Description
Springer Common Dilemmas in Family Medicine 1st Editon 2012 Softbound by John Fry
One of the eXCltmg challenges of medicine has been the reaching of decisions based on less than complete evidence. As undergraduates in teaching hospitals future physicians are taught to think in clear and absolute black and white terms. Diagnoses in teaching hospitals all are based on supportive positive findings of in vestigations. Treatment follows logically on precise diagnosis. When patients die the causes of death are confirmed at autopsy. How very different is real life in clinical practice, and particularly in family medicine. By the very nature of the common conditions that present diagnoses tend to be imprecise and based on clinical assessment and interpretation. Much of the management and treatment of patients is based on opinions of individual physicians based on their personal expenences. Because of the relative professional isolation offamily physicians within their own practices, not unexpectedly divergent views and opinions are formed. There is nothing wrong in such divergencies because there are no clear absolute black and white decisions. General family practice functions in grey areas of medicine where it is possible and quite correct to hold polarized distinct opinions. The essence of good care must be eternal flexibility and readiness to change long-held cherished opinions. To demonstrate that with many issues in family medicine it is possible to have more than one view I selected 10 clinical and II non -clinical topics and invited colleagues and fellow-practitioners to enter into a debate-in-print. 1 Mild-to-moderate hypertension — to treat or not to treat?.- The issues.- Commentary.- 2 Psychotropic pills or psychotherapy?.- The issues.- Commentary.- 3 Alcoholism — disease or self-inflicted vice?.- The issues.- Commentary.- 4 Acute myocardial infarction — home or hospital care?.- The issues.- Commentary.- 5 Is obesity worth treating?.- The issues.- Commentary.- 6 Diabetes: strict control or flexibility in management?.- The issues.- Commentary.- 7 Antibiotics for otitis media and sore throat?.- The issues.- Commentary.- 8 Premenstrual tension and the menopausal syndrome — specific treatment?.- The issues.- Commentary.- 9 Acute backache — active or passive treatment?.- The issues.- Commentary.- 10 Terminal care — at home or in the hospital or hospice?.- The issues.- Commentary.- 11 Compulsory immunization, or not?.- The issues.- Commentary.- 12 House calls — more or less?.- The issues.- Commentary.- 13 Teamwork — delegated or shared?.- The issues.- Commentary.- 14 Patient participation — more or less?.- The issues.- Commentary.- 15 Telling the truth, the whole truth, and nothing but the truth?.- The issues.- Commentary.- 16 How many patients — more or less?.- The issues.- Commentary.- 17 The medical check-up — useful or useless?.- The issues.- Commentary.- 18 Solo practice or group practice?.- The issues.- Commentary.- 19 Vocational training for family medicine — useful or useless?.- The issues.- Commentary.- 20 At least one female family physician in every group practice?.- The issues.- Commentary.- 21 Prevention — realistic or not?.- The issues.- Commentary.