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    As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

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Understanding the Collaborative Shift in Bedside Manner

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Doctor-Patient Relations in the Modern Era

[By Mario Moussa PhD]

[By Jennifer Tomasik MS]

[By Dr. David E. Marcinko MBA]


When it comes to the doctor-patient relationship, Health 2.0 needs guidelines. Several leading health providers have begun to call for them. We think guidelines would, among other things, help define the right mix of virtual and live communication.

Our relationship strategies take a step in this direction. Such a framework can be used to start a productive dialogue among health providers about social media. A hospital committee or some other governing body could easily use Web 2.0 tools—a blog or a wiki—to start the discussion. Before long, there would be ample case material to flesh out general principles.

Health 2.0 Needs Guidelines

Guidelines would also address a big barrier to using Health 2.0: getting paid. Currently reimbursement policies do not cover electronic communication, so physicians have little financial incentive to use it. In a 2003 study, only 9% of physicians were willing to use e-mail to communicate with patients. This has something to do with old habits. But it has a lot to do with payment schedules, too. Guidelines should feature the research that shows the positive health outcomes of strong physician-patient relationships and how social media tools help build relationships. In today’s “pay for performance” market, these outcomes help build credibility for wired communication.

Training Support

We also think Health 2.0 guidelines need to be supported by training. Studies show that training in interviewing and interpersonal skills produces substantial differences in the quality of care. Training in Health 2.0 communication would likely have a similar impact.


Paradoxically, as patients can access and control more data, they have a greater need for trusted physicians who communicate well using various mediums. As Ted Epperly, President of the American Academy of Family Physicians, has said, patients need “wise counsel” in sifting through the prodigious amounts of information available via Health 2.0. And physicians as well as patients need to learn how to navigate this environment. No longer the sole authoritative source of medical information, physicians need to adapt, becoming an experienced partner and guide for inquiring patients. Training can help doctors get comfortable in this new role.


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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com and http://www.springerpub.com/Search/marcinko

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Anderson, James G., Eysenbach, Gunther, and Rainey, Michelle R. “The Impact of CyberHealthcare on the Physician–Patient Relationship.” Journal of Medical Systems. 27 (2003): 67 – 84.

Kaplan, Sherrie H., Greenfield, Sheldon, Gandek, Barbara, et al. “Characteristics of physicians with participatory decision-making styles.” Annals of Internal Medicine. 124.5 (1996): 497–504

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4 Responses

  1. Mario and Jennifer,

    At the ME-P and the http://www.MedicalBusinessAdvisors.com
    we too believe that the health 2.0 enterprise knowledge is a collective process; but not an entirely democratic one.

    And, while we welcome and appreciate the increased participation of all contributing authors and commentators in the social medium, we will not abdicate our responsibility as patients, practitioners, informed-review editors and leaders of the health 2.0 future, by burying it under the currently fashionable “wisdom-of-crowds.”

    Dr. David Edward Marcinko MBA


  2. Many Errors Result of Physicians Not Listening

    Great effort goes into stopping preventable errors such as wrong-site surgeries, but the authors of a new study on unwanted variation in elective procedures say that many more errors are taking place because physicians are not listening to their patients.

    The latest report from the Dartmouth Atlas Project—Improving Patient Decision-Making in Health Care, which was conducted in conjunction with the Foundation for Informed Medical Decision Making—concludes that if physicians educated and listened to their patients more thoroughly, unwanted variation would decline.

    Researchers took an in-depth look at medical conditions involving decisions for elective care in cases where the statistics don’t recommend a single course of action. The study found that much of the difference is attributable to physicians’ preferences, not differences in patient populations.

    But, in cases of elective procedures, giving a patient a treatment he doesn’t want is as much an error as wrong-site surgery, said Michael Barry, a co-author and president of the decision-making foundation.

    Source: Joe Carlson, Modern Physician, [2/24/11]


  3. Positive changes seen in physician-patient relationship

    While we often comment on work that needs to be done to improve physician-patient communication and the numerous strains on this relationship, recent changes in the way doctors and patients interact have overall been positive, according to Dr. Alan Christensen of the University of Iowa, who studies patient-provider interactions and health services.


    Ann Miller RN MHA


  4. Beware the “Mind Gap” in Doctor-Patient Communications

    “Mind the Gap” is the warning heard on subway systems around the world. It is intended to alert folks to avoid accidentally stepping in the “gap” that separates the train from the platform … and falling.

    As used here, and in the book “Business of Medical Practice“, it is an expression that alludes to the communications gap that exists all too often today between patients and their physicians. Like the subway, this is a warning.

    It is intended to making health care providers and organizations aware of the consequences of poor physician-patient communications … and how to avoid them.



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