In The Surprising Lives of Small-Town Doctors, physicians put down their stethoscopes and pick up their pens to share some of the most frightening and pivotal moments of their careers. From making igloo house calls to bandaging animal bites to performing surgeries they may have only read about in textbooks, these young doctors speak of the many rewards of practising medicine in small communities. They also detail the fears, failures, and challenges of providing health care in the farthest reaches of our country--where the need for doctors is the greatest. Collectively, these stories capture the spirit, innovation, and resilience of these rural doctors and the communities they serve.

This comprehensive, first-of-its kind title is an indispensable resource for pharmacists looking to learn or improve crucial patient assessment skills relevant to all pharmacy practice settings. Pharmacists' role as health care practitioners is evolving as they are taking a more active part in primary patient care -- helping patients manage their medications and diseases, providing patient education, and, in some jurisdictions, prescribing and adapting medications. To perform their day-to-day duties, pharmacists are best-served using a framework called the patient care process. This framework involves three steps: patient assessment; care plan development and implementation; and monitoring and follow up. Organized in four parts, this practical book begins with introductory chapters regarding the basics of patient assessment and the patient care process. Part II includes a detailed assessment of common symptoms encountered by pharmacists. Part III discusses assessment of patients with various chronic illnesses. Part IV addresses select specialized topics and assessment considerations. An invaluable contribution to the literature, Patient Assessment in Clinical Pharmacy: A Comprehensive Guide will be of great benefit to pharmacists, regardless of their practice setting, and to pharmacy students as well.

Doctors, patients, investigators, administrators, and policymakers who assign diagnoses assume three elements: the name describes an entity with conceptual or evidentiary boundaries, the person setting the name has a high degree of certainty, and the name has a consensus definition. This book challenges this practice and offers an alternative to assigning diagnoses: quantitating diagnostic uncertainty in personal and public medical plans. This book offers the stakeholders' views participating in a workshop, sponsored by the Barbara Volcker Center/Hospital for Special Surgery, taking place in April 2020, about uncertain diagnoses. Chapters examine the circumstances in which diagnosis names are "unassignable", either because patients do not fit within diagnostic "boxes" or because health abnormalities evolve and change over time. In addition, the book deconstructs the processes of diagnosis and explores how different stakeholders used diagnosis names for various purposes. In examining pertinent questions, the book offers a roadmap to achieving consensus definitions or including measures of uncertainty in personal care, research, and policy. Diagnoses Without Names: Challenges for Medical Care, Research, and Policy is an essential resource for physicians and related professionals, residents, fellows, and graduate students in internal medicine, rheumatology, and clinical immunology as well as investigators, administrators, policymakers.

This invaluable guide to the GPVTS supports trainees from the process of application, through to qualification and beyond. Written by a recently qualified general practitioner, it combines a frank and friendly approach with a wealth of insider knowledge to guide the trainee through each stage of the training process. It not only features real-life case studies from those in training or who have recently completed training but also gives handy hints and tips on how to avoid some of the common trainee pitfalls. This first hand account aims to guide trainees through all the highs and lows of training and practising as a GP plus everything inbetween.

With all the attention heaped upon the most deadly sexually transmitted infection of all, HIV, other non-fatal forms of infection have been somewhat neglected, and even overlooked in sexual education. However, incidences of STIs such as chlamydia and gonorrhoea have been dramatically and silently rising in many parts of the world in recent years - though receiving far less attention. It is now recognized that this is a major public health issue, affecting thousands of people, irrespective of background, education or social class.
In Sexually Transmitted Infections: The Facts, David Barlow, for thirty years a consultant physician at a large London teaching hospital, describes, in a readable, sensible and light style, the common and rare conditions which are seen in clinic. Case histories drawn from real patients illustrate many of the pitfalls and problems that can arise from misunderstanding how diseases such as herpes or genital warts are transmitted. An important and novel section explains how and why the seemingly reliable tests from a hospital laboratory can be misleading and, in many cases, actually wrong. This new edition has been brought up-to-date with coverage of the new HPV vaccine for cervical cancer, recent work on the aetiology of bacterial vaginosis, evidence on the treatment and management of genital herpes simplex, and a totally revived section on HIV and AIDS.
Using the early section on symptoms, the reader is rapidly pointed to the relevant section of the book for explanations and reassurance. Providing essential information on all the main forms of sexually transmitted infections, the book delivers essential, accessible, pragmatic, information that should be read by all adults.

