[The change in medical practice. Psycho-social challenges for the profession].

Abstract:

:This article analyzes important changes in medical practice, focusing in those most deeply perceived by a group of physiciansfrom the Metropolitan Region of Santiago, included in a joint research conducted by the Departments of Psychiatry and Mental Health (East) of the Medical Faculty at the University of Chile and Public Health of the Catholic University of Santiago, during 2003. These are the perceived changes in the relationship between doctors and patients; increased limits in professional autonomy and the fragmentation of medical practice. Reflecting transformations in social relationships in general, they have added new stress and frustrations, as well as new opportunities and rewards to the medical profession. The perceptions identified are commented within the structural determinants of medical practice. These issues call for a refreshing discussion on the values supporting medical professionalism and the concept of profession in itself, in view of the challenges posed by the current social and cultural changes.

journal_name

Rev Med Chil

journal_title

Revista medica de Chile

authors

Horwitz N

doi

10.4067/s0034-98872004000600015

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

768-72

issue

6

eissn

0034-9887

issn

0717-6163

journal_volume

132

pub_type

杂志文章
  • [Andres Bello and the origins of the University of Chile].

    abstract::During colonial times the Royal University of San Felipe was founded in 1738. The first plan for medical studies was outlined in 1779. During the Independence, the National Institute created in 1813 took over higher education. The first Course of Medicine was dictated there in 1833. The University of San Felipe was re...

    journal_title:Revista medica de Chile

    pub_type: 传,历史文章,杂志文章

    doi:

    authors: Costa-Casaretto C

    更新日期:1992-01-01 00:00:00

  • [Incidence of thyroid cancer in an oncological clinic of Santiago, Chile].

    abstract:BACKGROUND:In Chile, Thyroid cancer (TC) is included in a list of diseases that have a guaranteed access to treatment, endorsed by the Ministry of Health. The care burden of the disease will depend on its incidence. AIM:To estimate the incidence of TC in Chilean patients with access to thyroid surgery and describe its...

    journal_title:Revista medica de Chile

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    authors: Sapunar Z J,Ferrer R P

    更新日期:2020-05-01 00:00:00

  • [Clinical features of Wegener granulomatosis and microscopic polyangiitis in Chilean patients].

    abstract:BACKGROUND:Systemic vasculitis are a group of heterogeneous diseases characterized by inflammation and necrosis of blood vessel walls. The etiology is not known, but geographic and environmental factors are implicated. AIM:To describe the clinical features of microscopic polyangiitis (MPA) and Wegener's granulomatosis...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/s0034-98872005000300001

    authors: Cisternas M,Soto L,Jacobelli S,Marinovic MA,Vargas A,Sobarzo E,Saavedra J,Chauan K,Meléndez G,Foster C,Pacheco D,Wainstein E,Grupo de estudio de las vasculitis, Sociedad Chilena de Reumatología.

    更新日期:2005-03-01 00:00:00

  • [Transition to adulthood of adolescents with inflammatory bowel disease].

    abstract::Inflammatory bowel disease (IBD) is a prevalent chronic disorder, often diagnosed during childhood. Studies have suggested that the incidence of IBD in this group of patients is increasing. Children and adolescents with IBD frequently have more extensive and severe disease than adults. Transition is an important conce...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,评审

    doi:10.4067/S0034-98872015000600010

    authors: Navarro E,Ossa JC,Simian D,Quera R

    更新日期:2015-06-01 00:00:00

  • [Association between handgrip strength and functional performance in Chilean older people].

    abstract:BACKGROUND:Handgrip strength is an important predictor of functional performance among older adults. AIM:To measure handgrip strength in older adults and relate its values to their clinical functional assessment. MATERIAL AND METHODS:Handgrip strength was measured in 1047 older adults living in the community and aged...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/S0034-98872016000500007

    authors: Mancilla S E,Ramos F S,Morales B P

    更新日期:2016-05-01 00:00:00

  • [Fighting the coronary artery disease epidemic in Chile: caveats in the control of cardiovascular risk factors].

    abstract::In this issue of the journal Lanas et al report an estimation of population attributable risk (PAR) for myocardial infarction (MI) derived from different risk factors in Chile. Cigarette smoking, dyslipidemia and hypertension accounted for 71% of total PAR. Mortality from MI has decreased in Chile, but epidemiologic s...

