Journal of General Internal Medicine

, Volume 19, Issue 3, pp 281–285 | Cite as

Contextualizing medical decisions to individualize care

Lessons from the qualitative sciences
  • Saul J. Weiner
Special Article


Clinical decision making can be described as answering one question: “What is the best next thing for this patient at this time?” In addition to incorporating clinical information, research evidence, and patient preferences, the process requires considering contextual factors that are unique to each patient and relevant to their care. The failure to do so, thereby compromising that care, can be called a “contextual error.” Although proponents of evidence-based clinical decision making and many scholars of the medical interview emphasize the importance of individualizing care, no operational definition is provided for the concept, nor is any methodology proposed for the interpretation of clinically relevant patient-specific variables. By conceptualizing the physician-patient encounter as a participant-observer case study with an N of 1, this essay describes how existing approaches to studying social systems can provide clinicians with a systematic approach to individualizing their clinical decision making.


Bariatric Surgery Medical Interview Family System Theory Contextual Error Weight Loss Clinic 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  1. 1.Section of General Internal Medicine, Department of MedicineUniversity of Illinois at ChicagoChicago

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