The population is ageing, and most cardiovascular diseases are more common in older people. Older people often present atypically, have multiple co-morbidities, and are vulnerable to therapeutic delays or errors. The healthcare needs of the elderly differ from those of younger patients and are more complex, related to the physical and psychological changes associated with ageing and other disease processes in the elderly population. In addition, the response to treatment may alter with ageing, yet many elderly patients with cardiovascular disease are not looked after by specialists. Cardiovascular Disease in the Elderly provides user-friendly advice in a field that has limited evidence but contributes significantly to the workload not only of cardiologists but also of elderly care physicians and general practitioners. It reflects current UK and international guidelines and provides key evidence based references. Wherever possible, published guidelines are incorporated to ensure the book reflects current recommended management. It indicates where practice differs from that of younger adults, and provides guidance on the ethical and clinical dilemmas particular to the elderly. The handbook covers many aspects of cardiovascular disease in the elderly and focuses on common problems, including heart failure, atrial fibrillation and isolated systolic hypertension.

Women are entering medical school in equal numbers as men, yet still face unique challenges in a profession where, overall, male physicians outnumber female physicians 3 to 1. Women in medicine also face decisions such as when to have a child during training and often struggle with work-life balance. This book features real stories and advice from mothers in medicine at all stages of training from medical student to practicing physician and addresses the topics that shape the lives, joys, and challenges of women in medicine today. The book is based on the best posts and wisdom shared on the Mothers in Medicine blog, which was established in 2008 by the editor and has published over 1500 posts and has over 4.8 million page views to date. The book is organized by themes that are unique to the physician-mother: career decisions, having children during training, navigating life challenges, practice issues, and work-life balance. Each chapter features an excerpt from the blog followed by an honest discussion of the key considerations, guidelines, and tips as related to each topic in the conversational, personal tone of the blog. The book concludes with a chapter that features the most popular questions posted on the Mothers in Medicine blog and a summary of the responses received from the community of readers. Mothers in Medicine: Career, Practice, and Life Lessons Learned is a valuable and contemporary resource for pre-medical students, medical students, residents, and physicians.

This convenient handbook is a comprehensive guide to the evaluation and treatment of more than 80 signs and symptoms. It is organized alphabetically, and each entry includes history and physical examinations; causes; differential diagnosis; diagnostic procedures; treatment approaches including when to refer and when to admit; ongoing care and follow-up; and prevention. Contents include: Abdominal pain Back pain Chest pain Diarrhea and steatorrhea Dizziness and vertigo Fatigue and weakness Fever Headache Heart murmurs Jaundice Rash Red eye/pink eye Sleep disturbances Speech and language concerns Vomiting Wheezing And more!

There is an ever-increasing emphasis on evidence-based medicine that is distinguished by systematic crafting of the patient-centered research question, detailed literature searches, and careful appraisal of the resulting evidence. The consensus that ultimately emerges must then be applied in specific clinical settings, and it is to this process that translational effectiveness analysis refers. This portable and easy-to-use handbook is intended as a practical teaching guide on translational effectiveness for students and clinicians. Specifically, it will serve as a primer on patient-centered outcomes research methodology in the health sciences and explain how to acquire and understand the fundamental data that determine which reports are valued as the "best available" evidence. It presents an accessible and readily intelligible set of principles which doctors, dentists, nurses, and insurance carriers will be able to use in the process of health care-related decision-making.

Older people have complex and unique primary care needs. The frequent occurrence of co-morbidities, polypharmacy, psychological, social and functional impairments can impact on the way problems present making the diagnosis and treatment more challenging for the primary care physician. The provision of healthcare is becoming more community-based and national service frameworks have highlighted the special healthcare needs of older people. This means that treating older patients will become an even larger proportion of the daily work of the general practitioner. Packed full of practical and down to earth advice for clinicians specialising in the care of older people, this book examines real problems that present on a day-to-day basis in the primary care environment. It provides GPs with specific advice and guidance to help them in the management of the often complex conditions that present in older people. Written by practising clinicians who are experts in the field, this book covers a diverse range of subjects from stroke medicine to incontinence to the role that the voluntary sector plays in the care of older people. It includes clinical case scenarios throughout and colour photographs in chapters on areas such as ophthalmology and dermatology enable readers to effortlessly understand the points being made. Easy to read and with most chapters co-authored by a specialist and a general practitioner, this book provides GPs, community and practice nurses, and those specialising in the care of older patients with an indispensable resource they can use to find practical advice from specialists in the field, including tips on differential diagnosis and summaries of the existing evidence-base and guidelines on treatment.

