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.

This 2006 volume provides a comprehensive discussion of communication between doctors and patients in primary care consultations. It brings together a team of leading contributors from the fields of linguistics, sociology and medicine to describe each phase of the primary care consultation, identifying the distinctive tasks, goals and activities that make up each phase of primary care as social interaction. Using conversation analysis techniques, the authors analyze the sequential unfolding of a visit, and describe the dilemmas and conflicts faced by physicians and patients as they work through each of these activities. The result is a view of the medical encounter that takes the perspective of both physicians and patients in a way that is both rigorous and humane. Clear and comprehensive, this book will be essential reading for students and researchers in sociolinguistics, communication studies, sociology, and medicine.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

Through ninety-five in-depth interviews with primary care physicians (PCPs) working in different settings, as well as medical students and residents, Practice Under Pressure provides rich insight into the everyday lives of generalist physicians in the early twenty-first centuryùtheir work, stresses, hopes, expectations, and values. Timothy Hoff supports this dialogue with secondary data, statistics, and in-depth comparisons that capture the changing face of primary care medicineùlarger numbers of younger, female, and foreign-born physicians.

A family orientation in health care can provide a wider understanding of illness and a broader range of solutions than the classic biomedical model. This volume thus offers practical guidance for the physician who would like to take greater advantage of this resource. The result is a readable guide, structured around step-by-step protocols that are vividly illustrated with case studies drawn from the authors extensive experience at the University of Rochester School of Medicine.

Fracture Management for Primary Care provides the guidance you need to evaluate and treat common fractures, as well as identify uncommon fractures that should be referred to a specialist. Drs. M. Patrice Eiff and Robert Hatch emphasize the current best guidelines for imaging and treating fractures so that you can make accurate identifications and select appropriate treatment. Detailed descriptions and illustrations combined with evidence-based coverage give you the confidence you need to make the right decisions. Online access to procedural videos and patient handouts at expertconsult.com make this quick, practical resource even more convenient for primary care clinicians who manage fractures. Access the information you need, the way you need it with a template format for presenting each type of fracture. Diagnose fractures accurately with the many high-quality images. Clearly see the anatomic relationships of bones and joints through schematic illustrations. Reference key information quickly and easily thanks to one-page management tables that summarize pertinent aspects of diagnosis and treatment. Treat displaced fractures using detailed, step-by-step descriptions of the most common reduction techniques. Access the fully searchable text online at expertconsult.com, along with video clips of reduction maneuvers and downloadable patient education and rehabilitation instruction handouts. Accurately identify fractures using optimal imaging guidelines. Apply splints and casts with confidence thanks to detailed descriptions and illustrations of technique. Tap into the latest best practices through more evidence-based coverage and updated references. Effectively manage emergency situations using guidelines for emergent referral, greater detail regarding methods for closed reductions for fractures and dislocations, and more.