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AuthorMendel, David. author
TitleProper Doctoring [electronic resource] / by David Mendel
ImprintLondon : Springer London, 1984
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Descript XIV, 178 p. online resource


There are many textbooks which give detailed descriptions of the causes, clinical features and treatment of disease. There are a number of books devoted to clinical methodoยญ logy which tell the student the questions which he must ask and describe the physical signs that he should seek. The authors of these books rarely devote more than a page or two to a job description and advice on how to acquire clinical skills. Although a sound knowledge of the facts is essential, a good doctor differs from a bad doctor more by his attitude and craftsmanship than by his knowledge. These important matters receive scant attention in the textbooks because the authors regard them as part of the spoken tradition which is taught at the bedside or in the clinics and is absorbed by watching clinicians while they are dealing with patients. The image of the doctor who greets patients with his pen poised over a prescription pad, and the calls for holistic medicine, imply that a number of students do not pick up the relevant attitudes and skills on the way. That this feeling is shared by the profession itself is suggested by the formaยญ tion of a society to promote the treatment of the whole patient, and another for the promotion of humanism in cardiology. Good doctors have been treating the whole patient humanely since the profession was founded, and I find it shocking that it is thought that such societies are necessary


1 The Job Description -- The Importance of Common-sense -- Polishing your Performance -- Craftsmanship -- Patient Handling, or Why Medicine Is Not Mechanics -- The Doctorโ{128}{148}Patient Relationship from the Doctorโ{128}{153}s End -- Doctors and the Media -- Too Clever by Half -- The Need for Role-Playing in Medicine -- Rehearsing your Role -- Type-cast by Nature -- Playing your Role -- Looking the Part -- Confidentiality -- 2 Taking the History -- Before Calling the Patient In -- The Patientโ{128}{153}s Stance -- The Doctorโ{128}{153}s Stance -- Meeting the Patient -- Taking the History: Why and How -- The Patientโ{128}{153}s Story -- How To Ask Questions -- Getting the Answers -- How Am I Doing? -- Diagnosis -- โ{128}{152}Difficultโ{128}{153} Patients -- Children -- Third Parties -- Confidentiality -- Writing Up the History -- Past History, Family History and Social History -- 3 Examination of the Patient -- Preparing for the Examination: Putting the Patient at Ease -- The Doctorโ{128}{153}s Stance During the Examination -- Getting the Hang of Physical Signs -- The Actual Examination -- Evaluating the Physical Signs -- 4 In the Ward -- The Effect of Ward Life on the PatientTalking to Patients -- Decision-Making at the Bedside -- The Megaround -- Dodging the Column -- Changing the Medication -- Discharge from Hospital -- Ward Notes -- 5 Investigation -- Factors Influencing the Ordering of Tests -- Is the Test Worth While? -- Telling the Patient About Tests -- The Actual Investigation -- When Things Go Wrong -- The Patient Who Refuses To Have a Test Done -- The Interpretation of Tests -- Telling the Patient About the Results of the Tests -- Filing of Results -- 6 On the Art of Diagnosis -- The Logical Basis of Diagnosis -- Pattern Recognition -- The Physiological Approach; Goodness of Fit: The Basis of Pattern Recognition -- The Importance of โ{128}{152}Mechanismsโ{128}{153} -- Attitude to Information; Incommensurable Values -- Making the Diagnosis -- 7 Advice and Explanation -- Deciding What Advice To Give -- The Consultation -- Building Up the Doctorโ{128}{148}Patient Relationship -- How Much To Tell the Patient; Explanation -- Reassurance; Helping the Patient to Adjust to the Facts -- If the Patient Rejects your Advice -- Drugs -- Fatal Diseases and Death -- 8 Attitude to Colleagues -- Hearsay Second Opinions -- Colleagues as Patients -- Relations with Non medical Colleagues -- Envoi -- The Response to Change -- Unchanging Aspects

Medicine General practice (Medicine) Medicine & Public Health General Practice / Family Medicine


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