Practice Under Pressure: Primary Care Physicians and their Medicine in the Twenty-first Century (Critical Issues in Health and Medicine Series)

by Timothy Hoff

Overview

Through ninety-five in-depth interviews with primary care physicians (PCPs) working in different settings, as well as medical students and residents, Practice Under Pressure provides rich insight into the everyday lives of generalist physicians in the early twenty-first century—their work, stresses, hopes, expectations, and values. Timothy Hoff supports this dialogue with secondary data, statistics, and in-depth comparisons that capture the changing face of primary care medicine—larger numbers of younger, female, and foreign-born physicians.

Product Details

ISBN-13:	9780813546766
Publisher:	Rutgers University Press
Publication date:	09/11/2009
Series:	Critical Issues in Health and Medicine
Edition description:	New Edition
Pages:	208
Product dimensions:	6.00(w) x 8.90(h) x 0.70(d)

About the Author

Timothy Hoff is associate professor of health policy and management at the University at Albany School of Public Health.

Table of Contents

Preface

1. The Transformation of Primary Care in the United States

Part I
2. A Typical Workday in Primary Care
3. How the Primary Care Workday Has Changed
4. Leaving Hospital Work Behind
5. The Routine and Nonroutine of Primary Care Work

Part II
6. Younger and Older Physicians in Primary Care
7. Women in Primary Care
8. International Medical Graduates in Primary Care

Part III
9. The Medical Home
10. No Quick Fix

Appendix

Editorial Reviews

"In this timely book, Timothy Hoff presents a survey of ninety primary care physicians. They speak their minds—and hearts. Hoff explains how, in a generation, our family doctors gave up hospital practice and found themselves boxed into fifteen minutes of face time with patients in the office: the business model that favors technology over talking and thinking. Primary care, which we need more of, cannot compete with the higher prestige and earnings of specialties like surgery and radiology. This book will help everyone—professionals, the public, and politicians—to grasp the nettle. Meanwhile the US healthcare system hardly deserves a passing grade."

ForeWord Reviews

"This is the best book on primary care to come along in years. Hoff's recommendations for improvement are grounded in the everyday experience of primary care providers and what they and others will need to make such improvements reality."

Dean, School of Public Health, University of California, Berkeley - Stephen M. Shortell

"Sociologist Timothy Hoff takes us to the heart and soul of the primary care crisis in America. Through personal stories, he reveals the daily frustrations and the deep compassion of these dedicated physicians."

former president, American Academy of Family Physicians - Bruce Bagley

"Practice Under Pressure could not be more timely. Timothy Hoff has written a concise, compelling examination of the work of primary care based on integration of qualitative data and published quantitative findings. Hoff interviewed 88 PCPs, residents, and students, as well as 2 nonphysician leaders. The book's power emanates from these narratives."

Journal of the American Medical Association

"The erosion of primary medical care is of increasing concern for the organization of our health care system, for patients, and for issues of access and cost. In this book, Timothy Hoff looks at this issue through the perspectives of primary care physicians and provides useful information for understanding significant changes in medical care and future challenges."

Institute for Health, Health Care Policy, and Aging Research, Rutgers University - David Mechanic

"This is the best book on primary care to come along in years. Hoff's recommendations for improvement are grounded in the everyday experience of primary care providers and what they and others will need to make such improvements reality."

From the Publisher

Calling primary-care medicine the "unsung hero of our health care system" and writing that no other part of that system "is in greater trouble right now," Hoff (health policy & management, Univ. at Albany Sch. of Public Health) attempts to look at the problems and possible solutions. He conducted 95 hour-long interviews with primary-care/generalist physicians, medical students, residents, and medical leaders. The interviews are synthesized as he discusses the diminished status and incomes as well as the demographics of this group, which has been overtaken by a system geared toward specialty care. The causes include primary-care physicians' image devolving into one of practitioners who are less thoroughly trained and knowledgeable. Few medical students now express an interest in primary care. Hoff acknowledges a turnaround will be difficult but suggests such things as an emphasis in medical schools on the field, an increase in reimbursement for preventive care, and the need for a more defined primary-care field. VERDICT Clearly and logically presented, this book will most likely be of interest to those in the primary-care field, health-care administration, and medical education.—Dick Maxwell, Porter Adventist Hosp. Lib., Denver

Library Journal