The practice of modern medicine

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Contens: 1. Health care and its delivery 2. ORGANIZATION OF HEALTH SERVICES 3. Levels of health care. 4. Costs of health care. 5. ADMINISTRATION OF PRIMARY HEALTH CARE 6. MEDICAL PRACTICE IN. DEVELOPED COUNTRIES 7. Britain. 8. United Stales. 9. Russia. 10. Japan. 11. Other developed countries. 12. MEDICAL PRACTICE IN DEVELOPING COUNTRIES 13. China 14. India. 15. ALTERNATIVE OR COMPLEMENTARY MEDICINE 16. SPECIAL PRACTICES AND FIELDS OF MEDICINE 17. Specialties in medicine. 18. Teaching. 19. Industrial medicine. 20. Family health care. 21. Geriatrics. 22. Public health practice. 23. Military practice. 24. CLINICAL RESEARCH 25. Historical notes. 26. Clinical observation. 27. Drug research. 28. Surgery. 29. SCREENING PROCEDURES THE PRACTICE OF MODERN MEDICINE Health care and its

delivery The World Health Organization at its 1978 international, conference held in the Soviet Union produced the Alma-Ata Health Declaration, which was designed to serve gov­ernments as a basis for planning health care that would reach people at all levels of society. The declaration reaf­firmed that "health, which is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, is a fundamental human and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector." In its widest form the practice of medicine, that is to say the promotion and care of

health, is concerned with this ideal. ORGANIZATION OF HEALTH SERVICES "It is generally the goal of most countries to have their health services organized in such a way to ensure that individuals, families, and communities obtain the max­imum benefit from current knowledge and technology available for the promotion, maintenance, and restoration of health. In order to play their part in this process, governments and other agencies are faced with numer­ous tasks, including the following: (1) They must obtain as much information as is possible on the size, extent, and urgency of their needs; without accurate information, planning can be misdirected. (2) These needs must then be revised against the resources likely to be available in terms of money, manpower, and

materials; developing countries may well require external aid to supplement their own resources. (3) Based on their assessments, countries then need to determine realistic objectives and draw up plans. (4) Finally, a process of evaluation needs to be built into the program; the lack of reliable information and accurate assessment can lead to confusion, waste, and inefficiency. Health services of any nature reflect a number "I in­terrelated characteristics, among which the most obvious but not necessarily the most important from a national point of view, is the curative function; that is to say caring for those already ill. Others include special services that deal with particular groups (such as children or preg­nant women) and with specific needs such as nutrition

or immunization; preventive services, the protection of the health both of individuals and of communities; health education; and, as mentioned above, the collection and analysis of information. Levels of health care. In the curative domain there are various forms оf medical practice. They may be thought of generally as forming a pyramidal structure, with three tiers representing increasing degrees of specialization and tech­nical sophistication but catering to diminishing numbers of patients as they are filtered out of the system at a lower level. Only those patients who require special attention or treatment should reach the second (advisory) or third (specialized treatment) tiers where the cost per item of service becomes increasingly higher. The first level represents