    journal_title:Revista medica de Chile

    pub_type: 评论,社论

    doi:/S0034-98872008000500001

    authors: Chamorro S G

    更新日期:2008-05-01 00:00:00

  • [Soft tissue sarcoma. Combined treatment of drug therapy, radiotherapy and conservative surgery].

    abstract::The preliminary results of a prospective and cooperative protocol for the treatment of soft tissue sarcomas of trunk and extremities, stages IB-IIIB are presented. Thirty one patients (17 males, 22 with a tumor larger than 5 cm) aged 16 to 68 years, were treated with one dose of epirubicin 70 mg/m2 i.v. and radiothera...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: San Martín S,Pérez R,Sepúlveda M,Rodríguez M,Durán B,Trujillo C,Arraztoa J

    更新日期:1993-02-01 00:00:00

  • [Resection gastric bypass in morbid obese patients aged less than 18 and over 65 years].

    abstract:BACKGROUND:The incidence of morbid obesity is increasing and gastric bypass is the most effective surgical treatment. AIM:To assess the long term results of resection gastric bypass among morbidly obese patients aged less than 18 and over 65 years in terms of weight loss and correction comorbidities. MATERIAL AND MET...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:/S0034-98872008001000003

    authors: Burgos L AM,Csendes J A,Papapietro V K

    更新日期:2008-10-01 00:00:00

  • [Treatment results of early breast cancer: a retrospective review].

    abstract:BACKGROUND:Breast cancer will develop in one out of ten women during their lifetime. Early diagnosis has increased in recent years. AIM:To describe a population of women with breast cancer stage T1N0M0. To analyze radiation therapy toxicity and to evaluate treatment results. MATERIAL AND METHODS:Retrospective review ...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/s0034-98872007000400003

    authors: Sánchez C,Bustos M,Camus M,Alvarez M,Goñi I,León A,Besa de C P

    更新日期:2007-04-01 00:00:00

  • [Environmental risk factors in the development and evolution of inflammatory bowel disease].

    abstract::Environmental factors may influence the development of Inflammatory Bowel Disease and modify its natural history. The objective of this review is to evaluate current evidence about environmental factors associated with the disease. A better knowledge about the pathogenesis of the disease can lead to better treatment s...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,评审

    doi:10.4067/s0034-98872019000200212

    authors: Meligrana NE,Quera R,Figueroa C,Ibáñez P,Lubascher J,Kronberg U,Flores L,Simian D

    更新日期:2019-02-01 00:00:00

  • [Spontaneous bacterial peritonitis: a frequent and recurrent complication in cirrhotic patients with ascites].

    abstract::One hundred and twenty consecutive patients with liver cirrhosis and ascites were prospectively studied in order to analyze the frequency, clinical and bacteriological features, recurrence, and prognosis of spontaneous bacterial peritonitis (SBP). Two variants of SBP were defined: culture positive SBP and culture nega...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Chesta J,Brahm J,Poniachik J,Latorre R,Hurtado C,Novoa X,Velasco M

    更新日期:1991-03-01 00:00:00

  • [Brown tumors in multiple locations: manifestation of severe renal osteodystrophy. Case report].

    abstract::We report a 25 years old woman with a four years history of end stage renal disease on hemodialysis. During the last two years of follow up, multiple tender nodules appeared in the left clavicle and ribs. These were diagnosed as brown tumors, secondary to osteitis fibrosa cystica, in the context of a secondary hyperpa...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Gómez MC,Riquelme P,Sirandoni G,Sapunar J,Princic E,Lee B

    更新日期:2003-10-01 00:00:00

  • [Nutritional status of school children from indigenous and non indigenous ancestry].

    abstract:BACKGROUND:The few studies in Chile assessing the nutritional status of indigenous children show a high prevalence of stunting, excess weight and feeding problems. AIM:To compare anthropometric indices in children from indigenous and non indigenous ancestry. SUBJECTS AND METHODS:School children aged 6 to 8 years old,...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Amigo H,Bustos P,Erazo M,Radrigán ME

    更新日期:1999-08-01 00:00:00

  • [Efficacy and associated costs of an outpatient intervention in women with severe depression and early trauma].

    abstract:BACKGROUND:A high proportion of women consulting for depression have a history of childhood abuse and trauma. AIM:To compare the efficacy and costs associated with a treatment that enquires directly into childhood trauma and understands present interpersonal difficulties as a compulsion to repeat the traumatic past, v...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,随机对照试验

    doi:/S0034-98872010000400006

    authors: Vitriol G V,Cancino A A,Florenzano U R,Ballesteros T S,Schwartz P D

    更新日期:2010-04-01 00:00:00

  • [Correlation between CA-125 marker with the presence and severity of pelvic endometriosis].

