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Resolución de desacuerdos en la relación paciente-médico: herramientas para mejorar la comunicación en el cuidado
W Levinson1, R Gorawara-Bhat, R Dueck
1Section of General Internal Medicine and Program for Physician Patient Communication Research, University of Chicago, Ill 60627, USA. wendy@medicine.bsd.uchicago.edu
JAMA
|October 27, 1999
Resumen
El cuidado administrado de la atención.
Área de la Ciencia:
- Gestión de la Gestión de la Atención Médica.
- Ética médica y ética médica.
- Comunicación paciente-médico Comunicación paciente-médico
Sus antecedentes:
- La atención administrada emplea incentivos financieros y restricciones de utilización, lo que afecta la toma de decisiones del médico y los costos de atención médica.
- La confianza del público se está erosionando debido a las preocupaciones sobre la objetividad del médico frente a las influencias financieras en la atención al paciente.
- Estos factores crean potencial para el conflicto dentro de la relación paciente-médico.
Objetivo del estudio:
- Identificar y articular los desacuerdos emergentes en la relación paciente-médico derivados de la atención administrada.
- Explorar escenarios específicos que ilustren conflictos relacionados con la asignación de recursos, el acceso de los pacientes y los incentivos financieros.
- Proponer estrategias de comunicación y políticas para mitigar estos desacuerdos.
Principales métodos:
- Convocó a un grupo multidisciplinario en octubre de 1998, que incluía representantes de pacientes, líderes de atención médica, médicos, expertos en comunicación y especialistas en ética.
- Se analizaron tres escenarios distintos: asignación de recursos (cambios de referencia), acceso del paciente (elección del proveedor) e incentivos financieros (pruebas de pedido).
- Desarrolló estrategias de comunicación para médicos y recomendaciones de políticas para planes/grupos de salud.
Principales resultados:
- Identificó áreas clave de conflicto médico-paciente que surgen de las prácticas de atención administrada.
- Ilustró posibles desacuerdos a través de escenarios específicos y identificables.
- Generó estrategias de comunicación accionables para mejorar las interacciones paciente-médico bajo atención administrada.
Conclusiones:
- Las estrategias de comunicación efectivas pueden ayudar a los médicos a navegar los conflictos relacionados con la atención administrada.
- Los planes de salud y los grupos de médicos pueden implementar políticas para reducir los desacuerdos entre pacientes y médicos.
- Abordar estas cuestiones es crucial para mantener la confianza y la atención óptima al paciente dentro de los sistemas de atención administrada.
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