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Huynh R, Satchithanandha V, Park JS, Seyfi D, Joseph D. Online Search Trends Related to Bariatric Surgery and Their Relationship with Utilization in Australia. Obes Surg 2024; 34:3412-3419. [PMID: 39141188 PMCID: PMC11349787 DOI: 10.1007/s11695-024-07457-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/30/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE There is an abundance of online information related to bariatric surgery. Patients may prefer a specific type of bariatric surgery based on what they read online. The primary aim of this study was to determine online search trends in bariatric surgery over time in Australia and worldwide. The secondary aim was to establish a relationship between public online search activity and the types of bariatric surgery performed in Australia. MATERIALS AND METHOD The terms "adjustable gastric band," "sleeve gastrectomy," and "gastric bypass surgery" were submitted for search volume analysis in Australia and worldwide using the Google Trends "Topic" search function. This was compared alongside the numbers of gastric bandings, sleeve gastrectomies, and gastric bypass surgeries performed in Australia over time to determine if there was a relationship between the two. RESULTS Search trends for "adjustable gastric band" and "sleeve gastrectomy" in Australia were similar to trends seen worldwide. However, search trends for "gastric bypass surgery" differ between Australia and the rest of the world. It took at least a year for online searches to reflect the higher number of sleeve gastrectomies performed relative to gastric bandings. There was a lag time of over four years before online searches reflected the higher number of gastric bypass surgery performed compared to gastric banding. CONCLUSION Search interests in Australia and worldwide were similar for gastric banding and sleeve gastrectomy but different for gastric bypass surgery. Online search activity did not have a significant association with the types of bariatric surgery being performed in Australia.
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Affiliation(s)
- Roy Huynh
- Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital, Level 7 - Main Clinical Building, 50 Missenden Road, Camperdown, NSW, 2050, Australia.
- Faculty of Medicine, UNSW Sydney, Kensington, NSW, 2050, Australia.
| | - Vyshi Satchithanandha
- Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital, Level 7 - Main Clinical Building, 50 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Jin-Soo Park
- Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital, Level 7 - Main Clinical Building, 50 Missenden Road, Camperdown, NSW, 2050, Australia
- Faculty of Medicine, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Doruk Seyfi
- Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital, Level 7 - Main Clinical Building, 50 Missenden Road, Camperdown, NSW, 2050, Australia
| | - David Joseph
- Department of Upper Gastrointestinal Surgery, Royal Prince Alfred Hospital, Level 7 - Main Clinical Building, 50 Missenden Road, Camperdown, NSW, 2050, Australia
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Larsen LT, Cecchini M. Connective and Tactfully Tactical: Connective Tactics and Professional Authority in Doctor-Patient Relationships. Soc Sci Med 2023; 326:115924. [PMID: 37141679 DOI: 10.1016/j.socscimed.2023.115924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 04/13/2023] [Accepted: 04/22/2023] [Indexed: 05/06/2023]
Abstract
Medical authority is often thought to be threatened by lay access to information, but how does professional authority work when citizens have more knowledge and choices? We seek to understand how professional authority works in doctor-patient relationships and what each side does to navigate medical encounters. Our abductive study is relational as it builds on qualitative interviews with both doctors and patients. While doctors and patients each try to steer the encounter towards their desired outcomes, they also employ a series of 'connective tactics' to maintain a good, professional relationship. These connective tactics are often draped in a 'tactful' and informal manner so as not to threaten the continuous authority relationship between professionals and citizens. Both sides have a repertoire of how to act on authority relations, often supported by courteous attempts to not insist on formal superiority or patient rights. Each side shifts between what may seem like traditional and connective ways to perform medical authority. Doctors can continue to act as knowledge authorities if they also at least appear to be equals with patients; and patients can use internet findings to get involved in medical decisions as long as they pretend to still respect medical authority.
