From Arrowsmith to The House of God, or ''Why now?'' (review of causes of and remedies for physician dissatisfaction) (editorial)
Article Abstract:
A growing dissatisfaction among physicians with the profession of medicine may be responsible for the recent decline in the number of medical school applicants, and this may have severe consequences for the physician-patient relationship and physician productivity. Some external reasons for physician dissatisfaction include heavy workload, bureaucratic interference, alienation from family and friends, difficult professional relationships, fatigue, fear of lawsuits, and, for women, conflicting demands of work and family. Solutions to alleviate the stresses of physician training have been implemented and include shortening of work hours, increased salaries, and improved working conditions. However, physician discontent may also arise from personal factors that may be associated with changes in the norms and attitudes of society. The cultural narcissism of today has changed the physician's motivation from service to man and society, to self-fulfillment and realization. The nature of physician satisfaction has also changed, so that it comes less from caring for patients than from curing a disease. Physicians have less patience and time for patients who do not respond to current treatments. Finally, physician satisfaction has shifted from achieving success in relation to personal professional standards, to achieving public popularity, which has recently declined for the medical profession. General discontent among physicians may become alleviated if physicians become aware of both the personal and external causes of their dissatisfaction. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Improvement in severe onchocercal skin disease after a single dose of ivermectin
Article Abstract:
Onchocerciasis is a condition resulting from infestation with the worm Onchocerca volvulus, which is characterized by the formation of node-like swellings over the coiled parasites. The disease is prevalent in Africa and Latin America, affecting 17.5 million people. In addition, 85 million people are at risk for developing this infestation. One million people infected with O. volvulus suffer visual complications, and have a greater rate of death than infected persons without visual problems. Onchocerciasis is often complicated by skin disease, which is associated with sleep deprivation due to excessive itchiness; new infection with different organisms; social exclusion; and even suicide. The drug ivermectin was shown to be both safe and effective in decreasing the number of parasites infecting an individual with onchocerciasis. However, the effect of ivermectin on complications of onchocerciasis is not known. Hence, the effect of ivermectin on skin complications associated with onchocerciasis was assessed in 21 infected persons. One dose of 150 micrograms per kilogram of body weight with ivermectin improved skin inflammation (dermatitis) within the first three months of treatment in patients with onchocerciasis. However, the drug had no effect on depigmented lesions, or affected skin areas lacking color. Ivermectin was well tolerated. These findings suggest that ivermectin is beneficial in treating dermatitis associated with onchocerciasis. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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