Comprehensive care of lesbian and gay patients and families.

A significant proportion of the population is predominantly gay or lesbian, but the unique health care needs of these patients and their families often are ignored. The most significant health risk for lesbians and gays may be that they avoid routine health care. Families that include gay members may have special needs, largely related to how homosexuality is perceived. Physicians can improve the health care of gay and bisexual men and women and their families by maintaining a non-homophobic attitude, being sure to distinguish sexual behavior from sexual identity, communicating clearly and sensitively by using gender-neutral terms, and being aware of how their own attitudes affect clinical judgment.

A house call program as an essential component of primary care training.

Despite the decline in the frequency of house calls by physicians during the twentieth century, such activities generally have been accepted as valuable and desirable by physicians and continue to be a feature of primary care practice. As the economic basis of health care undergoes significant changes in the era of managed care, the future viability of home visits by medical practitioners similarly hangs in the balance.

Comparisons among three types of generalist physicians: Personal characteristics, medical school experiences, financial aid, and other factors influencing career choice.

A national survey of family physicians, general internists, and general pediatricians was conducted in the US to examine differences among the three groups of generalists physicians, with particular regard to the factors influencing their choice of generalist career. Family physicians were more likely to have made their career decision before medical school, and were more likely to have come from inner-city or rural areas. Personal values and early role models play a very important role in influencing their career choice. In comparison, a higher proportion of general internists had financial aid service obligations and their choice of the specialty was least influenced by personal values. General pediatricians had more clinical experiences either in primary care or with underserved populations, and they regarded medical school experiences as more important in influencing their specialty choice than did the other two groups. Admission committees may use these specialty-related factors to develop strategies to attract students into each type of generalist career.