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Becoming a Consummate Clinician: What Every Student, House Officer and Hospital Practitioner Needs to Know

ISBN: 978-1-118-01143-0
224 pages
August 2012, Wiley-Blackwell
Becoming a Consummate Clinician: What Every Student, House Officer and Hospital Practitioner Needs to Know (1118011430) cover image

With hospital medicine growing rapidly in both scale and complexity, the learning curve for students is steeper, while experienced physicians are often called upon to act as mentors and caregivers in areas outside their primary fields of expertise. Becoming a Consummate Clinician, an exciting new book in the series Hospital Medicine: Current Concepts, describes in practical terms how clinicians and students can think more critically and act more insightfully in this era of information expansion and time compression. Developed for hospital-based clinicians and physicians-in-training, the book provides a road map for navigating key challenges in real-life medical practice related to assessing, integrating, and presenting clinical information. Clearly formatted and easily accessible, the book:

  • Fully integrates and emphasizes error avoidance and reduction
  • Highlights uses and limitations of algorithmic and evidence-based medicine in medical decision-making
  • Details effective strategies for looking and “re-looking” at biomedical data
  • Explains essential do’s and don’ts of medicalpractice, from patient history and exam to differential diagnoses
  • Describes best practices and pitfalls of gathering, processing, and communicating medical information
  • Presents strategies for attending physicians to develop the critical thinking skills of their trainees

Featuring real-world clinical examples, this concise, down-to-earth text is written to help both practitioners and students improve their overall clinical performance, and learn to communicate effectively with members of the caregiving team.

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Preface ix

Acknowledgments xi

INTRODUCTION: SURVIVING AND THRIVING IN WARD WORLD 1

PART 1 MEDICAL MUSTS AND MUST-NOTS: SIX ESSENTIALS OF WARD WORLD

1 HOW (NOT) TO PRESENT A PATIENT HISTORY 13

2 REEXAMINING THE PHYSICAL EXAM 37

3 HOW (NOT) TO ORDER AND PRESENT LAB TESTS 67

4 SEEING IS (ALMOST) BELIEVING: THE IMPORTANCE OF REVIEWING DATA 81

5 "WORSTS FIRST": HOW TO FRAME A DIFFERENTIAL DIAGNOSIS 93

6 CLINICAL QUERIES: ASKING THE 3½ KEY QUESTIONS 103

PART 2 MEDICAL MASTERIES

7 E = MC3: ERROR REDUCTION EQUALS MOTIVATION TIMES COMMUNICATION TO THE POWER OF 3 115

8 EVIDENCE-BASED MEDICINE: WHAT AND WHERE IS THE EVIDENCE? 131

9 CAUTION! DANGEROUS BIOMEDICAL SEMANTICS AT WORK 145

10 SOME SECOND OPINIONS: OUTLIERS, HOOFBEATS, AND SUTTON’S (FLAWED) LAW 165

11 A SIXFOLD PATH: FROM DATA TO KNOWLEDGE TO UNDERSTANDING 173

12 WHAT IS DISEASE? WHAT IS HEALTH? 181

Bibliography and Notes 195

Index 203

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Ary L. Goldberger, MD, is Director of the Rey Laboratory and Professor of Medicine at the Harvard Medical School. He is Program Director of the Research Resource for Complex Physiologic Signals, which is funded by the National Institute of Biomedical Imaging and Bioengineering and the National Institute of General Medical Sciences of the National Institutes of Health. He is also a core faculty member of the Wyss Institute for Biologically Inspired Engineering at Harvard.

Zachary D. Goldberger, MD, MS,is an Assistant Professor in the Department of Internal Medicine in the Division of Cardiology at Harborview Medical Center/University of Washington Medical School, in Seattle, WA. He received his medical degree from Yale University School of Medicine and then completed his Internal Medicine training at the University of Washington. He completed a fellowship in cardiovascular medicine at the University of Michigan, where he was a 2010-2012 Robert Wood Johnson Foundation Clinical Scholar.

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“The encouragement of all readers to rethink everything we assume to be true and to seek a deeper understanding of what we “know” is priceless . . . The quotes included throughout the book were both valuable and enjoyable.”  (The Hospitalist, 2 November 2014)

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