    abstract:BACKGROUND:Endometriosis affects at least 15% of infertile women. The diagnosis is made by direct visualization of implants either at laparoscopy or laparotomy. Elevation of plasma CA-125 levels has been associated with the presence of endometriosis. AIM:To search for a correlation between CA-125 and the presence of e...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Bianchi M,Macaya R,Durruty G,Manzur A

    更新日期:2003-04-01 00:00:00

  • [Application of a system of serological surveillance of Chagas disease in a region of high chagasic endemia. I. Prevalence of Trypanosoma cruzi infection in Salamanca].

    abstract::A serologic study for prevalence of Chagas infection was performed in Salamanca, Northern Chile. Indirect immunofluorescence and indirect hemagglutination reactions were used in samples from 1529 females and 698 males representing 10% of the population. A total of 499 positive results were obtained. The incidence of i...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Lorca M,Reyes V,Muñoz P,Tassara R,Canales M,Mercado R,Atías A

    更新日期:1991-04-01 00:00:00

  • [Default mode network and Alzheimer's disease].

    abstract::Brain functioning is mainly intrinsic, not primarily reflexive. This is supported by the high energy requirements of the resting brain (20% of all the energy consumed) which only marginally increases with changes in brain activity. Modern neuroimaging and neurophysiological techniques have led to the discovery of the ...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,评审

    doi:10.4067/S0034-98872013000300014

    authors: Vergara E F,Behrens MI

    更新日期:2013-03-01 00:00:00

  • [Immunologic and insulin secretion markers in non insulin dependent diabetic patients with secondary failure to oral hypoglycemic drugs].

    abstract:BACKGROUND:The pathogenesis of secondary failure to hypoglycemic agents is heterogeneous. Some patients are true insulin dependent diabetics with a slow autoimmune disease suggested by their positive islet cell antibodies. Others, have an increased insulin resistance. AIM:To assess the frequency of positive islet cell...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Maiz A,Manrique M,Arteaga A,Acosta AM,Andrade L

    更新日期:1995-10-01 00:00:00

  • [Thyroid stimulating hormone reference values derived from the 2009-2010 Chilean National Health Survey].

    abstract:BACKGROUND:The determination of thyroid stimulating hormone (TSH) reference values is critical for the diagnosis of thyroid diseases. AIM:To explore and discuss different definitions to establish TSH reference values using a Chilean national survey sample. MATERIAL AND METHODS:The 2009-2010 Chilean National Health Su...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/S0034-98872013000100013

    authors: Mosso L,Margozzini P,Trejo P,Domínguez A,Solari S,Valdivia G,Arteaga E

    更新日期:2013-01-01 00:00:00

  • [Prevalence of cardial or fundic mucosa and Helicobacter pylori in the squamous-columnar mucosa in patients with chronic patological gastroesophageal reflux without intestinal metaplasia comparated with controls].

    abstract:BACKGROUND:The mucosa distal to the endoscopic mucosal change zone can have easily diagnosed early alterations, in patients with chronic gastroesophageal reflux. AIM:To determine the type of mucosa existent in the zone distal to the squamous-columnar junction in patients with chronic gastroesophageal reflux without in...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Csendes A,Smok G,Christensen H,Rojas J,Burdiles P,Korn O

    更新日期:1999-12-01 00:00:00

  • [Comparative analysis of A(H1N1) influenza epidemiological dynamics in Chile].

    abstract::In order to increase awareness of the pandemic and to streamline control measures before any new outbreak of influenza we analyze the behavior of the cases of Chile and from 9 countries with more cases in 2009. Reproductive numbers, doubling times and estimations of susceptible and infected at the end of the epidemic ...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:/S0034-98872010000900016

    authors: Canals L M

    更新日期:2010-09-01 00:00:00

  • [Raúl B. Etcheverry, M.D. (1909-2014)].

    abstract::Professor Raúl B. Etcheverry, M.D., was a founder of Chilean Hematology back in the 1940's and a practicing physician and teacher until an advanced age. Being a superb clinician, he was admired by his ability to unveil from the most common to the most difficult diagnosis of blood disorders and neoplasms by examining b...

