This book is an indispensible guide and will prove more valuable than gold should a time arise in society where survival is the agenda of the day, should all conversions fail and we find ourselves face-to-face with any apocalyptic scenario, be it local, national or global in scope this manual will guide YOU in how to be your own doctor, when there is no doctor.
Addressing the problems facing medicine and medical education Cassell discusses the new generalism and the skills that physicians-in-training must be taught in order to practice the art of doctoring which centres on the person not the disease.
American medicine attracts some of the brightest and most motivated people the country has to offer, and it boasts the most advanced medical technology in the world, a wondrous parade of machines and techniques such as PET scans, MRI, angioplasty, endoscopy, bypasses, organ transplants, and much more besides. And yet, writes Dr. Eric Cassell, what started out early in the century as the exciting conquest of disease, has evolved into an overly expensive, over technologized, uncaring medicine, poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases. In Doctoring: The Nature of Primary Care Medicine, Dr. Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to America's health care needs. He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients, both well and sick, and to keep these patients as the focus of their practice. Modern medical training arose at a time when medical science was in ascendancy, Cassell notes. Thus the ideals of science--objectivity, rationality--became the ideals of medicine, and disease--the target of most medical research--became the logical focus of medical practice. When clinicians treat a patient with pneumonia, they are apt to be thinking about pneumonia in general--which is how they learn about the disease--rather than this person's pneumonia. This objective, rational approach has its value, but when it dominates a physician's approach to medicine, it can create problems. For instance, treating chronic disease--such as rheumatoid arthritis, diabetes, stroke, emphysema, and congestive heart failure--is not simply a matter of medical knowledge, for it demands a great deal of effort by the patients themselves: they have to keep their doctor appointments, take their medication, do their exercises, stop smoking. The patient thus has a profound effect on the course of the disease, and so for a physician to succeed, he or she must also be familiar with the patient's motivations, values, concerns, and relationship with the doctor. Many doctors eventually figure out how to put the patient at the center of their practice, but they should learn to do this at the training level, not haphazardly over time. To that end, the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based, and should try to produce doctors who rely on both their scientific and subjective assessments of their patients' overall needs. There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills. Cassell also advocates the need to teach the behavior of both sick and well persons, evaluation of data from clinical epidemiology, decision making skills, and preventive medicine, as well as actively teaching how to make technology the servant rather than the master, and offers practical tips for instruction both in the classroom and in practice. Most important, Doctoring argues convincingly that primary care medicine should become a central focus of America's health care system, not merely a cost-saving measure as envisioned by managed care organizations. Indeed, Cassell shows that the primary care physician can fulfill a unique role in the medical community, and a vital role in society in general. He shows that primary care medicine is not a retreat from scientific medicine, but the natural next step for medicine to take in the coming century.
Geographers have for a long time contributed much valuable detailed data on the geographical patterns of disease and health care delivery to the medical world. On its first publication in 1985, this edited collection addressed the need for a review of progress in the field of medical geography that could also shape further developments. Topics under discussion include national systems of health care, the utilisation of health services, medical planning and medical geography in the developing world. This is a comprehensive volume that is it still of great relevance to today’s students of medical geography, health care and demography.
This book arises from a lifetime's practical experience of work with people with Asperger's syndrome and autism. People with Asperger's syndrome easily drop through the net and fall into the wrong services - sometimes staying at home, depending on their families, sometimes falling into criminal justice or mental health services. Others, of course, fall into employment. Those in between, and there are many, benefit from the coaching approach developed by Bill Goodyear, which is described in this book. The book is crammed with practical tips, real life stories and new thinking. So often research results arrive from highly specialised work - this book attempts to synthesise a range of new learning from a number of fields and present a hopeful view of the condition - there are many entry points to use to create the possibility of forward motion and development.Touching lightly on some specific and recurring problems, the book unpicks our current understanding of the condition and describes in detail how to use coaching to empower and enable rather than to control and direct.
A reminder that some of the most important factors in healing are not high-tech marvels but ordinary factors such as love, compassion, friendship, and hope.
The first book to present the history, ideas, life and works of Chinese midwives and birth attendants, this volume seeks to encapsulate and explain the changing ideas about the practice of midwifery in China. Using participant observations and interviews, it examines each phase of the development of midwifery in depth. Providing a systematic study of the existing literature and contemporary national health policies, it analyses the factors contributing to the current demise of midwifery in China, such as the absence of national regulation, high standards of education and national midwives’ associations. Furthermore, it argues that China’s national statistics in the past six decades demonstrate clear evidence that minimising maternal mortality rates will only happen through wider availability of services, rather than through obstetric technology or facility based care. Ultimately, therefore this book supports the view that humanity and midwifery will survive to overcome domination by both technology and market forces and that economic growth and medical technology alone will not be sufficient in providing effective healthcare. This book is an indispensable resource for the study of Chinese midwifery, both in theory and in practice. As such it will be useful to students and scholars of Midwifery, Women’s Health, Sociology and culture and society in China.
Patrisia Gonzales addresses "Red Medicine" as a system of healing that includes birthing practices, dreaming, and purification rites to re-establish personal and social equilibrium. The book explores Indigenous medicine across North America, with a special emphasis on how Indigenous knowledge has endured and persisted among peoples with a legacy to Mexico. Gonzales combines her lived experience in Red Medicine as an herbalist and traditional birth attendant with in-depth research into oral traditions, storytelling, and the meanings of symbols to uncover how Indigenous knowledge endures over time. And she shows how this knowledge is now being reclaimed by Chicanos, Mexican Americans and Mexican Indigenous peoples. For Gonzales, a central guiding force in Red Medicine is the principal of regeneration as it is manifested in Spiderwoman. Dating to Pre-Columbian times, the Mesoamerican Weaver/Spiderwoman—the guardian of birth, medicine, and purification rites such as the Nahua sweat bath—exemplifies the interconnected process of rebalancing that transpires throughout life in mental, spiritual and physical manifestations. Gonzales also explains how dreaming is a form of diagnosing in traditional Indigenous medicine and how Indigenous concepts of the body provide insight into healing various kinds of trauma. Gonzales links pre-Columbian thought to contemporary healing practices by examining ancient symbols and their relation to current curative knowledges among Indigenous peoples. Red Medicine suggests that Indigenous healing systems can usefully point contemporary people back to ancestral teachings and help them reconnect to the dynamics of the natural world.
