Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.
J Gen Intern Med. 2022 Jan;37(1):222-224. doi: 10.1007/s11606-021-06895-2. Epub 2021 Jun 7.
While clinicians are often aware that their patients seek second opinions, they are rarely taught specific skills for how to effectively communicate with patients when they are the ones providing that second opinion. The nuances of these skills are amplified when the second opinion being provided is to the ubiquitous (and often anonymous) Dr. Google. In this perspective, the authors share an approach for discussing a patient's pre-visit health-related internet findings. After emphasizing the importance of setting the stage, they describe the WWW Framework which proposes "waiting" before responding with data, getting to the "what" of the patient's search, and "working together" to negotiate a plan. This stepwise approach is designed to provide psychological safety, build a therapeutic alliance, and empower collaborative treatment planning.
虽然临床医生通常意识到他们的患者会寻求第二意见，但当他们提供第二意见时，他们很少被教授如何与患者进行有效沟通的具体技能。当提供的第二意见是针对无处不在（且通常是匿名的）的谷歌医生时，这些技能的细微差别就会被放大。在这个角度下，作者分享了一种讨论患者就诊前与健康相关的互联网搜索结果的方法。在强调设置阶段的重要性之后，他们描述了 WWW 框架，该框架建议在使用数据回复之前“等待”，了解患者搜索的“内容”，并“共同努力”制定计划。这种逐步的方法旨在提供心理安全感，建立治疗联盟，并增强协作治疗计划。
