Canadian family physician Médecin de famille canadien
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In a qualitative study using focus group interviews, family physicians in London, Ont, were asked to describe how they perceived their role in follow-up cancer patient care. Barriers to fulfilling this role existed both in the tertiary cancer care setting and among the family physicians themselves. Suggestions for overcoming these barriers were generated.
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In a case history of Betty Barling, a patient who suffered from chronic illness, we see how ethics played a vital role in the outcome of Betty's condition. The case demonstrates the importance of listening objectively to patients' needs, analyzing those needs, and acting on them appropriately. The role of physician experience in patient outcome must also be recognized.
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Use of emergency outpatient services is described for a 34-bed rural hospital in Alberta. One in 10 outpatients was classified as having serious and extreme emergencies. Less than 3% were transferred to a higher level of care; 10% were admitted to the local hospital. Recommendations are made for staffing, training, inventory, and funding of small rural hospital emergency departments.
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The treatment of incompetent older people presents physicians and family members with complex medical, ethical, moral, and legal problems. This article explores the use of advance health care directives in the decision-making process, the qualities of the "ideal" directive, practical and legal issues relating to directives, and the role of the family physician in their implementation.