Physician assistant (American Academy of Physician Assistants)最新文献

Achieving patient compliance in taking prescribed medications is a formidable challenge for all clinicians. As PAs, we have daily opportunities to communicate with patients and improve their compliance. An office-based compliance program, combining patient education and behavior-modification components, can be beneficial in this regard. Strategies for improving compliance include giving clear, concise, and logical instructions in familiar language, adapting drug regimens to daily routines, eliciting patient participation through self-monitoring, and providing educational materials that promote overall good health in connection with medical treatment.

A distinguished panel of PAs discusses the medical approach to cardiac care utilizing more traditional methods of treatment, such as surgery and pharmacology, and the lifestyle approach, which emphasizes changes in diet, exercise, and a program of stress reduction. This Physician Assistant Forum examines the role of each program in clinical practice as well as the benefits, costs, and limitations of each approach.

This article examines the contribution of bedside calorimetry and nitrogen balance monitoring to the nutritional support of critically ill patients who are not served by the standard formulas. It describes the types of instruments available and discusses their usefulness in specific cases. The article closes with pointers on how a critical care metabolic service can be established and worked into a hospital's existing systems.

In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping.

The decade of the sixties was one of dramatic change in American culture. Looking back, the change that had the most effect on readers of this journal was the creation of the physician assistant profession. The original members of our profession were all former military medical corpsmen. This article provides a brief overview of this military heritage.

Autologous blood recovery devices have taken on new importance in the effort to conserve finite resources of blood products in the face of ever-growing demand. By incorporating this technology in the vascular, orthopedics, and cardiovascular arena, substantial savings of blood will be realized. The expanded utilization of autologous blood recovery will enable an already burdened blood supply system to continue to provide an adequate source for our patients. It will also help assuage our patients' fears by limiting their exposure to homologous products and the attendant risk of infection by blood-borne pathogens.

Pick up any newspaper or news magazine and chances are that an article on health care reform will be prominently featured. While we await the details of the plans for reform, we can divine some major implications. With certainty, one of these will be the need to access and integrate vast amounts of patient and provider data. These medical data, in electronic form, will fuel the interplay between provider, hospital, government organizations, and private health care management. These data will be used: to drive the outcome studies that will examine medical resource consumption; to track prescribing practices; to facilitate patient follow-up; and to monitor wellness programs. In short, data management will be an unseen, but very present, companion to all our practice decisions. The successful medical practitioners in the coming era will be those whose practices have an electronic infrastructure that allows comprehensive medical record keeping, inclusive of patient charting, billing, coding, scheduling, and data reporting to third parties.

Many PAs are grappling with the problem of how to best advance their careers. In this roundtable, the participants discuss traditional methods of advancement and examine the need for new models.