Extreme practicality | Extreme Clinic -- An Outpatient Doctor's Guide to the Perfect 7 Minute Visit |...

Work better | Extreme Clinic -- An Outpatient Doctor's Guide to the Perfect 7 Minute Visit | Thomas Laurence

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	• Extreme Clinic -- An Outpatient Doctor's Guide to the Perfect 7 Minute Visit Thomas Laurence Hanley & Belfus, 2003 - 200 pages average customer review:based on 4 reviews view larger image
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This Book Changed My Life

I'm double board certified in Pediatrics and Internal Medicine. This book changed my life. I see my kids again. I actually like my job. I thought the "seven-minute visit" was bad medicine and would upset my patients...but I was wrong. The author taught me a new way of thinking. Thank God for this man. I wish I had trained with him.

Extreme practicality

Should be issued to student's starting outpatient clinics so that they can be inculcated with reality early on. It's a sad state of affairs that we've been reduced to 7 minutes but that's the third party economics of it. If you take insurance, this book will help you out. Some bits are not exactly "psychosocially" optimal per the pundits but I think reflect real patient psychology better than they do.

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Work better

This book has been very helpful in increasing my productivity without sacrificing the quality of the visit nor my quality of life.

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A doctor's guide to a better practice (and a better life)

Since it is unlikely that the 10 minute visit will go the way of the dodo anytime soon, and so Dr. Tom Laurence, a clinical professor from the University of Illinois College of Medicine, has shared with us his accumulated insight in perfecting the seven-minute visit. Extreme Clinic has something to offer everyone who is practicing or will be practicing outpatient medicine in the future.

Before continuing, I must disclose that I received my medical training at the University of Illinois and have therefore had the pleasure of direct interaction with Dr. Laurence on the ward and in the clinic. To say a few words about the author: Dr. Laurence is a man of uncommon wit and wide-ranging talent. As an instructor, he is beloved by medical students and residents for his enthusiastic and entertaining teaching. To watch him interview a patient on teaching rounds is to be treated to a fantastic display that combines the best of showmanship and medical knowledge. When he takes a patient's history for a common complaint such as headache (or cephalgia, if you wish) it becomes something akin to a tightly-scripted, short two-man play -- with an economy of carefully-chosen questions from Dr. Laurence, the story unfolds effortless from the mouth of the patient. Extreme Clinic is a wonderful dose of the author's personal style of medicine and faithfully represents real, thoughtful techniques that are ready to be applied to your clinic.

If the outpatient clinic training that most medical students and residents receive is plain vanilla, then Extreme Clinic is Ben & Jerry's "Everything But The..." flavor. That is, the book contains a lot of great goodies all mixed together, but an individual may prefer some of the ideas it contains while not being so enthusiastic about others. However, nowhere in this book does the author demand adherence to all the advice given -- it is not a magic recipe or mystical system that must be followed verbatim to work. I'm sure that some of the notions advanced could even offend the most sensitive readers, but I am equally sure that few could read the book and not find suggestions that resonate with them and could serve to improve their personal practice. For example, the author's unique perspective on opthalmoscopic examination as a means of communicating with the patient is almost worth the price of the book alone.

The advice presented in the test is organized in a one-topic-per-chapter fashion, covering the topic both generally and specifically. The organization of the chapters and the overall lean nature of the book make for a convenient and quick read. Chapters include gems like "Think Disposition," "Zen Break," "The Set," "The Touch," "The Eye," "Rules and Decisions," "Expand That Normal," "Somatomancers," "Tests Won't Save You," "Compliance," "Preaching," "Your Study," "Atypical Horses," and many others. All chapters focus on real clinical issues and provide solid advice regarding how to be a good, caring, competent doctor without failing as a person, spouse or parent. Dr. Laurence promotes a scenario in which the clumsy, unfocused, overtime outpatient visit is streamlined through an approach that manages all aspects of the encounter from the beginning, middle, end and beyond. It considers diverse aspects such as the waiting room, decor, staff, history, physical, medications, lab tests, and professional reading. In the end both doctor and patient win as the quality of the service provided to the patient increases and the burden on the doctor decreases. Of course, square pegs cannot be pounded into round holes, and the author openly admits that some patients require and deserve more than seven minutes -- the rules in the book will break, but adhering to them where possible is the key to streamlining the day. Difficulties that arise are covered, including compliance, malingering, chronic pain, somatization, zebras and discontinuation. Not every doc may be able to master or become comfortable with all the patient-interaction and management techniques promoted in the text, but the book also covers aspects of mental well-being, professional preparedness, and philosophical concerns in medicine (and life, in case you want one in addition to your career).

In closing, Extreme Clinic is thought provoking for those physicians that currently practice in a different manner and potentially liberating for those physicians that always suspected there is a better, more efficient way, but simply need some encouragement and a little tutelage.

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Univ. of Illinois, Urbana. Offers practical guidance for residents and doctors on how to make hectic days in the clinic go smoothly, and relatively stress-free. Quick-paced and insightful, text shows how to take control of patients' visits, create an agenda for every patient encounter, and focus on the essence of the patient's illness. Softcover.