Sarah Woolf shares the impact her cancer treatment had on her mental health and describes why it is important to see each patient as a whole person, understanding that their body has meaning for them
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.
During the first half of the nineteenth century a major shift occurred in the medical treatment of illness in the United States, as physicians abandoned the use of "heroic" depletive therapies -- the ...pukes and purges made famous in the 1790s by Dr. Benjamin Rush of Philadelphia -- in favor of a let-nature-take-its-course approach to most diseases. Standard histories of American medicine have long attributed this shift to new theories and training methods as well as increased competition from homeopaths and botanical doctors. In this book, Catherine L. Thompson challenges that interpretation by emphasizing the role of patients as active participants in their own health care rather than passive objects of medical treatment.
Focusing on Massachusetts, then as now a center of U.S. medical education and practice, Thompson draws on data from patients' journals, medical account ledgers, physicians' daybooks, and court records to link changes in medical treatment to a gradual evolution of patient expectations across varied populations. Specifically, she identifies three developments -- the increasing use of cash in medical transactions, growing religious pluralism, and the rise of malpractice suits -- as key factors in transforming patients into active medical consumers unwilling to submit to doctors' advice without considering alternatives.
By showing how nineteenth-century patients shaped therapeutic practice "through the medical choices they made or didn't make," Thompson's study alters our understanding of American medicine in the past and has implications for its present and future.
Indigenous Marketing Welch, Natalie Michelle
Indigenous Business & Public Administration,
08/2023, Letnik:
2, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Apprehension of modern business in Indigenous communities has led to the lack of development of concepts like Indigenous marketing. Indigenous marketing is theoretical and practical. This piece will ...explore the operational definition of Indigenous marketing.
In this essay, I describe three characteristics that Indigenous Business and Public Administration should aim to develop to be a distinctly Native journal. The journal should not be contained by ...dominant stereotypes of Native Americans. It should reflect the adaptability and innovation that Native Americans have shown in surviving the continuing colonial endeavor to erase us. Finally, the relationships between members of this community should be prioritized at least as much as the content. I developed these characteristics by reflecting on my experiences in higher education along with the ideas of other Native scholars.
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