Amit comments on the difficulties in having an "evidential" approach to
some of these classic primary care problems:
>Weight loss in elderly
>fatigue
>The dizzy patient.
>recurrent UTI
>Approach to a patient who has fibromyalgia
>EB pain management
>Patient who says I have multiple allergies.
>abdominal pain with negative workup
>shoulder pain ( exercise vs injection)
>many more......
I would agree.
I feel there are many disorders in primary care where the pathology and its
presentation are but exhibit a unique "fingerprint" for that individual.
These are areas where population-type studies are going to be extremely
difficult. Furthermore such problems take up a significant proportion of our
caseloads, rather than just the very small proportion as has previously been
presumed following the study by Gill in the BMJ in 1997.
Dr Jon Wilcox
General Medicine, Paediatrics and Obstetrics,
Glenfield Medical Centre,
452 Glenfield Road,
Auckland 1310, New Zealand
Phone or Fax +649-444-7656
e-mail [log in to unmask]
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