Communicating bad news to patients.

This article reviews the literature on doctor/patient communication, emphasizing the communication of bad news. Available information supports the view that patients want more information than they generally receive and that, contrary to popular belief, patients who are better informed benefit from the information they receive. Physicians are seen as taking a less professional approach to communication activities than to clinical problem solving. Some strategies for approaching the problems identified are outlined.

Drug induced confusion in the elderly: a report of two cases.

Two case histories are presented to illustrate the advent of cerebral dysfunction in elderly people treated with drugs not usually associated with these side effects at the levels prescribed. A brief review of the side effects of these agents is covered. Some suggestion about the need for caution in the use of any medication are made as well as the need to consider toxic effects of medications as an etiological factor in confusion in the aged.

The role of the family physician in hospital part 2: use of hospital privileges.

A questionnaire on the hospital involvement of family doctors was completed by the active staff members of the Department of Family Medicine at St. Joseph's Hospital, Hamilton, in April, 1977. This paper is the second of four; the first dealt with the study's conception, design and methodology.This paper deals with the reasons why family doctors attend hospital, what they do there, how much time they spend there, and the use of hospital privileges, both attending and procedural. A discussion of the study's implications for general understanding of the family doctor's role, and necessary education for this role, concludes this section.Subsequent sections will give more detailed results of the family doctor's involvement in obstetrics and lastly the attitudes of family doctors toward their hospital environment.

The Role Of The Family Physician In Hospital Part 4: FPs' Attitudes Towards Their Hospital Role.

This fourth and final part of the report of a survey carried out at St. Joseph's Hospital, Hamilton, Ontario, examines the results from that portion of the questionnaire relating to attitudes of the family physicians surveyed. It was found that family doctors have strong ties to the hospital and see an association between the quality of community and hospital care and the maintenance of these hospital ties. Problems in clarifying and consolidating their role in hospital are identified and discussed, together with some implications concerning training programs in family medicine.

The role of the family physician in hospital part 3: obstetrics.

This is the third paper in a series of four on the part played by the family physician in a general hospital.Of 88 family physicians on active staff at St.Joseph's Hospital in Hamilton, 56 did deliveries. Most of those practicing obstetrics did most of their own deliveries. As the procedures became more difficult, fewer doctors performed them. Most of the members were involved with routine prenatal care, and some with high risk prenatal care. The resons for not doing obstetrics varied, but obstetrics till seem to be a very important part of the family physician's activity within the hospital.

On the diagnosis and management of functional diseases.

The diagnosis and management of functional disease poses special problems for the family physician. This paper focuses on specific approaches and strategies that may be incorporated into the clinical style of any physician. Meticulous clinical method, careful planning and patient education are seen as the foundation for management of these disorders.

The role of the family physician in hospital.

Five family doctors at St. Joseph's Hospital in Hamilton, Ontario, completed a comprehensive survey of 88 active, associate and senior members of the Department of Family Medicine, detailing their activities in hospital, their attitudes toward the hospital, their actual and desired roles and their Department of Family Medicine.The study illustrates the changing role in hospital from procedure-orientation to patient advocate, and the resulting problems. These problems were mainly lack of communication skills and feeling impotent in dealing with the hospital power structure. Implications for family medicine training programs, continuing medical education programs and teaching and community hospitals are discussed in a series of four papers.

Otitis media: separating facts from fancy.

Based on an extensive review of the literature, this paper concludes that several popular treatment regimens for otitis media are not based on proven data. Some of the myths dispelled concern incidence, drugs of choice, length of drug therapy and the use of ventilating tubes.

The team approach to health care in the home.

This article describes a program for health care in the home, centred on the activities of a community nurse practitioner working with several physicians. Problems and benefits of the experience are identified. Potential of improved functioning in the home, better level of health and cost savings with regard to hospital stay are suggested as possible benefits of this approach. Enough soft data have been accumulated to proceed with more formal investigation.

Continuing medical education in family medicine: a report of eight years' experience.

A practical method of providing continuing education for family physicians is described. Some of the problems and benefits of an eight-year experience are discussed. Changes in behaviour and activities in the group have led to some concrete achievements, including the foundation for a peer review program. It is suggested that this program could provide the basis for more comprehensive programs in continuing education in family medicine.