Is there a difference in the way family physicians and specialists deal with clinical problems? Family physicians, in contrast to specialists, work in a practice environment in which there is a high prevalence of symptomatic discomfort, but a low prevalence of frank disease. These circumstances result in clinical strategies that ...

The authors report on their study of the perceived acquisition of clinical skills by 151 second-year students in six required clerkships: surgery, internal medicine, pediatrics, obstetrics-gynecology, psychiatry, and family medicine. The students completed self-assessments of their clinical skills concerning 78 problems or procedures when taking the family medicine clerkship as ...

The economic decisions taken by family doctors in one family practitioner area in the north of England were examined. There was evidence of a differential response to professional and economic incentives by a group of "high investing" practices. On five indicators of improvement in practice 32% of the practices accounted ...

Family medicine departments have sought ways to stimulate medical students' interest in family practice. This article summarizes the concepts and structural components of a student summer assistantship program in family medicine. This program's goal was to stimulate interest in family practice by means of a 12-week summer experience designed to ...

This is a report on the development of a curriculum designed to meet the need to teach residents a caring model of medicine for effective management of the growing chronically ill population. A central unifying theme in this curriculum is the use of nonmedical literature, specifically Heartsounds, to provide a ...

Rates of consultations and prescriptions for patients referred to clinical psychologists, and for these patients' immediate families, were investigated for three-year periods both before and after referral. Patients and their children consulted more and had more medication prescribed before referral than control groups, this tendency being particularly prevalent in the ...

A one-week practice experience in a remote tropical rain forest area of Colombia is described. Frequency of diagnoses by ICD-9 category are compared between this practice setting and the author's university family medicine residency-based practice in Oklahoma. Implications of the similarities between the practices, as well as the differences, are ...

The incorporation of the sociobehavioral sciences into the teaching and practice of medicine has been a hallmark of family practice. The strong ecological orientation that family medicine shares with anthropology provides a unifying framework for incorporating anthropological concepts and techniques into clinical family practice. This paper presents an ecologically oriented ...

The primary focus of computer systems for family practice is on patient billing. Primary care physicians should be aware of the many other benefits that can and should be considered when planning a system for their practice. This article describes the type and extent of information that can be stored ...

Generic social work practice and family practice medicine complement each other. Placing first year field students in a family practice residency training program over a period of years can define the social work role broadly and open the door for a wide range of practice opportunities. The social work presence ...

As a result of increasing interest in medical hypnosis, a curriculum has been developed for teaching clinical hypnosis to family practice residents within a Canadian two-year training program. History and theories, demonstrations of techniques, practice of inductions, and clinical applications are presented to all second-year residents within a course titled ...

This study attempts to develop a valid and reliable scale to measure student attitude toward family medicine. It describes a 35-item Likert scale that incorporates the nature of family medicine, the competency of family physicians, and the academic image of family medicine departments. The scale was administered to 116 first-year ...

This paper describes how members of the Department of Family Medicine of the University of Ottawa developed lists of problems and procedures common and important in family practice in Canada and, on the basis of these lists, drew up guidelines for content in the 2-year residency program for family medicine. ...

While medical educators have devoted considerable effort to examining the optimal learning environment for teaching family medicine, less attention has been paid to "blocks" that prevent teachers of family medicine from being effective. This paper considers three major aspects of this problem: the personal and professional development of the teacher; ...

The experience of a pilot sports medicine clinic in affiliation with a family practice residency program is reviewed. The use of volunteer orthopedic staffing along with residents working in an acute sports medicine clinic in a community hospital proved to be a valuable addition to the orthopedic exposure during residency ...

To find out to what extent doctors appreciate the potential damage that bacteriuria may cause, we sent questionnaires to 195 family practitioners and trainees in one health board in Northern Ireland. The results of the survey showed that, though doctors seemed to be aware of the risk of renal disease, ...

Few physicians have opportunities that can match the pathologist's to bring compassion and understanding to the bereaved by means of the postautopsy consultation with families. The emotional responses of survivors are often dominated by guilt. Practical guidelines for talking to the bereaved consist of the honesty , compassion, and common ...

