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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.
This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.
This is an ideal resource for Family Physicians, providing a "refresher course" of sensible paths toward resolution of common mental health problems. It features an easy-to-read style, and well-focused references. The book summarizes the basic components of brief therapy and reviews how to conduct a brief therapy interview. Each chapter includes an outline, a case example or vignette, and a concise discussion of brief therapy strategies for the disorder.
This new edition has been fully revised to present students with the latest developments in the field of clinical medicine. Divided into nineteen sections, the book covers all systems of the body, providing in depth explanations of disease aetiology, clinical features, diagnosis, management, and complications. Each topic is highly illustrated with clinical photographs, tables and diagrams with explanations. A ‘miscellaneous’ chapter covers topics such as nutrition, metabolic syndrome, chemical warfare, drugs with multiple indications, stem cell therapy and more. The final sections, ‘Notes’ and ‘What’s New’, are new to this edition and provide the latest terminology, drug tips and references to help students in their preparation for exams. Key Points Fully revised, new edition providing students with the latest developments in clinical medicine Covers disease diagnosis and management in all systems of the body Highly illustrated with nearly 3000 clinical photographs, diagrams, tables and algorithms across more than 1000 pages Previous edition (9789380206348) published in 1999
This book is intended as an introduction to family medicine and to the behaviors, concepts, and skills upon which the clinical practice of the discipline is based. The chapters that follow will provide a foundation for the student during the pre-doctoral years, a base upon which he or she can build during residency training and practice. Fundamentals of Family Medicine presents Part I (the first 36 chapters) of Family Medicine: Principles and Practice. Because it is intended that the student will eventually move from use of this extracted material to the full textbook, the preface to the comprehensive edition has been included and cross-references to later chapters have been retained. Why publish a student edition? Medical students in various schools partici pate in courses covering a wide range of topics including communication skills, family dynamics, medical ethics, human sexuality, disease prevention, aging and death. Departments of family medicine generally assume a leadership role in presentation of such courses, and this book is intended to integrate these eclectic topics into a single textbook.
Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age—about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the "unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you." These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee's masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges.
'McWhinney's Textbook of Family Medicine' is one of the seminal texts in the field, defining the principles and practices of family medicine as a distinct field of practice. The fourth edition presents six new clinical chapters of common problems in family medicine.
Whether you offer comprehensive pregnancy care in your primary care facility, or provide prenatal and postpartum care, this book delivers the guidance you need to optimize health for both mothers and their babies. It covers all aspects of birth care, from preconception counseling and prenatal care, through labor and delivery (both low-risk and complicated), to postpartum care and the first month of life. The completely revised third edition includes the most up-to- date, evidence-based standards of care. It offers information that is patient centered, prevention oriented, educational, and sensitive to the care of the whole woman and her family. Features a reader-friendly outline/narrative format for ease of use in daily clinical practice. Describes how to care for patients with a wide range of medical conditions during pregnancy as well as pregnancy-related conditions. Takes a whole-family approach to maternity care, with discussions of maternal and paternal adjustment, marital adjustment, sibling adjustment, single-parent families, and return-to-work issues. Provides patient and family education materials on a full range of topics, from nutrition in pregnancy to breastfeeding. Features a section on alternative medicine in maternity care. Provides detailed instruction for a wide array of procedures, including cesarean delivery, perineal repair of simple and complex lacerations, circumcision, assisted deliveries, and amnioinfusion. A continued strong emphasis on evidence-based medicine includes an ongoing summary of Level A recommendations throughout the text. A new chapter summarizes practical applications of how to incorporate continuous quality improvement and enhanced medical safety into the maternity care setting. A new section details which immunizations can be used safely during pregnancy. A section on "Centering Pregnancy" discusses this new model of care and how it incorporates longitudinal group.
Offers guidance on the principles of family medicine, primary care in the community, and various aspects of clinical practice. Suitable for both residents and practicing physicians, this title includes evidence-based, practical information to optimize your patient care and prepare you for the ABFM exam.
This practical ‘How To’ guide talks the reader step-by-step through designing, conducting and disseminating primary care research, a growing discipline internationally. The vast majority of health care issues are experienced by people in community settings, who are not adequately represented by hospital-based research. There is therefore a great need to upskill family physicians and other primary care workers and academics to conduct community-based research to inform best practice. Aimed at emerging researchers, including those in developing countries, this book also addresses cutting edge and newly developing research methods, which will be of equal interest to more experienced researchers.