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This book presents a pediatrician's spiritual odyssey into the heart of the family and is a remarkable work of love and dedication that honors the human spirit at all ages. This kindly physician - whose earlier work, Who's Yelling in My Stethoscope?, earned many devoted readers - brings us poignant moments, cozy chuckles and sage advice gleaned from his busy pediatrics practice.
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.
The classic bestselling resource for every American household, Home Comforts addresses the meanings as well as the methods of housekeeping to help you manage everyday chores, find creative solutions to modern domestic dilemmas, and enhance the experience of life at home. "Home Comforts is to the house what Joy of Cooking is to food." —USA TODAY For the first time in nearly a century, here is an engaging and comprehensive book about housekeeping. Far from a dry how-to manual, nor a collection of odd tips and hints, a history book, or an encyclopedia compiled by a committee or an institute, Home Comforts is a readable guide for both beginners and experts of all the domestic arts. Including choosing fabrics, cleaning china, keeping the piano in tune, making a good fire, folding a fitted sheet, setting the dining room table, keeping surfaces free of germs, watering plants, removing stains—this guide covers everything that modern people might want to do for themselves in their homes. Further topics include: making up a bed with hospital corners, expert recommendations for safe food storage, reading care labels (and sometimes carefully disregarding them), keeping your home free of dust mites and other allergens, home safety and security, this is a practical, good-humored, philosophical, even romantic, guidebook to the art and science of household management.
This book comes from my experiences as a family doctor in a small town in Dorset England for 38 years covering 1972 to 2010. During most of that time being a Family Doctor was more than being a General Practitioner. I have tried to explain the changes that occurred without trying to extol the virtues of a golden age which never existed. The process of computerisation, advances in medicine, change in the family, de-skilling of the doctor, training of GPs and the rise of the ‘portfolio’ doctor are covered hopefully without over-doing it. I hope I have explained how doctor and patient became distanced and why. All through this period the control by Government extended. The Doctor now works for the Government and not the patient. Since I retired from the Practice 10 years ago the concept of a patient having their own Doctor for decades or generations has largely gone. What I have tried to do is to explain the changes and why they happened and to do it through the people I lived along side and cared for. They were sometimes hard work, sometimes irritating, often chaotic and occasionally terribly funny. But in the end they were my patients and I was their Doctor.
This book discusses the most important practical aspects involved in providing multidisciplinary Adolescent and Young Adult (AYA) services for cancer patients. It draws on international experience in several continents of establishing and running such services and provides a contemporary, practical approach to AYA care based on accumulated experience. It is of interest to those establishing or seeking to improve AYA services as well as those already caring for AYA cance patients. Among topics discussed are incidence trends and treatment pathways, access to clinical trials for adolescents, transition from pediatric to adult services, psychological support and social care as well as survivorship and fertility. This book is of value of those establishing new services, those developing an existing service and those whose work includes the care of AYA patients. It is an important companion for pediatricians, oncologists as well as other medical, nursing and allied health professionals caring for Adolescents and Yound Adults with cancer.