Biomedical subjects
L Scheingold
Publications and source records attributed to L Scheingold.
Balint work in England: lessons for American family medicine.
The work of Michael and Enid Balint in developing case discussion seminars for general practitioners in England has important implications for the teaching of family medicine in the United States. Focusing on the physician-patient relationship, their seminars evolved from an emphasis on a psychiatric history taken by the physician to a more pragmatic concern with the process of the everyday brief consultation. The leaders of traditional Balint groups guide group members toward open discussion of case material by modeling listening, curiosity, and tolerance for group members. Seminar goals include increasing general practitioners' sensitivity to their patients' emotional problems and expanding the practitioners' repertoire of interventions in the medical interview. With modifications, Balint-type seminars have been incorporated into some general practice and family medicine training settings both in England and in the United States. The unique features of Balint seminars within the context of medical education are their nondidactic, participatory nature, their goals of an emotional change within the physician, and their focus on the physician-patient relationship.
The art of medicine: seminars for practicing physicians.
Using a needs assessment based on a consumer opinion study, a series of seminars on "The Art of Medicine" was set up for medical staff in a large health maintenance organization. Taught by fifteen staff physicians who underwent a facilitator training program, the seminars focused on physician-patient relationships, with participants encouraged to reflect on successful interactions, particularly focusing on their own behavior. A syllabus included eleven observations for successful medical encounters, literature abstracts, and sample case studies. Qualitative evaluation indicated a positive response to the seminars, and further offerings on similar topics are planned.
Couples groups in family medicine training.
To tailor a behavioral science curriculum to family practice needs, less importance should be given to inpatient psychiatry, and more emphasis to the common outpatient problems seen in the primary care setting. The experience of co-leading a short-term couples therapy group during residency training can assist the family physician in becoming more comfortable with marital counseling. Each couples group was co-led by a resident and a behavioral scientist, with couples who had requested marital treatment from the mental health service of a health maintenance organization. After couples were initially evaluated with a pregroup questionnaire, a number of group therapy sessions were co-led, using specific communications techniques and exercises. Benefits to the resident included development of skills in handling small groups, learning behavioral tools for assisting couples, and developing increased comfort in approaching psychosocial issues.
Family focus: a new rotation.
Explore the source record for details and available documents.
A Balint seminar in the family practice residency setting.
British psychoanalyst Michael Balint made important theoretical and pragmatic contributions to family practice, through the seminars of general practitioners he led at the Tavistock Clinic. A weekly Balint seminar, modeled on the Tavistock groups, was held in a family practice residency. The group of second and third year residents, co-led by a behavioral scientist and a family practice faculty member, met for 12 weeks and then re-evaluated topics and discussion format. Issues covered included physician-patient relationships, ethical dilemmas, group therapy concerns, and coping with clinic pressures. Objective evaluation of these seminars, where the goal is attitudinal rather than behavioral change, presents some difficulty. The conclusion is that residents benefited from the seminar, and that some aspects of psychoanalytic theory and technique are applicable to the teaching of behavioral science in family practice residencies.
The use of videotape for teaching internal medicine in a family practice residency.
Explore the source record for details and available documents.
Training of behavioral scientists in family medicine.
Explore the source record for details and available documents.
Office efficiency in primary care.
Little has been written examining the issue of what contributes to efficiency in the primary care setting in HMOs. After a review of the literature, an informal study of primary care physicians at Group Health Cooperative of Puget Sound is described. Issues of physical space, telephone use, teamwork, the medical encounter, hospital rounds, charting, paperwork, and shifting gears when busy are addressed in the context of provider and patient satisfaction.