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· 분류 : 외국도서 > 의학 > 가정 간호
· ISBN : 9783030994143
· 쪽수 : 184쪽
· 출판일 : 2022-05-30
목차
1. The Importance of Primary Care
“The heroism of incremental care” (Atul Gawande) ? Effects of high quality primary care on health outcomes ? The long-term physician-patient relationship ? Seeing the big picture
2. Goals of Care in the Outpatient Clinic
Prevention: immunizations, screening, and education ? Management of acute and chronic illnesses ? Improving quality of care with panel management ? Examples of panel report cards ? Preventing hospital admissions and readmissions ? “Slow Medicine” and the concept of productivity
3. Medical Education in the Outpatient Clinic ? Benefits and Barriers
Benefits: role-modeling, mentoring, and one-on-one teaching ? Barriers: decreased clinical productivity, time constraints, inadequate financial support, lack of faculty expertise, and student preconceptions about primary care
4. Clinic Settings, Schedules, and Structures
How to make the most of a day (or half-day) in clinic ? Traditional “block” clinics versus longitudinal clinics ? Subspecialty clinics ? Physician offices ? Rural versus urban clinics ? Academic clinics ? Shared medical appointments and group clinics
5. COVID-19 and the Rapid Rise of Telemedicine
How COVID-19 has changed primary care ? Telephone and video visits: benefits and limitations ? Student participation in telemedicine ? Transitioning back to face-to-face visits ? Telemedicine is here to stay
6. Role of the Student in the Outpatient Clinic
Active versus passive clinic experiences ? Reporter-Interpreter-Manager-Educator (RIME) ? What the clinic attending is looking for ? Increasing the level of responsibility ? Working with the clinic staff ? Following up on test results and consults
7. Preparing to See the Patient
Chart review, challenges and benefits of the EMR ? Identifying important trends ? Setting priorities for the visit ? Status of prescriptions ? Routine testing ? Immunization and screening recommendations ? Clinical reminders
8. The Interview
Greeting and introduction ? Begin with an open-ended question, and listen carefully to the answer ? Look at the patient, not the screen ? Med reconciliation ? Evaluate new symptoms ? Do a focused review of systems ? Use motivational interviewing for behavioral change ? Dealing with talkative, quiet, angry, sad, and distracted patients ? Cyberchondriasis and related issues ? Using medical informatics in real time ? Shared decision-making ? Summing up the visit
9. The Physical Exam
Keep it focused ? The efficient, accurate, and repeatable physical exam ? Stethoscopes and reflex hammers: equipment you will need ? Checking your exam findings with the attending ? Key “biomarkers” in the physical exam ? How to check blood pressure correctly ? Point-of-contact ultrasound in the clinic
10. The Concise Oral Case Presentation
The SOAP format ? Pertinent positives and negatives ? Assessment and plan ? How to present routine follow-ups, new patients, urgent visits, and post-hospital visits ? Examples of concise oral presentations
11. Discussing the Case
Identifying key learning points from the case ? Using SNAPPS for case presentation, discussion, and teaching? Researching the case and reporting your findings ? Constructive questioning of assumptions and dogmas ? Responding to feedback
12. Writing a Clinic Note
The classic SOAP note and its function ? Avoid clutter in clinic notes ? Create and maintain an updated problem list ? Explain your reasoning in the assessment ? Avoid ‘problems not addressed’ ? The cut-and-paste perplex ? Examples of concise clinic notes
13. Performing Procedures in the Outpatient Clinic
Obtaining consent ? Explaining risks, benefits, and alternatives ? When to ask for a chaperone ? “See one, do one” ? Joint injections ? Incision and drainage of abscesses ? Minor skin procedures ? IM and SQ injections ? Venipuncture ? Ear lavage ? PAP tests, pelvic and rectal exams
14. Service-Learning Clinics
Working in shelters and homeless clinics ? Student-run clinics ? Medical and psychiatric conditions associated with homelessness ? Challenges and satisfactions of caring for the underserved
15. Careers in Primary Care: Infinite Variety, Tolerance of Uncertainty
Traditional primary care practice ? Academic careers in primary care ? The general internal medicine fellowship ? Role of the clinician-educator in medical education ? Finding your niche ? Compensation and lifestyle issues ? The future of primary care
