The Psychological Impact of Acute and Chronic Illness: A Practical Guide for Primary Care Physicians

1. Front Matter

   Pages i-xix

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2. Medical Illness: Why Consider Emotional Factors?

   Pages 1-29

3. Doctors and Patients: The Context of Modern Medicine

   Pages 31-45

4. Becoming a Patient: Adapting to Illness

   Pages 47-64

5. Special Issues in Coping with Chronic Illness

   Pages 65-79

6. Pharmacological Interventions

   Pages 81-107

7. The Impact of Illness on Family Members

   Pages 109-122

8. Trust in Patient-Physician Relationships

   Pages 123-135

9. Difficult Medical Patients

   Pages 137-155

10. Referring to a Mental Health Professional

    Pages 157-171

11. Back Matter

    Pages 173-176

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n the following pages, Dr. Greenberg delineates the complex forces at Iplay within patients who are newly ill or disabled, within physicians who do their best to guide patients through those debilities, and in the inter- tion that patient–physician dyads perform thousands of times daily to try to make sense of the patient’s plight. As a physician and medical educator who thinks about how to enhance communication between patients and physicians, I often view commu- cation challenges as arising from divergent cultural experiences. Each patient has a unique method of experiencing, deriving meaning from, and coping with a new or chronic illness. This approach is necessarily filtered through the patient’s family and social contexts and the patient’s current living situation. Physicians, too, bring psychosocial upbringing and current social c- text into their clinical practice settings. We have also been inculcated into a medical culture that takes its bright, impressionable, idealistic young and shapes them, sometimes brutally, into diagnosticians and proceduralists. We are just now beginning to understand the many components of the “hidden curriculum” of many medical schools – unspoken but powerful influences in training that undercut the humanity of trainees and turn them into poorer communicators than when they first started.

• Chronic
• Mental
• Psychology
• emotion
• intervention

• Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco

  Tamara McClintock Greenberg

Dr. Greenberg, a psychologist, is affiliated with the University of  California, San Francisco. Her experience has involved consulting with physicians regarding the psychological well being of medical patients.

Policies and ethics