The US healthcare system faces numerous difficulties: uncontrolled increases in costs; major access problems; doctor shortages; closing practices; inefficiencies; decreasing revenues; shrinking bottom lines; large numbers of uninsured and underinsured patients; and the upcoming increased demands in service posed by the Affordable Care Act. As a result, many physicians and health care organications are turning to group visits to address these problems. While Dr. Noffsinger's textbook Running Group Visits In Your Practice is the cornerstone reference on designing, implementing and running shared medical appointments (SMAs) in one's practice, it lacks the simplicity and practicality that clinicians are looking for to start their own SMA programs. The ABCs of Group Visits is a practical, streamlined and step-by-step guide focused on the implementation aspects of group visits.Healthcare professionals at every level are looking for alternate ways to deliver high quality care at lower cost, and it is clear to many that group visits provide a care delivery model that will address many of today's critical challenges. The ABCs of Group Visits quickly provides a solution for your busy practice."

Changes in health care are at a breakneck pace. Regardless of the many changes we have collectively experienced, delivering health care has been, is, and will continue to be an enormously information-intensive process. Whether caring for a patient or a population, whether managing a clinic or a continuum, we are in a knowledge exchange business. A major task for our industry, and the task for chief information officers (CIOs), is to find and apply improved strategies and technologies for managing healthcare information. In a fiercely competitive healthcare marketplace, the pressures to suc ceed in this undertaking-and the rewards associated with success-are enormous. While the task is still daunting, we can all be encouraged by progress being made in information management. There are documented successes throughout health care, and there is growing recognition by healthcare chief executive officers and boards that information strategies, and their deployment, are essential to organizational efficiency, quite pos sibly organizational survival.

Fundamentals of Clinical Practice is an introductory textbook focusing on the patient physician relationship. Formerly closeted behind closed doors, this most intimate of healing relationships is coming under increasing scientific scrutiny. Physicians and other healthcare providers are beginning to understand the critical importance of this relation ship to the health of patients, as well as to larger societal relationships, systems, and values. To facilitate the reader's exploration of the patient-physician relationship, all chap ters include numerous illustrative cases and conclude with cases for discussion that allow small groups of learners to tackle these difficult issues. Our hypothesis is that through discussion a deeper understanding of the dynamics of the patient-physician relationship will allow medical students and other future healthcare providers to form more effective therapeutic relationships with their patients. Part I of this textbook, "The Patient," explores the relationship through the patient's perspective, with chapters on human health and disease and individual and family devel opment. Understanding the patient's perspective is critical to establishing a sound thera peutic relationship. The day when a physician could maintain solely a disease or techno logical perspective is fading fast under the weight of patient criticism, particularly in primary care fields. Patients judge such a disease or technological perspective as less humane and frequently vote with their feet, finding other physicians who are much better able to balance the caring aspects of medicine with the curing.

Gastrointestinal motility has evolved from an esoteric laboratory tool into a sophisti cated diagnostic technique that is now widely used clinically to guide in management of complex gastrointestinal problems. Today, it is the most rapidly growing subspecialty within gastroenterology. Previously, many of the gastrointestinal motility problems were either ignored or attributed to a disturbance of "psyche." But with the growing knowledge and understanding of how a dysfunction of the gastrointestinal muscle and nerves can cause disease, we are at the threshold of a revolution in our approach to the diagnosis and treatment of gastrointestinal motility disorders. The purpose of this book is to serve as a useful, up-to-date reference manual and guide for the diagnostic and therapeutic approach towards common adult and pediatric gastrointestinal motility problems. In order to enhance the understanding of these disor ders, a problem-oriented approach has been chosen, and wherever possible the authors have provided clinical case scenarios to illustrate their message. The emphasis has been on how to diagnose and treat motility disorders rather than to provide an encyclopedic infor mation. The reference list at the end of each chapter should enable the enthusiast to seek further information. Some of the material presented in this book has been derived from the proceedings of the annual University ofIowa College of Medicine GI Motility Symposia."

For many years we have known that dental caries is one of the most common diseases of mankind. Only few people have sound teeth till the end of life. Formerly we thought that the only possibility to keep our teeth in good state was to go to the dentist regularly. Since we know how complicated our nutrition is we know too that we have to regard the composition of our food as a principal factor influencing the state of our teeth. The trace-elements e. g. play an important role. Studies with tracers during the last decades have shown that the minerals are metabolized very actively by living organisms. Thus research in our laboratory, together with Prof. SIZOO and Prof. OOLS, has demon strated that intravenously injected radio-active phosphorus has disap peared from the blood already half an hour after injection. Even the hard dental substance participates in this active metabolism."

Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is practical, office-based, and comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists. We examine and recommend applying collaborative care and other existing models of integrated care based on existing literature. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems We assume the use of integrated team staffing including a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s).

to Medical Manipulation John K. Paterson, MB. BS. MRCGP currently Vice-President and Han. Secretary of the British Association of Manipulative Medicine and member of the Scientific Advisory Committee of the International Federation of Manual Medicine and Loic Burn, BA. MRCS. LRCP. DPhysMed currently President of the British Association of Manipulative Medicine. Han. Secretary of the Scientific Section of the British League against Rheumatism and member of Council of the Back Pain Association ~~ M.TP PRESS LIM.ITED ~ a member of the KLUWER ACADEMIC PUBLISHERS GROUP LA CASTER I BOSTON I THE HAG E / DORDRECHT Published in the UK and Europe by MTP Press Limited Falcon House Lancaster, England British Library Cataloguing in Publication Data Paterson, John K. An introduction to medical manipulation. 1. Manipulation (Therapeutics) I. Title II. Burn, Loic 615.8'2 RM724 Published in the USA by MTPPress A division of Kluwer Boston Inc 190 Old Derby Street Hingham, MA 02043, USA Library of Congress Cataloging in Publication Data Paterson, John K., 1921- An introduction to medical manipulation. Bibliography: p. Includes index.

All practitioners and pharmacists interested in treatment with herbal remedies should have this book at their disposal. It is the definitive practice-oriented introduction - now in its fifth edition - to phytotherapy. Methodically classified by organic systems and fields of application, the text provides a quick insight into dosage, form of application and effects of the most important herbal remedies. Only those herbal remedies that are of pharmacological and clinical efficiency have been considered. The authors are highly experienced in the field of postgraduate medical education, and, with this work, present an indispensable reference book for the medical practice.

Psychology and Diabetes Care: A Practical Guide is a concise handbook for the practicing diabetes clinician who is interested in gaining a better understanding of his patients, and in learning simple skills and tips to manage patients more effectively. It identifies and explores key psychological interventions in diabetes care in order to help healthcare professionals support their patients effectively. Edited by an expert on the psychology of diabetes, and with contributions from a group of specialists in diabetes psychology, this book contains a myriad of insights into how to understand and treat the type 1 or type 2 diabetes patient.

John P. Horder, President, 1980-82 The first 30 years of the College have been an exciting experience for those most closely involved. Some have already passed on, but this account has been written soon enough for many of the actors to be historians. Future members of the College will be grateful to them for what they have written, as well as for what they did as a remarkably determined and harmonious team. Students of twentieth century medicine in this country will also be grateful for a first-hand account of the development of an institution which has been closely associated with, and partly responsible for, important changes in medical care and education. Those who read these pages may wonder how the builders of this young College could have found time to do much general practice. They did. The three editors of this history, which covers 25 years, and the general practitioner members of the Steering Committee all ran large practices, in which they worked very hard throughout that time. Most of their work for the College was done during off-duty hours, weekends and holidays. The College could not have developed as it did, had they not been personally concerned with the practical problems and needs of clinical medicine. This is also true of many of the contributors. It is impossible to mention everyone who deserves credit. The editors hope that they may be forgiven for any serious omissions.

Upon the request of the International Union of Theoretical and Applied Mechanics (IUTAM) the Swedish National Committee for Mechanics organized a colloquium on fatigue, which was held at the Royal Institute of Technology (Kung!. Tekniska Hogskolan) in Stock- holm, May 25-27, 1955. 35 lectures were delivered, principally dealing with problems of statistical and basic nature. Among the topics were to be found statis- tical theory of fatigue, cumulative damage, mechanism of fatigue, me- tallurgical aspects on fatigue, velocity of fatigue cracks, fatigue at elevated temperature, and fatigue at combined stresses. Lectures were going on simultaneously in two sections. Each lecturer had 15 minutes for presentation of his communication, and afterwards 15 minutes were reserved for discussion. Abstracts of the lectures were distributed about a month before the colloquium. The colloquium was attended by 149 participants from the follow- ing countries: Denmark (1), Finland (2), France (5), Germany (6), Italy (2), Netherlands (2), Norway (2), Poland (2), Saar (1), Spain (3), Sweden (100), Switzerland (1), United Kingdom (10), USA (8), USSR (3), and Yugoslavia (1). A complete list of the participants will be found below. The languages of the Colloquium were English, French, German and Italian. No lectures were delivered in Italian. Also, all contributions to the discussions have been translated to one of the first three languages. Statements and opinions advanced are always those of the individual authors or participants in the discussions.

