The modern physician is often multiparadigmatic as he serves many different types of people in many different existential circumstances. The physician basically often has three, very different sets of technologies or "toolboxes" at his disposal, derived from three different medical paradigms: classical, manual medicine; biomedicine; and holistic or consciousness-oriented medicine. ...

BACKGROUND: Communication via e-mail has become widespread. Nearly every practicing neurosurgeon is confronted with numerous unsolicited e-mail requests for medical advice, guidance, or information. Neurosurgeons need to be aware of the clinical, financial, legal, and ethical implications of providing medical consultation via e-mail. METHODS: A literature review of the penetration ...

A community sample of 1106 adults was examined to assess the impact of the doctor-patient relationship on participants' avoidance of treatment for a recognized medical or psychological problem. Of five aspects of participants' previous experience with their physicians, all but waiting time predicted participants' self-reported treatment avoidance. In two logistic ...

In many countries the sustainability of rural healthcare systems is being challenged by a shortage of rural physicians and difficulties in recruiting and retaining physicians in rural practice. There are numerous factors that influence efforts in rural physician recruitment and retention, many of which are beyond the scope of the ...

Since the (re) emergence of heterodox medicine across the Western world, there have been numerous interpretations of this phenomenon by the social sciences. Heterodox patients were said to be active consumers holding postmodern values, while heterodox physicians were described as heretics. Medical doctors taking up heterodox medicine were criticised for ...

BACKGROUND: There has been increasing attention devoted to patient safety. However, the focus has been on system improvements rather than individual physician performance issues. The purpose of this study was to determine if there is an association between certain physician characteristics and the likelihood of medical board-imposed discipline. METHODS: Unmatched, ...

In this study, the authors investigate how medical ideology and physician professional identity are socially constructed during morning report, a formal teaching conference considered to be a cornerstone of medical education. Analysis of transcripts from 20 meetings reveals physician identity is developed through ideological discourse that produces and reproduces systems ...

This study examined the individual and temporal factors that explain whether the medication cardex agrees with a physician's pediatric medication order. After controlling for several potentially confounding factors, it was found that, among other things, pediatric intensive care unit cardexes were 62% less likely to agree with the physician order ...

Primary care physicians are deluged with medical information from many sources: medical literature, public media and the Internet, the pharmaceutical and medical device industries, and patients themselves. How can a physician best deal with the volume of data provided by scientific research, medical education, drug promotion, popular opinion, government regulation, ...

With the anticipated growth of air travel, inflight illness and injury are expected to increase as well. This is because more elderly people and people with preexisting disease are taking to the air. Although inflight medical events and deaths are uncommon, physician passengers are occasionally called upon to render care. ...

Domestic abuse is a serious problem that may present directly or indirectly in the clinical setting. The astute physician may have the opportunity to directly intervene in this national dilemma. We present a patient who indirectly sought help through the medical setting, review the physician's responsibilities, and offer guidelines for ...

The European Federation of Internal Medicine, The American College of Physicians-American Society of Internal Medicine, and the American Board of Internal Medicine recently developed a Charter on Medical Professionalism that they hope will be accepted by physicians around the world. The charter is based on three principles: the primacy of ...

Radiologists who discover an urgent medical problem with a patient are accustomed to picking up the phone to immediately contact the referring physician. But in today's busy world it may take several tries to get through to the other doctor, and occassionaly the message may not be received at all.

BACKGROUND: The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. METHODS: We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and ...

This pilot study's purpose was to evaluate behavioral changes among medical directors and physicians following CME on risk management in long-term care (LTC) facilities. The setting was a satellite conference at the AGS Meeting Symposium 2000. CME participants included 51 medical directors, attending physicians, and nurses. Evaluations were based on ...

The two major continuing medical education (CME) credit systems for allopathic physicians in the United States are administered by the American Medical Association (AMA) and the American Academy of Family Physicians (AAFP). This article explores the history of AMA and AAFP CME credit and its value to physicians and the ...

Until the end of the Ottoman period the Hippocratic-Galenic doctrine, which had been improved by medieval Muslim medicine, was the pre-dominant medicine in the Holy Land. The penetration of modern medicine into the region was a slow process, advancing step by step over the years until it was established around ...

Obesity is a chronic medical disorder that is not going away anytime soon. Physicians need all the education, tools, and resources possible to successfully help their overweight and obese patients. Weight-loss medications alone are clearly not the answer. However, they are one tool physicians can use in combination with lifestyle ...

