Canadian family physician Médecin de famille canadien
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In a case history of Betty Barling, a patient who suffered from chronic illness, we see how ethics played a vital role in the outcome of Betty's condition. The case demonstrates the importance of listening objectively to patients' needs, analyzing those needs, and acting on them appropriately. The role of physician experience in patient outcome must also be recognized.
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The treatment of incompetent older people presents physicians and family members with complex medical, ethical, moral, and legal problems. This article explores the use of advance health care directives in the decision-making process, the qualities of the "ideal" directive, practical and legal issues relating to directives, and the role of the family physician in their implementation.
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Use of emergency outpatient services is described for a 34-bed rural hospital in Alberta. One in 10 outpatients was classified as having serious and extreme emergencies. Less than 3% were transferred to a higher level of care; 10% were admitted to the local hospital. Recommendations are made for staffing, training, inventory, and funding of small rural hospital emergency departments.
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This study examines the long-term outcome of a cohort of 317 pediatric patients who presented to an emergency department with chest pain. There were no deaths and few hospital stays. Patients were all perceived as "well" (self-assessment or parental assessment) at follow-up contact. This study supports the belief that chest pain in children is benign.