The Journal of family practice
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The cardiopulmonary resuscitation (CPR) experience of a family practice residency program within a community hospital was reviewed for the period of July 1, 1979, to June 30, 1981. CPR was attempted 300 times on 242 patients experiencing cardiopulmonary arrest. The emergency department and operating room were excluded from the study. ⋯ The length of time of each of the code conditions was determined, and its relationship to overall survival rates was found to be inversely proportional. Advanced age did not adversely affect the final outcome of successful attempts. This study reaffirmed the expectation that consistently good results can be obtained if the physician, staff, and resuscitation team members are properly prepared and clear role delineation exists.
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Academic development is recognized as a necessary requirement in family medicine and can be measured in part by assessing the experience with the promotions and tenure process in university departments. In this study a questionnaire was distributed to the chairmen of departments of family practice with direct medical school affiliations. The chairmen were asked to describe the current rank profile of the faculty in their departments and their perception of the importance of various criteria on promotion and tenure decisions at their school. ⋯ Research quality and quantity were considered the most important positive influences on promotions and tenure decisions. Teaching skills were slightly less important, and patient care and administrative skills were not important influences. This project demonstrates that (1) family practice faculties are relatively underdeveloped with respect to senior, tenured positions, (2) research is highly important to achieve promotion and tenure, but little time is available to the faculty to do that research, and (3) the needs of the departments in the areas of patient care and administration may conflict with the requirements for promotion and tenure.
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The Family Health Tree is introduced as a form to simplify the identification of physical symptom patterns within the family. Four kinds of information related to family systems that are consolidated by this form are simultaneity of symptoms, similarity of symptoms across family members, any dominant physical symptom within the family, and degree of focus vs distribution of symptoms among family members. Use of this information for prediction, patient education, and preventive health care is discussed.
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This article presents a family case study of a recurrent dilemma in family medicine. The ethical dilemma involves what role the physician should play in mediating a conflict in a family when the health needs and wishes of the individual patient do not parallel those of the other family members. Who is the patient, the individual or the family? It is the authors' conviction that in meeting the needs of the presenting patient, the family context is of great importance. ⋯ Also taken into account are the relevant facts, values, and the biases of the physician. Exploration of these factors allows the physician a comprehensive and logical approach for resolving such conflicts. Such a framework, however, can only provide guidance; it does not guarantee easy or uniformly acceptable alternatives to difficult issues.