ABSTRACT
Obsessive compulsive disorder (OCD) is more common than previously thought. Because 1% to 2% of the general population has OCD, its prevalence in the primary care setting has to be high. OCD is the fourth most common mental disorder. Recognition of clinical markers will increase diagnostic frequency and hopefully reduce the morbidity caused by the disorder. In addition to early recognition of the disorder, primary care physicians can help demystify the illness because of their relationship with the patient. OCD patients are not only embarrassed by their illness, but they also have a great fear of going "insane." A supportive nonjudgmental attitude will be therapeutic.
Subject(s)
Obsessive-Compulsive Disorder/diagnosis , Primary Health Care , Adolescent , Adult , Age Factors , Attitude of Health Personnel , Child , Diagnosis, Differential , Female , Humans , Incidence , Male , Obsessive-Compulsive Disorder/epidemiology , Physicians, Family , Prevalence , United States/epidemiologyABSTRACT
The art of medicine is now being practiced and competition fueled by advertising, an abundance of physicians, and the presence of large corporations that provide health care. Mass advertising does not supply the kind of information a patient needs to choose a health care provider. Marketing strategies can, however, be applied- namely, attention to patient education, to price of peripheral test and treatment, to your office's air of courtesy and considerateness, and to the range of services you offer. Analysis of the basics of biomedical ethics leads one to conclude that efforts to nourish patient satisfaction can be ethical and, indeed, can foster the art of medicine.
Subject(s)
Ethics, Medical , Marketing of Health Services/standards , Advertising , Economic Competition , Models, Theoretical , United StatesABSTRACT
A random sample of 265 patient charts was selected to assess the degree of provider continuity at the University of North Carolina Family Practice Center from July 1, 1983, to June 30, 1984. Continuity was measured using usual provider continuity, the ratio of the number of visits with the assigned physician divided by total visits. Usual provider continuity rates varied as predicted for three types of visits: acute illness (0.55), chronic illness (0.76), and health maintenance (0.86). The average rate of usual provider continuity was 0.68. Case mix had a statistically significantly effect on provider continuity when comparing acute care with either chronic or health maintenance care (P less than .01). Because case mix is relevant and varies from site to site, a method of rate standardization was suggested using data on case mix from the National Ambulatory Medical Care Survey. Direct rate adjustment, a standard epidemiologic technique, would make continuity rates directly comparable for sites with different case mixes.
Subject(s)
Continuity of Patient Care , Diagnosis-Related Groups , Primary Health Care , Adolescent , Adult , Aged , Ambulatory Care Facilities , Female , Humans , Male , Medical Audit , Middle Aged , North Carolina , Office VisitsABSTRACT
Postpartum thyroiditis is a disorder which is morphologically similar to Hashimoto's thyroiditis, but differs clinically. The disorder presents with a transient period of thyrotoxicosis which may be so mild that it is clinically missed. Many of these patients subsequently develop hypothyroidism which also spontaneously resolves. Documentation that the hypothyroidism is transient would be necessary to establish the diagnosis. There is a proclivity for this disorder to develop in the postpartum period. Two patients are presented with this disorder, one with a transient hypermetabolic state and one with a transient hypothyroid state.
Subject(s)
Postpartum Period , Thyroiditis/diagnosis , Adult , Diagnosis, Differential , Female , Humans , Hyperthyroidism/diagnosis , Pregnancy , Thyroiditis/drug therapy , Thyroiditis, Autoimmune/diagnosisABSTRACT
Family medicine programs need faculty well trained in the roles of educator, administrator, researcher, and clinician. While the need for faculty development is recognized in all colleges and departments, it is a particular problem in family medicine due to the shortage of faculty, diverse backgrounds of existing faculty, and current pressures to develop the research base for the discipline of family medicine. This study was conducted to gather information about the effectiveness of the two-to-three day workshop format for faculty development in family medicine. In a pre-post comparison and a nine-month follow-up of four faculty development workshops, significant and persistent changes were found in participants' ratings of their abilities to do faculty related skills. The three-day residential workshop was found to be an effective means for promoting faculty development.
