Fundamentals of Clinical Practice

Fundamentals of Clinical Practice, Second Edition presents medical students with a comprehensive guide to the social ramifications of a physician's work, and more experienced practitioners with the tools to augment their own patient-centered techniques.

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Fundamentals of Clinical Practice, Second Edition

Edited by

Mark B. Mengel, M.D., M.P.H. St. Louis University St. Louis, Missouri

Warren L. Holleman, Ph.D. Baylor College of Medicine Houston, Texas

and

Scott A. Fields, M.D. Oregon Health Sciences University Portland, Oregon

KLUWER ACADEMIC PUBLISHERS NEW YORK, BOSTON, DORDRECHT, LONDON, MOSCOW

eBook ISBN: Print ISBN:

0-306-47565-0 0-306-46692-9

©2002 Kluwer Academic Publishers New York, Boston, Dordrecht, London, Moscow Print ©2002 Kluwer Academic/Plenum Publishers New York All rights reserved No part of this eBook may be reproduced or transmitted in any form or by any means, electronic, mechanical, recording, or otherwise, without written consent from the Publisher Created in the United States of America Visit Kluwer Online at: and Kluwer's eBookstore at:

http://kluweronline.com http://ebooks.kluweronline.com

To those dedicated practitioners of the art who taught us that the core of clinical practice remains the patient–physician relationship

Contributors

Bruce Ambuel, Ph.D., M.S., Associate Professor of Family & Community Medicine, Waukesha Family Practice Residency Program, Waukesha, Wisconsin 53188 Elisabeth D. Babcock, Ph.D., President/CEO, Committee to End Elder Homelessness, Boston, Massachusetts 02118 Cyndi Jewell Baily, J.D., Associate General Counsel, Senior Vice-President and General Counsel, Baylor College of Medicine, Houston, Texas 77030 Kristen Lawton Barry, Ph.D., Senior Associate Research Scientist, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48108 Alan M. Blum, M.D., Professor and Gerald Wallace Chair, Department of Family Medicine, College of Community Health Sciences, University of Alabama School of Medicine, Tuscaloosa, Alabama 35401 Thomas L. Campbell, M.D., Professor of Family Medicine and Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York 14620 William M. Chop, Jr., M.D., Education and Research Foundation, Waco Family Practice Residency Program, Heart of Texas Community Health Center, Waco, Texas 76707-2291 John L. Coulehan, M.D., M.P.H., Professor of Preventive Medicine and Director, Institute for Medicine in Contemporary Society, SUNY at Stony Brook, Stony Brook, New York 11794-8036 Mark R. Cullen, M.D., Professor of Medicine and Public Health, Program Director, Yale Occupational & Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut 06510 Larry Culpepper, M.D., M.P.H., Professor and Chairman, Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts 02118-2393 Annette M. David, M.D., M.P.H., Associate Professor, Department of Physiology, Clinical Associate Professor, Department of Medicine, University of the Philippines, Philippine General Hospital Medical Center, Manila, Philippines vii

viii CONTRIBUTORS

Frank Verloin deGruy III, M.D., M.S.F.M., Woodward-Chisholm Professor and Chair, Department of Family Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80220 L