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.
Primary care physicians have a unique, long-term relationship with their patients. The nature of this relationship places primary care physicians in the position of managing both the physical and psychological response to serious illness. The Psychological Impact of Acute and Chronic Illness is specifically designed to help the primary care physician navigate normative and maladaptive reactions to illness. Physicians will learn how to identify coping responses in medically ill individuals, as well as proven strategies for intervention and pharmacological treatment of patients presenting with mental illness. Chapters are concise but comprehensive and emphasize the basics, from aspects of the illness process to knowing when to refer patients to mental health providers. Case examples throughout the book illustrate important concepts and techniques that enable the reader to maximize coping in patients and their families.
