When the Doctor-Patient Divide Is a Chasm

Published: June 23, 2019
Category: Bibliography
Authors: Alexander Blount
Countries: USA
Language: English
Types: Care Management, Population Health
Settings: Academic, Health Plan, Hospital, PCP


For an important group of patients, the divide between themselves and their healthcare team is a chasm. These patients are variously identified in different parts of the literature, as “complex,” as “deprived,” or as “trauma victims.” Their expectations of their doctors and their doctors’ expectations of how patients should behave can be wildly at odds. Doctors and other health professionals commonly make assumptions about the ability of these patients to be active parts of their healthcare plans. Even doctors and health professionals who are interested in partnership are likely to adjust their approaches to their care, using behaviors that are less patient-centered rather than more so. For their part, these patients are less likely to trust their relationship with the members of their healthcare team and to be less confident in their own ability to improve their health states. Their likelihood of adhering to a medical regimen is correlated with their experience of the caring and support coming from their healthcare providers. Trauma informed care (TIC) can provide guideposts needed to develop a pathway to partnership and healing for these patients and their healthcare teams.

Complex patients, Trauma victims, Healthcare reform, Disadvantaged patients, Primary care, Behavioral health

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