Michigan physician groups and the MSMS services they use

According to Petoskey family practitioner and MSMS Membership Chair Louis R. Zako, MD, MSMS has adapted perhaps better than any other state medical society to the changing medical marketplace. "MSMS continues to provide traditional member services--such as excellent CME programs, cellular phone service and auto leasing--at extremely competitive prices. In recent years MSMS has also kept pace with the increasing complexity of the business side of medicine," Doctor Zako says.     

Nurses preparing for change: their needs and concerns

As a result of decreased lengths of stay and cost-containment initiatives, fewer nurses are needed in acute care settings. The trend for community-based health care is broadening employment opportunities for nurses to work in community settings. As nurses are considering options to base their practice in community settings, it is important to understand their concerns about making this transition. The results of a qualitative study conducted to examine the concerns and educational needs of acute care nurses related to working in the community are reported. Clinical, professional, and intrapersonal skills important for a successful transition to community-based practice are identified and discussed.     

Obstetrician-gynecologists are primary physicians to women. I. Practice patterns of Michigan obstetrician-gynecologists

Michigan obstetrician-gynecologists were asked to complete questionnaires designed to determine what kinds of medical services they provide their patients. The questionnaires completed by 369 doctors, who had graduated from medical school between 1930 and 1964 and who are in active practice, form the basis of this report. More than 50% treat common non-obstetric-gynecologic disorders in their own patients and smaller numbers treat more serious medical conditions. This study confirms a previous one, derived from information obtained from patients, that obstetricians-gynecologists serve as primary physicians to women, not exclusively as specialist-consultants.     

Electroconvulsive therapy: a guide for family physicians

Electroconvulsive therapy, which works by creating a generalized seizure, is used most frequently to treat medication-resistant depression. Other indications for electroconvulsive therapy includes severe depression with suicidal ideation, acute mania and severe psychiatric illness with food and fluid refusal. Electroconvulsive therapy may be administered as an inpatient or outpatient procedure. Treatments are usually administered three times a week for six to 12 treatments. Before this therapy is used, a thorough medical and anesthetic history should be obtained, and a complete physical examination, an electrocardiogram and appropriate laboratory studies should be performed to rule out anemia, electrolyte imbalances, and cardiopulmonary and neurologic risk factors. Heart rate and rhythm, oxygenation, blood pressure and, often, the electroencephalogram are monitored continuously while the patient is anesthetized with a short-acting hypnotic agent and a muscle depolarizing agent. After electroconvulsive therapy, antidepressant or lithium therapy significantly reduces the symptom relapse rate.     

The supervision genogram: A tool for preparing supervisors-in-training.

The purpose of this article is to introduce the supervision genogram as a training tool that can be implemented in supervisor training. The supervision genogram is a unique training tool that may be used to enhance supervisors'-in-training self-awareness and understanding of the supervisory process. Psychological trainers who are responsible for training supervisors may also find that the supervision genogram can aid them in assessing the needs of supervisors-in-training and in creating corresponding supervisory environments and experiences. A detailed account of how to develop and process the supervision genogram is given. An overview of supervision genogram symbols and a completed supervision genogram are also provided. Implications for training, such as flexibility of application, ethical and professional issues, and developmental considerations for using this tool are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Instrumentation problems for physicians

The physician has, for whatever reasons, diminished his or her level of involvement on the team dedicated to developing, refining, and evaluating medical technology. As a result, the challenge confronting the physician and the technology development team today is to orchestrate a team structure that will ensure the greatest input and commitment from physicians and other professionals during current and future technology development. The charges of cost escalation and dehumanization in our system of health care delivery will also be discussed, as will the lack of, or confusion about, access to data concerning cost of a given instrument, and fuzzy semantics and perspectives on technology and instrumentation. The author suggests answers to, or means to ameliorate, the problems.     

Training for Iowa physicians

"Autonomous" thyroid nodule is a localized nodular lesion of the thyroid gland characterized by growth, iodine uptake and function, all independent from TSH control. These nodules represent a heterogeneous anatomic and clinical entity. The clinical diagnosis is based upon a negative suppression of nodule iodine uptake and scan imaging by T3 administration. The nodule function is determined by high serum thyroid hormone levels and/or low TSH (measured by ultrasensitive assay). Etiology and pathogenesis of these nodules is not yet completely clarified. Both genetic and environmental factors determine nodule growth and function: thyroid cells, in fact, are genetically heterogeneous and may have intrinsic (congenital) characteristics that may promote the growth of cellular clones having mitotic and functional activity that is partially independent of TSH. In these particular cell clones, environmental factors like iodine deficiency or other goitrogens may favour the growth of autonomous nodules and also, by activating their function, may induce toxicity. The autonomous thyroid nodules need to be treated only when they become toxic: in this case both surgical excision or radioiodine may be used.     

Rapid method for preparing Ehrlich hematoxylin

The new method consists of electrolysis for 48 hrs of haematoxylin template solution prepared by the standard method. The dye, after electrolysis, acquires the appearance and properties of hematoxylin prepared by the method of maturation at sunlight during several months. Spectral analysis of the dye and theoretical basis of the electrolytical acceleration of the dye maturation are presented.     

Review: the Michigan cleft twin study

The combined effects of clefting of the lip and/or palate and of their surgical repair have been examined for a cross-sectional sample of 20 MZ and 25 DZ like-sexed twins discordant for clefting, in the age range of 4 to 17 years. The findings of four studies published since 1975 on that sample are explored for the primary, contiguous and pleiotropic effects of clefting. The primary effects on facial structures of repaired cleft lip appear to be minimal. However, for twins with repaired cleft of the palate (with or without cleft of the lip), the maxilla was both deficient antero-posteriorly and was positioned more posteriorly than in their non-cleft co-twins. The maxillary first molars were usually slightly less erupted in the cleft twins than in the non-cleft twins. The cleft palate only twins had larger cranial base angles than their non-cleft co-twins. A contiguous effect of the posteriorly positioned maxilla was a mandibular rotation downward and backward in the cleft palate and bilateral cleft lip and palate groups but not in the unilateral cleft lip and palate group. The slightly larger cranial base angles found for cleft palate only, although contiguous in location, are more likely pleiotropic effect. The pleiotropic effects include a deficit in height and weight for cleft subjects which appears only after puberty. Although the teeth of the cleft twins tended to be smaller than those of the non-cleft twins, the amount was not clinically significant.     

Medicine and mass communication: an agenda for physicians

Because the medical content of the mass media significantly affects public attitudes and behavior, physicians should participate more fully as critics and sources of that content. Attempts to sway audiences with medical information alone are often unsuccessful. Communication is more likely to be effective when it offers people something they want, such as satisfaction of a need or legitimation of an existing value. Except for advertising, the media seldom engineer their impact intentionally. Instead, the producers of news and entertainment rely heavily on sources, critics, and pressure groups outside the communications industry. By mastering the patterns of media impact and the rudiments of public relations, physicians can make the media a useful tool of medicine.     

What journals for the physicians

An extragenital metastatic seminoma in a patient with Klinefelter's syndrome is described. The increased incidence of many types of malignancies in patients with this chromosomal abnormality and the increased susceptibility of XXY cells to transformation by oncogenic SV-40 virus are discussed. A relationship is suggested circumstantially by these observations.