By John Fry
Medicine is information. there's consistent public curiosity in healthiness and affliction; in clinical miracles and in breakthroughs; in clinical failures, mess ups and malpraxis ; in deficiencies and defects ofhealth prone; and within the emerging expenses ofhealth care. drugs is 'big business'. Physicians co me out close to the head cash earners in so much treatment platforms. within the Uni ted country the nationwide overall healthiness provider (NHS) now charges over [6000 million a yr ($ ro 800 million), a loose provider that charges each British guy, lady and baby [120 a 12 months ($216) in direct and oblique taxes. yet this can be lower than the [500 ($900) a 12 months that treatment expenses all people in united states and West Germany. In constructed international locations health and wellbeing care expenses are drawing close ro% ofthe gross nationwide product (GNP). it's significant enterprise additionally in that during Britain the NHS is without doubt one of the greatest employers; approximately I million Britons paintings as staff of the NHS, taking care of the opposite fifty four hundreds of thousands and within the united states the numbers are five million taking good care of 2. five thousands. the supply of healthiness companies is stuffed with difficulties and dilemmas. those difficulties and dilemmas pass all' nationwide barriers. All international locations proportion an identical difficulties and dilemmas. difficulties of pursuits, of criteria, of effectiveness and potency, and difficulties of family members among the clinical career, the general public and govern ment. remedy nonetheless is stuffed with mystique.
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Extra info for A New Approach to Medicine: Principles and Priorities in Health Care
The Department of Health and Social Security in its annual reports gives the an nu al prescription rate per person. That is the numbers of prescriptions issued divided by the population. This has shown an increase from five annual prescriptions in the I950S to over six prescriptions in 1975. Since the annual face-to-face consulting rate is four, a prescribing rate of six must mean that at least two of the preseriptions were for unseen or indireet eonsultations and that it has been an 57 A :"lEW APPROACH TO MEDICI:"IE increase in the indirect prescriptions that has resulted in the rise in prescribing rates and not any increase in face-to-face consultations.
The 200 contacts represent a 40-hour week, but there is a range from over 60 hours q uoted in N ew Zealand to less than 30 hours in some British practices. To this profile of work have to be added possible extra professional tasks including: postgraduate exercises, such as clinical meetings, 55 A NEW APPROACH TO MEDICINE seminars, lecture-discussions; committee and administrative work; teaching and research. Our typical primary physician may therefore be working a 45-50-hour week. TEMPORAL TRENDS Work patterns in primary care are not static.
Dunnell and Cartwright (1972) in a population survey in the UK found that over a 2-week period non-prescribed medicines (selfmedication) were consumed twice as often as prescribed medicines, even in the context of a British NHS. What is self-treated and with what? 1. Faced with unpleasant symptoms few (16%) ofus are sufficiently stoical and take no action to relieve the discomfort. 2). What do people take? The most frequently taken non-prescribed medicines recorded by Wadsworth et al. 2). ' It is not possible to give an accurate answer.
A New Approach to Medicine: Principles and Priorities in Health Care by John Fry