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Table 2 Overlap between MDM Model of Care and HIV Clinic Care

From: Minimally disruptive medicine (MDM) in clinical practice: a qualitative case study of the human immunodeficiency virus (HIV) clinic care model

  (+)α HIV Clinic model & (−)β MDM (+) HIV Clinic model & (+) MDM (−) HIV Clinic model & (+) MDM
Workload Sense-making   • Patient education on purposes for medication/adherence to medication • Tailored sense-making support
  • Coordinated, team-based care • Coaching to build patient capacity for self-care
Enacting Work • Adherence stressed in all sessions due to dire consequences of non-adherence • Coordinated, team-based care
• Medication burden recognized and supported
• Person-centered scheduling for all care*
Appraisal   • Consistent feedback regarding viral load/success of treatment plan  
Capacity Biography/living life • Unique focus on mental health/substance abuse
• Privacy mechanisms
  • Support during biographical disruption from illness
Resources   • Advocate for additional services  
Environment • Professionalism, Trust • Positive Healthcare Environment
• Coordinated, team-based care
• Continuity of coordinated care
• Entire team focused on workload/capacity
Work • Team members co-location • Additional services (such as home health) arranged for high-need cases • Coaching to build patient capacity for self-care
Social   • Social support assessed by a social worker
• Stigma minimized
• Social support system understood by all clinicians
• Social network support offered as part of care (e.g., patient groups, community resources)
Other   • Attention to clinician workload**
• Manageable case load
  1. α (+) = present in
  2. β (−) = absent from
  3. * Although this appeared in the HIV clinic, it was recognizably inconsistent and varied between staff members
  4. ** Recently, the work of MDM has recognized that understanding clinicians’ capacity and workload are also essential components of delivering a minimally disruptive care; thus, there is a need to assess and address that