VA researcher Dr. Saul Weiner and his colleague Dr. Alan Schwartz were honored with the 2017 PROSE Award for Excellence in Biological and Life Sciences for their book " Listening for What Matters: Avoiding Contextual Errors in Health Care."
The book is based on more than 10 years of research by Weiner and Schwartz looking at what happens when physicians only examine medical issues when treating patients and don't "read between the lines" to coax out contextual issues, like job loss or poverty, which may affect a patient's ability to follow doctor's orders.
The team examined hundreds of physician-patient interactions, at multiple medical sites including VA medical centers, using trained actors who recorded their medical visits for analysis and study. Participating physicians were informed about the nature of the study and had given consent to be recorded, but did not know which patients were really actors.
They published their findings in an article titled "Contextual Errors and Failures in Individualizing Patient Care: A Multicenter Study" in the Annals of Internal Medicine, July 2010. The work was funded by VA's Health Services Research and Development Service.
"We know that doctors want to treat patients as individuals, and to provide the best care for each patient," write Weiner and Schwartz in their blog Contextualizing Care. "But we also know that the systems and structure of medical practice, payment, and training work against individualized care."
"Through our research studies," they add, "we have demonstrated that the failure to contextualize care is common, costly, and leads to worse health for patients."
Weiner is deputy director for the VA Center of Innovation for Complex Chronic Health Care (CINCCH) and a staff physician at the Jesse Brown VA Medical Center in Chicago. CINCCH is dedicated to improving the quality of care for Veterans who have complex medical needs, such as multiple chronic illnesses. He is also professor of medicine, pediatrics, and medical education at the University of Illinois at Chicago.
Schwartz is a cognitive psychologist and serves as the Michael Reese Endowed Professor of Medical Education at the University of Illinois at Chicago.
The PROSE Awards are given by the Association of American Publishers to recognize the best in scholarly publishing. The 2017 PROSE Awards for Excellence were presented at a luncheon ceremony held in Washington, D.C., Feb. 2.
* Watch a video describing Dr. Weiner's and Schwartz's work into conceptualizing patient care.