In this paper, we propose analogies between medical discourse and Edward Said's "Orientalism." Medical discourse, like Orientalism, tends to favor institutional interests and can be similarly dehumanizing in its reductionism, textual representations, and construction of its subjects. To resist Orientalism, Said recommends that critics--"intellectuals"--adopt the perspective of exile. We apply ...

Talk between physicians and their patients has been shown to be shaped by participant characteristics,phase of the visit, and professional and institutional constraints. Surprisingly, the medical concern that brings the participants together has not been systematically and thoroughly investigated as a shaping influence on such talk. Based on a synthesis ...

The concept of the art of healing is intrinsically connected with the idea of healing powers. There are at least three possible approaches to that idea and all of them have different implications for the problem of medical wisdom. These are: the idea of the healing powers of nature, the ...

Recent studies have discussed the benefits of medical therapy for benign prostatic hyperplasia (BPH), but have not provided physicians with the necessary tools needed to translate the information into individualized, evidence-based recommendations for clinically important questions. Nomograms can help physicians individualize their treatment decisions and predict a likely outcome by ...

This article reviews the relation between social support and elder health, the social-support dimensions of religion, the relation between church attendance and elder health, the place of religion in the biopsychosocial model of medicine, and medical education's position on physician-patient communication about religion. It then examines the emergence of the ...

The evaluation of the medical activity is a major concern for hospitals and public health services. With the introduction of coding (IDC-10 and CHOP classifications) hospitals are now able to analyze their medical activity. A way to improve physicians' acceptance in analyzing their work is to give them valuable feedback ...

AIMS: Research has raised concerns about gender bias in medicine, i.e. that men and women might be treated differently due to gender-stereotyped attitudes among physicians. The authors investigated gender differences in medical management of a common health problem, irritable bowel syndrome (IBS). METHOD: In a national examination for Swedish house ...

BACKGROUND: Based on a series of clinical trials showing no difference in the effectiveness or tolerability of most major classes of antihypertensive medications, the Joint National Commission on High Blood Pressure Treatment recommends that physicians prescribe beta-blockers or diuretics as initial hypertensive therapy unless there are compelling indications for another ...

PURPOSE OF REVIEW: This review analyzes the literature on medical professionalism in order to inform further study, educational activity, and reflective practice for all phases of a physician's professional development from medical school through practice. RECENT FINDINGS: Several themes emerged from an analysis of the writing about medical professionalism during ...

BACKGROUND: Conceptual or theoretical analysts of trust in medical settings distinguish among markedly different objects or types of trust. However, little is known about how similar or different these types of trust are in reality and the relationship of trust with satisfaction. OBJECTIVES: This exploratory study conducted a comparison among ...

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a prevalent mental health condition, occurring in 3% to 5% of school-aged children. Although stimulant medications are a recommended treatment for this disorder, physicians. views of these medications have not been systematically evaluated. OBJECTIVE: This study examined physician-prescriber perceptions of using medications to ...

It seems that one-fourth of today's medical residents would choose another field if they had their education to do over again. Why the disillusionment with medicine? This article discusses the reasons and offers guidelines for recruiting young physicians who approach employment with uncertainty, skepticism and priorities that differ from those ...

PURPOSE: The purpose of this descriptive clinical research study was to identify which method of communication, verbal or written, has the greatest impact on physician adjustment of the antidiabetes medication regimen for hospitalized patients with hyperglycemia. METHODS: The medical records for 1026 patients hospitalized with diabetes at a large, metropolitan, ...

The female membership of the Mississippi State Medical Association and female physician employees of the Mississippi State Department of Health were surveyed (N = 350) to examine their practice-related decisions relative to breastfeeding; 215 (61%) responded to the survey. Discussion was commonly used for educating patients, with face-to-face demonstrations used ...

Provider's practice behaviors before and after physician and staff training in the use of a schizophrenia medication algorithm and the effects of education on physician adherence to the algorithm were evaluated. Medical records of 30 patients admitted between September 1 and November 30, 1999, and 30 patients admitted from September ...

In the first of these two articles it was expressed how, in practically all middle-income and many low-income countries, it is necessary to implement interventions in addition to the DOTS strategy if adequate tuberculosis control is to be achieved. We need to act in two directions: 1) in universities and ...

