Who is abraham varghese

View details for Web of Science ID Time constraints, technology, and administrative demands of modern medicine often impede the human connection that is central to clinical care, contributing to physician and patient dissatisfaction. To identify evidence and narrative-based practices that promote clinician presence, a state of awareness, focus, and attention with the intent to understand patients. After evidence synthesis, promising practices were reviewed in a 3-round modified Delphi process by a panel of 14 researchers, clinicians, patients, caregivers, and health system leaders.

Final recommendations incorporate elements from all highly rated practices and emphasize the practices with the greatest number of panelist votes. Following evidence synthesis, 13 distinct practices were reviewed by the Delphi panel, 8 of which met criteria for inclusion and were combined into a final set of 5 recommendations: 1 prepare with intention take a moment to prepare and focus before greeting a patient ; 2 listen intently and completely sit down, lean forward, avoid interruptions ; 3 agree on what matters most find out what the patient cares about and incorporate these priorities into the visit agenda ; 4 connect with the patient's story consider life circumstances that influence the patient's health; acknowledge positive efforts; celebrate successes ; and 5 explore emotional cues notice, name, and validate the patient's emotions.

This mixed-methods study identified 5 practices that have the potential to enhance physician presence and meaningful connection with patients in the clinical encounter. Evaluation and validation of the outcomes associated with implementing the 5 practices is needed, along with system-level interventions to create a supportive environment for implementation.

OBJECTIVE: We sought to investigate the concept and practices of 'clinician presence', exploring how physicians and professionals create connection, engage in interpersonal interaction, and build trust with individuals across different circumstances and contexts. For both medical and non-medical professionals, creating presence requires managing and considering time and environmental factors; for physicians in particular, this includes managing and integrating technology.

Listening was described as central to creating the state of being present. Within a clinic, presence might manifest as a physician listening without interrupting, focusing intentionally on the patient, taking brief re-centering breaks throughout a clinic day, and informing patients when attention must be redirected to administrative or technological demands.

Building on strategies from physicians and non-medical professionals, clinician presence is best enacted through purposeful intention to connect, conscious navigation of time, and proactive management of technology and the environment to focus attention on the patient. Everyday practice or ritual supporting these strategies could support physician self-care as well as physician-patient connection.

Good patient care is found not on a computer screen but in being truly present with patients. Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment, and other adverse consequences.

Our purpose was to collect vignettes of physical examination oversights and to capture the diversity of their characteristics and consequences. A cross-sectional study using an question qualitative survey for physicians was distributed electronically, with data collected from February to June of The participants were all physicians responding to e-mail or social media invitations to complete the survey.

There were no limitations on geography, specialty, or practice setting. The mode of the number of physicians missing the finding was 2, but many oversights were missed by many physicians. Most oversights took up to 5 days to identify, but 66 took longer.

Special attention and skill in examining the skin and its appendages, as well as the abdomen, groin, and genitourinary area could reduce the reported oversights by half. Physical examination inadequacies are a preventable source of medical error, and adverse events are caused mostly by failure to perform the relevant examination.

When I joined them 2 years later, they were teaching. The medical education process in Ethiopia is different from that in the U. When I got to the U. While I contemplated my next step, I worked as an orderly, first in a nursing home and then in a hospital.

Eventually, through the great efforts of one of my aunts, the Indian government took me in as a displaced person in , and I was able to resume my medical schooling in Madras.

I returned to the U. Looking back, that was the best medical education I could have had, because I saw what happened to the patient in the 23 hours and 58 minutes the doctors were not in the room. I also attribute that experience to my great appreciation for my colleagues in nursing, because they are spending the most time taking care of patients. I feel a sense of solidarity with nursing staff.

Working in the nursing home was truly an eye-opening experience. It was quite a shock to see the warehousing of the elderly happening there. I was responsible for 5 or 6 patients who were completely bedridden. My job was to get them cleaned up and fed in the morning, then take them to the recreation room where they would sit in front of the television all day. I thought it was very sad, very discouraging. The humanity of medicine later became a focus of your career.

Did witnessing the care in the nursing home spark that interest? It was part of it, but the other big moment for me was the arrival of HIV in the early s. If you made an astute diagnosis, you could have a patient rise like Lazarus and walk out of the hospital.

HIV humbled me, because I was watching young men my age succumb to a fatal disease for which we had absolutely no treatment. An entire generation of infectious disease clinicians were humbled by this disease. We learned what it meant to heal when we could not cure. We realized how much our presence and caring mattered. Witnessing the devastation of HIV also was the genesis of my becoming a writer. After training in infectious diseases in Boston, where I saw so many HIV cases, I took a faculty position at a hospital and medical school in a small town in Tennessee in We expected to see, at most, a couple patients with HIV every other year.

Instead, in a fairly short time, I encountered almost fold more patients with HIV than anyone predicted for that rural population. I wanted to tell that story, which, as it turned out, was the story of young men who had left that small town to pursue education or better opportunities, but also because they were gay and did not want their lifestyle to be evident to their friends and relatives. Years later, the virus had found them, and they were trying to come back to their hometown roots, either because their lovers had died and they had no one to care for them, or because they hoped that, by retreating to a small town, they would escape the plague that had decimated bigger cities.

Becoming a writer was a matter of self-preservation in the HIV era. I knew that if I wanted to keep doing this, I needed to pace myself. Writing became my escape from the pressures of being an infectious disease clinician during that time.

Other people might have played golf or something, but for me it was writing. How sustainable supply chains helped companies stay afloat in the pandemic. Choose your reason below and click on the Report button.

This will alert our moderators to take action. Nifty 18, Market Watch. ET NOW. Brand Solutions. Video series featuring innovators. ET Financial Inclusion Summit. And for Verghese, there is not a pronounced separation between his work as a physician and his work as a writer.

Verghese was born in Addis Ababa to expatriate Indian parents. He began medical school in Ethiopia, but his studies were interrupted by the civil war in By that time his parents had relocated to New Jersey and he joined them there. He returned to the U. And then, after moving once again to complete a fellowship in infectious diseases at Boston City Hospital, Verghese chose to return to Johnson City to settle.