Papers by William Ventres
Family medicine and community health, Apr 1, 2024
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompa... more Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'II: foundational building blockscontext, community and health', authors address the following themes: 'Context-grounding family medicine in time, place and being', 'Recentring community', 'Community-oriented primary care', 'Embeddedness in practice', 'The meaning of health', 'Disease, illness and sickness-core concepts', 'The biopsychosocial model', 'The biopsychosocial approach' and 'Family medicine as social medicine.' May readers grasp new implications for medical education and practice in these essays. 'I don't want to bother you, Doc…it's just that my breathing isn't so good just now.' My patient's breathing is, truly, more laborious than usual. She is 68 but looks much older-sagging skin, nicotine-stained teeth, on July 25, 2024 by guest.
Family medicine and community health, Apr 1, 2024
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompa... more Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'I: framing family medicine-history, values, and perspectives', the authors address the following themes: 'Notes on Storylines of Family Medicine', 'Family medicine-the generalist specialty', 'Family medicine's achievements-a glass half full assessment', 'Family medicine's next 50 years-toward filling our glasses', 'Four enduring truths of family medicine', 'Names matter', 'Family medicine at its core' and 'The ecology of medical care.' May readers find much food for thought in these essays.
Family Medicine and Community Health, 2024
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompa... more Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘III: core principles—primary care, systems, and family’, authors address the following themes: ‘Continuity of care—building therapeutic relationships over time’, ‘Comprehensiveness—combining breadth and depth of scope’, ‘Coordination of care—managing multiple realities’, ‘Access to care—intersectional, systemic, and personal’, ‘Systems theory—a core value in patient- centered care’, ‘Family-oriented practice—supporting patients’ health and well-being’, ‘Family physician as family member’ and ‘Family in the exam room’. May readers develop new understandings from these essays.
Family Medicine and Community Health, 2024
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompa... more Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'II: foundational building blockscontext, community and health', authors address the following themes: 'Context-grounding family medicine in time, place and being', 'Recentring community', 'Community-oriented primary care', 'Embeddedness in practice', 'The meaning of health', 'Disease, illness and sickness-core concepts', 'The biopsychosocial model', 'The biopsychosocial approach' and 'Family medicine as social medicine.' May readers grasp new implications for medical education and practice in these essays.
The Annals of Family Medicine, 2017
Family Medicine and Community Health, 2024
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompa... more Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In ‘I: framing family medicine—history, values, and perspectives’, the authors address the following themes: ‘Notes on Storylines of Family Medicine’, ‘Family medicine—the generalist specialty’, ‘Family medicine’s achievements—a glass half full assessment’, ‘Family medicine’s next 50 years—toward filling our glasses’, ‘Four enduring truths of family medicine’, ‘Names matter’, ‘Family medicine at its core’ and ‘The ecology of medical care.’ May readers find much food for thought in these essays.
PubMed, Jul 1, 1994
Background: Videotapes have been variably successful in teaching physical examination skills, int... more Background: Videotapes have been variably successful in teaching physical examination skills, interviewing strategies, and clinically relevant didactic material to medical students, residents, and physicians. The literature does not include evaluations of their success in introducing procedural techniques into clinical practice. Objectives: This study assessed whether the presentation of an instructional videotape influenced the adoption of a specific technique, assisting birth in the lateral position. Methods: Family practice residents, faculty, and physicians participated in educational presentations that reviewed how to assist childbirth in the lateral position. Three different formats were used for the presentations; an instructional videotape formed the core element of each presentation. Immediately following the presentations, and on one other occasion 4-6 months later, the participating physicians received questionnaires surveying their use of the lateral birth position. Results: Approximately 30% of the respondents who had not previously used the position used the lateral birth technique. Of the remaining respondents who had not used the technique, 64% considered using the technique with their laboring patients. Physicians who viewed the videotape in concert with other educational interventions were more likely to have adopted the new birth technique (P = .03). Conclusions: An instructional videotape, as part of a structured, interactive presentation, can be used successfully to introduce a procedure into the clinical practices of family physicians.
PubMed, 1996
Ethnography is a research method borrowed from cultural anthropology and a disciplined method for... more Ethnography is a research method borrowed from cultural anthropology and a disciplined method for understanding human conduct. It is a valid alternative to quantitative methods for primary care researchers. This article reviews the defining principles of ethnographic research, which uses principally observational methods to study actions and events that exist in natural situations. It is the job of ethnographic researchers to establish and frame their observations from the point of view of the people under observation. We present five steps fundamental to the development of an ethnographic research plan and a research case study that demonstrates the use of ethnography by a family physician.
