In modern terminology, diversity is understood to be a result of genetic variation. Which of the following is a recognized source of variation for
October 16, 2020
The Benefits of a Hospital Implementing a CDI Program
October 16, 2020

language and status discussion

After listening to the interaction of Dr. Ellers and Mr. Phelps, you can understand why, among the comments on her evaluations, were comments like “snooty,” “talked down to me,” “know it all,” and “What a snot!” You struggle over the next few days about how to talk to Dr. Ellers about her manner of speaking to clients. Then you hit upon an idea. Maybe you could use a language and power matrix to explain to her how she comes across to her patients.

One of the things you noticed during the office visit is that Dr. Ellers’ projection of superiority, or power,wasn’t static. It fluctuated. At one moment her words projected power, while at other times she seemed to come across as compassionate. (Keep in mind, you have both her taking to the dog and to Mr. Phelps to contend with.) You’ve scheduled a 30-minute appointment with her as well as the medical director to talk about some ideas for how she can improve her ocvmmuncaiton. Using the power and language matrix as your framework, you write up notes with specific example from the office visit to explain to her ways she might improve. For this assignment, you will submit the notes you will follow when you meet with her. There is no set length for this assignment, but you should have enough notes to guides you through the 30-minute meeting.

“heres the transcript”

MR. PHELPS

(Point to the dog’s leg)

I’m thinking the pain it might be

in his, you know, right leg.

DR. ELLERS

I’ll take a look and see what I can

find.

MR. PHELPS

I always used to scratch his belly

and his legs would go back and

forth like he loved it.

DR. ELLERS

That’s the scratch reflex.

Perfectly normal. To you it looks

like he’s being tickled. But ti him

it’s really more like an insect on

it and it’s a scratch reflex to get

rid of the bug. I did my residency

a long time ago with a guy who did

his whole Ph.D. on the scratch

reflex. Imagine.

MR. PHELPS

Hmm.

DR. ELLERS

Yea. Now watch as I immobilize each

leg when they’re moving and see if

the pain goes away.

MR. PHELPS

(Seemingly unconvinced.)

Yea.

DR. ELLERS

See, it doesn’t. He’s whining even

when the joint is immobilized.

That’s how we isolate joint pain.

It’s not in his legs.

MR. PHELPS

I didn’t know.

DR. ELLERS

That’s how we do it.

MR. PHELPS

So it doesn’t hurt him in…

6.

DR. ELLERS

(interrupting)

Not there. Not in the other leg

either.

MR. PHELPS

It sure does hurt him somewhere.

DR. ELLERS

Not in the leg.

MR. PHELPS

A lot of pain, don’t you think? I

got him almost about the time my

wife and me got married more than

ten years ago. He’s been around a

long time.

DR. ELLERS

Roll back on your tummy for me,

fella. Approximately how long ago

did the pain begin?

MR. PHELPS

Six months maybe.

DR. ELLERS

(A little surprised.)

Oh.

MR. PHELPS

I got laid off eight and a half

months ago I thought he’d get

better on his own.

DR. ELLERS

(Proudly)

When I rolled him over and palpated

his lumbar vertebrae, he jumped

like it hurt, right?

MR. PHELPS

Golly. Lumbar?

DR. ELLERS

Back of his spine. He’s got

something. Herniated disk?

Arthritis maybe. Maybe stenosis.

The spine canal gets narrow and

impinges on the nerve. I’ve seen it

in a lot of older dogs.

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