General practitioners and professional satisfaction.

One hundred and eighty-five general practitioners participated in a study regarding satisfaction from the doctor-patient relationship. Of these, 71% responded in writing to an open-ended item concerning personal satisfaction. Written responses were assigned to one or more of nine groupings formed by considering the content of general practice and conceptualising characteristics of the doctor-patient relationship. Four characteristics--activity, authority, objectivity and radionality (the clinical model) were assigned 299 written responses. Four characteristics--affinity, continuity, intimacy and reciprocity (the relational model) were assigned 287 responses. The paper discusses the two models, their respective characteristics and physician responses.

Teaching sex education and counseling for the primary physician.

Today's family physicians are being confronted by increasing numbers of patients who desire and need sex education and counseling. It is suggested that the family and primary physician can approach the multiple sex-related needs of the family by understanding the family life cycle and by using permission-giving, limited information, and specific suggestions with patients as needed and as appropriate. The experience of the University of Miami's Department of Family Medicine in teaching human sexuality to medical students, residents, and faculty of the medical center is cited to help other residency programs include sex counseling and sex education in the armamentarium of residents.

Resident participation in residency programs.

Residents need to participate more fully in decisions involving their educational process and their learning/work setting. In the Department of Family Medicine at the University of Miami School of Medicine, residents are involved in designing their curriculum, monitoring their work/learning settings, selecting their peers, and evaluating their peers and faculty. This style of residency program has significant implications not only for patient care but also for future physicians, medical departments, and medical associations.

In search of more comprehensive health care.

The role and responsibilities of a professional social worker are outlined, as well as the rationale for a health team in family medicine. Both the family practice residency and private practice are described as possible settings for proper utilization of social workers.

Health and disease profile of the island of Bimini based upon physical and multi-phasic screening of 530 residents - abstract

In collaboration with the Ministry of Health of the Bahamas, the Department of Family Medicine, University of Miami School of Medicine, through its residency programme, has been providing primary care to the island of Bimini for one year. In order to extend this care to include comprehensive medical care, a health and ecology fair was planned by the Medical School, the Ministry of Health and a Health Committee representative of the island community. The islanders themselves raised most of the funds to cover transportation, accommodations and cost of laboratory tests. Additional support was provided by G. D. Searle International Company and Biochemistry Associates International. Approximately 15 persons from the Department of Family Medicine provided the health manpower on a voluntary basis. The objectives of the study were: (1) to obtain prevalence information on biochemical and pesticide residues of the inhabitants, (2) to upgrade medical records of the community, and (3) establish a baseline profile of the population and biochemical characteristics of the individual against which future medicine could be practiced. Approximately one-third of the island (530) of the 1,500 inhabitants, mostly children and adolescents, participated in this fair. Physical and visual screening were conducted and serum was obtained from 254 islanders. SMA-12, VDRL, PAP smears, imminizations, TB tests, and serum organochlorine studies were completed. The prevalence of these biochemical test are presented and distribution frequences of selected biochemistries are discussed. Abnormal findings and the most suitable thyroid tests in a populatioin favouring fish in their diet is described. Plans for completion of a total island survey are under way for 1972 (AU)

Medical education and the family physician.

The family health care specialist is a physician who through continuity of care has developed a tenured relationship with the family. He accepts the family as the unit of care and actively promotes its health. In the past one could become a family physician through experience gained in the general practice of medicine or pediatrics. While many practitioners, internists and pediatricians have become good family doctors, none have been specifically trained for this role. It is the responsibility of the family physician to provide continuing and comprehensive family health care. Health concern can be divided into demands for which the patient seeks care and needs of which the individual or family is largely unaware. The degree of "comprehensiveness" is the extent to which the needs as well as the demand are met. The role of the family physician is to be a specialist in family health care and a generalist in the provision of primary medical care.