![]() All rights reserved.Ī positive doctor-patient relationship is believed to play a key role in the healing process in clinics. ![]() Ethnographic analysis identifies clerk's care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. In doing so PACT may reinforce a clinically defined culture of care that is countermand to PCMH ideals. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In this article we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. International implementation of the Patient-Centered Medical Home (PCMH) model for delivering primary care has dramatically increased in the last decade. We conclude that, if well supported, receptionists have the potential to positively influence health care acceptability, and patients' access to care.Ĭopyright © 2014 Elsevier Ltd. The agency of GPRs is most evident in their ability to shape the social dynamics of the waiting space, and to frame the health care experience as positive for people whose usual experience is marginalisation. They are de facto managers of this space however, they have limited agency within general practice settings, due to the constraints imposed upon them by physical and organisational structures. Our findings indicate that GPRs are on the edge of the practice team, yet carry a complex role at the frontline, in the waiting space. The study employed an adapted form of grounded theory. We ask 'How do GPRs see their role with regard to patients with complex health and social needs, in light of the spatio-temporal constraints of their working environments?' We engaged receptionists as participants to explore perceptions of their roles and their workspaces, deriving narrative data from three focus groups involving 14 GPRs from 11 practices in the Northland region of New Zealand. We explore the waiting room and its dynamics in terms of 'acceptability', an under-examined aspect of access to primary care. This process occurs in a particular space: the 'waiting room'. Receptionists literally 'receive' those who phone or enter the clinic, and are a critical influence in their transformation from a 'person' to a 'patient'. The place of the receptionist involves both a location within the internal geography of the clinic and a position within the primary care team. Revival attempts have been made with the development of open-source remakes such as CorsixTH.At the point of entry to the health care system sit general practice receptionists (GPRs), a seldom studied employment group. The game was re-released on GOG.com in 2012 and Origin in 2015, and the PlayStation version was released on the PlayStation Network in Europe in 2008, Japan in 2009, and North America in 2010. A Sega Saturn version was in development, but cancelled. Theme Hospital was a commercial success, selling over 4 million copies worldwide, and was ported to the PlayStation in 1998. The game received a generally positive reception, with reviewers praising the graphics and humour in particular. Multiplayer support with up to four players was added in a patch. Designers originally planned to include four distinct gameplay modes corresponding to historical time periods, but this was dropped due to time pressures on the team. Peter Molyneux and James Leach came up with the idea of creating a Theme game based on a hospital, but Molyneux was not directly involved in development due to his work on Dungeon Keeper. The game is noted for its humour, and contains numerous references to pop culture. The game is the thematic successor to Theme Park, also produced by Bullfrog, and the second instalment in their Theme series, and part of their Designer Series. Theme Hospital is a business simulation game developed by Bullfrog Productions and published by Electronic Arts in 1997 for the PC in which players design and operate a privately owned hospital with the goal of curing patients of fictitious comical ailments.
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