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Mentorship Annotated Bibliographies

Henna Datta

Glenelg High School

Aaltonen, P. (2019, July). Countering vaccine hesitancy with evidence-based decisions. (VITAL
SIGNS: Perspectives of the president of APHA). ​The Nation's Health,​ ​49(​ 5), 3. Retrieved
from Gale In Context: Opposing Viewpoints database.

In an article for ​The Nations Health​, Pam Aaltonen analyses the different ways by which

doctors can keep patients from being wary of vaccinations. She acknowledges the reasons why

many people have doubts about vaccines, but is careful to make it clear that she is confident in

their ability to lower the risk of vaccine-preventable diseases. She specifically gives a list of

ways to do this, while explaining the reasons why some people feel hesitant towards vaccines.

She claims that, in order to truly convince a patient that vaccines are necessary, the doctor must

allow them to voice any concerns completely before refuting any such concerns. She also found

that with young patients, it is essential to begin informing parents about the benefits of vaccines

as a part of prenatal care. Aaltonen ultimately attempts to thoroughly explain the best ways for

providing good evidence for the benefits of vaccines to those who have been misinformed about

them.

The author, Pam Aaltonen, is qualified to discuss patient-doctor relationships and

communication because her credentials include her PhD from Purdue University, and her job as

a nurse. Her contact information, including her email address, can be found at the bottom of the

article. Written 2 months ago, this source is relevant, as it provides information to solve an issue

that is being discussed currently. The author thoroughly evaluated all sides of the issue. For

example, she acknowledges those who have been misinformed about vaccinations and then
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addressed the opposing viewpoint by explaining that these people, although valid in their

concerns, have been given incorrect information by the media and simply need to be informed

adequately. This inclusion shows that alternate viewpoints to the author’s were acknowledged

because the author describes the perspective of those who are anti-vaccinations clearly before

explaining the reasons why this view is incorrect. The information contained in the source can be

verified elsewhere. For example, the author says that the World Health Organization has named

vaccine hesitancy a major threat to global health during the year 2019. This can be corroborated

by the World Health Organization, which found that vaccine hesitancy is one of the top 10

threats to health. The purpose of this article is to give doctors advice as to how to provide

information to those who have been misinformed. Thus, the audience is the doctors who must

communicate information to their patients. The article is most appropriate for this audience and

purpose because it gives a solid list of ways to manage such difficult situations involving the

mislead, while still using language that is suitable for a more professional audience.

Arford, P. H. (2005, March/April). Nurse-physician communication: An organizational

accountability. ​Nursing Economics​, ​23​(2), 72+. Retrieved from Gale General OneFile
database.
In an article for Nursing Economies, Patricia H. Arford emphasizes the importance of

nurse-physician communication in order to create the best treatment experience for a

patient. Arford begins by establishing that collaborative nurse-physician communication

has actually been linked to patient survival, particularly for patients in intensive care. She

then goes on to explain how she believes that the best way to minimize communication

mistakes between different specialists is to create an interdisciplinary team manager who

can ensure solid communication between members of the patient's family, specialists,
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primary physicians, and nurses. She recommends unit-based advanced practice nurses to

fill this role since they are least preoccupied with hands-on care. She also describes how

nurse-physician can often be conflictive because of the idea of authority. In some cases,

physicians see themselves as better than nurses, thus not valuing them as they should to

maintain a positive relationship. Legally, in some cases, nurses can be held accountable

for not questioning a physician’s orders. For this reason, nurses and doctors must have a

solid and effective method of communicating. Arford explains that nurses should use

medical language as frequently as possible to minimize confusion, and doctors should

view the nurses as partners in patient care. Ultimately, she concludes that solid

communication between medical staff will overall cause more efficient and effective

patient care.

The author, Patricia H. Arford, is qualified to discuss nurse-physician communication

because she is a PhD, RN, and works as an Associate Professor at the College of Nursing,

Medical University of South Carolina. This information can be found in the article, and

her contact information can be found on the Medical University of South Carolina

website. Although written over 10 years ago, this source is still relevant because it covers

the results of a study on intensive care patients that would still apply today given that

people still spend time in intensive care, and the physician-nurse relationship still is

complicated in many places. Even though this is an opinion, the author still presents

claims, reasoning, and evidence to show why that opinion is valid and credible. For

example, she cites several studies in her article and fully explains the importance of each

study. The coverage can be considered broad and deep because the article is carefully
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organized so that it can cover every aspect of physician-nurse communication. The

information contained in source can be verified elsewhere. For example, the author

claims that collaborative nurse-physician communication can improve patient survival,

which can be corroborated by Jeff Lagasse in his article “Poor Communication between

Doctors and Nurses can lead to costly mistakes” in which he explains that when doctors

and patients communicate, they can better understand all aspects of a patient’s experience

and thus improving treatment. The purpose of this article is to encourage a more

collaborate and open doctor-nurse relationship in order to improve communication

between the two. The audience is doctors and nurses alike, as the author makes it clear

that both of them need to improve their communication skills, which makes the article

appropriate for both groups.

Brown, Sarah. "Preserving the Human Touch in Medicine in a Digital Age." ​CMAJ: Canadian
Medical Association Journal​, vol. 191, no. 22, 3 June 2019, p. E622+. ​Gale in Context:
Science​,
link.gale.com/apps/doc/A587565661/SCIC?u=glen20233&sid=SCIC&xid=1b519218.
Accessed 22 Apr. 2020.
In an article for the ​Canadian Medical Association Journal​, Sarah Brown analyzes the

ways by which doctors can use telemedicine in order to enhance the communication,

while still maintaining the human touch aspect of medicine that makes it personal and

comfortable for patients. She asserts that it is important for healthcare professionals to

make sure to be aware of any unintended consequences of telemedicine, and encourages

that there is more discussion on how to best engage in such a form of treatment. She

makes sure to clarify that there is always room to improve, with every time of

communication, but is also sure to establish that it is important for doctors to remain
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personal with their patients, especially when delivering bad news. Despite the fact that it

might be significantly easier for doctors to give bad news over the phone rather than in

person, it is important to do so in person in order to make sure that trust and a connection

remains between patients and doctors.

The author, Sarah Brown, is qualified to discuss the topic of telemedicine used

practically because her credentials include work writing for Western University and as

writer for many medical journals. Her information can be found with a google search.

Written within the last year, this source is current on the topic of telemedicine, which is

sensitive to the passage of time. The author thoroughly evaluated all sides of the issue.

For example, she analyzes the benefits and drawbacks of telemedicine with support from

both sides of the argument, saying that it can both be highly beneficial and, if used wrong,

negatively impactful for patients. This inclusion shows that alternative viewpoints to the

authors were acknowledged because the other takes into account both points of view for

this controversial topic. The information contained in the article can be verified

elsewhere. For example, the author says that telemedicine can be convenient, but can

cause difficulties with proper conveying of information. This can be corroborated by Judy

L. Klein in her article “Managing the Risks of Telemedicine”, in which Klein also claims

that telemedicine can often cause misinformation between doctors and patients. The

purpose of this article is to inform doctors about the risks of telemedicine. The audience

would thus be doctors, because they are those who will benefit the most from the

information. The article is appropriate for this purpose because it provides quotes and

data from other doctors to support its argument while still covering the topic enough to
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show both sides.

Chen, P. W. (2009, November/December). A tool to strengthen the doctor-patient relationship.

The Hastings Center Report​, ​39​(6), 15+. Retrieved from Gale In Context: High School
database.
In an article for The Hastings Center Report, Pauline W. Chen argues that comparative

effectiveness research, the synthesis of research that compares the benefits and

drawbacks of different kinds of interventions for improving conditions, can help to

strengthen the doctor-patient relationship. She discusses the story of a doctor friend of

hers, Dr. G, who was sympathetic and caring in his practice. Dr. G treated a patient

named Carolyn, who had inflammatory breast cancer, and ended up amputating her arm

arm and left breast in order to get rid of the tumors, even though such an operation had

never been done before with that type of cancer and there was no comparative

effectiveness research available on it. Dr. G. wanted to provide this patient with more

time with her family, because she was a stay at home mother who spent most of her time

caring for her children. However, the treatment, which was debilitating, did not end up

working and Carolyn ended up passing away months later. Chen cites this event to

support why comparative effectiveness research could be so helpful, because, had there

been comparative effectiveness research on the type of treatment for taking care of

patients who suffered from the terminal illness that Carolyn had, Dr. G would not have

been so quick to leap into questionable territory for the treatment. Effective treatment can

strengthen the doctor-patient relationship and help to protect patients and doctors from

making rash decisions.

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The author, Pauline W. Chen, is qualified to discuss comparative effectiveness research

on the doctor patient relationship because her credentials include work as a surgeon,

author, and New York Times columnist. She also has a blog on which she studies the

relationship between doctors and patients. Her contact information can be found online.

