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Zackary Berger
Johns Hopkins University
  1. Communication Behaviors and Patient Autonomy in Hospital Care: A Qualitative Study.Zackary Berger - 2017 - Patient Education and Counseling 2017.
    BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...)
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  2. Are Children Allowed? A Survey of Childcare and Family Policies at Academic Medical Conferences.Dara Kass & Zackary Berger - 2019 - Academic Emergency Medicine 3 (26):339-341.
  3. Patient Centred Diagnosis: Sharing Diagnostic Decisions with Patients in Clinical Practice.Zackary Berger, J. P. Brito, Ns Ospina, S. Kannan, Js Hinson, Ep Hess, H. Haskell, V. M. Montori & D. Newman-Toker - 2017 - British Medical Journal 359:j4218.
    Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. -/- Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. -/- The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations.
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  4.  99
    Metrics of Patient, Public, Consumer, and Community Engagement in Healthcare Systems: How Should We Define Engagement, What Are We Measuring, and Does It Matter for Patient Care? Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review". [REVIEW]Zackary Berger - 2018 - International Journal of Health Policy and Management 8:49-50.
    In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved clinical outcomes (...)
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  5. Prior Authorization as a Potential Support of Patient-Centered Care.Leah Rand & Zackary Berger - 2018 - Patient 4 (11):371-375.
    We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...)
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  6. Clinical Care and Complicity with Torture.Zackary Berger, Leonard Rubenstein & Matt Decamp - 2018 - British Medical Journal 360:k449.
    The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet medical participation (...)
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  7.  96
    Patient Autonomy in Talmudic Context: The Patient’s ‘‘I Must Eat’’ on Yom Kippur in the Light of Contemporary Bioethics.Zackary Berger & Joshua Cahan - 2016 - Journal of Religion and Health 5 (5):5.
    In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in those instances in which treatment choices are sensitive (...)
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  8.  70
    The Medical Cosmology of Halakha: The Expert, the Physician, and the Sick Person on Shabbat in the Shulchan Aruch.Zackary Berger - 2018 - Studies in Judaism, Humanities, and the Social Sciences 1 (2).
    One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). Such (...)
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  9.  24
    Understanding Communication to Repair Difficult Patient–Doctor Relationships From Within.Zackary Berger - 2012 - American Journal of Bioethics 12 (5):15-16.
    The American Journal of Bioethics, Volume 12, Issue 5, Page 15-16, May 2012.
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  10.  12
    Reason for Hospital Admission: A Pilot Study Comparing Patient Statements with Chart Reports.Zackary Berger, Anne Dembitzer & Mary Catherine Beach - 2013 - Narrative Inquiry in Bioethics 3 (1):67-79.
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  11.  1
    The Need for Empathetic Healthcare Systems.Angeliki Kerasidou, Kristine Bærøe, Zackary Berger & Amy E. Caruso Brown - forthcoming - Journal of Medical Ethics:medethics-2019-105921.
    Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.
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  12.  12
    Bayesian and Frequentist Models: Legitimate Choices for Different Purposes of Clinical Research.Zackary Berger - 2010 - Journal of Evaluation in Clinical Practice 16 (6):1045-1047.
  13.  71
    Jonathan D. Moreno and Sam Berger (Eds.), Progress in Bioethics: Science, Policy, and Politics, Foreword by Harold Shapiro.Zackary Berger - 2011 - Theoretical Medicine and Bioethics 32 (3):211-215.
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  14.  5
    Influences on Primary Care Provider Imaging for a Hypothetical Patient with Low Back Pain.Hh le, Matt DeCamp, Amanda Bertram, Minal Kale & Zackary Berger - 2018 - Southern Journal of Medicine 12 (111):758-762.
    OBJECTIVE: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. -/- METHODS: An online survey asking 469 primary care providers (PCPs) across four practice sites whether they would order magnetic resonance imaging for a patient with uncomplicated back pain. Participants were randomized to one of four scenarios: a patient's preference for imaging (control), a patient's preference (...)
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  15.  4
    Review of Peter Ubel, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. [REVIEW]Zackary Berger - 2013 - American Journal of Bioethics 13 (4):53 - 54.
    (2013). Review of Peter Ubel, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. The American Journal of Bioethics: Vol. 13, No. 4, pp. 53-54. doi: 10.1080/15265161.2013.768866.
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  16. Making Sense of Medicine: Bridging the Gap Between Doctor Guidelines and Patient Preferences.Zackary Berger - 2016 - Rowman & Littlefield.
    The more we know about medicine, the more we realize that many health questions have no one true answer. Realizing this, and thinking carefully about how medicine asks patients to treat their conditions, leads us to some questions. How reliable are the guidelines that might form the basis of doctors’ advice? Is it wrong, after all, to base an approach to medicine on patients’ preferences? And, given that there is often a distance between the treatment a doctor advises and what (...)
     
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  17. Talking To Your Doctor.Zackary Berger - 2015 - Lanham, MD 20706, USA: Rowman and Littlefield.
    The last time you went to your doctor, you might have emerged feeling dissatisfied and disoriented. Nothing was clear after you left the office, and you don’t know whether it’s your fault or the doctor’s. While patients need to take control of the visit and set their agenda, the latest research shows that doctors and patients need to connect on a more emotional level as well. -/- In Talking to Your Doctor, readers will learn to: -/- •Talk to your doctor—and (...)
     
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