The idea of producing this book of case histories from general family prac tice was only a twinkle in the editors' eyes until October 1980, when in a room in the Marriott Hotel in New Orleans, the editors met with John Fry, Joseph Levenstein and Bill Jackson to discuss new book projects. The idea was put to the group, which endorsed it enthusiastically. Encouraged by this and by John Fry's advice, the conception of The Nature of General Family Practice took place. It was agreed that to illustrate the universal nature of general family prac tice it would be useful to collect case histories from all around the world, that for preference they should be brief, and that they should be ac companied by major questions and sub-questions, but no answers. The name 'Vignettes' was applied to these cases and their questions. Subsequently, well over a hundred family physicians were asked by letter to provide ten vignettes. Sixty doctors from ten countries accepted the invitation and forwarded their contributions during the second half of 1981. Almost all of those who, for a variety of reasons were unable to contribute, said they liked the idea and looked forward to using the final product. Altogether, over 600 vignettes were received, and 583 selected for final inclusion."

DDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analysis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was con cerned more with diagnosis in the widest sense and this series deals more definitively with general care and specific treatment of symp toms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and assessment and investigations, but the em phasis is on what to do best for the patient. Family medical practitioners have particular difficu1ties and ad vantages in their work_ Because they often work in professional isolation in the community and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and relatively untried methods compared with those that are 'old' and well proven. Their advantages are that because of long-term continuous care for their patients they have come to know them and their families FOREWORD well and are able to become familiar with the more common and less serious diseases of their communities."

Nutrition Guide for Physicians is a desktop reference guide on nutrition and its clinical implications for health and disease through the lifecycle. Presented in a new softcover format and user-friendly style, it serves as a valuable resource of practical information on nutrition for physicians in their daily practice. Nutrition Guide for Physicians is divided into three parts that cross the spectrum of nutritional concerns for improving the practice of medicine. Part One provides basic nutritional principles for physicians. Part Two covers nutrition through the lifecycle and optimal nutrition patterns through all stages of development. Part Three covers diet and its role in prevention, cause and treatment of disease. All chapters include figures and tables that provide useful descriptive and visual reviews. "Key points" and succinct "conclusions" are also provided for each topic. Nutrition Guide for Physicians provides a wide perspective of the impact that nutrition has upon medical practice and will be am indispensable resource for primary care physicians and other medical professionals.

A concise summary of the most important medical and scientific topics concerning cardiovascular medicine in the primary care environment. Writing in an easy-to-read format-background, diagnosis, and disease management-and emphasizing practical techniques of evaluation and treatment, the authors explain the basic mechanisms underlying cardiovascular disease states and the treatment strategies that arise from them. Topics range from acute coronary syndromes, arrhythmias, and hyperlipidemia, to hypertension, pericardial diseases, valvular disease, and stable angina. Cardiology in Family Practice: A Practical Guide offers a clear understanding of today's standard approaches to cardiovascular illnesses and a highly valuable resource when specific questions arise during the care of patients. A special PDA version of Cardiology in Family Practice: A Family Guide is also available.

This book presents an invaluable symptoms-based approach to sports cardiology for sports medicine physicians, primary care physicians, and cardiologists. Edited by an authority in the field, the text offers sought-after insight on the cardiac health of athletes. Case studies are featured throughout to further understanding and the integration of concepts into daily practice. With contributions by both sports medicine physicians and cardiologists, this timely book bridges the gap between disciplines and is an unparalleled resource for those looking to effectively manage the cardiac health of active patients.

This book presents a broad yet focused treatment of central topics in the field of clinical neurophysiology. The volume was inspired by the clinical neurophysiology lecture series at Beth Israel-Deaconess Medical Center and Rhode Island Hospital. Much like the lecture series, this book is designed to acquaint trainees with the essential elements of clinical neurophysiology. Each chapter is written by leading and respected clinical neurophysiologists.

Asian Americans are the fastest growing minority group in the United States. When Asian immigrants arrive in the United States, they regularly encounter a vast number of difficulties integrating themselves into their new culture. In Handbook of Mental Health and Acculturation in Asian American Families, distinguished researchers and clinicians discuss the process of acculturation for individuals and their families, addressing the mental health needs of Asian Americans and thoroughly examining the acculturative process, its common stressors, and characteristics associated with resiliency. This first-of-its-kind, multi-dimensional title synthesizes current acculturation research, while presenting those concepts within a clinical framework. In addition to providing an in-depth look at both past and present research and offering directions for future topics to explore, the book also offers a range of practical tools such as research scales to measure levels of acculturation, interview techniques, and clinical approaches for special populations including children, the elderly, and their families. Thought-provoking and informative, Handbook of Mental Health and Acculturation in Asian American Families will enhance the understanding of the clinical and sociocultural problems Asian Americans face, providing clinicians with all the necessary insights to better care for their patients.

