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Few doctors receive formal training in how to conduct an outpatient consultation or how to compose and dictate an outpatient letter. Trainee surgeons in each new specialty spend their first few weeks in outpatient clinics learning by experience with all the pitfalls this entails. Much work involves seeing patients who have been brought back for review by their predecessors. Problems are caused by inexperience, unfamiliarity, fear of making mistakes, the pressure of patient numbers and lack of training.New doctors will find little help in the standard textbooks on how to follow-up patients.This book provides the necessary background information to enable rational decision making in a concise and economical style. It describes reasonable and safe lines of management suitable for most patients, ideal for when discussion with a senior colleague is not possible. Since the First Edition was published surgical outpatient services have undergone tremendous change. The traditional general surgical clinic has been replaced by specialist clinics where decisions on patient management are taken by multidisciplinary teams.This new edition is multi-authored to take account of the multidisciplinary approach. As well as an overall review of general outpatient issues, every major specialty is covered, with clear notes for each condition covering history, examination, investigations, results, treatment, follow-up and post-operative follow-up. The book can be read before or during clinics, and enables trainees to have an action plan in mind before they walk into a consultation. All surgeons have to be trained to go through the process of dealing with unfamiliar clinical conditions for the first time. Surgeons will use this book as a useful foundation on which to build their own personal knowledge.
Contains the full texts of all Tax Court decisions entered from Oct. 24, 1942 to date, with case table and topical index.
For a long time I have felt that the present gynaecological training for registrars lacked familiarisation and understanding of the basic principles of surgery. This is due to several factors. Firstly, the historical separation of gynaecology from general surgery which led to our development as an independent speciality (and which Victor Bonney foretold to our detriment when he opposed the formation of the College of Obstetricians and Gynaecologists as a separate body from the College of Surgeons). Secondly, a vast improvement in medical management of many gynaecological conditions has made surgical practice dull and an unquestioning daily routine with little or no surgical instruction for many junior staff. Thirdly, the arrival of subspecialisation has exacerbated this, as complicated surgery may be referred out by the general gynaecologist. Finally, the trend in further education towards writing an MD rather than taking an FRCS degree. The arguments for and against were set out in an editorial in the British Journal of Obstetrics and Gynaecology (1983), later taken to task in the ensuing correspondence. That editorial. together with the difficulty in finding up-to-date articles on surgical principles in one volume, were the catalysts for this book. With the help of colleagues from other disciplines, I have attempted to present recent advances side-by-side with modern-day gynaecological practice.
This book examines and discusses the decision of whether or not to admit specific patients to the hospital for over 85 diagnoses commonly seen in the emergency department. Each chapter covers the background, evidence, and treatment and admission recommendations, based on current literature and clinical consensus. Tables and bulleted lists clearly describe the protocol for each presentation. Comprehensive references are included to aid the reader in the decision-making process.
"This book shows how the investigation of healthcare databases can be used to examine physician decisions to develop evidence-based treatment guidelines that optimize patient outcomes"--Provided by publisher.
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