Although written over 10 years ago, this source is still relevant because it covers an issue

regarding the doctor-patient relationship that has still not been solved, and provides a

potential solution to that issue. The author thoroughly evaluated all sides of the issue. For

example, she acknowledges the impact of sympathy on decision making for doctors

without any sort of medical support, because it creates a sense of understanding of such

physicians. This inclusion shows that alternative viewpoints to the authors were

acknowledged because the author is providing reasoning as to why comparative

effectiveness research has not been utilized in the past as a jumping point to explain why

it should be utilized in the future. The information in the source can be verified

elsewhere. For example, Chen claims that comparative effectiveness research can help

doctors navigate decision-making, which can be corroborated by an article by Johns

Hopkins Univerity that states that comparative effectiveness research will help generate

better information about risk and costs of treatment options, thus helping health care

providers make informed health care decisions. The purpose of this article is to

encourage policymakers to provide more funding for comparative effectiveness research

as a whole in order to facilitate positive doctor-patient decision-making. The audience

would then be policy-makers, because they are the ones who are ultimately the ones who

can control funding for such research. The audience could also be doctors because the
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article discusses the importance of research on prescribing adequate treatment for

patients. This article is appropriate for this audience and purpose because it provides

plenty of research that would help to convince policy-makers of the significance of the

findings.

Cole, Megan B., et al. "The Effects of Integrating Behavioral Health into
Primary Care for Low-income Children." ​Health Services Research​, vol. 54,
no. 6, Dec. 2019, p. 1203+. ​Gale in Context: High School,​ link.gale.com/
apps/doc/A609143877/GPS?u=glen20233&sid=GPS&xid=61fb8368. Accessed 24 Apr.
2020.
In an article for the Health Service Research and Educational Trust, Megan B. Cole, Qiuyuan

Qin, Radley C. Sheldrick, Debra S. Morley, and Megan H. Bair-Merritt discuss the importance

of integrating behavioral health care for children who come from low-income households.

Adding this kind of care is essential because it helps to prevent and help children who are at a

higher risk for developmental delays and mood disorders. Children who come from

lower-income families also tend to be underserved when it comes to having their behavioral

health needs met. Many different programs have been put into place that have helped, including

the TEAM UP program, which helped to provide such behavioral support for the children who

suffer from developmental issues. However, the authors do admit that the studies that they have

done that support the claim that behavioral health should be integrated further into the behavioral

care for children have several limitations, specifically because the data collected follows a

longitudinal study and it is difficult to compare individuals with an entire population when the

sample is so large but there could easily be misclassifications with any individual patients

because they are not being given the exact same treatments. Ultimately, implementing mental

health services for low-income children will help to decrease the number of children with mental
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disorders, although the implementation will likely be expensive for parties outside of the

benefiting families.

The authors are qualified to discuss the topic of behavioral healthcare for low-income

children because their credentials include a PhD and work at the Department of Health, Law,

Policy, and Management at the Boston University School of Public Health, at the Department of

Pediatrics at the Boston Medical Center, and the Department of Pediatrics at the Boston

University School of Medicine. All of them have contact information listed at the bottom of the

article. Written less than a year ago, this source is current on the topic of behavioral healthcare,

especially since it is a report on a longitudinal study. The authors thoroughly evaluated all sides

of the issue. For example, they covered all of the limitations that they believed the study might

have had, while still establishing that they believed that the results were statistically significant

enough for changes in policy to be made. The information contained in the source can be verified

elsewhere. For example, the authors claim that lower-income children are at greater risk for

mental illness. This can be corroborated by S Hodgkinson in his article, “Improving Mental

Health Access for Low Income Children”, in which he establishes that living in a low-income

household has been linked to poor health as well as an increased risk for mental health problems

especially in children. The purpose of this article is to encourage policy-makers to begin

implementing more funding for programs that help to provide behavioral healthcare for

low-income children. The audience would thus be policy-makers who have control over funding

for different organizations. This article is appropriate for this purpose and audience because it

provides in-depth evidence and scientific proof that such actions would be beneficial, while also

providing sufficient information on the organization that the authors support.

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Coulter, A. (2002, September 28). Patients' views of the good doctor: Doctors have to earn
patients' trust. (Editorials). ​British Medical Journal,​ ​325(​ 7366), 668+. Retrieved from
Gale In Context: High School database.

In an article for the British Medical Journal, Angela Coulter describes the ways

by which doctors can earn the trust of their patients. Specifically, Coulter reviews the

wants of the patients as well as the importance of empowering them by looking through

history. She discusses women’s health groups, particularly how they tend to demean their

patients. Although doctors and patients do not always have the same views and ideas, the

doctor should always attempt to make the patient feel informed and aware of everything

that is going on with their health. Coulter found that, although patients generally want to

trust their doctors, they do not want their doctors to abuse that trust. For that reason, they

often do not blindly believe everything that is told to them, and they have the right to

know and be able to discuss everything about their condition. Additionally, Coulter

suggests training for doctors who prioritize usage of their time over the empowerment of

their patients. She claims that, as doctors fail to keep their patients involved in their own

treatment, the reputation of such doctors will continue to go down.

Angela Coulter is qualified to discuss the patient-doctor relationship and a

patient’s perspective of their doctor because her credentials include working as the chief

executive of Picker Institute Europe, a non-profit dedicated to patient-centered care. Her

contact information, including her email address, can be found at the bottom of the

article. Although written more than ten years ago, this source is still relevant because the

patient experience still includes interactions with medical professionals. Since the patient
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experience has not changed, the same concepts apply when discussing the treatment of

patients by doctors. The author thoroughly evaluated all sides of the issue. She

acknowledges how many doctors find that time is more valuable than a patient’s personal

feelings of involvement, as if there is less time alloted for each individual patient, there

will be more time to see more patients. This helps to give a different perspective. The

information in this source can be verified elsewhere. For example, the author says that

patients generally want a passionate doctor who does not rush them. This information can

be corroborated by Lauren Cranford in her article “What Do Patients Really Want from

their Doctors” in which she explains that, in a study, it was shown that patients want

transparency, trust, compassion, and enough time to be able to ask the questions that they

want answered. The purpose of this article is to provide doctors with the patient

perspective on what the best way to establish a connection is. The audience is primary

care physicians in particular, as most of the advice given in the article directly applies to

them. The article is appropriate for this purpose and audience because it provides solid

proof while citing specific patient experiences.

De, U., & Bhattacharya, P. (2003). Communicating bad news: An approach. ​Indian Journal of
Surgery,​ ​65(​ 3), NA+. Retrieved from Gale General OneFile database.

In an article for the Indian Journal of History, De Utpal and P. Bhattacharya

address the difficulties faced by doctors who need to deliver hard news before providing

ways to ease the stress of this aspect of the job. The authors explain that bad news, when

communicated in a way that is not sufficient, can gravely impact both those giving the

information and those receiving it. For this reason, doctors must be sufficiently trained to
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appropriately handle difficult scenarios. Otherwise, they may end up worrying about an

unexpected reaction from the patient. The authors also detail the three ways by which a

doctor could go about delivering information, which include non-disclosure (when a

responsible adult and the doctor keep news from a patient), full disclosure (giving all

information possible to the patient), and individualized disclosure (where information is

disclosed specifically based off of the patient and their situation. Non-disclosure is seen

as unethical, and full disclosure can often cause high levels of distress. For this reason,

the authors support individualized disclosure, as it can help maximize the quality of life

for that patient. The authors provide a detailed list, which explains all of the points that

must be considered by a doctor before they go and give bad news to a patient. Solid

communication is especially necessary for seriously ill patients, and more doctors need to

be trained to communicate properly.

The authors are qualified to discuss patient-doctor communication because their

credentials include working for the Departments of Surgery and Pathology in West

Bengal, India. Both of them have contact information that can be found at the bottom of

the article. Although this article was written over 10 years ago, the information is still

relevant because proper communication is still an issue that doctors face today. Many

people still have to deal with terminal illnesses, and need to be informed about it

tactfully. The authors thoroughly evaluated all sides of the issue. For example, they

included the three main ways by which bad news can be delivered. This inclusion shows

that alternate viewpoints to the authors’ were acknowledged because the authors are

showing that they have evaluated more than one method of communication, and that they
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have decided which one is the most useful based off of that. The information contained in

the source can be verified elsewhere. For example, the authors define bad news as

anything that can majorly impact a patient’s view of their future, especially terminal

illness. This information can be corroborated by Gregg K. Vandekieft in his article

“Breaking Bad News”, written for the American Family Physician, in which he explains

that bad news, although stereotypically associated with terminal illness, can also simply

be life-altering information. The purpose of this article is to inform doctors about the

importance of proper doctor-patient communication when dealing with difficult news.

