1Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
2Department of General Practice, University of Liège, Liège, Belgium
Copyright © 2016 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest with associated the material presented in this paper.
Types1 | Hypothetical scenarios | Shifting levels of activities | Hypothetical next paths |
---|---|---|---|
12 | A prompt treatment for a painful breast mass | III -> III | -> I, III, or death |
23 | Prompt management of a mass found by the SM as recommended by the PCP | I -> II -> III | -> I, III, or death |
34 | Reassurance with watchful waiting and avoiding overtreatment of a benign lesion found by the SM as recommended by the PCP | I -> II -> IV | -> I |
45 | Prompt treatment of an evidently dangerous mass found by chance | I -> II -> III | -> I, III, or death |
56 | Valid evaluation for a palpable mass found by chance, such as an incidentaloma | II -> IV | -> I, III, or death |
1 Complexity arises from the interaction of doctor and patient knowledge in different situations; In each case, poor communication skills, inattention, and/or lack of process control could make the patient remain in category IV; that is, insecure and worried.
2 The patient knows he/she has a problem (III) and the doctor accepts and provides care for it (III); The problem resolves (I), remains chronic (III), or the patient dies.
3 The patient is asymptomatic and healthy (I), and undergoes screening (II); The doctor finds and provides care for a disease (III); The patient recovers (I), the problem remains chronic (III), or the patient dies.
4 The patient is asymptomatic and healthy (I), and undergoes screening (II); The problem found is benign and the problem resolves (I), or the patient does not believe it has resolved and remains sick or worried (IV); Reassurance and good communication allow the patient to feel healthy (I).
5 The patient is asymptomatic and healthy (I), and undergoes screening (II); Early diagnosis is made by chance (II); the doctor finds and provides care for a disease (III); The patient recovers (I), the problem remains chronic (III), or the patient dies.
6 The patient has an ongoing health problem (III); The doctor unexpectedly finds a new problem unknown to the patient; that is, an incidentaloma (II) that induces anxiety in the patient (IV); Either the problem was in fact trivial and after explanation the patient does not worry anymore (I), or the patient becomes severely ill and is cared for (III); The patient recovers (I), the problem remains chronic (III), or the patient dies.