Emeritus Faculty, Acad Council, Medicine
View details for PubMedID 15122822
View details for PubMedID 10882769
The education of residents is shifting to the ambulatory care setting. In addition, there is a growing trend toward managed care and increasing competition for patients to be served by "real-world" practices. The authors describe the formation and operation of a program that was established in 1981 at the Stanford University School of Medicine to respond to these changes: the Stanford Medical Group (SMG), a model group practice in internal medicine that operates within the academic medical center. Because raising the status of the clinician-educator faculty was a critical issue for the SMG, the authors also describe the Medical Center Professoriate, a separate faculty track created in 1989 to recognize and reward Stanford's clinician-educators. The authors conclude that the SMG has succeeded in its training and patient care goals and has weathered the great changes in the health care environment that have taken place since 1981. They also report that the separate faculty track is serving its purpose well. They hope that educators and program directors at other academic medical centers may find the descriptions of the SMG and the professoriate useful in solving similar problems.
View details for Web of Science ID A1992JU07800001
View details for PubMedID 1388521
Parkinson's disease affects thousands of Americans, men and women equally and apparently with little regard to race. Its diagnosis depends largely on repeated clinical observations of representative signs, such as resting tremor, rigidity, bradykinesia, and gait disturbances. Patients progress through stages: Early disease involves only one limb or side and confers minimal disability, but advanced disease restricts patients to full care. Treatment is chosen on the basis of disease stage and patient response. Combination carbidopa-levodopa (Sinemet) is appropriate for any significant degree of disability, and other antiparkinsonian drugs and anticholinergic agents may be used as adjuncts. Electroconvulsive therapy, use of selegiline hydrochloride (Eldepryl), and surgery are still undergoing investigation but may hold promise.
View details for Web of Science ID A1991FX06500013
View details for PubMedID 1905807
Although breast enlargement in boys and men can cause both psychological and physical distress, the disorder is rarely serious and is readily treatable. Several factors can lead to the estrogenic excess that causes growth of breast tissue. Dr Jacobs describes a patient with gynecomastia related to cirrhosis of the liver who responded promptly to a brief course of tamoxifen citrate therapy.
View details for Web of Science ID A1991EW73100022
View details for PubMedID 1990392
Primary care physicians need to be aware of iatrogenic disease and its causes. Adverse drug reactions, including drug-drug interactions, and certain diagnostic procedures may lead to iatrogenic complications. Hospitalized patients, especially the elderly, face increased risks of such complications. Physicians who are aware of common adverse reactions to drugs, drug combinations, and medical procedures may be able to help patients avoid unnecessary distress and morbidity.
View details for Web of Science ID A1990CK01300012
View details for PubMedID 2296559