The audience is, thus, doctors, particularly those who take care of terminally ill patients.

The article is appropriate for this purpose and audience because it details important ideas

that a doctor should keep in mind while delivering bad news, while still making sure that

all of the suggestions can be easily implemented.

Dermer, M., Martel, J., & Greenhill, A. (2019, December 9). Continuity of care: The key in
telemedicine. ​CMAJ: Canadian Medical Association Journal,​ ​191(​ 49), E1363. Retrieved
from Gale In Context: Science database.
In an article for The Canadian Medical Association Journal, Mark Dermer, Julien Martel,

and Alexandra Greenhill discuss the drawbacks and positive impacts new

technologies in medicine, particularly those that impact communications. In

general, it has been shown that people favor telemedical innovations, but others

worry that it contributes to a loss of human connection. The authors establish that

compassion is an essential part of being a physician, according to the general

public. Specifically, the authors claim that virtual clinics must focus on the

continuity of care, meaning that the patients have one physician that they are
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connected with consistently virtually, to avoid any kind of disruption. They

discusss Dialogue, a virtual care software platform that uses artificial intelligence

to make sure that patients are connected to the same professional every time. The

artificial intelligence is advanced enough to be able to share patient information

with the patient’s other practitioners as well, as long as the patient gives their

consent. The authors state that following Dialogue’s process of pairing patients

with the same practitioner every time will maximize patient outcomes, and

minimize any kind of negative impacts of using telemedicine.

The authors, Mark Dermer, Julien Martel, and Alexandra Greenhill, are qualified

to discuss the topic of telemedicine due to their credentials including working as a

medical director, chief of privacy officer, and telemedicine doctor in Montreal

and working as a chief medical officer in Vancouver. Their contact information

can all be found in the article. Written in the past year, this source is current on

telemedicine. Even though this is an opinion, the authors still present claims,

reasoning, and evidence to show hy that opinion is valid and credible. For

example, they cite a poll report that stated that Canadians are largely favorable

towards innovations in health care and telemedicine in order to support their

ideas. The coverage can be considered broad and deep because it provides plenty

of evidence, while still covering multiple perspectives on the topic before

explaining why their approach to the issue of telemedicine being too impersonal

is the best. The information in the source can be verified elsewhere. For example,

the authors say that telemedicine can cause issues because it loses the personal
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aspect of medical care, which can be corroborated by Brian Wu in his article

“What Are the Benefits and Advantages of Telemedicine”, in which he states that

telemedicine does not allow for a personal relationship with doctors. The purpose

of this article is to encourage companies that regulate telemedicine to incorporate

care continuity, so that the patient would be seeing the same doctor every time

they use the program. Thus, the audience would be telemedicine companies. The

article is appropriate for this purpose and audience because the companies

themselves would have the most control over how the programs work.

Francos, George C., and Henry L. Schairer, Jr. "Hypertension: Contemporary

Challenges in Geriatric Care. (The Heart)." ​Geriatrics,​ vol. 58, no. 1,
Jan. 2003, p. 44. ​Gale General OneFile,​ link.gale.com/apps/doc/A97347268/
GPS?u=glen20233&sid=GPS&xid=fe04d832. Accessed 24 Apr. 2020.
In an article for Geriatrics, Volume 58, George C. Francos and Henry L. Shairer Jr.

discussed the various aspects and complications of hypertension while specifically

focusing on geriatric patients. The authors cover the different causes of hypertension

while also discussing the various treatments for it, including salt restrictions, reduced

alcohol intake, and weight loss. Generally, hypertension require intensive lifestyle

changes that are often difficult, especially for geratric patients who struggle with losing

weight and incorporating exercise into their daily routines. The authors go through the

results of a study done in which patients were given antihypertensive agents. This study

ultimately showed that most patients who struggle with hypertension will benefit from

antihypertensive agents, even when those patients struggle with complications from

hypertension such as diabetes and heart failure.

The authors are qualified to discuss the topic of hypertension because their credentials
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include work as a clinical professor of medicine at Jefferson Medical College and

as a clinical instructor of medicine. Their emails can be found at the bottom of the

article. Although written over 10 years ago, this article is still relevant because it

covers hypertension as an illness impacting geraitric patients. In the years that

have passed, hypertension is still greatly affecting such patients. Even though this

is an opinion, the author presents claims, reasoning, and evidence to show why

that opinion is valid and credible. For example, they provide man\y different

statistics from their own study that they used to formulate their opinion. The

coverage can be considered broad and deep because of the depth into which the

authors covered hypertension, and because of the quantity of evidence they used

to support their conclusion at the end of the article. The information contained in

the source can be verified elsewhere. For example, the authors claim that

hypertension is often treated with a low salt-intake diet. This can be corroborated

by Sung Kyu Ha in her article “Dietary Salt Intake and Hypertension” in which

she explains that a lower salt intake will help to lower blood pressure and lessen

the risks that come with hypertension. The purpose of this article is to encourage

doctors to use hypertensive agents to lower the blood pressure of hypertensive

patients in conjunction with other treatments such as a different diet and exercise

plan. The audience would thus be doctors. The article is appropriate for this

because it provides ample evidence to support its argument and because it directs

its call to action at doctors.

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Glauser, W. (2019, September 16). Virtual care has potential to fragment primary care and
disturb continuity of care, warn doctors. ​CMAJ: Canadian Medical Association Journal​,
191​(37), E1038+. Retrieved from Gale In Context: Science database.
In an article for the Canadian Medical Association Journal, Wendy Glauser presents her

perspective on virtual care walk-in clinics. Virtual walk-in clinics are generally clinics

located in pharmacies, where patients come in and a registered nurse or trained assistant

guides them and conducts tests while being directed by a doctor over a video call. Such

clinics are beneficial for smaller communities with no road access and larger

communities that do not have a lot of doctors. However, it has become a concern that, in

communities that do have access to doctors, there will be a lack of communication and

understanding between doctors at different locations, which ultimately could end up

delaying treatment for patients. Many doctors worry that virtual walk-in clinics could

cause care to be fragmented and confusing, complicating treatment too much to be able to

have a genuine impact on the patient. Thus, some people argue that virtual care should

not be offered at all in areas that do have sufficient doctors. Ultimately, Glauser argues

that care needs to be better integrated into practices, and virtual care should be utilized

mainly by family doctors who need to reach elderly patients unable to visit in person.

The author, Wendy Glauser, is qualified to discuss virtual care because her credentials

include work as a researcher, a reporter for the Journalists for Human Rights, and as a

journalist for CMAJ news. Her contact information can be found online. Written this

year, this source is current on the topic of virtual care. The author thoroughly evaluated

all sides of the issue. For example, she acknowledges that virtual care can be beneficial in

many areas, and then addressed that opposing viewpoint by explaining that there are still
 18

many issues from virtual care, particularly in areas that have doctors in them already.

This inclusion shows that alternate viewpoints to the author were acknowledged because

the author thoroughly explains both reasons for and against virtual care, depending on the

area. The information contained in the source can be verified elsewhere. For example, the

author says that virtual care is particularly beneficial in areas with limited doctors, which

can be corroborated by Kimberlyn Marie McGrail in her article “Virtual Visits and

Patient-Centered Care: Results of a Patient Survey and Observational Study”, in which

she confirms that physicians are generally needed more in rural and remote areas, so that

is where virtual care is needed. The purpose of this article is to inform physicians on the

topic of virtual care, and to raise awareness for the lack of physicians in some areas. The

audience would then be physicians and policymakers in charge of regulating virtual care,

as they would have the most impact on whether the current situation is changed.

Graves, D. E. (2012, August 15). The patient 'cringe' list ends here: Shooting yourself in the foot:
Who is at fault for the 'failed encounter'? ​Ophthalmology Times​, ​37​(16), 27+. Retrieved
from Gale General OneFile database.

In an article for the Ophthalmology Times, Dianna E. Graves discusses the

concept of a patient cringe list and details the ways by which doctors can avoid the need

to create such a list. A patient cringe list is a list of patients who a medical professional

would rather avoid, whether it be because of the patient’s attitude or because the patient

takes up a lot of time during appointments. However, Graves claims that the patient

cringe list exists only because there is a lack of personal care for that patient from the

doctor. After an experience during which she discovered that she was on the “cringe list”
 19

for one of her doctors, she came to the realization that the people on her list may not be

purposefully bad patients, but rather, neglected and/or desperate patients who simply

need to be treated as human beings instead of just names to be checked off. Graves

specifically suggests to treat each patient like a family member and to care about them

the way you would a relative. She asserts that patient care should be more important than

the inconvenience that that patient might cause for the doctor because otherwise, the

work loses its meaning.

