The Lifeworld of the Complex Care Hospital Doctor: A Complex Adaptive Phenomenological Study

Area of Science:

• Medical Sociology
• Healthcare Management
• Complexity Science

Background:

• Rising chronic conditions have shifted acute care demographics towards complex patient needs.
• Acute care settings, designed for episodic treatment, now frequently manage chronic and multi-morbid patients.
• This necessitates a re-evaluation of medical practice within these environments.

Purpose of the Study:

• To examine the lived experience of medical doctors providing complex healthcare in acute settings.
• To analyze the unique characteristics and challenges of this specialized practice.
• To identify opportunities for optimizing complex care in acute environments.

Main Methods:

• Qualitative study involving interviews with four medical doctors.
• Analysis of interview data using a combined framework of phenomenology and complexity theory.
• Exploration of the 'lifeworld' of doctors managing complex patient cohorts.

Main Results:

• Complex care in acute settings is a dynamic, expansive, immersive, and relational practice.
• This specialized form of care has become common without full recognition of its unique nature.
• Doctors experience this practice as demanding due to the fast-paced, pressurized environment.

Conclusions:

• Complex care in acute settings represents a significant, evolving area of medical practice.
• There is an opportunity to redefine health and illness concepts to better encompass complexity.
• Future research, practice, and system design should focus on optimizing care for health complexity across all settings.