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I was a Medical Student in 1966 when the Millis Report on the training of the generalist physician was published,de?ning the concept of primary care. According to the Report, the primary provider has four major responsib- ities or roles. The ?rst role is that of initial contact care of the undiffer- tiated patient. The second is to provide comprehensive care based on the belief that the primary provider should be able to manage the overwhe- ing majority of problems with which patients present. Equally important is the third role continuity and coordination of care within the health care system. Finally,the primary provider is responsible for demonstrating le- ership in the community. This Report's description of a primary provider seems as relevant today as it was when it was written. In 1994,the Institute of Medicine's assessment of primary care added the responsibility of family and community integration of care to the Millis Report description. Without question there are many challenges to a contemporary imp- mentation of this comprehensive description of primary care, beginning with the level of individual patients who so often suffer from complex pr- lems, such as mental disorders and obesity. Treating these conditions in a brief primary care visit is dif?cult. At the level of the larger system, re- bursement is often inadequate and can represent policies that are uns- portive of primary care, such as those that compromise payment for preventive services that help patients to quit smoking or lose weight.
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Specifically designed for physical therapists in the primary care environment, this new resource helps the reader develop the vital communication and differential diagnosis skills necessary to provide high quality patient care and assume a valuable role on the health care team. Comprehensive coverage includes each skill that the physical therapist outpatient practitioner needs to meet the challenges of a changing profession: communication skills, technical expertise, and clinical decision-making ability. This reference helps the practitioner quickly develop an accurate physical therapy diagnosis; adapt an examination and intervention approach to meet the individual's cultural, communication, anatomic, and physiologic needs and abilities; triage patients from a physical therapy perspective and decide who requires the expertise of a physical therapist certified specialist; recognize patient symptoms and signs that necessitate communication with other health care providers; and participate in the decision-making process regarding the selection of appropriate diagnostic imaging modalities. Instructor resources are available; please contact your Elsevier sales representative for details. Promotes safe, effective, and efficient care applicable to physical therapy - the first resource specifically designed for PTs in primary care. Covers both soft skills (communication and problem-solving) and technical skills (physical examination, differential diagnosis, and ancillary modalities). Emphasizes the communication skills vital for establishing rapport with patients and gathering data. Presents everything that a physical therapist needs to know about the patient interview. Lays the foundation for differential diagnosis and recognition of conditions that may require referral to other health professionals. Includes coverage of special populations, pharmacology, urgent situations, diagnostic procedures, and more.
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