Sebastian Feldmann widmet sich auf Grundlage eines umfassenden Reengineering-Ansatzes der Konstruktion eines humanoiden Roboterprototyps unter Berucksichtigung neuer Erkenntnisse aus dem Forschungsbereich der Humankommunikation bzw. der nonverbalen Kommunikation. Er entwickelt einen neuartigen Demonstrator, mit dessen Hilfe zukunftig das Thema der Akzeptanz eines humanoiden Roboters im Beisein eines menschlichen Interaktionspartners umfassend erforscht werden kann und uberwindet mit einem virtuellen Skelettmodell und einer eigens entwickelten Skriptanimationssoftware Defizite der nonverbalen Kommunikation.

Working in the outpatient clinic is a key training experience for medical students. When they arrive at the clinic, students may discover that their time on the inpatient wards does not necessarily prepare them to perform well in the outpatient setting. Everything is different in the clinic, from the nature and context of the patient encounter to the student's role in note-writing, oral case presentation, and case discussion with the attending physician. The purpose of this book is to guide students as they transition to the world of 15-minute appointments, telemedicine, cyberchondriasis, motivational interviewing, shared medical appointments, and real-time informatics. The aim is to give students a clear understanding of their role in a variety of clinic settings, to evaluate and present their patients well, maximize learning, and provide excellent care for their patients. Excelling in the Clinic explains the process of becoming an effective, efficient, and scholarly worker in the primary care clinic.

Is there an epidemic of depression sweeping the world, or are we radically altering our interpretation of normal human experiences? Do we need a dose of medication or a renewed sense of meaning? In this second edition of Beyond Depression, Christopher Dowrick - an academic general practitioner - takes a critical insider's look at commonly held views about the diagnosis and management of depression. He argues that our belief in depression as a medical condition is based on commercial, professional, organisational and cultural factors which combine to sustain the popularity of depression as a concept, which is based more on our values than on science. Based on the best contemporary evidence available, this second edition includes new research findings on the management of mild and recurrent depression, the possibility of a genetic basis to depression, and extended arguments on the limitations of screening, and the placebo effects of antidepressant medication. The author considers alternative ways of understanding the thoughts and feelings that we currently describe as depression, drawing on cross-cultural, religious, political and literary sources. He proposes a conceptual framework that provides a means of moving beyond depression as a medical concept and as a personal problem. When applied to encounters between doctors and patients in primary care it leads us towards enabling narratives, with an emphasis on listening and understanding rather than diagnosis and prescription. Beyond Depression combines a comprehensive analysis of current scientific evidence with an impressive review of linguistic, literary and philosophical perspectives. Moving seamlessly between controlled trials and Camus, from prescribing to Proust, the book is informed throughout by a series of sensitive case studies drawn from the author's personal experience.

Developed by a renowned group of international authors, this engaging, case-based title once again offers readers a wide range of thought-provoking case studies that reflect contemporary, challenging, hands-on clinical care. Expanded and fully updated, Endocrinology and Diabetes: A Problem Oriented Approach, 2nd Edition addresses the complete range of endocrinologic problems found in patient care, offering the reader a convenient and pointed way to solve clinical problems in a timely manner. Due to its comprehensive coverage and practical focus, this title has developed a special place in the field of endocrinology and will again be of great interest to endocrinologists, diabetologists, internal medicine physicians, family physicians, fellows, and residents. The enthusiastic reception and warm welcome of the first edition of this book was overwhelming and gratifying. Despite many standard texts that cover physiology and clinical aspects of endocrinology, this book found a special place because it focused on patient care and practical aspects of endocrine practice. In the current volume we were fortunate to again have the honor of collaboration by international authors who pride themselves foremost as clinical endocrinologists. We hope our readers will find this updated, improved edition worthwhile, and use it for the benefit of their patients.

Die Autoren zeigen in der vorliegenden Studie einen neuen Weg auf, wie die Arzt-Patienten-Interaktion auf ihre Wirkung hin untersucht werden kann. Innovativ wird am Beispiel der grundversorgenden Padiatrie personale Kompetenz als relevanter Wirkfaktor arztlichen Handelns empirisch sichtbar gemacht. Der Gegenstand der Kommunikation erlaubt es nicht, den engen Forschungsstandards der sog. evidenzbasierten Medizin zu folgen. Die Studie verspricht Praktikern keine Handlungsrezepte, gibt aber Impulse und Orientierung, das eigene Handeln zu reflektieren, um es an der einen oder anderen Stelle neu auszurichten.

