Donald A. Bloch, MD: a remembrance.

When someone dies, the world, or at least a representative portion of it, should stop, take note, weep, give thanks, and then measure the influence of that life on those it has touched so that moving forward is made more meaningful. This article takes a moment to remember Donald A. Bloch, MD.

Physician self-disclosure in primary care visits: enough about you, what about me?

Background: The value of physician self-disclosure (MD-SD) in creating successful patient-physician partnerships has not been demonstrated.

Methods: To describe antecedents, delivery, and effects of MD-SD in primary care visits, we conducted a descriptive study using sequence analysis of transcripts of 113 unannounced, undetected, standardized patient visits to primary care physicians. Our main outcome measures were the number of MD-SDs per visit; number of visits with MD-SDs; word count; antecedents, timing, and effect of MD-SD on subsequent physician and patient communication; content and focus of MD-SD.

Depression, perceived family criticism, and functional status among older, primary-care patients.

Objective: Relatively little research has examined the role of family factors in later-life depression, particularly in the broad range of depressive conditions seen in primary care. Authors tested the hypotheses that 1) perceived family criticism is independently associated with depression, 2) that family criticism and depression are independently associated with functional disability, and 3) that perceived family criticism moderates the association between depression and functional disability.

Methods: This cross-sectional study recruited 379 adults age > or =65 years from primary-care practices.

Physician responses to ambiguous patient symptoms.

Objective: To examine how primary care physicians respond to ambiguous patient symptom presentations.

Design: Observational study, using thematic analysis within a larger cross-sectional study employing standardized patients (SPs), to describe physician responses to ambiguous patient symptoms and patterns of physician-patient interaction.

Setting: Community-based primary care offices within a metropolitan area.

The family experience of "sudden health": the case of intractable epilepsy.

This article reports the experience of "sudden health" among six families who participated in an exploratory qualitative study of families with a member who elects to have corrective surgery for intractable epilepsy. Families were interviewed pre- and post-surgery (6-8 months) and the interviews were analyzed using a constant comparative methodology. Findings indicated that (1) families were organized in two primary ways (nesting and crisis) to deal with epilepsy and the aftermath of surgery and (2) "sudden health" had differing effects on these families depending on their organizational style, emotional communication process, and developmental dynamics.