PubMed, Jun 1, 1992
The literature to date on Do-Not-Resuscitate (DNR) decision-making is based upon data derived fro... more The literature to date on Do-Not-Resuscitate (DNR) decision-making is based upon data derived from structured questionnaires, hypothetical scenarios, descriptive epidemiology, or simulated discussions. Lacking in the literature has been a critical examination of the health care professional-patient-family relationship and its impact on decision-making regarding resuscitation. The purpose of this study is to identify and describe organizational and communication factors that affect the process and outcome of DNR discussions and decision-making. Individual and focus-group interviews were conducted with sixteen key informants professionally knowledgeable about resuscitative issues. Thematic analysis of these interviews revealed that a variety of cultural and professional values, as well as previous personal experiences, influenced the assumptions that providers made when engaging in DNR decision-making. Specific recommendations are made to help family physicians identify communication strategies that foster understanding and lead to participatory decisions about resuscitation among patients and families.
Annals of global health, Sep 25, 2014
PRiMER: Peer-review reports in medical education research, Feb 7, 2023
Background and Objectives: In order to emphasize the role family medicine plays in providing robu... more Background and Objectives: In order to emphasize the role family medicine plays in providing robust primary care in functioning health care systems, we piloted a novel online curriculum for third-year medical students. Using a digital documentary and published articles as prompts, this Wipped-classroom, discussion-based Philosophies of Family Medicine curriculum (POFM) highlighted concepts that have either emerged from or been embraced by family medicine (FM) over the past 5 decades. These concepts include the biopsychosocial model, the therapeutic importance of the doctor-patient relationship, and the unique nature of FM. The purpose of this mixed-methods pilot study was to assess the effectiveness of the curriculum and assist in its further development. Methods: The intervention-POFM-consisted of _ve 1-hour, online discussion sessions with 12 small groups of students (N=64), distributed across seven clinical sites, during their month-long family medicine clerkship block rotations. Each session focused on one theme fundamental to the practice of FM. We collected qualitative data through verbal assessments elicited at the end of each session and written assessments at the end of the entire clerkship. We collected supplementary quantitative data via electronically distributed anonymous pre-and postintervention surveys. Results: The study qualitatively and quantitatively demonstrated that POFM helped students understand philosophies fundamental to the practice of FM, improved their attitudes toward FM, and aided in their appreciation of FM as an essential element of a functioning health care system. Conclusion: The results of this pilot study show effective integration of POFM into our FM clerkship. As POFM matures, we plan to expand its curricular role, further evaluate its inWuence, and use it to increase the academic footing of FM at our institution.
Journal of the American Board of Family Medicine, Jul 1, 2019
Following up with undecided patients is also critical. What is most important is that we family p... more Following up with undecided patients is also critical. What is most important is that we family physicians integrate ACP with our patients, exploring what works best in context of our own practices.
Journal of the American Board of Family Medicine, 2019
Advance care planning conversations traditionally have been promoted using the Standard of Substi... more Advance care planning conversations traditionally have been promoted using the Standard of Substituted Judgment and the Standard of Best Interests. In practice, both are often inadequate. Patients frequently avoid these conversations completely, making substituted judgment decisions nearly impossible. Surrogates are also often unable to make clinical decisions representing the best interests of family members as patients. Many physicians are unskilled at discussing these difficult and complex decisions with surrogates as well. Using an integrative family medicine ethics approach, we present a case study that demonstrates how skillful family physicians might introduce and conduct these conversations at routine office appointments, reconciling ethical theory with both patient-centered and physician-centered considerations in a practical and time-sensitive fashion. We believe 3 physician behaviors will help prepare patients to engage their surrogates and help empower surrogates to serve their role well, if and when that time comes: 1) thinking broadly about clinical issues and ethical considerations; 2) engaging in a mindful and contemporaneous deliberation with the patient-and surrogate when appropriate and possible-about these issues and considerations; and 3) cultivating a reflective responsiveness to these interactions, both when things go well and when they do not.
The topic of resuscitative decision making for hospitalized patients has generated numerous discu... more The topic of resuscitative decision making for hospitalized patients has generated numerous discussions among clinicians and ethicists. Traditionally, their attention has focused on normative standards, describing how decisions should be made, rather than on how they are made in practice. This study uses qualitative techniques, including key informant and participant interviews, participant observation, and microanalysis of in-hospital discussions, to assess what influence the doctor-patient relationship and other sociocultural and contextual determinants have on actual decision making and communication regarding resuscitation. The results suggest that many factors influence these processes. These include issues of competency and ambiguity, prototypical images of life and death, and the use of a structured form for documentation purposes. In light of these findings, the discussion suggests ways in which physicians can improve resuscitative communication with patients and families
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Papers by William Ventres