Primary care medicine, as we know and remember it, is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between ...physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection as health care steadily becomes more transactional than relational. The thin-margin efficiency, rapid pace, and high volume demanded by the new health care economics do not work for primary care, an inherently slower, more personal, and uniquely tailored service.
InOut of Practice, Dr. Frederick Barken juxtaposes his personal experience with the latest research on the transformations in the medical field. He offers a cool critique of the "market model of medicine" while vividly illustrating how the seemingly inexorable trend toward specialization in the last few decades has shifted emphasis away from what was once the foundation of medical practice. Dr. Barken addresses the complexities of modern practice-overuse of diagnostic studies, fragmentation of care, increasing reliance on an array of prescription drugs, and the practice of defensive medicine. He shows how changes in medicine, the family, and society have left physicians to deal with a wide range of geriatric issues, from limited mobility to dementia, that are not addressed by health care policy and are not entirely amenable to a physician's prescription. Indeed, Dr. Barken contends, the very survival of primary care is in jeopardy at a time when its practitioners are needed more than ever.
Illustrated with case studies gleaned from more than twenty years in private practice and data from a wide range of sources,Out of Practiceis more than a jeremiad about a broken system. Throughout, Dr. Barken offers cogent suggestions for policymakers and practitioners alike, making clear that as valuable as the latest drug or medical device may be, a successful health care system depends just as much on the doctor-patient relationship embodied by primary care medicine.
Health care today is characterized by an increasing number of patients with comorbidities for whom interphysician collaboration seems very important. We reviewed the literature to understand what ...factors affect interphysician collaboration, determine how interphysician collaboration is measured, and determine its effects. We systematically searched six major databases. Based on 63 articles, we identified five categories that influence interphysician collaboration: personal factors, professional factors, preconditions and tools, organizational elements, and contextual characteristics. We identified a diverse set of mostly unvalidated tools for measuring interphysician collaboration that focus on information being transferred and understood, frequency of interaction and tone of the relationship, and value judgements about quality or satisfaction. We found that interphysician collaboration increased clinical outcomes as well as patient and staff satisfaction, while error rates and length of stay were reduced. The results should, however, be interpreted with caution, as most of the studies provide a low level of evidence. Keywords: systematic review, interphysician, collaboration, Physician, medical specialist, hospital
...it might not even detect people like Ian Paterson and Harold Shipman. BMJ 2017; 357: j2138. doi:10.1136/bmj.j2138 28465310 2 Bourne T Wynants L Peters M. The impact of complaints procedures on the ...welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey.
The article discusses the origin of the nominal forms ending in--ih ichi of the type medih 'doctor' and lampadarih 'chandelier' in dialectal Slovenian on the Slovenian-Friulian language boundary. ...Regarding their origin, these forms represent loanwords from Friulian, where they typically end in -i (cf. Friul. miedi 'doctor', lampadari 'chandelier'), reflecting their original Romance pre-forms medicu(M) and LAMPADARIU(M). The contribution tries to account for the presence of the voiceless velar fricative h chi in both groups of borrowings, taking into consideration the linguistic history of both Friulian and Slovenian. While the voiceless velar fricative g in the medih-type can most probably be explained by assuming a more archaic phonetic reflex of the original medicu(M) in Old Friulian, the origin of chi in the lampadarih-type seems to be the result of analogical processes in the linguistic history of Slovenian. Keywords Language Contact; Friulian; Slovenian; medih; lampadarih.
De ahí pasa a la Lima de finales del siglo XVIII y principios del XIX, para ocuparse del papel que tuvo en la transmisión de los textos de Caviedes el médico mulato José Manuel Valdės, cuya obra ...Jouve Martín ya analizó en su estudio The Black Doctors of Colonial Uma (McGill-Queen's Press, 2014). A continuación, El poeta y sus coleccionistas explora el interés que sintió por Caviedes el Coronel Manuel de Odriozola, figura destacada de la política y las letras del Perú, un país que, al final de su vida, le daría miserablemente la espalda; el papel que cumplió Ricardo Palma en la transformación de Caviedes en una especie de poeta nacional; los empeños bibliófilos del argentino Gregorio Beeche, uno de los mayores coleccionistas latinoamericanos del siglo XIX; el oportunismo de Francisco Pérez de Velasco, un inversor y diplomático perteneciente a la clase alta de Lima, que fue el responsable de que dos de los manuscritos más importantes de Caviedes acabasen engrosando los fondos bibliográficos de las universidades de Yale y de Duke; la compra al por mayor de libros y manuscritos por parte de Hiram Bingham III, el célebre descubridor del Macchu Pichu, durante su paso por Lima; el curioso interés que tuvo por Caviedes el excéntrico escritor argentino Wenceslao Jaime Molins; y el oscuro destino del supuesto manuscrito que acabó agenciándose el médico boliviano Rolando Costa Arduz.
The state of medical education and practice in the UK report: 2016. http://www.gmc-uk.org/publications/somep2016.asp. Applicant numbers to 'early deadline' university courses increase by one per ...cent, UCAS figures reveal today. 26 Oct 2016. https://www.ucas.com/corporate/news-and-key-documents/news/applicant-numbers-%E2%80%98early-deadline%E2%80%99-university-courses-increase.
French social insurance, like UK national insurance, is a proportional tax used to fund healthcare on an annual pay as you go basis. A single payer, tax financed healthcare system like the NHS offers ...greater efficiency and equity.
