Primary care medicine, as we know and remember it, is in crisis. While policymakers, government administrators, and the health insurance industry pay lip service to the personal relationship between physician and patient, dissatisfaction and disaffection run rampant among primary care doctors, and medical students steer clear in order to pursue more lucrative specialties. Patients feel helpless, well aware that they are losing a valued close connection as health care steadily becomes more transactional than relational. The thin-margin efficiency, rapid pace, and high volume demanded by the new health care economics do not work for primary care, an inherently slower, more personal, and uniquely tailored service. In Out of Practice, Dr. Frederick Barken juxtaposes his personal experience with the latest research on the transformations in the medical field. He offers a cool critique of the "market model of medicine" while vividly illustrating how the seemingly inexorable trend toward specialization in the last few decades has shifted emphasis away from what was once the foundation of medical practice. Dr. Barken addresses the complexities of modern practice—overuse of diagnostic studies, fragmentation of care, increasing reliance on an array of prescription drugs, and the practice of defensive medicine. He shows how changes in medicine, the family, and society have left physicians to deal with a wide range of geriatric issues, from limited mobility to dementia, that are not addressed by health care policy and are not entirely amenable to a physician’s prescription. Indeed, Dr. Barken contends, the very survival of primary care is in jeopardy at a time when its practitioners are needed more than ever. Illustrated with case studies gleaned from more than twenty years in private practice and data from a wide range of sources, Out of Practice is more than a jeremiad about a broken system. Throughout, Dr. Barken offers cogent suggestions for policymakers and practitioners alike, making clear that as valuable as the latest drug or medical device may be, a successful health care system depends just as much on the doctor-patient relationship embodied by primary care medicine.
Still the most widely used comprehensive resource in orthopaedic surgery, Campbell's Operative Orthopaedics is an essential reference for trainees, a trusted clinical tool for practitioners, and the gold standard for worldwide orthopaedic practice. Unparalleled in scope and depth, this 14th Edition contains updated diagnostic images, practical guidance on when and how to perform every procedure, and rapid access to data in preparation for surgical cases or patient evaluation. Drs. Frederick M. Azar and James H. Beaty, along with other expert contributors from the world-renowned Campbell Clinic, have collaborated diligently to ensure that this 4-volume text remains a valuable resource in your practice, helping you achieve optimal outcomes with every patient. - Features evidence-based surgical coverage throughout to aid in making informed clinical choices for each patient. - Covers multiple procedures for all body regions to provide comprehensive coverage. - Keeps you up to date with even more high-quality procedural videos, a new chapter on biologics in orthopaedics, and expanded and updated content on hip arthroscopy, patellofemoral arthritis and more. - Follows a standard template for every chapter that features highlighted procedural steps, high-quality illustrations for clear visual guidance, and bulleted text. - Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices
This book presents a uniquely broad and pioneering history of premodern toxicology by exploring how late medieval and early modern (c. 1200–1600) physicians discussed the relationship between poison, medicine, and disease. Drawing from a wide range of medical and natural philosophical texts—with an emphasis on treatises that focused on poison, pharmacotherapeutics, plague, and the nature of disease—this study brings to light premodern physicians' debates about the potential existence, nature, and properties of a category of substance theoretically harmful to the human body in even the smallest amount. Focusing on the category of poison (venenum) rather than on specific drugs reframes and remixes the standard histories of toxicology, pharmacology, and etiology, as well as shows how these aspects of medicine (although not yet formalized as independent disciplines) interacted with and shaped one another. Physicians argued, for instance, about what properties might distinguish poison from other substances, how poison injured the human body, the nature of poisonous bodies, and the role of poison in spreading, and to some extent defining, disease. The way physicians debated these questions shows that poison was far from an obvious and uncontested category of substance, and their effort to understand it sheds new light on the relationship between natural philosophy and medicine in the late medieval and early modern periods.
The revolution in psychiatry that began in earnest in the 1960s led to dramatic advances in the understanding and treatment of manic-depressive illness. Hailed as the most outstanding book in the biomedical sciences when it was originally published in 1990, Manic-Depressive Illness was the first to survey this massive body of evidence comprehensively and to assess its meaning for both clinician and scientist. It also vividly portrayed the experience of manic-depressive illness from the perspective of patients, their doctors, and researchers. Encompassing an understanding about the illness as Kraeplin conceived of it- about its cyclical course and about the essential unity of its bipolar and recurrent unipolar forms- the book has become the definitive work on the topic, revered by both specialists and nonspecialists alike. Now, in this magnificent second edition, Drs. Frederick Goodwin and Kay Redfield Jamison bring their unique contribution to mental health science into the 21st century. In collaboration with a team of other leading scientists, a collaboration designed to preserve the unified voice of the two authors, they exhaustively review the biological and genetic literature that has dominated the field in recent years and incorporate cutting-edge research conducted since publication of the first edition. They also update their surveys of psychological and epidemiological evidence, as well as that pertaining to diagnostic issues, course, and outcome, and they offer practical guidelines for differential diagnosis and clinical management. The medical treatment of manic and depressive episodes is described, strategies for preventing future episodes are given in detail, and psychotherapeutic issues common in this illness are considered. Special emphasis is given to fostering compliance with medication regimens and treating patients who abuse drugs and alcohol or who pose a risk of suicide. This book, unique in the way that it retains the distinct perspective of its authors while assuring the maximum in-depth coverage of a vastly expanded base of scientific knowledge, will be a valuable and necessary addition to the libraries of psychiatrists and other physicians, psychologists, clinical social workers, neuroscientists, pharmacologists, and the patients and families who live with manic-depressive illness.
In this book, members of the Cedars-Sinai Medical Center, Liver Support Unit (LSU) present the most current understanding of the pathophysiology of liver failure and how its various forms and manifestations are classified, and summarize the state of the art in the diagnosis and management of the disease.
One cannot understand Latin America without understanding the history of the Catholic Church in the region. Catholicism has been predominant in Latin America and it has played a definitive role in its development. It helped to spur the conquest of the New World with its emphasis on missions to the indigenous peoples, controlled many aspects of the colonial economy, and played key roles in the struggles for Independence. The History of the Catholic Church in Latin America offers a concise yet far-reaching synthesis of this institution’s role from the earliest contact between the Spanish and native tribes until the modern day, the first such historical overview available in English. John Frederick Schwaller looks broadly at the forces which formed the Church in Latin America and which caused it to develop in the unique manner in which it did. While the Church is often characterized as monolithic, the author carefully showcases its constituent parts—often in tension with one another—as well as its economic function and its role in the political conflicts within the Latin America republics. Organized in a chronological manner, the volume traces the changing dynamics within the Church as it moved from the period of the Reformation up through twentieth century arguments over Liberation Theology, offering a solid framework to approaching the massive literature on the Catholic Church in Latin America. Through his accessible prose, Schwaller offers a set of guideposts to lead the reader through this complex and fascinating history.
The eight people charged with conspiring to assassinate President Abraham Lincoln were tried by a military commission under military law. The author contends that this was illegal, since the civilian legal system was fully functioning. The many ways in which the defendants' rights were violated are described, as are the ways in which the trial testimony was either not accurate or not legally obtained. The trial is also compared with other incidents in which the U.S. military was used in police and judicial functions, with questionable results. The book is a warning against unchecked power by the executive branch of the government.
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