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A family orientation in health care can provide a wider understanding of illness and a broader range of solutions than the classic biomedical model. This volume thus offers practical guidance for the physician who would like to take greater advantage of this resource. The result is a readable guide, structured around step-by-step protocols that are vividly illustrated with case studies drawn from the authors extensive experience at the University of Rochester School of Medicine.
The first edition helped bring the family approach to health care into the medical mainstream. This new edition, like the first, provides health care professionals with a practical guide to working with and treating both the individual patient and the family. Tackling challenging and emerging issues, such as AIDS and the family, race and gender, child abuse and domestic violence in addition to pregnancy, child behavior and chronic illness, this volume is sure to be an indispensable guide for primary care providers.
A practical guide for health professionals working in primary care who wish to improve their management of problem patients, problem families and problem situations.
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
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.
Psychosocial problems appear within a medical context worldwide, and are a major burden to health. Psychosomatic Medicine: An International Primer for the Primary Care Setting takes a uniquely global approach in laying the foundations of bio psychosocial basic care (such as recognizing psychosocial and psychosomatic problems, basic counseling and collaboration with mental health specialists) and provides relevant information about the most common mental and psychosomatic problems and disorders. The scope of the book is intercultural—it addresses global cultures, subcultures living in a single country and strengthening the care given by physicians working abroad. This clinically useful book outlines best practices for diagnosing the most common bio psychosocial problems and mastering the most common communication challenges (e.g. doctor-patient conversation, breaking bad news, dealing with difficult patients, family and health systems communication and collaboration). Every chapter integrates basic theoretical background and practical skills and includes trans-culturally sensitive material, important for work with patients from different cultures. Psychosomatic Medicine: An International Primer for the Primary Care Setting serves as an excellent resource for clinicians hoping to gain and develop knowledge and skills in psychosomatic medicine.
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.