PDF-(EBOOK)-Doctoring: The Nature of Primary Care Medicine

American medicine attracts some of the brightest and most motivated people the country has to offer and it boasts the most advanced medical technology in the world a wondrous parade of machines and techniques such as PET scans MRI angioplasty endoscopy bypasses organ transplants and much more besides And yet writes Dr Eric Cassell what started out early in the century as the exciting conquest of disease has evolved into an overly expensive over technologized uncaring medicine poorly suited to the health care needs of a society marked by an aging population and a predominance of chronic diseases In Doctoring The Nature of Primary Care Medicine Dr Cassell shows convincingly how much better fitted advanced concepts of primary care medicine are to Americas health care needs He offers valuable insights into how primary care physicians can be better trained to meet the needs of their patients both well and sick and to keep these patients as the focus of their practice Modern medical training arose at a time when medical science was in ascendancy Cassell notes Thus the ideals of scienceobjectivity rationalitybecame the ideals of medicine and diseasethe target of most medical researchbecame the logical focus of medical practice When clinicians treat a patient with pneumonia they are apt to be thinking about pneumonia in generalwhich is how they learn about the diseaserather than this persons pneumonia This objective rational approach has its value but when it dominates a physicians approach to medicine it can create problems For instance treating chronic diseasesuch as rheumatoid arthritis diabetes stroke emphysema and congestive heart failureis not simply a matter of medical knowledge for it demands a great deal of effort by the patients themselves they have to keep their doctor appointments take their medication do their exercises stop smoking The patient thus has a profound effect on the course of the disease and so for a physician to succeed he or she must also be familiar with the patients motivations values concerns and relationship with the doctor Many doctors eventually figure out how to put the patient at the center of their practice but they should learn to do this at the training level not haphazardly over time To that end the training of primary care physicians must recognize a distinction between doctoring itself and the medical science on which it is based and should try to produce doctors who rely on both their scientific and subjective assessments of their patients overall needs There must be a return to careful observational and physical examination skills and finely tuned history taking and communication skills Cassell also advocates the need to teach the behavior of both sick and well persons evaluation of data from clinical epidemiology decision making skills and preventive medicine as well as actively teaching how to make technology the servant rather than the master and offers practical tips for instruction both in the classroom and in practice Most important Doctoring argues convincingly that primary care medicine should become a central focus of Americas health care system not merely a costsaving measure as envisioned by managed care organizations Indeed Cassell shows that the primary care physician can fulfill a unique role in the medical community and a vital role in society in general He shows that primary care medicine is not a retreat from scientific medicine but the natural next step for medicine to take in the coming century. Teaching Clinical Reasoning In The Apprenticeship Model . Nothing. My Thanks. Dennis Baker. Greg Turner. Lynn Romrell. Goals. Stimulate discussion of clinical reasoning in the context of curriculum redesign. Our Moment in History. John Saultz, MD. Professor and Chairman. OHSU Family Medicine. To share the story of how our discipline’s new strategic plan, . Family Medicine for America’s . Health. , came about. Paige Hatcher, MD. - Diplomate. , ABFM. - Preventive Medicine Resident, OHSU. - MPH Candidate, PSU. - Health Policy Fellow, OHA. Capacity. Average panel size as the population ages is estimated to increase to 2300 per PCP. Amy Russell, MD. Medical Director MAHEC/MMA Primary Care . Asheville, NC. Family Medicine at Its Peak. Amy Russell. MD. Medical Director MAHEC/MMA Primary Care. April 2015. Presentation Goals. Why Primary Care is Important. John Saultz, MD. Professor and Chairman. OHSU Family Medicine. To share the story of how our discipline’s new strategic plan, . Family Medicine for America’s . Health. , came about. To outline the plan’s core recommendations. System . Global . T. rend and . in . K.S.A. . . OBJECTIVES:. By . the end of this session the . Students . should be able t. o. :. Discuss the global trend in health care system. History of health Care system in the Kingdom. Increasing Access to Care under the . Affordable Care Act:. Utilizing the Health Care Continuum to Increase Access. Joint Informational Hearing of the . Senate Committee on Health . and the . Senate Committee on Business and Professions. Primary . Care & Public Health - The Interface. EPID . 6OO . - Introduction to Public . Health. 2015. (With acknowledgement to Stephen . Rothemich. , MD. Dept. of Family Medicine). Ecology of . Medical. March 28, 2019. Dawn Prentice, LCSW. Director of Integrated Care and Health Psychology. St. Louis Behavioral Medicine Institute. Ronald B. Margolis, PhD. Founder and CEO of Saint Louis Behavioral Medicine Institute. primary care . setting. . Evidence based medicine has had an increasing impact on primary care over the last few years. . In . the . UK it . has influenced the development of . :. Guidelines. Quality . Primary care medicine, as we know and remember it, is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection as health care steadily becomes more transactional than relational. The thin-margin efficiency, rapid pace, and high volume demanded by the new health care economics do not work for primary care, an inherently slower, more personal, and uniquely tailored service. In Out of Practice, Dr. Frederick Barken juxtaposes his personal experience with the latest research on the transformations in the medical field. He offers a cool critique of the “market model of medicine” while vividly illustrating how the seemingly inexorable trend toward specialization in the last few decades has shifted emphasis away from what was once the foundation of medical practice. Dr. Barken addresses the complexities of modern practice—overuse of diagnostic studies, fragmentation of care, increasing reliance on an array of prescription drugs, and the practice of defensive medicine. He shows how changes in medicine, the family, and society have left physicians to deal with a wide range of geriatric issues, from limited mobility to dementia, that are not addressed by health care policy and are not entirely amenable to a physician’s prescription. Indeed, Dr. Barken contends, the very survival of primary care is in jeopardy at a time when its practitioners are needed more than ever. Illustrated with case studies gleaned from more than twenty years in private practice and data from a wide range of sources, Out of Practice is more than a jeremiad about a broken system. Throughout, Dr. Barken offers cogent suggestions for policymakers and practitioners alike, making clear that as valuable as the latest drug or medical device may be, a successful health care system depends just as much on the doctor-patient relationship embodied by primary care medicine. A Comparison of State Definitions. November 2020. 1. Why Set a Primary Care Spend Target? (1 of 2). The U.S. health care system is largely specialist-oriented. Research has demonstrated that greater relative investment in primary care leads to better patient outcomes, lower costs, and improved patient experience of care.. . Rebuilding the Foundation of Health Care. Nationalacademies.org/. primarycare. primarycare@nas.edu. Linda McCauley. , . Emory University . (Co-Chair). Asaf. Bitton. , . Ariadne Labs. Tumaini Coker. Quick Survey. 3 Simple Rules. Data. Data. Data. American Academy of Family Physicians American Academy of . Nurse Practitioners . American Academy of . Pediatrics. . American Academy of . Physician Assistants .