The Journal of the American Board of Family Practice / American Board of Family Practice
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Human brucellosis has a serious medical impact worldwide, and its eradication poses major difficulties. Although human brucellosis is relatively rare in the United States (approximately 100 cases per year), there is concern that this disease is largely underdiagnosed and underreported. Additionally, immigrants from endemic areas are arriving to this country, and Brucella species are considered to be biologic agents for terrorism. Human brucellosis affects all age-groups, and family physicians are not well versed in recognizing and treating this potentially life-threatening condition. ⋯ Appropriate antimicrobial therapy and duration of treatment of human brucellosis will reduce morbidity, prevent complications, and diminish relapses. Because of the nonspecific symptoms and rarity of human brucellosis in the United States, family physicians must acquire a detailed dietary and occupational history to diagnose the disease promptly. Family physicians must assume a responsible role in reporting this disease, as well as be aware of persons at high-risk for this disease and the potential sources of infection.
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J Am Board Fam Pract · Sep 2002
Effect of managed care and financing on practice constraints and career satisfaction in primary care.
The shift away from third party insurers to risk-sharing arrangements affecting care management and clinicians could be the most fundamental change in the health care system. Analysis was undertaken to study how managed care, practice setting, and financial arrangements affect physicians' perceived impact on their practice. ⋯ Physicians in solo and 2-physician practices were least satisfied with their careers and reported more constraints on their clinical freedom and income than physicians in other settings. Physicians in group practices or staff model HMOs are more likely to report time pressure than physicians in solo or 2-physician practices. Family practice falls between internal medicine (less satisfied, more practice constraints) and pediatrics (more satisfied, fewer practice constraints).