As disciplines of reproductive medicine, the fields of sexually transmitted diseases and family planning are characterized by intrinsic similarities and fundamental differences. The similarities provide a foundation upon which to merge the two disciplines, but the differences pose practical limitations. While a union of these two fields into a common ...

This month HCSM interviews W. Jack Stelmach , MD. Director of the Family Practice Residency Program at Baptist Memorial Hospital and a Clinical Professor of Medicine at the University of Missouri, Kansas City School of Medicine in Kansas City, Missouri. He is the past President of the American Academy of ...

The United States Air Force Medical Service is well suited for family practice because of its early identification with the small community hospital. A plan was originally developed in 1968 to bring family practice to every Air Force member. This paper traces the progress of the program, identifies problem areas, ...

The clinical experience of 40 Duke University medical students during their required two-month clinical clerkships is analyzed to compare experience on the traditional internal medicine, surgery, pediatrics, obstetrics-gynecology, and psychiatry clerkships with experience on a new family medicine clerkship. On the traditional clerkships, the students saw mostly hospital inpatients for ...

Several taxa of small frogs from the southern hemisphere contain alkaloids similar or identical to compounds previously known only from neotropical poison frogs of the family Dendrobatidae. Skin of the Brazilian toad Melanophryniscus moreirae (family Bufonidae) contains a new alkaloid 8-hydroxy-8-methyl-6-(5'-hydroxy-2'-methyl-hexylidene)-1-azabicycl o-[4.3.0] nonane (C16H29NO2), which is designated pumiliotoxin 267C. Such ...

The core experience of family practice-the consultation between doctor and patient-is the same for all family physicians, whether they practice in urban, rural or isolated areas. There is not yet a family practice model of this consultation, and the result is wide differences in residency programs' curricula, and residents' perception ...

We now have good information about family medicine in terms of content, principles, and practice load. Undergraduate, residency and continuing education are improving, but some family medicine programs still have limited support from their university's faculty and governments. Residency in-training assessment and the certification process are better developed than is ...

Questionnaires were circulated to the parents of spina bifida children. 105 responses were received, representing a third of all families contacted. Of these over 50% indicated bowel management to be a problem, and this finding was not related to the child's age or the method used. Families who complained of ...

Everyone seems to agree that we should be concerned with the economic security of all small businesses, and in particular, the clients whom we serve. Businesses and consumers are equally concerned and occasionally scared. Both are cautious when spending hard-earned dollars. Animal care, which is not a routine budgetary expenditure, ...

Although there have been many noteworthy attempts to integrate a family focus into family medicine, there is little evidence that this integration has occurred in either residency education or community practice. When the specialty was founded, a family emphasis may have been politically useful as a way to differentiate the ...

The Department of Family Medicine and Practice at the University of Wisconsin has designed and conducted an academically intensive third-year three-month family practice clerkship based in private practice settings. This experience differs from more traditional preceptorships in the amount of academic structure and quality control applied to the student's learning ...

Negotiation, a common term in American society, is a process that can be especially useful to family medicine as a specialty that interfaces with many other clinical areas. The basic concepts of the negotiation process, including Maslow's need theory, terminology, and the three phases of the process (ie, planning, implementation, ...

The concepts and methods of the teaching programs in family medicine for undergraduate medical students at the Sackler School of Medicine in Tel Aviv and the Hebrew University-Hadassah Medical School in Jerusalem are presented. Undergraduate teaching of family medicine at Tel Aviv is concentrated in a three-week clerkship in the ...

Awareness that the competent family physician in the community is the key person in providing economic and effective health services is increasing. In Israel, as in most Western countries, this need is being met by postgraduate vocational training in family medicine. In Israel, the 4-yr curriculum, after completion of the ...

Family medicine is an emerging discipline, in the process of generating a literature and language of its own. This paper explores the ways in which language can both facilitate and inhibit changes in the way the world is seen and thought about.

Four brief case reports are presented from a series of Balint-type seminars on psychosocial problems at a university Family Medicine Centre. These cases illustrate the difficulties encountered by family practitioners when faced with a negative therapeutic response. When confronted by this outcome, it is important for the physician to define ...

