Family medicine
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This study examined the accuracy of patient estimates of time spent in the waiting room, examining room, and with the physician. In addition, the impact of physician touch (such as a handshake in greeting) upon those estimates was determined. Patients were noted to be quite accurate in estimates of waiting room time. ⋯ The overestimation of physician contact time was positively related to the number of interruptions requiring the physician to leave the examining room. Minimal touch in greeting had no effect on estimates of waiting room time but did significantly magnify the underestimation of examining room waiting time. Patients who were touched did, on an average, overestimate physician contact time to a greater extent than those who were not touched; however, this difference did not reach statistical significance.
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A multitude of determinants have been identified as predictive of broken appointments. The majority of prior studies have been limited to univariate analysis of the relationship between predictors and appointment keeping behavior. The present report studied 25 independent predictors of no-show behavior using both univariate and multivariate analyses. ⋯ Multivariate analysis may yield a more accurate and clinically useful model of no-show behavior. For example, language barrier may be more of a problem than the race of the patient. Prospective studies might benefit from these considerations.
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Many ambulatory pediatric encounters result in drug therapy. Drug dose determination, based on a child's weight, can often be simplified by modifying the order of mathematical calculation. Specifically, multiplying by body weight as the last calculation, rather than as the initial calculation, often yields values easily manipulated mentally. With this mathematical manipulation, the identical calculation is often performed repetitively which, with time, may facilitate the calculation.
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As family physicians increasingly begin to practice in a variety of settings both in the U. S. and abroad, they are faced with the challenge of caring for patients from different ethnic and socioeconomic backgrounds. In particular it has been suggested that delivering effective and acceptable community oriented primary care requires a deeper understanding of the cultural background of patients, their families, and the social contexts in which they live. ⋯ The "anthropology of family medicine" (the theoretical focus) is distinguished from the "anthropology of family practice" (the applied focus), and contributions from medical anthropological research at the micro (practitioner-patient relationship), intermediate (family), and macro (community) levels of analysis are examined. In particular, three clinical case vignettes are presented which illustrate the ways in which cultural issues can become critical in the care of patients and their families. Finally, the activities of the STFM Task Force on Skills and Curriculum Development in Cross-Cultural Experiences are described, and future directions for research and teaching efforts are proposed.