Winter 2007 - Volume 11 Number 1

Original Research and Contributions

Rapid Intraoperative Parathyroid Hormone Assay in the Surgical Management of Hyperparathyroidism
Craig M Nelson, PhD, CLS; Noel S Victor, MD
In this study, intraoperative PTH levels predicted the postoperative outcome for all patients, providing valuable information to surgeons and decreasing the duration of surgery and hospital stay.

Perinatal Loss Among Twins
Anne Lynch, MD, MSPH; Robert McDuffie Jr, MD; Ella Lyons, MS; Mary Chase; Miriam Orleans, PhD
From this retrospective cohort study, Lynch et al conclude that loss in twins is most strongly associated with monochorionic diamniotic placentation. They emphasize the importance of comprehensive clinical review to fully understand the sequence of clinical events leading to this adverse pregnancy outcome.

Heart Failure Etiology Is Usually Pluricausal Whether or Not There is Associated Coronary Disease
Arthur L Klatsky, MD; Sharon Gronningen, RN; Natalia Udaltsova, PhD; Douglas Chartier, MD; Somjot S Brar, MD; James Schipper, MD; Robert J Lundstrom, MD
An attempt to classify underlying etiology of heart failure for an epidemiologic study yielded surprises, including that no preponderant cause was identifiable in a large proportion and that most had multiple etiologic factors.

Communication Practices of Physicians With High Patient-Satisfaction Ratings
Karen Tallman, PhD; Tom Janisse, MD; Richard M Frankel, PhD; Sue Hee Sung, MPH; Edward Krupat, PhD; John T Hsu, MD, MBA, MSCE
Videotaped clinic visits and follow-up interviews reveal that the highest rated physicians focus on the patient's agenda and draw out their story with active listening responses, which builds a personal connection.

Association Between Satisfaction and Familiarity with Physician Among New Adult Members
William C Wells, PhD; Dorothy Ries Faison Meder, MFA, EMBA
Patients judge clinicians on the basis of how well they think clinicians know and care about them as individuals. Wells and Meder found a consistent trend of increasing satisfaction in the first four new patient visits with the same provider thus supporting the assumption that patient satisfaction increases as familiarity increases.

Review Article

Thomas Stibolt, MD
The Care Management Institute's guidelines for asthma care describe diagnosis, differential diagnosis, assessment of severity, treatment, and when to call for consultation. Stibolt uses a case example to illustrate the guidelines and their practical use.

Case Studies

The Barrier of Fear: An Ethnographic Interview About Native American Health Disparities
Dawson S Brown
This case study examines the consequences of cultural barriers in health care delivery, which were revealed in an ethnographic medical interview with a patient who attributes her health and well-being to her return to traditional Blackfeet Native American practices.

Narrative Case Study: Adoption
Linda L Hill, MD, MPH
A personal study is the foundation of this substantive argument in favor of a psychosocial approach to an adoption history when obtaining a medical history from a patient.

Clinical Medicine

Applying an Open-Access Model to a Psychiatric Practice
Richard J Moldawsky, MD
An anecdotal review of an open-access model for psychiatric return visits reveals its challenges and advantages, including higher patient satisfaction, increased access, and decreased workload for clerical staff. A more systematic review is necessary.

Evaluation of Nocturia in the Elderly
Dean A Kujubu, MD; Sherif R Aboseif, MD
A case study of this troublesome and common symptom reveals its impact on quality of life--further sleep disruption, cognitive dysfunction, daytime somnolence, depression, etc--and its more serious association with a 1.8-fold increased risk of hip fracture.

People Using Technology to Transform Care: The 21st Century Care Innovation Project
Hannah King, MPH; Ruth Brentari, MHA; Leslie Francis, MBA, MHA; Charles M Kilo, MD, MPH
Through the use of technology--telephone appointments, secure messaging, and the Panel Support Tool for population care management--the 21st Century Care Innovation project is improving patient care delivery and developing a more fulfilling and sustainable work environment for physicians.

The Hospital on Bushenyi Hill
George C Halvorson
This final chapter from the new book published by The Permanente Press: Health Care Co-Ops in Uganda: Effectively Launching Micro Health Groups in African Villages, by George Halvorson includes clinically interesting descriptions of locally enacted prevention measures for reducing malaria, diarrhea, and contaminated water.

The Role of Primary Care Practitioners in Psychosocial Care in Germany
Steffen Häfner, MD; Ernst-Richard Petzold, MD
Two German physicians describe a major difference between the actual operation of primary care in Germany--where psychosomatics has a major role in everyday primary care--and the US.


Intubating Stillborns
Nicholas J Rotondo, MD, ACS, ACOG

Improving Health Care Quality: Current Concepts
Michael J Pentecost, MD


Looking for an Opportunity to Serve Your Community? Suggestions on Volunteering at a Homeless Medical Clinic
Lee Jacobs, MD

A Next Step: Reviewer Feedback on Quality Improvement Publication Guidelines
Tom Janisse, MD

Book Reviews

Overdosed America, The Broken Promise of American Medicine

The Body Bears the Burden: Trauma, Dissociation, and Disease

Soul of the Healer

Stamp: The Doctor

Patience with Patients
Laura Morgan, MD

Patience is a Virtue
Laura Morgan, MD

Man on a Bench

Please Call Me - The Doctor In Me

Mellowed with Age

My Struggle with "Used to Be"

The Amazing Plastic Child

On the Cover

Tinker Toys
John E Fortune, MD


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