The purposes of this study were to examine humanism as exhibited in physicians and to develop and standardize an instrument measuring humanism in physicians. This study had four specific objectives: (1) to determine whether family practice residents are more humanistic than internal medicine and surgery residents, (2) to determine whether ...

Official guidelines regarding the training of family practice residents in newborn medicine have been meager and general. Guidelines have traditionally focused on defining the requisite duration rather than the content of nursery rotations. A competency-based curriculum in newborn medicine is needed that defines requisite knowledge, skills, and attitudes; defines the ...

In a time-and-motion study in family practice it was found that 35,8% of all patient contact was per telephone. The study further revealed that 12,3% of total practice time was spent on the telephone, stressing its importance as a useful tool in family practice. The study supports others which suggest ...

Family practice presents some complex patient management problems with organic, social, and psychological components. There is a great potential for creative problem solving in such patient management problems, in that many alternative solutions are possible. A cross-sectional study was carried out to test the hypothesis that "more creative people as ...

In this article, the authors present a method to assist in curriculum planning and report an application of the method at one institution. Through interviews of 40 selected subjects, the authors identified 27 content elements appropriate for inclusion in a family medicine curriculum for medical students. These elements were organized ...

Recent surveys have suggested that practice management instruction in family practice residency programs is inadequate. The majority of third-year family practice residents graduating in 1980 felt inadequately trained in nearly all aspects of practice management. Thirty-five percent of these residents noted that their residency programs offered no regularly scheduled time ...

Medicine selection and storage was examined in 130 families. Over 50 per cent were found to be less than adequate. Health education advice helped half the inadequate group to change to adequate. Age and social class were not related to hoarding of prescribed drugs, to initial standards of storage or ...

Sixty-eight graduating resident physicians were interviewed during their final months of training to investigate the process and problems of selecting a practice after years of tightly structured medical education. The practice choice decision-making process commonly followed this sequence of steps: (a) acknowledging and undertaking the practice choice task; (b) defining ...

The changes in family practice residency selection from 1978 to 1981 were studied by means of a questionnaire, and selection of family practice residency was identified by region. The relationship between the administrative status of family practice (department, division, or no formal unit) and selection of family practice residency was ...

A cost-benefit analysis (CBA) model that can be used to estimate the economic consequences expected from the inclusion of clinical pharmacy services in a family practice clinic was developed; use of the model was demonstrated by applying it to a hypothetical solo-physician practice. The effects that clinical pharmacy services would ...

The 11 practices of the Barbados Family Practice Morbidity Survey were analyzed according to the age and sex of the physicians. Male physicians had larger practice populations than did the female physicians but carried on fewer repeat encounters during the 12 months of the survey. The female physician practices recorded ...

A new picrodontid primate, Draconodus apertus, is described from the North Horn Formation, Dragon Canyon, central Utah, USA. The fauna from Dragon Canyon is considered to be early middle Paleocene (early Torrejonian) in age by faunal and paleomagnetic correlation with the sequence in the San Juan Basin, New Mexico. Draconodus ...

In 1979 the American Academy of Family Physicians, as the first phase of a long-range study of family practice residency outcomes, surveyed graduates for the years 1970 through 1978 who were diplomates of the American Board of Family Practice. This report is limited to an overview analysis of the hospital ...

The branch of clinical medicine most likely to qualify as a social science is family medicine. Whether family medicine is a social science is addressed in four steps. First, the nature of family medicine is outlined. Second, the extent to which social science knowledge is used in family practice is ...

The purpose of this study was to examine the practice location patterns of 1970-1978 graduates of family practice residency programs. Comparisons were made between the number of graduates practicing in a region in 1979 with the number of all graduates during 1970-1978 from family practice residency programs in that region ...

Family practice research so far has placed a heavy emphasis upon diagnoses (or problems). There are no published descriptive studies of symptoms collected in a family practice in the United States. This study is a collection of the symptoms encountered by a family medicine resident during his three years in ...

During the 1960s national policy groups assessed the consequences of a four-decade decline in the nation's number of general practitioners. Various proposals were offered to make general practice a more attractive specialty. Most of the proposals have been institutionalized by means of a family practice specialty board, accredited family practice ...