Biomedical subjects
J H Renner
Publications and source records attributed to J H Renner.
Patient education. Developing a health care partnership.
Increasingly, patients are insisting on becoming partners in their own health care. Physicians who welcome such involvement should try to determine the medical IQ and knowledge base of the patient and then provide appropriate educational experiences. An atmosphere encouraging genuine dialogue is essential to a successful partnership.
Suggestions for treating recurrent urinary tract infections.
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Cooperation between an academic subspecialty department and a community-based family medicine department: a developmental model.
While new, community-based family practice residency programs desperately need support from sister departments in academic centers, a variety of problems frequently prevents such cooperation. At the University of Wisconsin, Madison, the Department of Human Oncology, which is University Hospital-based, has worked to develop an appropriate educational program in oncology, together with and for the Department of Family Medicine and Practice, which is community-based. This paper, relating how and why these two departments have cooperated in this project, is presented to assist other departments in similar situations.
The development of a "statement of policy regarding consultations".
The use of consultations in family medicine has often been misunderstood by both the persons seeking the consultations and the persons acting as consultants. A policy regarding the use of consultants has been written by the Department of Family Medicine and Practice at the Center for Health Sciences, University of Wisconsin. The statement includes a definition of "consultation," the reasons and goals for consultation, and the manner in which consultations are obtained. The policy includes the family practice residents, faculty, and patients in the decision-making process prior to all consultations.
Importance of obstetrics in a comprehensive family practice.
Four family practices in the San Francisco Bay Area, two of which did not include obstetrics and two of which did, were examined with reference to their patient populations and to the number of families for which they provided comprehensive, continuous family care. The groups practicing without obstetrics were found to do acute care primarily and, to a lesser extent, long-term care internal medicine, with very little pediatrics or gynecology. The groups practicing with obstetrics did significantly more minor surgery, gynecology, pediatrics, and psychotherapy. During the six-week study, the group practicing with obstetrics saw five times as many patients who were members of families receiving continuous, comprehensive care from the practice under observation. Psychotherapy done by the group including obstetrics was primarily family therapy; for the other group, individual therapy. If larger studies support these findings, then important implications are suggested for training programs in family practice and for the resident deciding to enter practice.
A patient and family number assignment and chart filing system for family physicians.
The Department of Family Medicine and Practice at the University of Wisconsin-Madison has devised and implemented an alpha-numeric system of identifying patient records together with a system of chart filing based on a variation of terminal digit filing. The system provides each patient with a unique identification number. This permanently assigned number is used as part of the medical record (chart) information, as the basis for assigning an account number, as the basis for determining the storage location of the chart in the record room, and as the basis for a family identification number. The number defines the patient's sex and position within the family, and its permanency ensures a capability for conducting both short- and long-term ambulatory care research in the family context.
Problem-specific coding systems.
The data found in medical records, particularly in problem-oriented records, could yield very useful information for many aspects of the health care delivery system. Unless the tools and methods used in the analysis of health care data are very carefully designed, the potential value of this information cannot be fully realized. Coding is a critical step in the process of converting medical record data into useful information. This paper presents six criteria as design goals for a standard, comprehensive, coherent set of nomenclatures, classifications, taxonomies, and corresponding coding schemes for the analysis of medical and administrative record data. These goals are: compatibility with established routine operating procedure, health care problem specificity, hierarchical structure, economy through articulation of the components with one another and through the similarities in various aspects of health care delivery, and adaptability to change.
The awareness of osteoporosis among health professionals, consumers, and journalists.
A survey of physicians, consumers, journalists, and experts on osteoporosis showed that the level of awareness, particularly among consumers and physicians, regarding osteoporosis and calcium supplementation is high. Professionals and consumers alike agree that osteoporosis is a serious disease. Most think that the disease is preventable, although serious. Most women are aware that osteoporosis may begin years before symptoms become evident, and that they may be subject to the disease. Most consumers and professionals believe that the ideal time to begin osteoporosis prevention is adolescence. If prevention does not begin during that age, some physicians suggest that any steps toward prevention taken premenopausally are beneficial. Nearly all of those surveyed believe that calcium as well as exercise helps prevent osteoporosis. Although about 90 percent of the physicians surveyed agreed that estrogen replacement therapy (ERT) alleviates osteoporosis; only 48 percent of postmenopausal women believe that ERT is helpful. The majority of the professionals who responded believe that most women do not get enough calcium in their diets, and that most women do not exercise enough. Although in most instances the consumers responding to this study were slightly less informed about the risks and factors associated with osteoporosis than were the professionals, the opinions of the four groups surveyed were similar for most of the topics discussed.