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Affiliation(s)
- Lars Thorup Larsen
- Department of Political Science, Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark.
| | - Mathilde Cecchini
- Department of Political Science, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
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Stivers T, McCabe R. Dueling in the clinic: When patients and providers disagree about healthcare recommendations. Soc Sci Med 2021; 290:114140. [PMID: 34774251 DOI: 10.1016/j.socscimed.2021.114140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We begin by considering the evolving nature of the physician-patient relationship. Research shows that physicians have retained significant authority as health professionals but not to the extent that they had in the golden age of doctoring. Instead, as patient centered care movements gained momentum, patients became empowered through policies and parallel consumer social movements. Patient-centered care advocates envisioned an active patient who would ask questions and voice preferences and concerns but would remain rational and thus make choices that remained in line with standard of care practices. Instead, we discuss research on patient communication with clinicians that has documented an unexpected form of patient participation: patients sometimes advocate for treatments that are not necessarily good for them and sometimes resist recommendations that are the current standard of care. We review the varied ways in which these engaged patients influence diagnoses and treatment/care outcomes. Finally, we introduce the eight papers that comprise this special section of Social Science and Medicine on dueling in the clinic.
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Vigier M, Thorson KR, Andritsch E, Stoeger H, Suerth L, Farkas C, Schwerdtfeger AR. Physiological linkage during interactions between doctors and cancer patients. Soc Sci Med 2021; 284:114220. [PMID: 34273870 DOI: 10.1016/j.socscimed.2021.114220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Doctors and patients influence each other when interacting and, as a result, can become similar to each other in affect and behavior. In the current work, we examine whether they also become similar to each other on a moment-to-moment basis in their physiological responses. Specifically, we examine physiological linkage-how much a doctor's (or patient's) physiological response predicts a patient's (or doctor's) response at a subsequent time interval-and whether this changes over the course of doctor-patient relationships (measured as the number of consultations held for each unique doctor-patient dyad). METHODS We collected interbeat interval responses (IBI) continuously during consultations between oncologists and patients undergoing cancer treatment (N = 102 unique doctor-patient interactions) at a hospital in Austria. RESULTS Physiological linkage varied by an interaction between role (doctor vs. patient) and relationship length (in a non-linear, quadratic pattern). Patients showed significant positive linkage to their doctors (i.e., doctors' physiological responses positively, significantly predicted patients' responses) in relationships that spanned three to eight consultations together. Patients were not linked to their doctors in shorter or longer relationships. Doctors were never significantly linked to their patients, meaning that patients' physiological responses never predicted doctors' responses. CONCLUSION These results reveal that, by influencing patients' physiological responses on a moment-to-moment basis, doctors may have even more influence over patients' physiology than previously known.
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Affiliation(s)
- Marta Vigier
- Division of Oncology, Medical University of Graz, Graz, Austria; Department of Psychology, University of Graz, Graz, Austria.
| | - Katherine R Thorson
- Department of Psychology, Barnard College of Columbia University, New York, USA.
| | | | - Herbert Stoeger
- Division of Oncology, Medical University of Graz, Graz, Austria
| | - Leonie Suerth
- Department of Psychology, University of Graz, Graz, Austria
| | - Clemens Farkas
- Division of Oncology, Medical University of Graz, Graz, Austria
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Dugan K, Ablah E, Okut H, Srinivasan S, Salyers W. Guideline Adherence in Dyspepsia Investigation and Treatment. Kans J Med 2020; 13:306-310. [PMID: 33343824 PMCID: PMC7735428 DOI: 10.17161/kjm.vol13.13838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/20/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The impact of dyspepsia guidelines on clinical practice may be poor. Provider adherence with dyspepsia guidelines was examined to determine their impact on clinical practice. METHODS Provider adherence with the 2005 American College of Gastroenterology Guidelines for the Management of Dyspepsia and the 2017 American College of Gastroenterology and Canadian Association of Gastroenterology joint Dyspepsia Management Guidelines was assessed on a national level using data from the National Ambulatory Medical Care Survey (NAMCS). Patient visit data, including reason for visit of dyspepsia, diagnosis of dyspepsia, or diagnosis of H. pylori infection from NAMCS years 2012 through 2015, were used. Provider adherence with dyspepsia management guidelines was determined based upon provision of at least one recommended test or treatment for dyspepsia. RESULTS Providers appeared to adhere to the 2005 ACG guidelines for 49.7% of patient visits. Providers appeared to adhere to the 2017 ACG/CAG guidelines for 51.0% of patient visits. CONCLUSION Provider adherence with the 2005 ACG and the 2017 ACG/CAG Dyspepsia Management Guidelines was determined to be low in this study, highlighting the need to increase evidence-based medical treatment and efficient resource use for dyspepsia.