Dianna E. Graves is a clinical services manager at St. Paul Eye Clinic. She

graduated from the School of Ophthalmic Medical Technology. All of her contact

information, including her email, can be found at the bottom of the article. The article

was published in 2012, meaning that it was not written within the last five years.

However, this source is still relevant because it discusses the treatment of patients, which

is not a time-sensitive issue. Graves does not discuss particular medical treatments,

instead, she focuses on relations between patient and doctor. The author thoroughly

evaluated all sides of the issue. For example, she acknowledges the feelings of doctors

who dislike hearing from certain patients and who go out of their way to avoid them. She

lists the ways by which they would try to avoid these patients and describes her own

experiences doing such things. Graves displays sympathy towards these doctors before

providing them with ways to make the working experience easier for both doctor and

patient. The information contained in the source can be verified elsewhere. For example,

Graves explains that avoiding a patient can only cause trouble, as it is the doctor’s moral

responsibility to be there for their patients as much as they possibly can despite any
 20

inconveniences that might bring, which can be corroborated by Linda Girgis in her

publication “Why Doctors Are Losing the Public’s Trust”, in which Girgis asserts that

doctors must put patient’s well being before any potential financial drawbacks that may

come with making that choice. The purpose of this article is to convince other medical

professionals to focus on the patient personally rather than avoiding them if they are

difficult to deal with. Thus, her specific audience would be other medical professionals

while because they are a group of people that would best sympathize with her at the

beginning of the article and agree with her towards the end when she begins to share her

opinions.

Greenhalgh, T., & Gill, P. (1997, December 6). Pressure to prescribe: Involves a complex
interplay of factors. ​British Medical Journal​, ​315​(7121), 1482+. Retrieved from Gale In
Context: High School database.
In an article for the British Medical Journal, Trisha Greenhalgh and Paramjit Gill explain

the factors that are taken into account when prescriptions are given and elaborate on the

pressure that is felt by physicians to prescribe medication. Prescriptions are influenced

mainly by the doctor, patient, doctor-patient interact, and the social context of the time,

specifically financial incentives, and prior conceptions about the medications. According

to the authors, studies have shown that prescribing behaviors of doctors have to do with

the doctor’s perspective on the patient’s social background. They explain that, in many

cases, practitioners prescribe more medications than patients expect, likely because they

want to meet a patient’s expectations and then over-estimate. They then establish that

prescriptions are given based on many different decisions, which are made by a multitude
 21

of people giving their influence and opinion. Ultimately, methods should continue to be

set so that the factors that impact the decision to prescribe are regulated.

The authors, Trisha Greenhalgh and Paramjit Gill, are qualified to discuss the topic of

prescribing behaviors of doctors because their credentials include work as senior lecturers

at the Department of Primary Care and Population Sciences at the Whittington Hospital.

Both of their contact information is listed at the bottom of the article. Although written

over 10 years ago, this source is still relevant because it describes an issue that is

currently still in existence. Giving prescriptions still require careful decision making and

are influenced by many different factors. The authors thoroughly evalulated all sides of

the issue. For example, they discuss the difficulty that many doctors might have when

prescribing due to the influence of the patient and their own preconceptions about the

medication that they want to be prescribed, before explaining that this cannot be the only

influence. This inclusion shows that alternative viewpoints to the author’s were

acknowledged because the authors state that there is reasoning why such events occur,

but they still stand by the idea that more factors, such as the financial ability and true

condition of a patient, need to be taken into account. The information contained in the

source can be verified elsewhere. For example, the author says that the placebo effect in

medication can cause a reduction in symptoms, even if there is no true result, which can

be corroborated by Tim Newman in his article, “Is the Placebo Effect Real”, where he

states that placebos are a psychological method of self-healing that occurs due to the

reduction of conditions that are usually self-reported. The purpose of this article is to

inform doctors on the process of prescribing, and to caution them against giving into
 22

patients who are already sure of what medication and treatment they want when they

come in. Thus, the audience would be doctors. This article is appropriate for this purpose

and audience because it uses formal language and provides plenty of data supporting their

point to appeal to physicians.

Laurant, Miranda, et al. "Evidence Based Substitution of Doctors by Nurses in Primary Care?"
British Medical Journal​, vol. 320, no. 7241, 15 Apr. 2000, p. 1078. ​Gale in Context:
High School,​
link.gale.com/apps/doc/A61995046/SUIC?u=glen20233&sid=SUIC&xid=9acec572.
Accessed 20 Apr. 2020.
In an article for the British Medical Journal, ​Miranda Laurant​, ​Michelle Sergison​,

Shirley Halliwell​ and ​Bonnie Sibbald​ discuss the impact of substituting nurses for

doctors in order to optimize the cost effectiveness of health services for patients. By

substituting nurses, patients will have to pay significantly less for treatment that is still

good enough to support them. The authors explain that, in the past forty years, nursing

has become an increasingly popular profession, while the demand for nurses increased as

well. Nurses also began learning a lot more things about medicine, thus allowing them to

fill health needs that they wouldn’t have before that time. Nurses can fulfil a wide range

of tasks that allow them to involve themselves deeply in patient care, thus making them

essential for cost-effective treatment for patients.

The authors of this article, ​Miranda Laurant​, ​Michelle Sergison​, ​Shirley Halliwell

and ​Bonnie Sibbald​ are qualified to discuss nursing and its impact on patient care

because their credentials include work as a researcher for the Centre for Quality Care

Research at the Universities of Nijmegen and Maastricht, a research associate for the

Research and Development Department, and as a research technician at the University of

 23

Manchester. The author’s information can be found at the bottom of the article. Although

written more than 10 years ago, this source is still relevant because it covers the topic of

doctors and nurses and their relationship, which is still a relevant topic today, when

doctors and nurses still have a similar dynamic and still work closely together. The

authors thoroughly evaluated all sides of the issue. For example, they discuss how nurses

are sometimes less qualified for treating certain illnesses, while still maintaining that they

have a wide range of abilities that makes them an asset for treating patients who cannot

afford to see a doctor but need care. This inclusion shows that the authors evaluated all of

the pros and cons of nurses substituting for doctors. The information in this source can be

verified elsewhere. For example, the authors say that nurses have a wide range of skills

that are very useful in treating patients. This can be corroborated by M Fukada in his

article, “Nursing Competency: Definition, Structure, and Development”, in which he also

establishes that nurses need to be competent in a multitude of different practices. The

purpose of this article is to inform policy makers and medical practices about the ways by

which they can help their patients afford care while taking advantage of the nurses that

work with them. The audience would thus be those policy makers, because they are the

ones who can make a difference for it. The article is appropriate for this purpose and

audience because it deeply covers both sides while explaining the importance of nurses in

primary care.

Mackenzie, G. M. (1997, September 13). The caring doctor is an oxymoron. ​British Medical
Journal,​ ​315(​ 7109), 687+. Retrieved from Gale In Context: High School database.
 24

In an article for the British Medical Journal, Graeme Mackenzie explains why she

believes that over personalizing patient care can result in poor treatment in general

practice. He claims that, ultimately, being a doctor is more about being able to make a

decision without any bias, and that by caring, there is a greater risk of making the wrong

decision when it comes to treatment. Additionally, he believes that over-personalized

medicine can encourage patients to demand too much of a doctor’s time because it makes

them feel comfortable enough to come to the doctor for any small ailment, even when

there may be other patients who need attention more. He admits that medicine often

involves difficult decisions, particularly when prioritizing patients, but that patients must

also be able to step back and help themselves when the solution can be found by a simple

internet search. Ultimately, he finds that caring for a patient can impair the intellectual

processes necessary for being a doctor on a more professional level.

The author, Graeme Mackenzie, is qualified to discuss the intimacy of a doctor-patient

relationship because her credentials include working as a general practitioner who sees

many patients. His email address is not in the article but other relevant contact

information can be found at the bottom of the page. Although written more than 10 years

ago, this source is still relevant because it discusses the personal experiences and

opinions of someone who has worked as a general practitioner and has formed ideas and

collected evidence based on their own experiences as well as outside. The author

thoroughly evaluated all sides of the issue. For example, he acknowledges patients who

believe that they should have as much attention as they feel as if they require by saying

that he understands and recognizes the importance of every patient. This inclusion shows
 25

that alternate viewpoints to the authors were acknowledged because the author shows that

he has looked at the issue from multiple points of view and completely understands all of

the perspectives. The information contained in the source can be verified elsewhere. For

example, the author says that there is a lot of under-capacity in general practice. This can

be corroborated by FD Richard Hobbs in his article “Academic primary care: at a tipping

point?”, in which he admits that academic general practice is at an under capacity, which

is why there should be more research done overall relating to primary care. The purpose

of this article is to convince doctors that it is more important to keep a clear head than it

is to become emotionally connected to their patients. The audience, then, would be the

doctors, particularly those who have private practices. The article is appropriate for this

purpose and audience because it contains a lot of anecdotes that doctors would be able to

connect to, thereby making it more effective towards doctors in particular.

