The Journal of family practice
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Continuity of care, one of the basic characteristics of family medicine, was studied over a 12-month period in a family practice residency program. Continuity was measured in three contact areas; office hours, after hours, and on the inpatient service. The intensity of continuity was defined at three levels, from encounters with the personal physician to those with physicians on other medical teams. ⋯ Residents from other years were noted to have lower levels of continuity. Similar figures were noted for family practice inpatients. Continuity of care in private practice occurs in about 80 percent of patient encounters and it seems reasonable and feasible to expect residency training programs to come close to this figure.
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While the elderly comprise a large proportion of patients seen in ambulatory care settings, characteristics of these patients have not been well documented. This paper summarizes results of a survey of functional impairment of elderly patients seen in a family medicine center. Assessments were performed in the areas of social and economic resources, mental health, physical health, and the ability to perform routine activities needed for independent living. Results of the survey suggest that family physicians need to know how to perform a multidimensional functional assessment in order to formulate a comprehensive treatment plan for elderly patients.
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The final cosmetic and functional result of closure of a facial wound is many times determined by the promptness and appropriateness of initial care. This includes keeping the wound clean and not adding to the injury. A decision must then be made at the level of primary care to carry out the closure or refer the patient to someone with more expertise. ⋯ Fine suture and accurate approximation of the wound edges are also extremely important. Careful follow-up of the wound for potential infection, suture reaction, etc, with removal of sutures as soon as possible, greatly enhances the healing of the wound. These points are discussed in detail with guidelines for making the decisions and providing good wound closure.