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'Walking together': How relationships shape physicians' clinical reasoning.

Jeffrey D Krimmel-Morrison1, Bjorn K Watsjold2, Gabrielle N Berger1

  • 1Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

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Summary
This summary is machine-generated.

Physicians’ patient relationships significantly shape clinical reasoning by balancing care standards with patient-centeredness. Understanding these dynamics is crucial for medical training and practice.

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Area of Science:

  • Medical Education
  • Qualitative Research
  • Health Psychology

Background:

  • Clinical reasoning is increasingly recognized as context-dependent.
  • Physician-patient relationships are significant contextual factors influencing clinical decision-making.

Purpose of the Study:

  • To explore how physicians' relationships with patients shape their clinical reasoning processes.
  • To understand the interplay between maintaining relationships and clinical decision-making.

Main Methods:

  • Constructivist grounded theory approach.
  • Semi-structured interviews with 15 primary care physicians.
  • Constant comparative analysis of interview transcripts.

Main Results:

  • Patient agency emerged as a central influence on clinical reasoning.
  • Physicians individualized care based on contextualized illness understandings.
  • Tensions between standard care and patient-centeredness were managed to maintain relationships.
  • Caregiver relationships were also identified as important contextual influences.

Conclusions:

  • Physician-patient and caregiver relationships significantly influence clinical reasoning.
  • Balancing professional standards with patient-centeredness creates tensions.
  • Findings have implications for medical training and clinical practice.