In the modern practice of medicine, new challenges complicate the ethical care of patients. Today's times require a contemporary take on the concept of medical ethics. The idea for this textbook was born out of a need for a teaching resource that merges medical ethics theory with the practical needs of modern clinical medicine. In Evidence-Based Medical Ethics: Cases for Practice-Based Learning, the authors address what has been missing in existing text books and ethics courses to date - clear-cut ethical and legal guidelines that provide a method for the reader to learn how to systematically manage dilemmas seen in the everyday practice of medicine. The reader is guided through several "typical" patient scenarios and prompted by various questions that should be entertained by the treating health care provider. Then, relevant evidence-based medicine, legal precedent, and the ethical theory that applies to the situation are revealed. Often, finding the "best" ethical solution for each problem is automatic, as the solution often becomes self-evident during information-gathering. This general method is reinforced throughout the text with multiple different cases, using a practice-based approach by building on the reader's developing skills. Additionally, we have sought to emphasize a culturally competent manner in resolving these dilemmas, respectfully addressing issues of age, gender, and culture whenever possible. The main goal of Evidence-Based Medical Ethics: Cases for Practice-Bases Learning is to assist the reader in adapting a patient-centered and evidence-based approach to dilemmas faced in their future practice of medicine.

During the past several years, there has been an extensive reappraisal of the physiologic changes of pregnancy and their associated disorders, along with a refinement of diagnostic procedures and evaluation of the therapeutic approaches that are of primary concern to the physician. In Shoulder Dystocia and Birth Injury: Prevention and Treatment, Third Edition, noted authority James A. O'Leary, M.D., with 40 years experience as an M.D. academician, lecturer, practitioner and clinical researcher with almost 200 contributions to the OB-GYN literature and textbooks, shares his insight on treatment techniques, identification and treatment of predisposing risk factors, current statistical data, ultrasound diagnosis and the necessary steps toward prevention, along with a thorough review of the important medical-legal issues.

Shoulder Dystocia and Birth Injury: Prevention and Treatment, Third Edition supplements the limits of personal experience with the accumulated experience of many talented clinicians to aid physicians, midwives, and professionals in training with the most current information in this vital field.

Advances over the past two decades have enabled physicians to revolutionize the manner in which they can assess and manage children's pain. Thirty years ago it was thought that young children did not experience pain and therefore it was not necessary to treat it. Today professionals from a variety of disciplines have contributed data that have revolutionized medical perspectives. Technological advances now enable doctors to treat acute pain in fetuses, premature neonates, infants, toddlers, children, and adolescents with increasing precision and efficacy. Research highlighting the context of chronic pain has moved them away from a mind-body dichotomy and toward an integrated, holistic perspective that leads to substantial improvement in children's adaptive functioning as well as subjective discomfort.

This book covers these topics and is intended for anyone who provides medical care to children. Each chapter provides an overview of the problem, followed by a "hands on" description of relevant assessment and intervention strategies. The role of the primary care practitioner is highlighted, both as a front-line resource as well as a consumer of specialized pediatric pain treatment services. Each chapter ends with a summary and specific bullet points highlighting the most central elements, making for quick and easy reference.

Integrated care is receiving a lot of attention from clinicians, administrators, policy makers, and researchers. Given the current healthcare crises in the United States, where costs, quality, and access to care are of particular concern, many are looking for new and better ways of delivering behavioral health services. Integrating behavioral health into primary care medical settings has been shown to: (1) produce healthier patients; (2) produce medical savings; (3) produce higher patient satisfaction; (4) leverage the primary care physician 's time so that they can be more productive; and (5) increase physician satisfaction. For these reasons this is an emerging paradigm with a lot of interest and momentum. For example, the President 's New Freedom Commission on Mental Health has recently endorsed redesigning the mental health system so that much of this is integrated into primary care medicine.

Advances over the past decades in space flight technology have allowed U.S., Russian, and other space programs to not only increase the frequency of manned space flights but also to increase the duration of these flights. As such, a large body of knowledge has been developed regarding the ways in which space flight affects the health of the personnel involved. Now, for the first time, this body of clinical knowledge on how to diagnose and treat conditions that either develop during a mission or because of a mission has been compiled by Drs. Michael R. Barratt and Sam L. Pool of the NASA/Johnson Space Center. This text is a must have for all those associated with aerospace medicine.

The Handbook of Nutrition in Ophthalmology is the first general text on nutrition and eye health created for physicians, nutritionists, and researchers. The author provides important links between the epidemic of obesity and implications it has for eye disease and blindness. The volume also includes chapters addressing nutritional aspects of preventing eye disease in diabetes mellitus and other optical neuropathies, making this a unique book.