patient’s life that needs improvement for long term physical and emotional health.

Question 42

Risk reduction and early detection

Answer 42

Doctors monitor recognize problems and screen unrecognized disease. Doctors collaborate as well.

Question 43

Patient-centered method advantages

Answer 43

1. Greater levels of patient’s satisfaction.
2. Greater levels of doctor’s satisfaction.
3. Better patient adherence.
4. Improves patients outcomes.
5. Has positive impact on health care utilization costs.
6. Fewer malpractice claims.
7. Higher quality of self-reporting.
8. Greater physician detection and patient insight.

Question 44

How do you assess quality of health care?

Answer 44

By degree of patient satisfaction.