Biomedical subjects
D M Baughan
Publications and source records attributed to D M Baughan.
Barriers to diagnosing anxiety disorders in family practice.
Although anxiety disorders are common, their accurate diagnosis and effective treatment may be hindered by both physician and patient factors. Both denial on the part of patients and avoidance of conflict by physicians may be based on outdated concepts of stigma attached to "mental" illness and failure to accept the biopsychosocial model of illness. Physician failure to discriminate between the different anxiety conditions and to recommend the treatment appropriate for each specific diagnosis are additional significant barriers. The situation is further complicated when the patient's symptoms change over time. Although both physician and patient may experience significant discomfort in exploring anxiety symptoms, a thorough clinical history is essential to the diagnosis and provides the basis for successful management of these conditions.
The health care system has an eating disorder.
The health care system crisis has been proclaimed and analyzed so much by economists, policy analysts, politicians, business executives, and journalists that the key statistics and phrases are becoming as familiar as the lyrics of a popular song-14 percent of the GNP goes to health care, 37 million Americans lack health insurance, too many specialists and not enough primary care physicians, etc. What I have not found is a comprehensive assessment of how the health care system got so sick. The different social science specialists focus on their respective symptoms or organs, but do not propose therapies to treat the entire organism. Ilya Prigogine's Theory of Dissipative Structures (now old hat since he won the Nobel Prize in 1977) demonstrated that self-organizing systems, be they health care systems or individual patients, respond in similar ways to the demands of illness and growth. Therefore, a clinical correlation for the health care system may have more than poetic appeal. I would like to offer the following clinical analogy for what ails our health care system.
Privacy beliefs and the violent family.
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Increased surgical options for dysfunctional uterine bleeding.
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Primary care needs of Cambodian refugees.
Cambodian refugees who endured the Pol Pot regime experienced a horrendous assault on their physical and mental health. The complaints and diagnoses of 168 Cambodian refugees who presented to a family medicine primary care clinic between 1985 and 1987 were examined. Fourteen of these patients were visited in their homes to obtain in-depth perspectives of their health beliefs and needs. The results support the growing awareness that Cambodian refugees require sensitive and sophisticated approaches to dealing with widespread emotional and physical dysfunction.
Family medicine in Costa Rica: the beginning.
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Intrauterine transfusion: ethical issues involving a Jehovah's Witness mother.
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Management of problem patients with multiple chronic diseases.
Residents in a university-based family medicine program perceived patients with diabetes mellitus, hypertension, and obesity as problem patients. The residents' perceptions of 166 patients were compared with information from a chart audit. A resident questionnaire outlined the goals, obstacles, and strategies pertaining to management of these patients as well as residents' perceptions of patient expectations. The results prompted a shift in focus from the problem patient to the problem patient-physician relationship and brought forth improved strategies that hold potential for making a difference in patient and physician satisfaction and outcome of care.
Contemporary scientific principles and family medicine.
Twentieth century developments in the sciences of physics, chemistry, and biology have led to new principles and paradigms with which the social, philosophical, and clinical tenets of family medicine are fully consistent. Familiarity with these new scientific models can give not only validation for the concepts inherent in family medicine but also a rigorous framework to guide family medicine research in a direction of the richest intellectual integrity.
The development of an instrument to measure medical students' beliefs about family medicine.
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