Meryn, S. (1998, June 27). Improving doctor-patient communication: Not an option, but a
necessity. ​British Medical Journal,​ ​316(​ 7149), 1922. Retrieved from Gale In Context:
High School database.
In an article for the British Medical Journal, Seigfried Meryn discusses the

changing times and explains why, as technology allows for greater communication, the

medical field has to evolve. The author mainly emphasizes the idea that the concept of

responsibility for an individual patient’s health has been shifting, as patients now want to

feel fully involved in the medical decisions made about them. When doctors do not

include their patients in discussion, it is more likely that the patient will leave that doctor.

Meryn found that, as doctors increase the ways by which they communicate, the amount
 26

of trust that patients have for their doctors will also increase. Doctors have a moral

responsibility to give the best care that they possibly can to their patients, as patients

ultimately put their utmost trust in doctors to help them. The author also concluded that

there is a clear correlation between effective communication and improved health

outcomes. This correlation was likely due to the impact of emotional health on

physiological well-being. The author asserts that it has been found that current teaching

methods regarding communication skills are ineffective, as many doctors do not know

how to effectively communicate. Learning communication skills will take time, and

developing new ways to communicate will also create a need for doctors to learn about

how to use these new methods. However, Meryn asserts that teaching communication

skills should be part of all medical training, as it is so essential to making sure that the

patient experience is positive and does not worsen any condition that the patient may be

in.

The author, Seigfried Meryn, is qualified to discuss doctor-patient communication

because of his credentials as a specialist in internal medicine and endoscopy in Vienna.

His contact information, although not available on the article, can be found online

through his website. Although written over ten years ago, this source is still relevant

because it specifically addresses the changing times and establishes that the information

presented will still be accurate in the future, as times are always evolving. The ideas

expressed in the article are still valid because doctor-patient communication and the ways

by which it happens are still changing. The author thoroughly evaluated all sides of the

issue. For example, he acknowledges that developing communication skills may take a
 27

significant amount of time, and that it will be difficult to truly incorporate learning these

skills into curriculums. The inclusion shows that alternate viewpoints to the author’s were

acknowledged because the author is admitting that it will be difficult, especially for those

who already work in the medical field, to adapt to changes. However, he still asserts that

it is necessary, despite the difficulty. The information in the source can be verified

elsewhere. For example, the author says that a good doctor-patient relationship can

improve the health of a patient. This information can be corroborated by an article

published by the American College of Obstetricians and Gynecologists titled “Effective

Patient-Physician Communication”, in which it is established that a physician who

encourages open communication can improve the chances of finding an accurate

diagnosis and thereby ultimately benefit long-term health. The purpose of this article is to

encourage teaching communication skills in medical schools and throughout the pre-med

process. The audience is those who are currently working as physicians, as well as those

who work at medical schools and universities who can make a difference in the issue

discussed. The article is appropriate for this purpose and audience because it fully

explains the reasoning behind why better communication skills are needed while

addressing the long-term benefits of such programs.

Naditz, Alan. "Internet-based Office Visits Can Cut Heart Attack Risk."
​Telemedicine and E-Health​, vol. 14, no. 4, May 2008, p. 317. ​Gale in
​Context: High School,​ link.gale.com/apps/doc/A179736522/
GPS?u=glen20233&sid=GPS&xid=7d464ef3. Accessed 24 Apr. 2020.
In an article for Telemedicine and E-Health, Alan Naditz presents and analyzes the data

found from a study done by the Temple University School of Medicine that ultimately

revealed that patients who communicate regularly with their patients over the internet
 28

show a significant reduction in their blood pressure, and other types of cardiovascular

disease risk factors. This is likely due to the fact that there is less of a time commitment

for the patient, and there is also a reduction in the amount of stress on the patients when it

comes to visiting their doctors. Naditz establishes that telemedicine, combined with the

traditional doctors office visits, can improve doctor-patient communication and lower the

patient’s risk of developing heart disease or other cardiovascular diseases later in their

lives.

The author, Alan Naditz, is qualified to cover this topic because of his work as a writer

for many different medical journals. His information can be found with an online search.

The author thoroughly evaluated all sides of the issue. For example, he analyzed the

study done in depth, while making sure to point out the potential issues with

telemedicine, claiming that it would be overall more beneficial in combination with the

regular care given by an in-person doctor. The information contained in his source can be

verified elsewhere. For example, the author says that using an internet-reporting system

can improve doctor-patient communication. This can be corroborated by Maryam

Alvandi in her article “Telemedicine and its Role in Revolutionizing Healthcare

Delivery”, in which she also suggests that telemedicine can greatly improve

communication between doctors and patients due to its convenience and accessibility.

The purpose of this article is to inform doctors of the potential benefits of telemedicine.

The audience would then be the doctors who are able to put telemedicine into practice at

their own offices. The article is appropriate for this purpose and audience because it

provides sufficient proof and uses language that is easily understandable by physicians.
 29

Nielsen, M. (2019). Direct Primary Care--Where Does Integrated Behavioral Health Fit?

Families, Systems & Health,​ ​37(​ 3), 255+. Retrieved from Gale In Context: High School

database.

In an article for the American Psychological Association, Marci Nielson discusses the

integration of behavioral health services into primary care. She establishes that

technology is a growing method for creating a convenient, advanced, comfortable patient

experience. Nielson explains that behavioral health integration would help to maximize

comprehensive care, but it would also create an increase in clinician burnout. There are

currently concerns about a primary care physician workforce shortage, which is partially

attributed to difficult times in medical school and an overload on administrative burdens.

Doctors would much rather be able to care for their patients, instead of spending so much

time doing paperwork. Nielson suggests that a team-based approach to primary care, in

which administrators try to reduce workload overall by distributing it more evenly

throughout a team of professionals. This would allow for lower burnout, and more

effective collaboration and trust. Additionally, technology will allow for online

consultations and telehealth to become more popular, so that there are fewer costs and

more focus on care. Nielson concludes by stating that primary care should be evolving

further in order to enhance health care and maximize the doctor’s amount of time per

patient. Ultimately, a better distribution of work among teams in groups will allow for

this, and an independent direct primary care practice will allow for stronger

patient-and-family centered care.

 30

The author, Marci Nielson, is qualified to discuss the topic of the integration of

behavioral health into primary care because her credentials include working as the

President and Chief Executive Officer of the Patient-Centered Primary Care

Collaboration, an organization which works to improve the U.S health system by

strengthening advanced primary care. Her contact information can be found on her

website. Written within the past year, this source is current on integration of behavioral

health. The author thoroughly evaluated all sides of the issue. For example, she

acknowledged the perspective that adding in an extra factor for physicians to take into

account could contribute to burnout, and ultimately, poorer performance on the part of

the doctor, but ultimately explains that behavioral health care should be integrated into

primary care because of its ability to widen the perspective and view of a patient’s

condition. Even though this is an opinion, the author still presents claims, reasoning, and

evidence to show why that opinion is valid and credible. For example, when discussing

burnout as a whole, Nielson cites a study that proved that a broader scope of practice,

such as one that takes into account behavioral health, is generally associated with

maintaining physician wellness, which is very important. This coverage can be

considered broad and deep because it provides plenty of deep research and data regarding

the topic, while still covering multiple aspects of the doctor experience. The information

in the source can be verified elsewhere. For example, the author says that burnout is a

long-term stress reaction, causing symptoms of exhaustion, depersonalization, and a lack

of feelings of personal accomplishment, which can be corroborated by Robert Pearl in his

article, “The Unspoken Causes of Physician Burnout”, in which he states that burnout in
 31

physicians is characterized by depression, exhaustin, and dissatisfaction. The purpose of

this article is to encourage practices to increase the focus on behavioral health and spread

work out more evenly among staff so that there is wider comprehension for patients as

well as a more fulfilling experience for doctors.

Ostwal, S. (2019). Are we really providing quality care to patients; A physician's perspective.
Indian Journal of Palliative Care​, ​25​(3), 481. Retrieved from Gale General OneFile
database.

In a letter addressing the editor of the Indian Journal of Palliative Care, Shrenik

Ostwal asserts his opinion on maximizing the benefits of care for those who suffer from

life-threatening illnesses. Ostwal claims that the most important aspect of palliative care

is the ability to connect and communicate with patients on a personal level, as this would

make it easier to provide care that perfectly meets the patient’s needs. There is also a

decrease in the number of opioids available, which makes it harder for patients who

require such drugs for pain relief to acquire any. Additionally, the number of patients

being referred to palliative care has drastically increased, to the point where there is now

a decrease in strong interpersonal relationships between doctors and patients. Every staff

member working in palliative care wants to provide the best treatment for each individual

patient. There are many factors, however, that work to inhibit them. In order to reduce the

effects of these factors, there needs to be an increase in resources, trained staff,

communication, and family involvement.

