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Biomedical subjects

A M Adelman

Publications and source records attributed to A M Adelman.

14 recordsLinked to original sources
PubMed1995

Abdominal pain in an HMO.

BACKGROUND: Previous surveys have found that 14%-25% of the population report abdominal pain. Only one study examined the age-gender specific prevalence of abdominal pain in the population, and no study has examined the self-reported causes of abdominal pain. METHODS: To describe the epidemiology of abdominal pain in a large health maintenance organization population, 6,199 randomly selected members were contacted and interviewed by telephone about the occurrence of abdominal pain and related health care in the past year. RESULTS: Of those interviewed, 27% reported abdominal pain in the past year, while 38% of those individuals saw a physician for their pain. Women were more likely than men to have had pain and to have seen a physician for their pain. Fewer older individuals reported abdominal pain, but when pain occurred, they sought medical care more often than younger individuals. CONCLUSIONS: Women and younger individuals report abdominal pain more frequently. Women and older individuals are more likely to seek care for their pain.

Abdominal Pain↗
PubMed1994

House call practices: a comparison by specialty.

BACKGROUND: There has been no national survey of physician house calls since 1980, and in particular, no survey of pediatric house calls in 30 years. This national study was undertaken to compare physician house call practices among family physicians, general internists, and general pediatricians. METHODS: A mail survey was conducted of 1500 primary care physicians who were randomly selected from the American Medical Association Physician Master File. Five hundred physicians were selected from each of three specialties: family medicine, internal medicine, and pediatrics. RESULTS: Nine hundred six questionnaires were returned for a response rate of 59%. The percentage of family physicians making house calls was significantly greater than that of internists or pediatricians (63%, 47%, and 15%, respectively). Factors associated with making house calls were: house calls being a common practice in the community, solo practice, specialty (family practice), sex (male), and practice location in the northeast. Physicians who agreed with the following attitudes were more likely to make house calls: (1) making house calls leads to high patient satisfaction; (2) house calls are important for good comprehensive patient care; and (3) house calls are satisfying for physicians. Physicians who agreed that making house calls exposes them to a significant malpractice risk were half as likely to make house calls. CONCLUSIONS: Family physicians made significantly more house calls than internists or pediatricians.

Attitude of Health Personnel↗
PubMed1991

The family physician and home care.

House calls can still serve many functions in the overall care of the patient. By improving the relationship between physician and patient, providing the physician with important information that can only be gained from a home visit and allowing the physician to remain active in the care of the homebound patient, house calls make a valuable contribution to the total care of certain patients. House calls should remain a part of the practice of the family physician and can be incorporated into a busy physician's practice.

Algorithms↗
PubMed1991

The house call in residency training and its relationship to future practice.

The aging of the population makes education in geriatrics vital to family practice residents, including training in house calls. This study examined the relationship of house call training in residency with current house call practices of recent graduates of family practice residencies. A questionnaire mailed to a random national sample of 301 family physicians who completed residency training between 1981 and 1986 obtained a 66% response rate with three mailings. House calls were not required in the curriculum for 80% of respondents, 30% never did house calls in residency, and 55% recognized they were not well trained in house calls. Graduates of programs in which faculty made house calls and those in which residents made house calls on a longitudinal basis were significantly more likely to offer house calls in their practices. This suggests that resident education can offer positive experiences in house call training to encourage future physicians to include house calls in their practices.

Family Practice↗
PubMed1991

New visits for abdominal pain in the primary care setting.

Abdominal pain is a common problem in primary care. Previous studies of this problem are limited by either the age group examined or the clinical setting. Findings of the 1980 and 1981 National Ambulatory Medical Care Surveys were combined to assess new visits for abdominal pain. A visit to a physician was considered to be for new abdominal pain when: 1) the principal reason for the visit was either stomach or abdominal pain, cramps, or spasms; 2) the visit was not the result of a referral; and 3) the physician had not previously seen the patient for the condition associated with the pain. Abdominal pain was the most frequent reason for a new pain visit. Women sought medical care for new abdominal pain more frequently than men. Most patients saw general practitioners or family physicians for evaluation of their pain, only 5% of patients were subsequently referred, and 6% were hospitalized. Clinical lab tests were ordered in 45% of new abdominal pain visits, while in approximately 20% X-ray procedures were ordered. Seventy percent of the patients were given a prescription, with antacids and antispasmodics being prescribed most frequently.

Abdominal Pain↗
PubMed1990

Alternate drugs.

It is important to consider a number of factors when deciding on drug therapy for elderly patients. The principles of efficacy, side effect profile, ease of administration, interaction with other drugs or concomitant illness, cost, and constant reevaluation of the need for continued treatment should be remembered for any treatment. In many cases the ideal drug may be initially no drug at all. A number of alternative drugs are available for most conditions, and the drug of choice for the elderly may actually be one of these alternative agents. We have attempted to consider these basic principles as they may be applied in making a decision for ideal drug therapy and for alternative therapies for elderly patients.

Aged↗
PubMed1989

House call practices among young family physicians.

Once a major part of medical practice, physician house calls have declined in frequency over the years. Recently, it has been suggested that house calls are increasing. This study examined the current self-reported house call practices among recent graduates of family practice residency programs in the United States. A questionnaire was mailed to a cross-sectional, random national sample of 301 family physicians who are members of the American Academy of Family Physicians and who completed a residency between 1981 and 1986. There was a 66% response rate to three mailings, with 197 questionnaires analyzed. Sixty-two percent of the physicians reported they were making house calls. The majority (53%) made less than one house call per month. Fewer than 15% made house calls on a weekly basis. There was a downward trend by residency year in the percentage of physicians making house calls when comparing graduates from 1981 to 1986. House calls do not appear to be a significant part of the practice of young family physicians.

Adult↗
PubMed1989

Rehabilitation in the elderly.

Prevention of disease should be every physician's goal, however, when primary or secondary prevention fail, rehabilitation of the patient becomes an additional goal. Elderly patient can be as successfully rehabilitated as younger patients, but their special needs are most successfully met by a multidisciplinary team. Almost every patient with a disability warrants a trial of rehabilitation aimed toward placing the patient in the least restrictive environment possible. Rehabilitation is especially useful in patients with arthritis, and following stroke, joint replacement, and amputation.

Activities of Daily Living↗
PubMedDate not supplied

The association of psychosocial factors with the resolution of abdominal pain.

Although abdominal pain is a common presenting complaint in the family practice setting, its natural history and psychosocial associations have not been clearly described. A prospective study was conducted of 92 patients who presented with abdominal pain to the University of Iowa and Cedar Rapids Family Practice Centers between September 1982 and March 1983. Patients were given a self-administered questionnaire for measuring stress, family functioning, and psychological symptoms. All patients were followed for at least six weeks. Resolution of the pain was documented by chart audit, telephone, or mail follow-up. Two-thirds of the patients experienced resolution of their pain within six to eight weeks. The scores on the Hopkins Psychological Symptom Checklist, Family APGAR, and the Daily Hassles Stress Scale did not predict resolution of pain. Age, sex, education, occupation, and final diagnosis also did not predict resolution of pain. Marital status was not associated with pain resolution, though widowed and separated individuals more often had pain at follow-up.

Abdomen↗