This fully updated and expanded third edition is a reference guide on nutrition and its clinical implications for health and disease through the life-cycle. The book endeavors to address the needs of those who would most benefit from up-to-date information on recent advances in the field of nutrition. Written by experts in the field, chapters cover a diverse range of nutritional areas that present a succinct overview of recent thinking and discoveries that have the greatest capacity to aid physicians and other healthcare professionals in improving the nutritional health of their clients. The text is divided into eight parts. Part one and two address the nutrient requirements and special nutrition-related issues for people across all stages of the lifespan-from pregnancy and infancy through the adolescent years to the older adult years. Part three summarizes the role of nutrition in the prevention and management of chronic conditions frequently seen in clinical practice, including obesity, diabetes, bone disorders, coronary heart disease, hypertension, and cancer. Part four describes different dietary patterns (the Mediterranean diet, the DASH diet, the vegetarian diet, and the ketogenic diet). Part five describes nutrition challenges specific to surgery and several different acute diseases and disorders (gastrointestinal disorders, food allergy and intolerance, diseases of the liver and pancreas, kidney disease, eating disorders, bariatric surgery, sarcopenia, and drug interactions with food). Part six looks at different aspects of the diet (coffee, tea, dietary fat, dietary sugars, energy drinks, alcohol, dietary fiber, vitamins, minerals, and the gut microbiome). Part seven examines a range of factors that influence dietary health decisions (creating nutritional behavior change, methods for assessing nutritional status, Dietary Reference Intakes, an overview of the diet and food guides, food labels, and sources of nutrients). Finally, part eight looks at dietary supplements (including the problem of dishonest marketing) and false and misleading information in the area of nutrition. The growing nutritional impact of COVID-19 is discussed throughout the book where appropriate. Nutrition Guide for Physicians and Related Healthcare Professions Third Edition serves as a comprehensive guide that is organized by age/lifespan, nutrition therapy in relation to chronic disease and COVID, diet and its role in prevention, dietary requirements and recommendations, and influencing health decisions for the patient. It is a valuable resource of practical and easy-to-access information on nutrition for physicians, nurses, pharmacists, and others in their daily practice.

Designed for primary care clinicians, this book is about patients who suffer with long term pain. Written in a distinct, friendly style, it analyses ideas about pain from the simple to the complex and provides up-to-date and relevant information written by doctors whose practice is either wholly or substantially related to people with pain. It provides examples of everyday patients to provide clinicians with the confidence to prescribe and treat patients with more difficult pain. In an attempt to 'demystify' some areas of pain medicine it also includes details of the science behind common conditions and their remedies in order to emphasise the psychological and social impacts of pain.

Chronic kidney disease (CKD) is a major global public health problem, affecting nearly one in seven adults in the United States alone. It is a disease that integrates chronic illness at several levels, and the progressive condition is associated with high rates of co-morbidity. This text provides a comprehensive, current state-of-the art review of this field, serving as a valuable resource for primary care providers and non-nephrology clinicians that treat patients with CKD. It is comprised of 24 chapters focused on specific aspects of the disease. The first 2 chapters provide a bit of background on the disease, describing the anatomy and physiology of the kidney as well as the definition and epidemiology of the disease. The following 3 chapters discuss the detection, prevention and progression of the disease. The next 6 chapters describe the relationship of the disease with other conditions and most common co-morbidities such as diabetes and hypertension. The chapters, that follow focus on the CKD associated complications and the CKD within special populations such as the elderly and minorities as well as dietary restrictions and drug dosing. The book concludes with discussion on preparation for renal replacement therapy and preemptive organ transplantation as an alternative to dialysis in the management of the advanced CKD. Written by experts in the field, Approach to Chronic Kidney Disease is a comprehensive guide for clinicians, especially primary care providers including residents and fellows in training, who take care of chronic kidney disease patients. It is also a useful tool for researchers dealing with this challenging field.

This text offers a new interpretation of the dramatic changes that occurred in women in medicine over the course of the last seventy years, starting from the 1950s when women physicians were a curiosity to the present day when their presence is accepted and their achievements are broadly acknowledged. In seven chapters arranged by decades, this book examines the seminal events that shaped what has been described as "the changing face of medicine." Using the lived experiences of women physicians featured as vignettes throughout the narrative, the book traces the effects of the quota system for admissions, second wave feminism and Title IX legislation, the restrictions of the "glass ceiling," and a cascade of "equity issues" in career advancement and salary to offer a new account of the roles women played in shaping the standards and the contributing to progress in the field of medicine. Women faced gender specific challenges to enter, train and practice medicine that did not abate as they strove to balance work and family. As the book shows, such challenges and the attendant institutional responses offered by medical schools and government rulings shaped how women "do" medicine differently. Women and the Practice of Medicine offers a unique interpretation of this history and accounts for the changes in social norms as well as in women's perspectives that have made them an invaluable "new normal" in the contemporary world of medicine. This book fills a gap in the more recent history of women in medicine, much of which is written by academic historians or sociologists; this book contributes a clinician's "on the ground" point of view. It includes a researched, structured historical narrative spanning the last 70 years, but it seeks to frame this narrative with the personal stories and accomplishments of women physicians who lived through the time in question. The book also provides an overview of how much has changed in the practice of medicine as well as a reminder of what has not changed and what needs to further evolve for women to be equitable partners in medicine as well as other professional disciplines. The book concludes with two appendices containing a questionnaire used in interviews of 40 women conducted at the start of the book project, and a summary of the qualitative findings from the semi-structured interviews.

