‘This study of general practice and the attitudes of patients and general practitioners to it is the most significant book yet written about the NHS.’ This was how the reviewer in the ‘British Medical Journal’ reviewed Ann Cartwright’s earlier book Patients and their Doctors. In General Practice Revisited, originally published in 1981, Ann Cartwright and Robert Anderson compare the experiences and views described in the first study, carried out in 1964, with those revealed by a second survey in 1977.In the intervening period there were a great many changes in the organization of general practice. For example appointment systems and nurses working in the surgery became the rule rather than the exception, and the number of doctors working in health centres or using deputizing services rose dramatically. This study shows how the basic patient-doctor relationship has been affected by these changes. A fundamental feature of the survey is the demonstration that the attitudes and practices of patients and doctors are linked, and that it is possible to relate the experiences and degree of satisfaction of patients to the doctor’s age, sex, size of practice, equipment, ancillary help, and indeed to the doctor’s views and habits.By bringing the picture of general practice up-to-date Ann Cartwright and Robert Anderson provided the basic data for any discussion of primary health care in this country at the time.

This book adopts an interdisciplinary approach with a wide scope of perspectives on primary healthcare, describing related principles, care models, practices and social contexts. It combines aspects of development, research and education applied in primary health care, providing practitioners and scholars with a comprehensive overview of the current knowledge and delivery models of healthcare in community settings. It covers the practical, philosophical and scholarly issues pertinent to the delivery, financing, planning, ethics, health politics, professional and technological development, resources, and monitoring in primary health care. Contributors are from a diverse range of academic and professional backgrounds, bringing together collective expertise in mainstream medicine, nursing, allied health, Chinese medicine, health economics, administration, law, public policy, housing management, information technology and mass communications. As such, the book does not follow the common clinical practice or service-based approach found in most texts on primary care.The contents will serve as a useful reference work for policymakers, researchers, community health practitioners, health executives and higher education students.

An anthology that addresses the changing nature of rural medicine in the United States "These authors courageously document the emotional and literally physical vulnerabilities they experience while delivering care in rural communities. ... This book exquisitely illustrates the complexity of 'dual relationships' and boundary issues in rural practice."--Family Medicine Over the past thirty years, rural health care in the United States has changed dramatically. The stereotypical white-haired doctor with his black bag of instruments and his predominantly white, small-town clientele has imploded: the global age has reached rural America. Independently owned clinics have given way to a massive system of hospitals; new technology now brings specialists right to the patient's bedside; and an increasingly diverse clientele has sparked the need for doctors and nurses with an equally diverse assortment of skills. The Country Doctor Revisited is a fascinating collection of essays, poems, and short stories written by rural health care professionals on the experiences of doctors and nurses practicing medicine in rural environments, such as farms, reservations, and migrant camps. The pieces explore the benefits and burdens of new technology, the dilemmas in making ethically sound decisions, and the trials of caring for patients in a broken system. Alternately compelling, thought provoking, and moving, they speak of the diversity of rural health care providers, the range of patients served in rural communities, the variety of settings that comprise the rural United States, and the resources and challenges health care providers and patients face today.

This is a history of general practice under the National Health Service, covering the whole of the first 50 years, from 1948 to the present.

Primary Care now highlights two additional areas compared to the previous edition, equity in health services and health, and the overlap between clinical medicine and public health. It provides a basis for future directions in health policy.

Aimed at medical students and junior doctors, A Textbook of General Practice 2e incorporates the essential information that a student needs to know and understand about general practice and being a general practitioner. The learning style of the book is based on experiential and reflective principles in keeping with modern educative theory and prac

The capacity of professional medicine to resist change - and also concordance - is impressive, but perplexing. It is one of the issues I seek to address in this book. I suggest that a preoccupation with trying to change the relationship between the professional-patient dyad has deflected attention from the extent to which such relations are embedded in, and constrained by, wider administrative and organisational structures, especially as these relate to the operation of professional hierarchies and interprofessional deference and allegiances. Barriers to change also result from the inertia of a system which has evolved a highly stylised etiquette as an adaptive mechanism to contain the difficulties and tensions intrinsic to the medical consultation. Its therapeutic purpose and potential are often subordinate to the goal of achieving success as a social encounter. The principles of concordance are deeply challenging to traditional professional roles and status. However, medicine has always displayed an ability to block change through tactics of appropriation and incorporation. Professionals have often shown particular difficulty giving up their monopoly of 'expertise' and in acknowledging the legitimacy of the patient perspective. Although the term 'concordance' has become quite widely used, its meaning is usually subverted by its employment as a synonym for 'compliance', albeit 'informed' compliance. A slightly more sophisticated version values professional elicitation of the patient perspective in order to more accurately tailor information as a means of overcoming the unhelpful m/sconceptions that impede compliance. The original emphasis on the consultation as a negotiated exchange, in which the professional has something of value to learn from the patient, has largely been lost. The rhetoric of modernity and change provides an effective mask for inertia and conservatism. Preface.