Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age—about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the "unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you." These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee's masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges.
With family doctors increasingly overburdened, bureaucratized, and burned out, how can the field change before it's too late? Over the past few decades, as American medical practice has become increasingly specialized, the number of generalists—doctors who care for the whole person—has plummeted. On paper, family medicine sounds noble; in practice, though, the field is so demanding in scope and substance, and the health system so favorable to specialists, that it cannot be fulfilled by most doctors. In Searching for the Family Doctor, Timothy J. Hoff weaves together the early history of the family practice specialty in the United States with the personal narratives of modern-day family doctors. By formalizing this area of practice and instituting specialist-level training requirements, the originators of family practice hoped to increase respect for generalists, improve the pipeline of young medical graduates choosing primary care, and, in so doing, have a major positive impact on the way patients receive care. Drawing on in-depth interviews with fifty-five family doctors, Hoff shows us how these medical professionals have had their calling transformed not only by the indifferent acts of an unsupportive health care system but by the hand of their own medical specialty—a specialty that has chosen to pursue short- over long-term viability, conformity over uniqueness, and protectionism over collaboration. A specialty unable to innovate to keep its membership cohesive and focused on fulfilling the generalist ideal. The family doctor, Hoff explains, was conceived of as a powered-up version of the "country doctor" idea. At a time when doctor-patient relationships are evaporating in the face of highly transactional, fast-food-style medical practice, this ideal seems both nostalgic and revolutionary. However, the realities of highly bureaucratic reimbursement and quality-of-care requirements, educational debt, and ongoing consolidation of the old-fashioned independent doctor's office into corporate health systems have stacked the deck against the altruists and true believers who are drawn to the profession of family practice. As more family doctors wind up working for big health care corporations, their career paths grow more parochial, balkanizing the specialty. Their work roles and professional identities are increasingly niche-oriented. Exploring how to save primary care by giving family doctors a fighting chance to become the generalists we need in our lives, Searching for the Family Doctor is required reading for anyone interested in the troubled state of modern medicine.
This handbook covers practical issues, such as how to deal with confidentiality, compliance, complaints, and referral letters as well as clinical medicine. It also raises issues such as dealing with stress and entering the profession.
An essential guide to general practice and being a general practitioner, A Textbook of General Practice is written specifically with the medical student and foundation doctor in mind, reflecting current teaching practice. Readers are encouraged to learn through doing, with practical exercises throughout the book. Student and tutor quotes offer insights into personal experience, while thinking and discussion points encourage reflection. With content entirely updated to reflect the latest recommendations from Tomorrow's Doctors, the third edition of A Textbook of General Practice is the number one choice for undergraduates seeking a narrative introduction to this important discipline.
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
This practical clinical manual provides everything the veterinary practitioner needs to know about small animal dental disease commonly seen in practice. Coverage includes diagnostic techniques, step-by-step procedure guidelines, and practical tips. - Concentrates on the most commonly encountered dental problems in small animal practice - The author is a world authority on small animal dentistry and provides practical tips and unique insights on best practice - Color photographs and high-quality illustrations make this an essential consulting room companion - Highlights risks associated with various procedures - Includes details of how to manage complications - Includes the common diseases in the dog and cat, but also deals with dental disorders in lagomorphs and rodents, as these are becoming increasingly popular as petsNew for the second edition - An expanded equipment and instrumentation chapter covers the subject in more depth and includes new available instrumentation and augmented sections on care of equipment - The extraction chapter is totally rewritten and covers new techniques and instrumentation - Illustrated with many updated and additional photographs.
An important and definitive study and critique of 86 general practices in Ontario and Nova Scotia, with particular attention to the quality of medical care and to problems of medical education and of the organization of medical care as these relate to quality. It was conceived by the College of General Practice of Canada and directed by Kenneth F. Clute. The book is addressed to all those who are interested in the broader aspects of the question of how people can best be provided with good medical care.
From a leading figure in Australian medicine comes this edition of thi s immmensely user-friendly reference that employs a symptom-based appr oach to clinical practice. For the full range of conditions met in pri mary practice, you'll review approach to the patient, the physical exa m, probable causes, differential diagnosis, and treatment strategies. Throughout, Dr. Murtagh adds his own clinical pearls that are both ins ightful and a delight to read. Superb illustrations demonstrate examin ation technqiue and abundant use of tables and charts makes diagnosis quick and easy. Most importantly, the clinical insights of internation ally recognized authority Dr. John Murtagh make this a unique and usef ul resource for the physician, nurse practitioner or physician assista nt.
This study is concerned not with famous doctors, but with the rank and file practitioners of the 18th and 19th centuries. Some common assumptions about the history of the medical profession are challenged in this book, based largely on manuscript sources.
Formulating a diagnosis purely on the basis of clinical judgement can be fraught with difficulty and danger, yet this is the challenge faced every day by Primary Care physicians, who rarely have access to the diagnostic tools available to hospital-based colleagues. Differential Diagnosis in Primary Care has been specifically written with the needs of the Primary Care physician in mind. It examines the potential causes of common presentations and aims to help the physician differentiate between diseases, using history and examination alone. Diseases are listed in descending order of prevalence, with the commonest causes first, while high-risk conditions are highlighted to ensure they are not overlooked. Its unique tabulated format ensures key information is easily accessible, and the user-friendly format ensures the book can be used during consultations, home visits, and on ward rounds. Whether used by the undergraduate, postgraduate trainee or the experienced Primary Care physician, Differential Diagnosis in Primary Care is an invaluable tool designed to improve the reader's ability to diagnose on the basis of clinical judgement alone.
