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Doctors, Dilemmas, Decisions

Doctors, Dilemmas, Decisions

Ben Essex

ISBN: 978-0-727-90859-9 December 1994 BMJ Books 316 Pages


In Stock



The general practitioner is required to make hundreds of decisions every day and each must be tailored to the specific needs of the individual patient.

This first book on decision making in general practice is an invaluable reference for all concerned with providing quality care. Using over 200 real life cases, it analyses the difficulties arising in:

Diagnosis, investigation, management, follow up, outcome, prevention, practice organization.

A body of rules that can be applied to these wide ranging issues provides a framework to improve decision making skills in ways that are ethical, cost-effective, safe, and acceptable for GPs, trainees, trainers and medical students. Here is an essential guide to understanding this critical element of general practice.



I. Decision analysis.

1. Introduction.

2. Classification of decisions.

3. Evaluation of rules.

4. Study decisions in general practice.

5. Factors and pathways.

6. Training.

7. Sharing decisions..

II. Specific decisions.

8. Diagnosis.

9. Investigations.

10. Objectives.

11. Management options.

12. Indications.

13. Follow up and outcomes.

14. Prevention..

III. Special problems.

15. Decisions about children.


17. Mental illness.

18. Violence.

19. Communicating decisions.

20. Requests.

21. Mistakes..

IV. Organisation.

22. Practice staff.

23. Referral decisions.

24. Responsibilities.

25. Protocols and policies.

26. Decisions and the district nurse.

27. Waiting lists..

V. Specific factors.

28. Acceptability.

29. Compliance.

30. Confidentiality.

31. Consent.

32. Culture.

33. Risk.

34. Urgency.

35. Social problems.

36. Conclusion.

"unique...addresses the sort of general practice problems other medical texts often ignore" - Lancet