The Practice Of Medicine

"Although physicians make use of science, this book argues that medicine is not itself a science, but rather an interpretive practice that relies heavily on clinical reasoning." "In How Doctors Think, Kathryn Montgomery contends that assuming medicine is strictly a science can have adverse effects. She suggests these can be significantly reduced by recognizing the vital role of clinical judgment."--BOOK JACKET.

The book - which includes essays by physicians, philosophers, and a nurse - is divided into three parts: one deals with how empathy is weakened or lost during the course of medical education and suggests how to remedy this; another describes the historical and philosophical origins of empathy and provides arguments for and against it; and a third section offers compelling accounts of how physicians' empathy for their patients has affected their own lives and the lives of those in their care. We hear, for example, from a physician working in a hospice who relates the ways that the staff try to listen and respond to the needs of the dying; a scientist who interviews candidates for medical school and tells how qualities of empathy are undervalued by selection committees; a nurse who considers what nursing can teach physicians about empathy; another physician who ponders whether the desire to be empathic can hinder the detachment necessary for objective care; and several contributors who show how literature and art can help physicians to develop empathy.

A look at the emotional side of medicine—the shame, fear, anger, anxiety, empathy, and even love that affect patient care Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But doctors’ emotional responses to the life-and-death dramas of everyday practice have a profound impact on medical care. And while much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. In What Doctors Feel, Dr. Danielle Ofri has taken on the task of dissecting the hidden emotional responses of doctors, and how these directly influence patients. How do the stresses of medical life—from paperwork to grueling hours to lawsuits to facing death—affect the medical care that doctors can offer their patients? Digging deep into the lives of doctors, Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Danielle Ofri offers up an unflinching look at the impact of emotions on health care. With her renowned eye for dramatic detail, Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don’t only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about “toxic sock syndrome,” cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness. The stories here reveal the undeniable truth that emotions have a distinct effect on how doctors care for their patients. For both clinicians and patients, understanding what doctors feel can make all the difference in giving and getting the best medical care.

This text offers a new interpretation of the dramatic changes that occurred in women in medicine over the course of the last seventy years, starting from the 1950s when women physicians were a curiosity to the present day when their presence is accepted and their achievements are broadly acknowledged. In seven chapters arranged by decades, this book examines the seminal events that shaped what has been described as “the changing face of medicine.” Using the lived experiences of women physicians featured as vignettes throughout the narrative, the book traces the effects of the quota system for admissions, second wave feminism and Title IX legislation, the restrictions of the “glass ceiling,” and a cascade of “equity issues” in career advancement and salary to offer a new account of the roles women played in shaping the standards and the contributing to progress in the field of medicine. Women faced gender specific challenges to enter, train and practice medicine that did not abate as they strove to balance work and family. As the book shows, such challenges and the attendant institutional responses offered by medical schools and government rulings shaped how women “do” medicine differently. Women and the Practice of Medicine offers a unique interpretation of this history and accounts for the changes in social norms as well as in women’s perspectives that have made them an invaluable “new normal” in the contemporary world of medicine. This book fills a gap in the more recent history of women in medicine, much of which is written by academic historians or sociologists; this book contributes a clinician’s “on the ground” point of view. It includes a researched, structured historical narrative spanning the last 70 years, but it seeks to frame this narrative with the personal stories and accomplishments of women physicians who lived through the time in question. The book also provides an overview of how much has changed in the practice of medicine as well as a reminder of what has not changed and what needs to further evolve for women to be equitable partners in medicine as well as other professional disciplines. The book concludes with two appendices containing a questionnaire used in interviews of 40 women conducted at the start of the book project, and a summary of the qualitative findings from the semi-structured interviews.

A risk factor is anything that increases the risk of disease in an individual.

More than two million medical students, doctors and other health professionals from around the globe have owned a copy of Davidson’s Principles and Practice of Medicine since it was first published. Today’s readers rely on this beautifully illustrated text to provide up-to-date detail of contemporary medical practice, presented in a style that is concise and yet easy to read. Davidson’s provides the factual knowledge required to practise medicine, explaining it in the context of underlying principles, basic science and research evidence, and shows how to apply this knowledge to the management of patients who present with problems rather than specific diseases. The book has won numerous prizes including being highly commended in the British Medical Association book awards. Davidson’s global perspective is enhanced by the input of an international team of authors and a distinguished International Advisory Board from 17 countries. Building on the foundations laid down by its original editor, Davidson’s remains one of the world’s leading and most respected textbooks of medicine. The underlying principles of medicine are described concisely in the first part of the book, and the detailed practice of medicine within each sub-specialty is described in later system-based chapters. Most chapters begin with a two-page overview of the important elements of the clinical examination, including a manikin to illustrate the key steps in the examination of the relevant system. A practical, problem-based clinical approach is described in the ‘Presenting Problems’ sections, to complement the detailed descriptions of each disease. The text is extensively illustrated, with over 1000 diagrams, clinical photographs, and radiology and pathology images. 1350 text boxes present information in a way suitable for revision, including 150 clinical evidence boxes summarising the results of systematic reviews and randomised controlled trials and 65 ’In Old Age’ boxes highlighting important aspects of medical practice in the older population. A combined index and glossary of medical acronyms contains over 10 000 subject entries. The contents can also be searched comprehensively as part of the online access to the whole book on the StudentConsult platform. Access over 500 self-testing questions with answers linked to the book’s content for further reading. The text uses both SI and non-SI units to make it suitable for readers throughout the globe. A new chapter specifically on Stroke Disease recognises the emergence of Stroke Medicine as a distinct clinical and academic discipline. A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories. New ‘In Adolescence’ boxes recognise the fact that many chronic disorders begin in childhood and become the responsibility of physicians practising adult medicine. These boxes acknowledge the overlap ‘transitional’ phase and highlight the key points of importance when looking after young people. The regular introduction of new authors and editors maintains the freshness of each new edition. On this occasion Dr Ian Penman has joined the editorial team and 18 new authors bring new experience and ideas to the content and presentation of the textbook. An expanded International Advisory Board of 38 members includes new members from several different countries.

The medical profession, challenged by critics and reformers, is hard-pressed to give account of itself. Just what do physicians stand for? What do they revere? Where are they headed? These questions are becoming increasingly important yet increasingly difficult to answer, by established physicians and aspiring medical students alike. The perceived paralysis in the face of such questions and challenges is the central problem around which this book was written. To correct this failure, Dr. Trotter proposes the application of Josiah Royce's "philosophy of loyalty" and the related thought of Alasdair MacIntyre to the practice of medicine. Uniquely qualified as both a professionally trained philosopher and an experienced physician, Trotter is the first to apply systematic philosophical precepts to this fundamentally important professional discipline.

Women have engaged in healing from the beginning of history, often within the context of the home. This book studies the role, contributions and challenges faced by women healers in France, Spain, Italy and England, including medical practice among women in the Jewish and Muslim communities, from the later Middle Ages to approximately 1800.