Ashley M Hesson

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OBJECTIVES To evaluate interactional effects of patient-centered interviewing (PCI) compared to isolated clinician-centered interviewing (CCI). METHODS We conducted a pilot study comparing PCI (N=4) to CCI (N=4) for simulated new-patient visits. We rated interviews independently and measured patient satisfaction with the interaction via a validated(More)
OBJECTIVE To identify the functional magnetic resonance imaging (fMRI) changes associated with a patient-centered interview (PCI) and a positive provider-patient relationship (PPR). METHODS Nine female patients participated, five randomly selected to undergo a replicable, evidence-based PCI, the other four receiving standard clinician-centered interviews(More)
BACKGROUND Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation(More)
Some experts contend that requiring patients to pay out of pocket for a portion of their care will bring consumer discipline to health care markets. But are physicians prepared to help patients factor out-of-pocket expenses into medical decisions? In this qualitative study of audiorecorded clinical encounters, we identified physician behaviors that stand in(More)
OBJECTIVE With increasing exposure, medical students may forget that technical jargon is unfamiliar to laypeople. To investigate this possibility, authors assessed student perceptions of patient understanding across different years in medical school. METHODS 533 students at 4 U.S. medical schools rated the proportion of patients likely to understand each(More)
BACKGROUND More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. OBJECTIVE We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient(More)
In this paper we present a case study of a syntactic sociolinguistic variable that has resisted previous attempts at quantitative analysis of usage, the double modal construction of Southern United States English (e.g., You know what might could help that is losing some weight). While naturally-occurring double modals have been exceedingly rare in(More)
OBJECTIVE High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. METHODS The(More)
Barriers to effective provider-patient communication take many forms that can be difficult to recognize and appropriately address. This paper offers probabilistic indicators for one such form, patient-produced "I don't know" (IDK), distinguishing its use as a cognitive claim and its use as a strategy for resisting discussion of sensitive topics. A total of(More)
OBJECTIVE We investigate dementia patients' use of "I don't know" (IDK) in Mini-Mental State Exams (MMSEs) using objective linguistic indicators to differentiate IDK signalling lack of knowledge (LOK) from IDK used to hedge responses, affect exam progression etc. We hypothesize that increased proportional use of LOK-IDK correlates with worsening dementia(More)