Richard Cooper has advanced a projection of a sizable deficit in physicians in the United States, requiring the training of as many as 10,000 additional physicians annually by the year 2025. He questions the ability of U.S. medical schools to "fill the gap." This challenge presents another important dilemma for ...

The Hawaii Supreme Court ruled on June 10, 2002, that physicians might be liable to non-patient third parties if they fail to warn their patients regarding a medication's adverse effect on driving. Conceivably, this liability may also extend to physicians who fail to inform their patients and/or the Department of ...

PURPOSE: Medical learners look to role models to better understand the values, attitudes, behaviors, and ethics of the medical profession. This study examined issues related to physicians serving as role models for diverse medical learners. METHOD: Between September and November 2000, in-depth semi-structured 30-minute interviews were conducted with 29 highly ...

Patients and physicians enter the medical encounter with unique perspectives on the illness experience. These perspectives influence the way that information is shared during the initial phase of the interview. Previous research has demonstrated that patients who are able to fully share their perspective often achieve better outcomes. However, studies ...

Physician competence is a universal concern, one that Canada and the US have addressed in differing, but also in similar, ways. Focusing on the roles physicians play, the Royal College of Physicians and Surgeons of Canada (RCPSC) has implemented a uniform procedure for developing and assessing competencies. The US does ...

Reviews of medically related communication research clearly demonstrate that physicians have been studied far longer and more frequently than any other type of health care provider; nevertheless, much of what is known is limited to what is said by primarily male, White, primary care physicians during the delivery of outpatient ...

Mismanagement of the complex emotions and work/life balancing challenges that come with a medical career is a risk factor that tends to go unaddressed in today's medical workplace. Visionary medical leaders recognize this dilemma and become ambassadors of effective emotional management (EEM) for physicians. EEM is a model for promoting ...

OBJECTIVES: To explore the perception of unmet needs in the medication use process from the perspectives of three of the principal participants in the process--physicians, pharmacists, and patients--and to identify the individual(s) or strategy(ies) perceived to be the best or most likely candidate(s) to resolve the problems identified. PARTICIPANTS: Physicians ...

The purpose of the study was to survey primary physicians about the possible impact of computerized medical records on clinical practice. METHODS AND DESIGN: 236 primary care physicians from the Negev health district in Israel, attending a course prior to installation of computerized record keeping, were given two open-ended questions ...

OBJECTIVE: To reduce the number of potentially inappropriate medication orders, based on the Beers' criteria, for an elderly population residing in assisted living facilities through consultant pharmacist medication review, interventions, and recommendations DESIGN: Prospective case series of consultant pharmacist recommendations. PATIENTS: Census of 456 residents of assisted living facilities who ...

To investigate the features of recent unnatural deaths from mishaps and possible negligence related to medical practice, forensic autopsy cases (n=856) during the past 6 years (1996-2001) at our institute were reviewed. Among them, there were 28 cases of medical practice-related fatalities (male/female, n=16/12; range 32-87 years of age). Half ...

OBJECTIVE: To assess the change in frequency and methods with which a pilot group of rural physicians consulted on-line medical resources before and after an educational intervention. DESIGN: Physicians were randomly assigned to an educational intervention or control group. Self-administered questionnaires were completed before and 3 months after the intervention. ...

The term somatic fixation describes a model in which the patient's problems are medicalized both by the patient and by the physician. This phenomenon was described by a group of researchers from the Netherlands, in 1983. This paper discusses somatic fixation and its implications. Somatic fixation should be distinguished from ...

BACKGROUND: [corrected] Promoting the adoption of medical evidence into clinical practice has been advocated as one approach to improving healthcare quality and reducing medical errors. Data describing the effectiveness of different strategies to achieve this goal in real-world settings are limited. OBJECTIVE: To determine the effectiveness of selected interventions on ...

The Multinational Force and Observers is an 11-nation coalition force with the mission of peacekeeping in the Sinai. It commenced operations in 1982 and continues today after two decades of successful enforcement of the 1979 Egyptian-Israeli Treaty of Peace. The fielding of a medical support team for this mission was ...

BACKGROUND: Many employees are required to travel by air as part of their work, and occupational physicians may be asked to give travel health advice and to carry out risk assessments. AIMS: This review examines the stresses of air travel, including those due to travel to and transit through the ...