Shrenik Ostwal is a consultant in the Department of Pain and Palliative Medicine

in Narayana Superspecialty Hospital, which is located in West Bengal, India. He earned

 32

his medical degree in palliative medicine from Tata Cancer Research Memorial Institute.

Dr. Ostwal has much experience dealing with terminally-ill patients from his work at the

hospital. He can be contacted through ResearchGate or through the Narayana

Superspecialty Hospital, where he works. This source was published on July 1, 2019,

making it highly relevant to current times. Dr. Ostwal provides a deep and broad analysis

of the current status of palliative care and the proper ways by which he believes it can be

improved, as shown by his use of cause-effect scenarios as well as thorough explanations

for each scenario. He presents solid evidence and reasoning to show why his opinions

are valid and credible. For example, he addresses the official definition of palliative care

before providing reasons why the established standards are not being met. The

information contained in the source can be verified elsewhere. Dr. Ostwal claims that

bereavement counseling can enhance the quality of life for those who are suffering from

life-threatening illnesses, which can be corroborated by Jennifer Tabler in her publication

“Missed Opportunity: Hospice Care and the Family”. Tabler also states in her article that

patients who chose to go through bereavement therapy felt higher satisfaction with the

care that they were given. The purpose of this article is to raise awareness about the lack

of resources that those who work in palliative care deal with. The audience is, ultimately,

others who work in the medical field, as the article was published in the Indian Journal of

Palliative Care. The article is appropriate for this purpose and audience because it is

appealing to the audience for support, as Dr. Ostwal is arguing that the field of palliative

care has been underserved.

 33

Paiva, D., Abreu, L., Azevedo, A., & Silva, S. (2019, June). Patient-centered communication in
type 2 diabetes: The facilitating and constraining factors in clinical encounters. ​Health
Services Research,​ ​54(​ 3), 623+. Retrieved from Gale In Context: High School database.
In an article for Health Services Research, Dagmara Paiva, Liliana Abreu, Ana Azevedo,

and Susana Silva explore the aspects of patient-centered communication for patients with

type two diabetes in particular. Patient-centered communication is the most vital part of

patient-centered care. Communication skills on the part of the healthcare providers is a

must, especially with patients with diabetes, because there are many crucial pieces of

information that must be passed on to patients that cannot be misunderstood. There are a

lot of very important aspects of clinical communication that impact a patient’s condition.

Ultimately, effective communication helps with making decisions, exchanging

information, responding to emotions, and enabling patient’s ability to manage their own

conditions. The author’s provide the results of a study that they conducted in which

patients with specific characteristics were sampled in order to make sure that there were

providers matched for patients of all kinds, and then the providers showed varying levels

of care and proper communication as would be given in a regular care setting. The results

showed that the patient doctor relationship, which includes values, roles, and

responsibilities of both patients and providers when making decisions, disease and

treatment-related behaviors, and gathering and providing information were the three main

factors that impacted the participants. The authors finish by stating the patients can claim

a more active role in communications with their healthcare providers, which will thus

enable better navigation of particular services necessary for those patients. Additionally,

the patients will be able to conform to more treatment-related behaviors.

 34

The authors, Dagmara Paiva, Liliana Abreu, Ana Azevedo and Susana Silva are qualified

to discuss the topic of patient-centered communication in care for those with type 2

diabetes because their credentials include PhDs among all four authors, and work at the

Institute de Saude Publica and USF Monte Murado, and multiple hospitals. Their contact

information can be found online, through the hospitals at which they respectively work.

Written less than a year ago, this source is current on patient-centered communication.

Even though this is an opinion, the author still presents claims, reasoning, and evidence

to show why that opinion is valid and credible. For example, they provide data from a

study that they completed themselves, while explaining the reasoning for those results

organized carefully into parts. The coverage can be considered broad and deep because it

gives such an in depth analysis of the results while still covering multiple aspects of

doctor-patient communication. The information contained in the article can be verified

elsewhere. For example, the authors claim that 1.5 million people die of diabetes each

year, because diabetes is a leading cause of death globally, which can be corroborated by

Andrew Stokes and Samuel H. Preston in their article “Deaths Attributable to Diabetes in

the United States: Comparison of Data Sources and Estimation Approaches”, in which

they state that diabetes is the seventh leading cause of death in America, due to the

massive risks and complications stemming from the condition. The purpose of this article

is to inform health care providers and patients with diabetes about proper communication,

particularly when giving instructions about treatment. The audience would thus be

diabetic patients and their doctors. This article is appropriate for this purpose because it
 35

provides hard research that was done by the authors as well as support from other sources

written by other researchers.

Pidano, A. E., & Honigfeld, L. (2017). "Doctor, are you listening?" Communication about
children's mental health and psychosocial concerns. ​Families, Systems & Health,​ ​35(​ 1),
91+. Retrieved from Gale In Context: High School database.
In an article for the Families, Systems, and Health Volume, Anne E. Pidano, and Lisa

Honigfeld describe the importance of communication, particularly between parents and

care providers in a pediatric setting. They cite many different studies, particularly those

that support the idea that communication skills, especially related to the disclosure of

mental health issues, are very important in order to maximize the quality of care for

pediatric patients. Especially with younger kids, parents are the most important way by

which pediatricians are able to get information about their patients. The authors make

sure to emphasize the idea that pediatricians need to be more open to discussing

psychosocial issues that parents might have in mind relating to their child. Pediatricians

should follow specific guidelines in order to properly provide care to their patients,

collaborating with parents to yield the best possible results. Ultimately, the authors

conclude that more effective communication will help to ensure that pediatric residents

will have access to better communication tools and will help them to identify treatments

that a patient might benefit from.

The authors are qualified to discuss doctor-patient communication. Pidano’s

credentials include a PhD and work experience in the Department of Psychology for the

University of Hartford. Honigfeld’s credentials include a PhD and work experience at the

Child Health and Development Institute of Connecticut. Both of their contact information
 36

can be found at the bottom of the article. Written 3 years ago, this source is current on

the topic of doctor-patient communications. Although this is an opinion, the authors still

presents claims, reasoning, and evidence to show why that opinion is still valid and

credible. For example, they cite many previous studies throughout the entire article, such

as the one carried out by Nobile and Drotar, which marked the importance of

parent-provider communication. The coverage can be considered broad and deep because

of the number of other studies cited and because of the fact that the article covers many

different subtopics related to the overall argument. The information in this source can be

verified elsewhere. For example, the authors say that The American Academy of

Pediatrics guidelines for mental health competencies specifically notes the importance of

the provider’s connection with the child and the family. This can be corroborated by the

American Academy of Pediatrics, in the publication “The Future of Pediatrics: Mental

Health Competencies for Pediatric Primary Care”, in which it is confirmed that the

provider must have a positive relationship with the child and the child’s family. The

purpose of this article is to encourage doctors to form a stronger relationship with their

patients, and to listen to their concerns about their children’s mental health. The audience

would then be pediatricians. This article is appropriate for this purpose and audience

because it provides plenty of support from previous studies as well as a call to action at

the end of the article asking for more doctors to follow their proposed guidelines.

Pritchard, M. J. (2011). Using the hospital anxiety and depression scale in surgical patients.
Nursing Standard​, ​25​(34), 35+. Retrieved from Gale General OneFile database.
 37

In his paper “Using the hospital anxiety and depression scale in surgical patients,''

Michael John Pritchard explains the psychological effects that an operation can have on a

patient, and describes the ways by which he believes that doctors can help alleviate some of the

stress brought onto these patients. Pritchard specifically focuses on preoperative anxiety and

depression, which can occur especially among patients who feel as if they need to maintain an

image or those who are worried about the outcome of the surgery. He also describes how, for

many patients, anxiety can have adverse physiological effects that have the potential to impact

the surgery. Pritchard suggests that doctors utilize the Hospital Anxiety and Depression Scale

(HADS) to help patients go into and come out of surgery with less anxiety, because HADS is a

short, effective way to measure a patient’s anxiety levels or their risk for developing anxiety later

on. However, he does not fail to mention that some levels of anxiety are normal, and can actually

be beneficial for the patient. Higher levels of anxiety can impact the effectiveness of anesthesia

as well, so Pritchard cautions doctors to focus more heavily on the mental health of the patient as

they are carrying out the normal procedures for a surgery. He suggests that each patient should

be given HADS before major or minor surgeries, and that the magnitude of psychological care

that they require should be based on the results of the test. Pritchard asserts that measuring

anxiety before surgeries should become part of the pre-operative assessment instead of being

considered an optional part of the process.