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Affiliation(s)
- Katelyn Dugan
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Elizabeth Ablah
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Hayrettin Okut
- Department of Population Health, University of Kansas School of Medicine-Wichita, Wichita, KS
- Office of Research, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Sachin Srinivasan
- Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - William Salyers
- Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
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Stivers T, Timmermans S. Medical Authority under Siege: How Clinicians Transform Patient Resistance into Acceptance. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2020; 61:60-78. [PMID: 32073304 DOI: 10.1177/0022146520902740] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Over the past decades, professional medical authority has been transformed due to internal and external pressures, including weakened institutional support and patient-centered care. Today's patients are more likely to resist treatment recommendations. We examine how patient resistance to treatment recommendations indexes the strength of contemporary professional authority. Using conversation analytic methods, we analyze 39 video recordings of patient-clinician encounters involving pediatric epilepsy patients in which parents resist recommended treatments. We identify three distinct grounds for parental resistance to treatments: preference-, fear-, and experience-based resistance. Clinicians meet these grounds with three corresponding persuasion strategies ranging from pressuring, to coaxing, to accommodating. Rather than giving parents what they want, physicians preserve their professional authority, adjusting responses based on whether the resistance threatens their prerogative to prescribe. While physicians are able to convert most resistance into acceptance, resistance has the potential to change the treatment recommendation and may lead to changed communication styles.
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Puckett C, Wong JC, Daley TC, Cossen K. How organizations shape medical technology allocation: Insulin pumps and pediatric patients with type 1 diabetes. Soc Sci Med 2020; 249:112825. [PMID: 32088512 PMCID: PMC8063485 DOI: 10.1016/j.socscimed.2020.112825] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/18/2020] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
Abstract
Although guidelines for prescribing insulin pumps to patients with type 1 diabetes (T1D) focus on patient assessment, sociological research shows decision-making is influenced by the organizations within which actors are embedded. However, how organizational context shapes unequal resource allocation by race and class is less well understood. To investigate this, we compare two pediatric endocrinology centers differing in racial and socio-economic equity in pump use. Using over 400 h of observations and 16 provider interviews, we find allocation is shaped by how organizations use patient cultural health capital to determine pump eligibility, frame technology use, and structure decision-making processes. Overall, findings extend health inequalities research by describing how organizations shape technology resource allocation by race and class.
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Affiliation(s)
- Cassidy Puckett
- Department of Sociology, Emory University, 1555 Tarbutton Hall, Room 225, Atlanta, GA 30322, USA.
| | - Jenise C Wong
- Department of Pediatrics, Division of Endocrinology, University of California, San Francisco, USA
| | - Tanicia C Daley
- Department of Pediatrics, Division of Endocrinology, Emory University School of Medicine, USA
| | - Kristina Cossen
- Department of Pediatrics, Division of Endocrinology, Emory University School of Medicine, USA
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“We were on our own”: Mothers' experiences navigating the fragmented system of professional care for autism. Soc Sci Med 2018; 215:61-68. [DOI: 10.1016/j.socscimed.2018.08.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/25/2018] [Accepted: 08/30/2018] [Indexed: 11/22/2022]
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Ayuandini S. How variability in hymenoplasty recommendations leads to contrasting rates of surgery in the Netherlands: an ethnographic qualitative analysis. CULTURE, HEALTH & SEXUALITY 2017; 19:352-365. [PMID: 27594422 DOI: 10.1080/13691058.2016.1219919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Hymenoplasty is surgery to alter the shape of the hymen membrane in the vaginal canal, commonly performed to minimise the aperture. This medical operation is often requested by women who expect that their virginity will be under scrutiny, particularly during their first sexual encounter on their wedding night. Despite increasing demand for the surgery all over the globe, there is no one standard of practice in performing hymenoplasty. In the Netherlands, the manner in which medical consultations concerning the procedure take place depends heavily on the consulting physician. This paper looks at two different approaches to hymenoplasty consultation in the Netherlands: a pedagogical philosophy adopted in a public hospital and a practical approach employed by a private clinic. Each approach culminates in a contrasting result: patients in one medical establishment are twice as likely to undergo hymenoplasty than those visiting the other.
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Affiliation(s)
- Sherria Ayuandini
- a Anthropology Department , Washington University in St. Louis , St. Louis , USA
- b Sociology Department , Universiteit van Amsterdam , Amsterdam , the Netherlands
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