Common Dilemmas in Family Medicine

Paperback Engels 2012 1983e druk 9789401091947
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Samenvatting

One of the eXCltmg challenges of medicine has been the reaching of decisions based on less than complete evidence. As undergraduates in teaching hospitals future physicians are taught to think in clear and absolute black and white terms. Diagnoses in teaching hospitals all are based on supportive positive findings of in­ vestigations. Treatment follows logically on precise diagnosis. When patients die the causes of death are confirmed at autopsy. How very different is real life in clinical practice, and particularly in family medicine. By the very nature of the common conditions that present diagnoses tend to be imprecise and based on clinical assessment and interpretation. Much of the management and treatment of patients is based on opinions of individual physicians based on their personal expenences. Because of the relative professional isolation offamily physicians within their own practices, not unexpectedly divergent views and opinions are formed. There is nothing wrong in such divergencies because there are no clear absolute black and white decisions. General family practice functions in grey areas of medicine where it is possible and quite correct to hold polarized distinct opinions. The essence of good care must be eternal flexibility and readiness to change long-held cherished opinions. To demonstrate that with many issues in family medicine it is possible to have more than one view I selected 10 clinical and II non -clinical topics and invited colleagues and fellow-practitioners to enter into a debate-in-print.

Specificaties

ISBN13:9789401091947
Taal:Engels
Bindwijze:paperback
Aantal pagina's:400
Uitgever:Springer Netherlands
Druk:1983

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Inhoudsopgave

1 Mild-to-moderate hypertension — to treat or not to treat?.- The issues.- The case for treatment (1).- The case for treatment (2).- The case against treatment.- Critique.- Commentary.- 2 Psychotropic pills or psychotherapy?.- The issues.- The case for pills.- The case for psychotherapy.- Commentary.- 3 Alcoholism — disease or self-inflicted vice?.- The issues.- The case for alcoholism as a non-disease (1).- The case for alcoholism as a non-disease (2).- The case for alcoholism as a disease.- Critique.- Commentary.- 4 Acute myocardial infarction — home or hospital care?.- The issues.- The case for home care.- The case for hospital care.- Commentary.- 5 Is obesity worth treating?.- The issues.- The case for treating obesity.- The case against treating obesity.- Commentary.- 6 Diabetes: strict control or flexibility in management?.- The issues.- The case for strict control.- The case for realistic control.- The case for flexibility below 11.0 mmoI/I.- Commentary.- 7 Antibiotics for otitis media and sore throat?.- The issues.- The case for antibiotics.- The case against antibiotics.- Commentary.- 8 Premenstrual tension and the menopausal syndrome — specific treatment?.- The issues.- The case for specific therapy (1).- The case for specific therapy (2).- The case against specific treatment.- Commentary.- 9 Acute backache — active or passive treatment?.- The issues.- The case for active treatment.- The case for conservative management.- Commentary.- 10 Terminal care — at home or in the hospital or hospice?.- The issues.- The case for home care of the dying.- The case for hospital/hospice care (1).- The case for hospital/hospice care (2).- Commentary.- 11 Compulsory immunization, or not?.- The issues.- The case for compulsory immunization.- The case against compulsory immunization.- Commentary.- 12 House calls — more or less?.- The issues.- The case for fewer house calls (1).- The case for fewer house calls (2).- The case for more house calls (1).- The case for more house calls (2).- Commentary.- 13 Teamwork — delegated or shared?.- The issues.- The case for delegation (1).- The case for delegation (2).- The case for sharing.- Commentary.- 14 Patient participation — more or less?.- The issues.- The case for less patient participation (1).- The case for less patient participation (2).- The case for more patient participation (1).- The case for more patient participation (2).- The case for more patient participation (3): self-care benefits for primary care practitioners.- Commentary.- 15 Telling the truth, the whole truth, and nothing but the truth?.- The issues.- The case for telling the patient the truth.- Pallesen The case against telling the patient the truth.- Commentary.- 16 How many patients — more or less?.- The issues.- The case for fewer patients (1).- The case for fewer patients (2).- The case for more patients.- Commentary.- 17 The medical check-up — useful or useless?.- The issues.- The case for a medical check-up.- The case for screening.- The case against a medical check-up.- Commentary.- 18 Solo practice or group practice?.- The issues.- The case for solo practice.- The case for group practice: the future practice model in family medicine.- Commentary.- 19 Vocational training for family medicine — useful or useless?.- The issues.- The case for vocational training.- The case against vocational training.- Critique.- Commentary.- 20 At least one female family physician in every group practice?.- The issues.- The case for a female doctor in every group practice (1).- The case for a female doctor in every group practice (2).- The case against a female doctor in every practice.- Commentary.- 21 Prevention — realistic or not?.- The issues.- The case for realistic prevention.- The case for more prevention.- Critique.- Commentary.

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