Michael John Pritchard is qualified to discuss the psychological effects of surgery

preoperative and postoperative, as he has worked as an advanced nurse practitioner at

Clatterbridge Hospital. His contact information, including his email address, can be found at the

bottom of the article. Written less than ten years ago, this source is still relevant because it
 38

discusses an issue that is still current, and contains information that can still be applied. Surgery

is still a common medical procedure. The author thoroughly evaluated all sides of the issue. For

example, he acknowledges that adding HADS as part of the preoperative evaluation could be

expensive, as it costs money and resources. He makes sure to discuss the how beneficial HADS

has been in the past, but still admits that there is a price to pay for such treatment. Still, he stands

by his opinion that it should become a required part of the surgical process. The information

contained in the source can be verified elsewhere. For example, the author says that HADS is a

highly accurate way to measure anxiety and depression quickly, particularly for those who are

suffering from physiological pain as they take it, which can be corroborated by Michael O’Leary

in his article “HADS: A Quick and Effective Measure of Anxiety and Depression in Acute

Pain”, in which he claims that HADS has been proven to be a valid way to measure anxiety and

depression that is specifically associated with pain. The purpose of this article is to convince the

reader that HADS should be added as part of the preoperative procedures for those who are

about to go into surgery. The audience is those who work in the medical field, specifically

surgeons, as those are the people who can make a difference in the issue that the author

discusses. The article is meant to help convince other members of the medical field to work

towards better mental health care preoperation, and to help make HADS a mandatory part of it.

Ray, A., & Pathak-Ray, V. (2018, November). Withering trust: Redefining the doctor patient
relationship. ​Indian Journal of Ophthalmology,​ ​66(​ 11), 1529. Retrieved from Gale
General OneFile database.

In a document for the Indian Journal of Ophthalmology, Amitava Ray and Vanita

Pathak-Ray analyze the ways by which the relationship between the doctor and patient
 39

has changed over the course of history, while discussing how to improve the current

status of that relationship. They assert that, in current times, it is much easier for patients

to find information through the internet. In the past, this has not been a problem, as it was

primarily the doctors that held the highest authority on different medical conditions and

the symptoms that come with them. However, the authors have found that as technology

continues to progress, patients are often coming in better informed about their conditions.

Doctors then find that these patients have unrealistic expectations about the treatment that

they will receive, as the patient believes that everything they read on the internet is

irrefutably correct. Communication and trust between the doctor and patient is essential,

especially now that everyone has access to information. The authors also mention health

care, which has now become significantly more expensive worldwide. The authors claim

that the increase in the cost of healthcare has made it much more difficult for people to

get the treatments that they need. Additionally, pay for doctors in government hospitals is

much lower than in the private sector, so public hospitals struggle with an overload of

patients, many of whom can not afford the treatment that they need. Ultimately, the

authors strongly believe that effective communication and new policies to improve costs

will be essential to improving the overall reputation of doctors all around the world.

The authors, Amitava Ray and Vanita Pathak Ray, are qualified to discuss

the relationship between doctors and patients. Amitava Ray works in the Department of

Neurosurgery at Apollo Hospitals, whole Vanita Pathak-Ray works in the Department of

Ophthalmology at Apollo Hospitals. Both of them can be found online, and can be

contacted through LinkedIn. Written less than a year ago, this article is current on the
 40

topic of doctor-patient communication. The authors thoroughly evaluated all sides of the

issue. For example, they acknowledge those who put their trust in the internet rather than

medical professionals by stating that they are valid in wanting to know more about their

conditions and that the internet can help them become more informed. This helps to

show the viewpoint of those who believe it is entirely the fault of doctors for not

completely informing the patient themselves. The information contained in the source

can be verified elsewhere. For example, the authors state that public hospitals are unable

to deal with the massive number of patients who need care, as they are poorly

understaffed. This can be corroborated by Kim Krisberg in her article “Study: Not

enough hospitals are addressing ER overcrowding”, in which she agrees that researchers

have found that there are way too many patients who require treatment, and not enough

being done to solve the problem. The purpose of this article is to convince the medical

community that there needs to be a bigger focus on communication between doctors and

patients so that a trust is formed between the two parties. The main audience is medical

professionals, as they are the main group who would be able to implement the author’s

suggestions. The article is appropriate for this purpose and audience because the authors

provide facts and evidence, as well as anecdotes that the reader could relate to as a

doctor, in order to support the main point.

Salisbury, C., & Fahey, T. (2006, April 25). Overcoming clinical inertia in the management of
hypertension. ​CMAJ: Canadian Medical Association Journal,​ ​174(​ 9), 1285+. Retrieved
from Gale In Context: Science database.
In an article for the Canadian Medical Association Journal, Chris Salisbury and Tom

Fahey explain clinical inertia as a concept and describe the reasons why policy should be
 41

changed to minimize clinical inertia. They first define clinical inertia as being a blanket

term to describe when chronic diseases, particularly hypertension and diabetes, are

inadequately managed due to an overestimation of care provided, lack of education, and a

lack of proper treatment plan for patients. They go on to describe a study done, in which

it was discovered that patients with hypertension and diabetes that were given medication

with a step-by-step care protocol administered by a nurse were more likely to show an

improvement in blood pressure. They propose that, ultimately, the best way to handle

such a situation where clinical inertia is occuring, is to try to encourage drug treatment

along with implementation of increased care programs by all types of healthcare

professionals, including nurses and specialists. An overall policy that dictates the way the

programs work will make it easier for communication to occur, and thus will help to

improve the condition of a patient quicker and more efficiently.

The primary author, Chris Salisbury is qualified to discuss clinical inertia because his

credentials include work as a Professor of Primary Health Care in the Department of

Community Based Medicine at the University of Bristol. Information about Salisbury can

all be found at the bottom of the article, including his email address and current

occupation. Although written over 10 years ago, this source is still relevant because it

encourages drug implementation along with care implementation, which is still not

widely practiced. Additionally, since the policies suggested are based off of an opinion,

they are still valid as being supported with evidence from studies. The author thoroughly

evaluated all sides of the issue. For example, he acknowledges the idea that a

collaborative treatment may not make any difference by admitting the main study he uses
 42

as a basis for his opinion may have shown results that were based partially on chance.

This inclusion allows for the author to express that his opinions were built on more than

just one study, while still addressing an opposing view. The information contained in the

source can be verified elsewhere. For example, the author says that clinical inertia is

ultimately a lack of adequate care for a patient with chronic illness that results in

negative consequences. This can be corroborated by William David Strain in his article

“Clinical Inertia in Individualizing Care for Diabetes: Is There Time to do More in Type

2 Diabetes?”, in which he explains clinical inertia as being a failure to establish

appropriate targets in treatment in order to sufficiently achieve treatment goals. The

purpose of this article is to inform physicians of clinical inertia so that they can avoid

experiencing it with their own patients. The audience would then be such physicians, as

they are the most likely to be able to implement the ideas presented by the authors. The

article is appropriate for this purpose and audience because it presents valid sources and

evidence for the ultimate opinion while still using language for both physicians and

policymakers.

Snowden, M. (2012, April). Patients can't do it alone: Hospitals and health systems hold the keys
to enabling patient accountability. ​Health Management Technology​, ​33​(4), 16+.
Retrieved from Gale In Context: High School database.
In an article for Health Management Technology, Miles Snowden describes the ways by

which he believes that hospitals and other health systems should manage patients,

particularly those with chronic illnesses. He finds that putting more responsibility on the

doctor to interact with patients will result in better treatment outcomes for patients,

because many patients are not as proactive about following treatments in the way that
 43

doctors expect them to be. Snowden further expands on this by explaining that the

physicians and hospitals alike must develop a shared mindset, targeting optimal outcomes

with low overall cost for both the patient and the doctor. The best way to do this,

ultimately, is to encourage patient accountability, while attempting to improve the health

of at-risk patients instead of attempting procedures. This will financially benefit the

hospital while benefiting the patient physically. Snowden also pushes the idea that

providers should provide health-management technology in order to manage care away

from home, reducing the overall time a patient has to stay at the hospital. Finally, he

establishes the idea of transparency in treatment, encouraging informed decision making

as being significant in improving the doctor patient relationship, which then encourages

positive patient behavior in complying with treatments.