    journal_title:Revista medica de Chile

    pub_type: 传,历史文章,杂志文章

    doi:10.4067/S0034-98872014000300017

    authors: Reyes B H

    更新日期:2014-03-01 00:00:00

  • [Admission diagnosis and nutritional evolution of the beneficiaries of "Corporación para la Nutrición Infantil-CONIN"].

    abstract:BACKGROUND:The nutritional impact of CONIN nutritional recovery centers must be evaluated, considering the current epidemiological situation in Chile and the new therapeutic focus giving more emphasis to ambulatory treatment. AIM:To analyze the nutritional status of children treated at traditional CONIN centers, the r...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Pizarro T,Rodríguez L,Atalah E

    更新日期:2003-09-01 00:00:00

  • [Clinical differences between patients consulting for occupational neurosis and common illnesses].

    abstract:BACKGROUND:In Chile, occupational illnesses are defined by the "Work-related accidents and occupational illnesses law". The institutions that administer that law have the legal obligation to determine the "occupational" or "common" origin of accidents and diseases. AIM:To compare symptoms and problems at work in a gro...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:/S0034-98872011001000019

    authors: Trucco B M,Rebolledo M P

    更新日期:2011-10-01 00:00:00

  • [Health-related quality of life in Chilean patients with chronic obstructive pulmonary disease].

    abstract:BACKGROUND:Chronic obstructive pulmonary disease (COPD) has a relevant impact on health-related quality of life (HRQoL). Short Form 6 dimensions (SF-6D) quality of life tool allows researchers to calculate preference-based utilities using data from SF-12 or SF-36 questionnaires. AIM:To provide normative values of SF-6...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/S0034-98872017000200001

    authors: Collado-Mateo D,Adsuar JC,Olivares PR,García-Gordillo MÁ

    更新日期:2017-02-01 00:00:00

  • [Problems in the diagnosis of thyroid dysfunction of the elderly adult].

    abstract::Thyroid disfunction in the aged is often misdiagnosed either due to scanty symptoms, masking by other ailments or because function tests can be altered by extrathyroid causes such as chronic diseases, drugs or undernutrition. We surveyed 93 patients from 60 to 104 years old (73 females) living in geriatric homes. Most...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Wainstein E,Castillo A,Pineda G

    更新日期:1990-04-01 00:00:00

  • [Screening and barriers for treatment of postpartum depression in Chilean public primary health care centers].

    abstract:BACKGROUND:Postpartum depression (PPD) is a public health issue, and appropriate screening may lead to clinical gains. AIM:To describe the screening for PPD, its relationship with the use of health care services, and treatment access barriers in Chilean public primary health care (PHC) centers. MATERIAL AND METHODS:P...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,多中心研究

    doi:10.4067/s0034-98872018000901001

    authors: Rojas G,Guajardo V,Martínez P,Fritsch R

    更新日期:2018-09-01 00:00:00

  • [HDL cholesterol: a new target in the treatment of lipid disorders and atherosclerosis?].

    abstract::Low plasma HDL cholesterol levels are an independent risk factor for atherosclerotic cardiovascular disease. During the past years, the study of HDL has been stimulated by the discovery of novel genes and proteins, which have provided new insights into the molecular and cellular mechanisms involved in HDL metabolism. ...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章,评审

    doi:10.4067/s0034-98872005000700011

    authors: Laris Mdel R,Arteaga A,Cuevas A,Rigotti A

    更新日期:2005-07-01 00:00:00

  • [Sympathetic denervation of an extremity as a presentation form of apical lung cancer].

    abstract::We report a 56 years old male patient presenting with a sympathetic denervation of the right upper limb due to an apical lung cancer. Vasomotor paralysis of the limb was objectively documented with a contact termography. The clinical presentation of this patient was unusual, considering that the alteration occurred wi...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:

    authors: Campero M,Verdugo RJ,Stuardo A,Tenhamm E

    更新日期:1995-05-01 00:00:00

  • [Microsatellite instability among patients with colorectal cancer].

    abstract:BACKGROUND:In patients with colorectal carcinoma, insertions or deletions of short sequences of DNA, a phenomenon called microsatellite instability, are observed. AIM:To look for microsatellite instability and mutations of MLH1 and MSH2 gene mutations in patients with colorectal carcinoma. MATERIAL AND METHODS:Ten pa...

    journal_title:Revista medica de Chile

    pub_type: 杂志文章

    doi:10.4067/s0034-98872006001000002

    authors: Montenegro Y,Ramírez-Castro JL,Isaza LF,Bedoya G,Muñetón-Peña CM

    更新日期:2006-10-01 00:00:00