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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.
'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.
From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well. Nobody should have to die in pain. Nobody should have to die alone. This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning. Ira Byock is also the author of The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life.
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.
I WAS NOT A GOOD MEDICAL STUDENT BLUNT BUT GOOD THE LIFE AND DECLINE OF THE FAMILY DOCTOR This trilogy records the life, starting as a young man, who decided, after the death of his mother, to make a difference by becoming a Doctor. It plots the course from an eighteen year old who had discovered the freedom of being a student away from home to a successful General Practitioner and Trainer. Part one is the experiences of a medical student in the 1960s, and Part two as a junior doctor in the 1970s. The third part records the life of the Family Doctor through anecdotes of his patients and the ultimate decline of the concept of a Family Doctor. After 48 years and at least 300,000 patients later, it is mission accomplished.
This “comforting…thoughtful” (The Washington Post) guide to maintaining a high quality of life—from resilient old age to the first inklings of a serious illness to the final breath—by the New York Times bestselling author of Knocking on Heaven’s Door is a “roadmap to the end that combines medical, practical, and spiritual guidance” (The Boston Globe). “A common sense path to define what a ‘good’ death looks like” (USA TODAY), The Art of Dying Well is about living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with them, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event. This handbook of preparations—practical, communal, physical, and spiritual—will help you make the most of your remaining time, be it decades, years, or months. Based on Butler’s experience caring for aging parents, and hundreds of interviews with people who have successfully navigated our fragmented health system and helped their loved ones have good deaths, The Art of Dying Well also draws on the expertise of national leaders in family medicine, palliative care, geriatrics, oncology, and hospice. This “empowering guide clearly outlines the steps necessary to prepare for a beautiful death without fear” (Shelf Awareness).
NATIONAL BESTSELLER *SHORTLISTED FOR THE 2022 WRITERS' TRUST BALSILLIE PRIZE FOR PUBLIC POLICY* An urgently important exploration of the human stories behind Canada's evolving acceptance of Medical Assistance in Dying (MAiD), from one of its first and most thoughtful practitioners. Dr. Jean Marmoreo spent her career keeping people alive. But when the Supreme Court of Canada gave the green light to Medical Assistance in Dying (MAiD) in 2016, she became one of a small group of doctors who chose to immediately train themselves in this new field. Over the course of a single year, Marmoreo learns about end-of-life practices in bustling Toronto hospitals, in hospices, and in the facilities of smaller communities. She found that the needed services were often minimal—or non-existent. The Last Doctor recounts Marmoreo's crash course in MAiD and introduces a range of very different and memorable patients, some aged, some suffering from degenerative conditions or with a terminal disease, some surrounded by supportive love, some quite alone, who ask her help to end their suffering with dignity and on their own terms. Dr. Marmoreo also shares her own emotional transformation as she climbs a steep learning curve and learns the intimate truths of the vast range of end-of-life situations. What she experiences with MAiD shakes her to her core, makes her think deeply about pain, loneliness, and joy, and brings her closer to life’s most profound questions. At a time when end-of-life care and its quality are more in the public eye than ever before, The Last Doctor provides an accessibly personal, deeply humane, and authoritative guide through this difficult subject.
Since the previous edition of Ian McWhinney's text was published in 1989, family medicine has assumed an increasingly important role in the modern health care system. The growth of managed care in The United States and of similar movements in other countries has made it more important than ever to define and conceptualize the discipline and to synthesize its body of knowledge and skills. The author brings to this task a lifetime's experience in family practice and academic family medicine. The first edition was widely acclaimed for its originality, depth of analysis, and elegant style. The book has now been extensively revised, while retaining its original structure. The first ten chapters are devoted, as before, to a conceptualization and description of the field, Much new material has been added on the patient-centered clinical method, illness narratives, the biological basis of family medicine, health promotion, the concept of risk, and the contribution of evidence-based medicine. Chapter 9 now includes an authoritative review of evidence-based preventive strategies. The five clinical chapters exemplify the application of basic principles in practice. These have all been updated with the results of new research. The chapters on the practice of family medicine cover such topics as home care, records and practiced management. The revisions of these reflect many changes that have occurred since the first edition. A new chapter on alternative (complementary) medicine fills the need for reliable information on this topic. The book has been designed to be read as a whole, with fundamental ideas forming a continuous thread which runs through all its sections.