Articles: emergency-medicine.
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At its root, medical professionalism is service delivered according to patient's interest. It is essential to reinforce this notion because financial pressures threaten the integrity of the patient-physician relationship. Excessive commercialism directly contrasts the ideals of medical professionalism. ⋯ If historical standards of professionalism give way to market-driven incentives, the provision of medical care will become a commodity and the practitioners will be only agents of service delivery. Such a model not only threatens the the physician's identity, but also threatens the patient's interests. Medicine can never succeed as a transaction; it can only succeed as a partnership, a trusting exchange with patients, which is the hallmark of professionalism.
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Rural general practitioners (GPs) traditionally provide the initial care for the very ill and severely traumatised in small and medium-sized rural hospitals. It has been said that these patients would be better managed in a level 1 trauma centre. The present paper will test this hypothesis and shows that the benefits of the expertise available in the large centres may be outweighed by the loss of life in the prehospital phase, most of which occurs before the arrival of the ambulance. ⋯ A national standard for training rural GPs in emergency management skills is needed. Emergency facilities and equipment must be maintained and improved throughout rural Australia. These facilities and their staff must be accredited so that the ambulance service can more appropriately determine its transport priorities.
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There is a wide variety of ethical issues and dilemmas involving resuscitation, the act of restoring life to a patient in cardiorespiratory arrest. Decisions must be made rapidly and often must be based on suboptimal levels of information available at the time. Certain issues should be considered when one is making decisions in the resuscitation arena, including positive-aspects of resuscitation, not only the possibility of restoring life to the patient but also providing a sense of closure and resolution of guilt for the survivors. During and following resuscitative efforts, the psychologic and emotional well-being of the survivors should also be given close attention.