The author, Miles Snowden, is qualified to discuss the topic of patient compliance and

accountability because his credentials include his role as the chief medical officer of

OptumHealth. His contact information can be found online. Written less than 10 years

ago, this source is still relevant, especially since it covers issues with patient

accountability, which have no real, achievable solution. Even though this is an opinion,

the author still presents claims, reasoning, and evidence to show why that opinion is valid

and credible. For example, the article is carefully organized by the three categories of

“accountability enablers” that he recommends hospitals to consider when adopting

models of accountable care, and provides detailed explanations and evidence for each

enabler. The coverage can be considered broad and deep because of how it covers each

category thoroughly, explaining the reasoning for each and the ways by which the
 44

hospitals can avoid making errors that could lower the quality of a patient’s treatment.

The information contained in the source can be verified elsewhere. For example, the

author says that a strong doctor patient relationship is essential to changing patient

behavior, particularly when it comes to complying with treatments. This can be

corroborated by Ngaire Kerse in her article “Physician-Patient Relationship and

Medication Compliance: A Primary Care Investigation”, in which she confirms that the

patient-doctor relationship is essential to the delivery of primary care health. The purpose

of this article is to encourage doctors to hold their patients accountable and give them

more responsibility in managing their own treatment. The audience is the physicians, as

they are the ones who can implement the authors ideas. The article is appropriate for this

audience and purpose because it provides plenty of evidence and is organized neatly so

that hospitals and physicians can follow each aspect of the author’s ideas.

Tan, S.Y. (2012, April 15). Terminating the doctor-patient relationship. ​Family Practice News​,
42​(7), 49+. Retrieved from Gale In Context: High School database.

In an article for ​Internal Medicine News​, S.Y Tan details the ethical and legal

implications and factors that can affect the process of refusing treatment. Tan states that

the patient may be refused treatment with or without the patient’s consent in situations

that involve irreconcilable differences. However, it is important to note that a doctor must

continue to treat the patient until a new doctor has been found. Additionally, a group

practice cannot legally refuse to treat a patient or group of patients, although one member

may be allowed to refuse, the entire practice may not. Tan asserts that physicians are

obligated to treat their patients, and they cannot do this if they withdraw care unless they
 45

have consulted the patient. There are many patients who can be antisocial or disruptive.

However, in many cases, these patients require life-saving treatments. Despite the nature

of such difficult patients, the physician is required to them treat if there are no other

practices in the area that are able to treat a difficult patient. If there are, then the physician

is allowed to refuse treatment.

The author of this article, S.Y. Tan, is an emeritus professor of medicine at the

University of Hawaii, Honolulu. Dr. Tan has written a book about the subject as well. His

email address and other contact information can be found at the bottom of the article.

Although it was written over 5 years ago, the article is still relevant because it contains

information about policies that would not have drastically changed over the past 10 years

due to the precedents set by the court cases cited in the article. The author thoroughly

evaluated all sides of the issue. For example, he acknowledges many different court cases

all of which had different outcomes by providing details on each one while giving deep

explanations on the reasoning behind each ruling. The information contained in the

source can be verified elsewhere. For example, the author says that doctors have a

responsibility to continue treating a patient until a new doctor has been found. This can

be corroborated by Laura L. Katz in her article “When a Physician May Refuse to Treat a

Patient”, where she claims that physicians have to continue to provide care until the

relationship between the physician and patient has been terminated. The purpose of this

article is to inform about the possible reasons and situations in which a doctor is allowed

to terminate a relationship with a patient. His likely audience is medical students or active

medical professionals, as he is a professor and his goal is to teach. This article is

 46

appropriate for this purpose and audience because it includes many real-life examples of

how and when certain policies have been challenged or applied, thus reinforcing his

points on how to best deal with different situations.

Worcester, S. (2012, June). Build trust with parents to overcome vaccine hesitancy. ​Pediatric
News​, ​46​(6), 8. Retrieved from Gale General OneFile database.
In an article for Pediatric News, Sharon Worcestor discusses the current child

immunization programs in the United States and explains why many children have not

been able to benefit from such programs. Much of the information in the article is

paraphrased and quoted from Dr. Reingold, a professor of epidemiology. The author

establishes that immunization programs have been successful in the past, but the fact that

many parents are overly concerned about the safety of vaccines has lessened the positive

impacts of immunization. She mainly finds that vaccine hesitancy, refusing vaccines

despite their availability, is an issue that greatly contributes to the development of

diseases. However, Worcestor claims that, with the building of trust with potentially

hesitant parents, vaccines can reach more children. Although parents have worries and

anxiety regarding vaccines, it is likely that with trust-building and patience, these worries

can be erased. Additionally, the author found that having accurate information and fair

compensation for those who have been negatively impacted by vaccines can help

promote vaccine programs.

The author, Sharon Worcestor, is qualified to discuss vaccine hesitancy because

of her 25 years of experience in medical journalism and her various work as a reporter

who specializes in science and medicine. Written less than 10 years ago, this source is

current on the topic of vaccine hesitancy, especially since the issue is still relevant. The
 47

author thoroughly evaluated all sides of the issue. For example, she acknowledges the

parents who are against vaccines, and explains why those parents feel the way they do

about vaccinations. This inclusion shows that the author evaluated all sides, while

understanding that there are many factors that impact the views that people have on the

issue of vaccines. The information contained in this source can be verified elsewhere. For

example, the author says that those who refuse vaccinations are most likely those with a

higher income and, generally, a college degree. This information can be corroborated

Nicholas Bakalar in his publication, “Rich, White, and Refusing Vaccines” in which he

explains that the main group of people who refuse vaccinations are often wealthy and

well-educated. The purpose of this article is to encourage doctors to build trust with their

patients, particularly with the parents of younger patients. The audience is mainly

pediatricians, as they will have to deal with young patients more often and will also

benefit the most from reading this article. The article is appropriate for this purpose and

audience because it is written formally and contains verifiable information, but still

manages to provide solid advice for pediatricians who are concerned with communication

about vaccines.

Zulfiqar, A.A., Hajjam, A., Talha, S., Hajjam, M., Hajjam, J., Erve, S., & Andres, E. (2018).
Telemedicine and Geriatrics in France: Inventory of Experiments. ​Current Gerontology
and Geriatrics Research​, ​2018​. Retrieved from Gale Academic OneFile Select database.
In an article for the current Gerontology and Geriatrics Research, A.A. Zulfiqar, A.

Hajjam, S. Talha, M. Hajjam, S. Erve, and E. Andres, explain the impact of telemedicine

practices on health fields such as diabetology, nephrology, neurology, and cardiology,

fields that usually apply particularly to geriatric patients. Information and communication
 48

technologies allow for elderly people to have improved medical care, particularly those

who are dependent. Telemedicine, is a form of medical practice that uses communication

technology to interact with their patients without necessarily being in their patients

presence. It has shown that it is highly effective in managing chronic diseases such as

heart failure and high blood pressure, because it is easier to monitor those patients.

Telemonitoring also leads to a reduction in overall societal cost, because accurate data is

able to be collected without the use of a doctor’s valuable time. Many studies have shown

that telemedicine can reduce the number of days that it takes to improve after important

surgeries and treatments. Telemedicine in nursing homes has also been able to improve

the lives of those residing in such homes because it improves the effectiveness of the

doctors. The authors conclude their article by establishing that telemedicine will be

highly impactful in geriatrics, because of its ability to preserve quality of life for seniors

at home and in retirement homes, while also reducing preventable hospitalizations in

emergency rooms.

The authors, A.A. Zulfiqar, A. Hajjam, S. Talha, M. Hajjam, S. Erve, and E.

Andres are qualified to discuss telemedicine in the field of geriatrics because their

credentials include work as a doctor at the ​Centre​ H

​ ospitalier​ U
​ niversitaire​ d
​ e​ R
​ eim​s and

Scientific Director of PrediMed technology. Contact information can be found online for

the main authors of this article. Written 1 year ago, this source is current on the topic of

geriatrics and telemedicine. The authors thoroughly evaluated all sides of the issue. For

example, they acknowledged the idea that telemedicine might simply lower the humanity

in treatment without providing significant benefits in exchange by stating this idea in the
 49

introduction, before refuting it with data. This inclusion shows that alternative viewpoints

to the authors’ were acknowledged because the authors provided an idea that was the

opposite to their own so that they would be able to explain why that viewpoint was

flawed and push their point forwards. The information contained in the source can be

verified elsewhere. For example, the authors say that telemedicine will provide for better

communication between patients and doctors, thus improving the speed at which patients

can get treatment, which can be corroborated by Ronald C. Merrell in his article

“Geriatric Telemedicine: Background and Evidence for Telemedicine as a Way to

Address the Challenges of Geriatrics”, in which he said that telemedicine will provide for

improvement in condition as well as a way to save money. The purpose of this article is

to provide evidence for doctors encouraging the increase of telemedicine in primary care

for geriatric patients. The audience would thus be primary care physicians. The article is

appropriate for this purpose and audience because it provides ample evidence from

studies that have been done in the past, as well as using terminology that would be best

suited for doctors.