With family doctors increasingly overburdened, bureaucratized, and burned out, how can the field change before it's too late? Over the past few decades, as American medical practice has become increasingly specialized, the number of generalists—doctors who care for the whole person—has plummeted. On paper, family medicine sounds noble; in practice, though, the field is so demanding in scope and substance, and the health system so favorable to specialists, that it cannot be fulfilled by most doctors. In Searching for the Family Doctor, Timothy J. Hoff weaves together the early history of the family practice specialty in the United States with the personal narratives of modern-day family doctors. By formalizing this area of practice and instituting specialist-level training requirements, the originators of family practice hoped to increase respect for generalists, improve the pipeline of young medical graduates choosing primary care, and, in so doing, have a major positive impact on the way patients receive care. Drawing on in-depth interviews with fifty-five family doctors, Hoff shows us how these medical professionals have had their calling transformed not only by the indifferent acts of an unsupportive health care system but by the hand of their own medical specialty—a specialty that has chosen to pursue short- over long-term viability, conformity over uniqueness, and protectionism over collaboration. A specialty unable to innovate to keep its membership cohesive and focused on fulfilling the generalist ideal. The family doctor, Hoff explains, was conceived of as a powered-up version of the "country doctor" idea. At a time when doctor-patient relationships are evaporating in the face of highly transactional, fast-food-style medical practice, this ideal seems both nostalgic and revolutionary. However, the realities of highly bureaucratic reimbursement and quality-of-care requirements, educational debt, and ongoing consolidation of the old-fashioned independent doctor's office into corporate health systems have stacked the deck against the altruists and true believers who are drawn to the profession of family practice. As more family doctors wind up working for big health care corporations, their career paths grow more parochial, balkanizing the specialty. Their work roles and professional identities are increasingly niche-oriented. Exploring how to save primary care by giving family doctors a fighting chance to become the generalists we need in our lives, Searching for the Family Doctor is required reading for anyone interested in the troubled state of modern medicine.

Heirs of General Practice is a frieze of glimpses of young doctors with patients of every age—about a dozen physicians in all, who belong to the new medical specialty called family practice. They are people who have addressed themselves to a need for a unifying generalism in a world that has become greatly subdivided by specialization, physicians who work with the "unquantifiable idea that a doctor who treats your grandmother, your father, your niece, and your daughter will be more adroit in treating you." These young men and women are seen in their examining rooms in various rural communities in Maine, but Maine is only the example. Their medical objectives, their successes, the professional obstacles they do and do not overcome are representative of any place family practitioners are working. While essential medical background is provided, McPhee's masterful approach to a trend significant to all of us is replete with affecting, and often amusing, stories about both doctors and their charges.

This book provides family doctors with a wealth of evidence-based indications and tips regarding geriatric medicine and approaches for the management of older patients, to be applied in daily practice. After discussing old and new features of healthy ageing and the approaches required in Family Medicine Consultation, the text introduces key elements of geriatric medicine such as frailty, sarcopenia, and the comprehensive geriatric assessment (CGA), before describing a range of characteristics unique to older patients in different contexts, with a dedicated section on Palliative Care. The role of polypharmacy and the importance of quaternary prevention and deprescribing are also addressed. Finally, the book emphasizes both the importance of a humanistic approach in caring and the approach of research and meta-research in geriatrics. Though many texts explore the role of primary care professionals in geriatric medicine, the role of family doctors in older people care has not yet been clearly addressed, despite the growing burden of ageing, which has been dubbed the “silver tsunami.” Family physicians care for individuals in the context of their family, community, and culture, respecting the autonomy of their patients. In negotiating management plans with their patients, family doctors integrate physical, psychological, social, cultural and existential factors, utilizing the knowledge and trust engendered by repeated visits. They do so by promoting health, preventing disease, providing cures, care, or palliation and promoting patient empowerment and self-management. This will likely become all the more important, since we are witnessing a global demographic shift and family doctors will be responsible for and involved in caring for a growing population of older patients. This book is intended for family medicine trainees and professionals, but can also be a useful tool for geriatricians, helping them to better understand some features of primary care and to more fruitfully interact with family doctors.

Drawing on the expertise of a nationally recognized group of family practice educators affiliated with the University of California, Drs. Little and Midtling are able to present many specific examples on meeting the challenges of becoming a family physician. Also included are chapters that draw out the differences between inpatient and outpatient service, discuss the teaching of practice management, and touch on the impact of specialists in ethics and cross cultural communication on family practice teams. The concluding chapters examine how family physicians have survived in the "medical community", and examine the future of family practice.

This easy-to-use reference helps practitioners quickly diagnose common skin disorders and determine appropriate treatment options. More than 500 fullcolor images speed diagnosis by showing the reader distinguishing characteristics of each disorder, as well as providing clear comparisons between similar looking conditions. Features of the text include fornulary tables of leading topical agents and preparations by brand name, as well as patient handouts in English and Spanish. Basic derm rologic procedures are presented in a simple, easyto-understand format, making this guide an invaluable reference for office surgery. The Second Edition features new, larger photos, more patient handouts, and new material on several disorders. Also included is an expanded basic procedures section with new and more detailed procedures and more illustrations and photos of necessary equipment.

Next in Line is the first book to examine the doctor-patient relationship in the context of its new environs, in particular the impact of efficiency-driven innovation and retail-care models on physician mindsets and the patient experience. The overall picture is one of lowered expectations -- a transactional, impersonal, and institutionally-limited incarnation of the medical bedside that leaves all parties underwhelmed and overstressed.

How patients heal doctors In Patients and Doctors, physicians from around the world share stories of the patients they'll never forget, patients who have changed the way they practice medicine. Their thoughtful reflections on a variety of themes--from suffering to humor to death--help us to understand the experience of doctoring, in all its ordinary and extraordinary aspects. In settings as diverse as Slovenia and Sweden, Cambodia and New Jersey, we learn what makes the healer feel graced with insight or scarred with misadventure. In Washington State, we anguish with patient and doctor alike when a young resident removes a screw from a little boy's foot; on the Israeli-Jordanian border, a woman goes into labor just as the air-raid sirens signal the beginning of the Gulf War. These compelling accounts remind us what is at stake in doctoring, reinforcing the value of stories in the teaching and practice of medicine: to calm, to validate, and to illuminate the human experience. "These stories illustrate humane physicians at their best."--Sharon Kaufman, author of The Healer's Tale