By Ian R McWhinney
"Highly acclaimed in its first 3 variants, McWhinney's Textbook of relations medication is among the seminal texts within the box. whereas many relatives drugs texts easily conceal the issues a practitioner may perhaps see in scientific perform, McWhinney's defines the rules and practices of kinfolk medication as a separate and particular box of perform. The fourth version offers six new medical chapters of commonRead more...
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Extra resources for McWhinney's textbook of family medicine
I sat there amazed,” wrote de Silva, “and thought to myself, what in the world is this man thinking about? This is not a problem of logistics. … This is a war that needs discussion of strategic purpose and of strategy itself. 210). McNamara was, of course, a generalist and an able one. But in this case he was confusing depth with detail, thus failing to identify the main problem. 5. As science advances, the load of information increases. The contrary is true. It is the immature branches of science that have the greatest load of information: “The factual burden of a science varies inversely with its level of maturity,” wrote Sir Peter Medawar (1967).
On the whole, our tendency to think in terms of individual patients more than abstractions is a strength, though it can lead us astray if it diverts us from the appropriate pursuit of diagnostic precision. Our valuation of particular knowledge, however, can make it difficult for us to feel comfortable in the modern academic milieu, where diagnosis and management are more usually seen in terms of generalizations than particulars. The risk of living too much in a world of generalizations and abstractions is detachment from the patient’s experience and a lack of feeling for his suffering.
The drive by managers for efficiency can place stresses on relationships between doctors and patients and between professional colleagues. The rigid application of clinical guidelines, and the enforcement of sharply defined professional roles, can be a threat to clinical judgment and professional morale. The fragmentation of medicine makes it necessary to distinguish the roles of primary care physician and referral ( 28 ) Basic Principles specialist. But the types of collaboration between family physician and specialist vary from patient to patient and from condition to condition.