This issue includes articles on an especially diverse set of issues affecting you and your colleagues – difficult patient encounters, preventive care coding, malpractice, ICD-10, and employment contracts. As we prepared the issue for publication, we were surprised to recognize that, despite the breadth of the subject matter, several of these articles underscore the same important point: the value of taking the time to understand patients in their unique social context and uncover what is important to them.
This reminder deserves additional emphasis, particularly because the challenges of practice that demand so much of your attention outside of the exam room may tend to overshadow it. Here is how our authors brought it to light:
In her article about difficult patient encounters, Jennifer Edgoose, MD, MPH, describes how a greater focus on understanding the patient’s agenda and social context are important parts of an approach that can transform these visits. She tells the story of Beverly, a patient whose needs were illuminated by her response to the simple request, “Tell me about yourself.”
In their discussion of malpractice risk reduction, Suraj Achar, MD, and Wiggin Wu highlight the value of shared decision making between physician and patient (and its documentation, of course) in mitigating risk.
In reviewing the components of preventive care coding, Timothy Owolabi, MD, CPC, and Isac Simpson, DO, remind us that a comprehensive or interval past, family, and social history is an essential component of the comprehensive history required for documenting and billing a preventive care visit.
Finally, in a poignant essay in our “Last Word” department (“A Family Physician’s Legacy”), Kari Lima, MD, eulogizes family physician Mitchell Cohen, MD, her mentor, whose profound impact on his patients, as well as on his rural community and Dr. Lima, came from the fact that “he had taken the time to know their backgrounds, their families, and their motivations.” She now endeavors to “care for them like Mitch did” – a formidable and worthwhile challenge for all.