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.
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.
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 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.
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.
For the aspiring or practising GP, the variety of career opportunities has never been greater. Although general practice is extremely demanding and requires a wide range of expertise, adopting the right approach to it can make it highly rewarding. Succeeding as a GP will guide you through the complexities of training, assessment and self-regulation, advise you on coping with the vagaries of partnerships, management and finance, and help you to meet the challenges of medicine in general practice today. Society is changing, patients' expectations are changing, and so too are the skills required of a GP. This comprehensive book contains a wealth of information for all those who have embarked on a career in general practice or who are contemplating doing so.
This book describes the diseases that are most frequently encountered during general medical consultation. The discussion of each condition includes the following: Introductory paragraph. This section summarizes the condition, its definition, main clinical characteristics, and epidemiology, as a quick guide for the doctor regarding the specific disease, the type of people who may suffer from it, and its prognosis. Etiopathogenesis. Here, the causes of the disease are explained in a simple and concrete manner to give the doctor a clearer picture of the pathology of the disease. Signs and symptoms. In this section the most significant characteristics of the disease are described, which makes it possible to identify and differentiate the disease from other similar ones. Diagnosis. This section provides the key information to establish the diagnosis of each condition. In most cases, the clinical information is explained in such a way that neither laboratory nor office testing will be required. Treatment. This section contains a concise listing of the most effective, current, accessible, and least toxic drugs to treat the disease, together with dosages for adults and children (where applicable), in addition to the length of time that the drug should be taken. Almost all of the drugs described are available in generic form, which is an important economic consideration for the patient. In Mexico and many other countries, the quality of these products is verified by bioequivalence tests to compare the activity of the patent drug with the generic one. Most physicians need to prescribe fewer than 100 different drugs for their various patients. Therefore, it is much more important, especially in terms of patient safety, that the doctor have in-depth prescription information about a few drugs, than to know a little about a wide range of drugs that he/she may never have the opportunity to prescribe.
Computers and the General Practitioner focuses on the applications of computers in various aspects of health service, including ECG analysis, primary care, and diagnosis. The selection first tackles general practice and technological promise and experience of pioneers. Topics include information systems and general practice, trends in silicon chip technology, and problems of computer usage in National Health Service practice. The publication then examines security in computer controlled information systems and national strategy for primary care computing, including security defenses, linked systems, cryptography, and basic system. The text takes a look at the computer education of the general practitioner, use of computers in the consulting room, and ECG analysis by computer in general practice. Discussions focus on the problems associated with educating doctors, features of a heuristic system, and the function of the computer as a general practitioner's diagnostic assistant. The selection is a dependable source of data for doctors and readers interested in exploring the applications of computers in health services.
