PROBLEM ADDRESSED A recently implemented model of care in long-term care facilities (LTCFs) called Care by Design addresses concerns about a previously uncoordinated care system, a reduction in family physician services, and high rates of ambulance transports to emergency departments. OBJECTIVE OF PROGRAM Care by Design is designed to increase access to care and continuity and quality of care...

When patients die in the emergency department (ED), emergency physicians (EP) must disclose the bad news to family members. The death is often unexpected and the act of notification can be difficult. Many EPs have not been trained in the skill of communicating death to family members. This article reviews the available literature regarding ED death notification training and proposes future dire...

BACKGROUND There is limited understanding of the impact of Triple C competency-based curriculums on the preparation of residents for family practice. This paper describes a competency-based curriculum within an integrated longitudinal block design and presents preliminary evaluation data on the impact of this curriculum on preparedness for family practice. METHODS First and second year family...

In this issue of Academic Medicine, Broderick and Nocella describe the creative use of an educational consortium model to bring community providers together to solve the fiscal crisis faced by the local family medicine residency program, which was sponsored by a single-program sponsoring (hospital) institution. The authors of this commentary explore the specific adaptation of the educational co...

WITHIN THE TRADITIONAL framework of the physician-patient relationship, the primary concern of the physician is usually the diagnosis and treatment of a patient with a presenting problem. Underlying basic assumptions that are generally accepted are (a) responsible understanding by the patient of the medical advice given and (b) sufficient motivation for compliance with the physician's instructi...

BACKGROUND Schizophrenia is mainly characterized by chronic psychotic symptoms such as delusions, hallucinations, and negative symptoms such as social withdrawal. These symptoms cause behavior problems, i.e. aggressive behavior violence, or social isolation that affect the patients' lives, and the health status and daily routine of caregivers or family members. Psychological distress or burden ...

Family Stroke Education • An educational program for family members of patients experiencing a recent stroke is described. The educational sessions involve all members of the rehabilitation team in a round table discussion as well as a question and answer format. Surveys of family members indicate this educational process resulted in a decreased anxiety about stroke, improved communications wit...