RATIONALE, AIMS AND OBJECTIVES Physicians' recognition of oral-systemic health relationships may support medical-dental communication, although its relationship with clinical practice remains uncertain. This study described overall and disease-specific patterns of self-reported awareness in a convenience sample of physicians in Türkiye and explored differences according to demographic and professional characteristics. METHOD This descriptive cross-sectional online survey included physicians with at least 1 year of clinical experience who were recruited through professional networks. Following ethical approval, responses included in the final dataset were submitted between 17 March and 7 May 2026. Self-reported awareness was assessed using a Turkish-adapted 10-item questionnaire that had not undergone formal cross-cultural validation. The items formed a study-specific summary index ranging from 0 to 40 (Cronbach's α = 0.847). Disease-specific responses were treated as the primary findings, whereas the summary index and subgroup comparisons were secondary and exploratory. RESULTS Among 109 physicians, the median summary index score was 34/40 (IQR: 30-38), and the mean was 33.26 ± 6.67. Twenty-five participants (22.9%) attained the maximum score, indicating a substantial ceiling effect and limited discrimination at the upper end. Agreement was highest for the general oral-systemic relationship (98.2%), the impact of oral disease on quality of life (96.3%), and the periodontal disease-cardiovascular disease association (93.6%). Recognition was lower for chronic kidney disease (63.3%) and rheumatoid arthritis (54.1%). Exploratory estimates for sex, specialist status, and graduation year were imprecise, with confidence intervals including zero and allowing potentially meaningful associations in either direction. CONCLUSION In this convenience sample, self-reported awareness was generally high but varied across specific periodontal-systemic associations. The findings represent self-reported recognition rather than objective knowledge, competence, or referral behaviour and should not be generalised to physicians in Türkiye overall. Representative samples, validated instruments, and objective or vignette-based measures are needed to determine whether self-reported awareness is associated with oral-health assessment or dental referral.
RATIONALE, AIMS AND OBJECTIVES Psychiatric training teaches the content of the clinical interview systematically, that which is asked, screened and documented, but it transmits tacitly, most often by osmosis in supervision, the moment at which one asks, the duration one grants a pause, and the point at which one changes direction. This essay takes the training of a professional drummer as a case of embodied, temporal procedural expertise and asks what that competence makes visible about timing in the psychiatric interview. ARGUMENT The essay first develops a positive reading, on which percussion supplies useful categories for describing clinical listening, and then turns it into a negative one, on which the decisive gain is not technical. Percussive expertise does not add a method to the clinical repertoire; it marks and renders thinkable the precise point at which the formal curriculum fails to reach the singular experience of the encounter. The account draws on the literature on tacit knowledge and reflection-in-action (Polanyi, Schön) to characterise timing as procedural knowledge, and on lived time (Minkowski) and implicit temporality and intercorporeal synchrony (Fuchs) to situate it within phenomenological psychopathology. Percussion is treated not as metaphor but as a case of embodied procedural expertise, and the correspondence claimed between percussive and clinical operations is functional and deliberately bounded, not one of identity. CONCLUSIONS The contribution of the musician to clinical practice is less an additional technique than a lucidity about the limit of formalisable knowledge, and about the singular that no diagnostic category exhausts. RELEVANCE TO THE JOURNAL This essay addresses the philosophy of clinical practice and the person-centred care agenda central to this journal. It concerns a dimension of the clinical encounter, its temporal organisation, that resists codification and is therefore poorly served by the formalising tendencies of contemporary evidence-based practice. By clarifying where formalisable knowledge ends and irreducibly procedural clinical judgement begins, the essay contributes to the journal's continuing debate on tacit knowledge, technical rationality, and the limits of rule-based accounts of clinical practice.
BACKGROUND Quantitative biometric measurements are expressed in heterogeneous units and numerical ranges, complicating their representation on a unified interpretive scale. Conventional standardization provides cross-variable comparability through population- or distribution-derived parameters but remains distribution-relative. A methodological gap arises when the intended reference information instead consists of externally specified paired boundaries. OBJECTIVE To introduce the Guideline-Anchored Interval Metric (GAIM), a stand-alone, boundary-anchored, piecewise-linear framework for representing heterogeneous quantitative measurements relative to externally specified paired boundaries. METHODOLOGY Given positive lower (L) and upper (U) boundaries, GAIM defines a geometric reference center C = √(U × L) and direction-specific Threshold-Center Distance units, TCDl = C - L and TCDᵤ = U - C. Four interpretive zones map observations within and beyond the boundaries onto a continuous scale. By construction, L, C, and U map to GAIM values of -1.00, 0.00, and +1.00, respectively. RESULTS Analytical verification and illustrative biomarker applications demonstrate that GAIM is continuous, strictly monotonic, direction-sensitive, and boundary-anchored. The four interpretive zones reduce mathematically to two linear branches joined at C. The geometric center provides multiplicative balance between the positive boundaries, while separate TCD units accommodate unequal lower and upper distances. GAIM is invariant under consistent positive multiplicative unit conversion. Once L and U are specified, transformation parameters are derived algebraically without contemporaneous estimation of cohort-derived location or dispersion parameters. CONCLUSION GAIM provides a stand-alone transformation for expressing heterogeneous quantitative measurements on a common boundary-relative scale when valid positive paired boundaries are available. It offers an alternative reference architecture to distribution-relative standardization when boundary-relative interpretation is intended. Its validity depends on appropriate boundary selection, and its clinical utility requires empirical evaluation.
