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On a plan entirely new: with a description of the vegetables made use of, and directions for preparing and administering them, to cure disease
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.
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.
This Second Edition of Family Medicine: Principles and Practice presents a scien tific approach to health and illness in the context of mankind's most enduring societal unit-the family. This is a new book, building on the strengths of the First Edition. The emphasis of this book, like that of the specialty itself, is on the clinical delivery of health care; that is, how the practitioner manages common problems and recognizes uncommon entities encountered in office, hospital, home, and nursing home. In the First Edition, we were faced with the problem of how to organize a family medicine textbook that dealt with clinical topics yet represented more than a series of essays on the specialties for the generalist reader. We began by identifying specific objectives, outlined in the preface to the First Edition. From this evolved an approach which has been called the biopsycho social perspective-inclusion of behavioral, family, social, and cultural aspects of health care integrated with the traditional "manifestations-and-manage ment" textbook model. The First Edition also introduced a comprehensive classification of clinical problems in family medicine now used in curriculum planning in many family practice residency programs.
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.
The 1990s marked a new era in family formation. Increased access to donor sperm enabled single women and lesbian couples to create their families on their own terms, outside the bounds of heterosexual married relationships. However, emerging “alternative” families were not without social and political controversy. Women who chose to have children without male partners faced many challenges in their quest to have children. Despite current wider social acceptance of single people and same sex couples becoming parents, many of these challenges continue. In Romancing the Sperm, Diane Tober explores the intersections between sperm donation and the broader social and political environment in which “modern families” are created and regulated. Through tangible and intimate stories, this book provides a captivating read for anyone interested in family and kinship, genetics and eugenics, and how ever-expanding assisted reproductive technologies continue to redefine what it means to be human.
Details the steps consumers must take to navigate the confusing world of medicine to improve the quality of care received