The need to expand expertise in cancer genetics beyond highly specialized genetics clinics is increasingly being recognized. In response, this practical book provides oncologists, specialist nurses, genetic counsellors, family doctors, and geneticists with comprehensive and easy-to-use guidelines on risk assessment and appropriate management.
The book focuses on common familial cancers such as breast, colorectal, ovary, prostate and melanoma, and separate chapters cover cancer predisposing syndromes such as neurofibromatosis, familial adenomatous polyposis and their management.

This book aims to be a single point of reference for advances in the care of geriatric populations across medical and surgical specialties. The aging population is a unique demographic with its own health challenges. Geriatricians are specifically trained to address these challenges but few medical students or residents enter geriatrics, even as the demand for geriatric expertise increases. The practices of many medical and surgical specialists are dominated by older patients who may themselves see many specialists but rarely visit geriatricians. This updated edition elucidates the most common medical conditions seen in aging patients and translates approaches to those conditions for physicians across specialties. Divided into three sections that assemble crosscutting issues, medical specialties, and surgical and related specialties, this book serves as a guide for clinicians of all backgrounds who will work with older patients as the demographic ages further. This second edition of Geriatrics for Specialists expands the number of specialist chapters to reflect growth in research in aging and clinical care for older people in dermatology, plastic surgery, and behavioral neurology. All original chapters from the first edition are extensively revised and updated to reflect the rapid growth of new knowledge in the field.

This book provides a practical, evidence-based overview of the supportive care of patients with urological failure, covering issues such as quality of life measurements, the role of the multidisciplinary team, and psychological and social support for patients, families and carers. The book focuses on chronic symptoms such as chronic prostatitis. It begins by looking at quality of life measurements, self-help strategies, the role of the interdisciplinary team, and psychological and social support. It then moves on to clinical chapters which cover issues such as patients who present with hematuria, urinary retention, urinary incontinence, neurological disease affecting the urinary tract, chronic prostatitis, and infertility; ending with a chapter on supportive care for the urology patient and family in the future. The book places a special emphasis on symptomatic interventions, particularly in the setting where the course of the illness cannot be modified.

Cicely Saunders is universally acclaimed as a pioneer of modern hospice care. Trained initially in nursing and social work, she qualified in medicine in 1958 and subsequently dedicated the whole of her professional life to improving the care of the dying and bereaved people. Founding St Christopher's Hospice in London in 1967, she encouraged a radical new approach to end of life care combining attention to physical, social, emotional and spiritual problems, brilliantly captured in her concept of 'total pain'. Her ideas about clinical care, education and research have been hugely influential, leading to numerous prizes and awards in recognition of her humanitarian achievements. In this book the sociologist and historian David Clark presents a selection of her vast correspondence, together with his own commentary. The letters of Cicely Saunders tell a remarkable story of vision, determination and creativity. They should be read by anyone interested in how we die in the modern world.

This book provides a clinically useful resource for evaluation and management of the symptoms and issues that burden survivors of breast cancer. Improvements to breast cancer screening and treatment have resulted in more patients than ever before having been cured after local definitive and systemic therapies. Primary care providers and specialists must be increasingly familiar with the issues that breast cancer survivors routinely face. This is the first book to provide a single resource for common issues faced by breast cancer survivors from a truly multidisciplinary perspective; each chapter of this text is coauthored by at least one oncologist and one specialist outside the field of oncology in order to include the perspectives of relevant disciplines. User-friendly and clinically applicable to all specialties, individual chapters also include tables and figures that describe how best to conduct initial evaluation of the given symptom as well as an algorithm, where applicable, outlining the optimal management approach. Common Issues in Breast Cancer Survivors: A Practical Guide to Evaluation and Management empowers non-cancer specialists and practitioners who care for breast cancer survivors to address common issues that impact patient quality of life.