[Shadowing as a pedagogical method for teaching interprofessional collaboration].

Shadowing enables us to follow individuals on a daily basis without disrupting the normal course of their activities. During their final year externship in a family doctor's practice, medical students from the University of Lausanne meet a patient at home and observe other professionals, thus enriching their understanding of collaborative practice. This approach fosters understanding of roles, teamwork and reflection on professional positioning.

[Sex and gender issues in the organisation of tomorrow's medicine].

Medicine is evolving with increasing feminization and the rise of part-time work. Women now outnumber men among graduates but are underrepresented in leadership roles and in the highest-paid specialties. To meet these economic and organisational challenges, this article proposes a number of courses of action.

[The prescription: messenger between the person, the doctor's office, the nursing and pharmacy teams].

Interprofessional collaboration is essential to enhance quality of care and patient safety. It is clearly defined and requires the following 6 competencies: role clarification, teamwork, interprofessional conflict resolution, collaborative leadership, interprofessional communication and patient/client/family/community-centered care. Through different variations of a clinical scenario in primary care, we propose to demonstrate the importance of putting these skills into practice and to analyze the opportunities to reflect on the different types of interprofessional interactions depending on the complexity of the situation.

Sex/gender bias in the management of chest pain in ambulatory care.

Objective: Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex differences in the management of chest pain in ambulatory care.

Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences.

A physician who communicates in a patient-centered way is a physician who adapts his or her communication style to what each patient needs. In order to do so, the physician has to (1) accurately assess each patient's states and traits (interpersonal accuracy) and (2) possess a behavioral repertoire to choose from in order to actually adapt his or her behavior to different patients (behavioral adaptability). Physician behavioral adaptability describes the change in verbal or nonverbal behavior a physician shows when interacting with patients who have different preferences in terms of how the physician should interact with them.

[Gender and disparities: the example of tobacco smoking].

Smoking prevalence is globally five times higher among men compared to women but this gap tends to decrease. Regarding health consequences of smoking, women tend to be more vulnerable than men. They are namely more at risk to present certain lung cancers and die of cardiovascular disease.

Finding the right interactional temperature: do colder patients need more warmth in physician communication style?

Being aware of which communication style should be adopted when facing more difficult patients is important for physicians; it can help prevent patient reactions of dissatisfaction, mistrust, or non-adherence that can be detrimental to the process of care. Past research suggests that less agreeable patients are especially critical towards, and reactive to, their physician's communication style, compared to more agreeable patients. On the basis of the literature, we hypothesized that less agreeable patients would react more negatively than agreeable patients to lower levels of affiliativeness (i.

[Urinary incontinence: neither men nor women should be forgotten].

The prevalence of urinary incontinence is higher in women, but up to 40% of elderly men suffer from it. It is very important for care givers to search actively for this problem, because only half of the patients, mostly men, will seek help specifically for this symptom. The patients, who do not ask for help, mostly women, think that urinary incontinence is a normal problem while getting old and think that there is no specific treatment for it.

When physician-expressed uncertainty leads to patient dissatisfaction: a gender study.

Context: Communication guidelines often advise physicians to disclose to their patients medical uncertainty regarding the diagnosis, origin of the problem, and treatment. However, the effect of the expression of such uncertainty on patient outcomes (e.g.

[Are there differences between men and women with pain?].

An increasing number of articles are published on the differences about pain in men and women. These differences seem to be due to the sex, the biological dimension of the person, and to the gender, which is the role given to that person in a given social and culture environment. The pain prevalence is higher in women, its threshold and tolerance are lower.

[Hypertension: is the actual definition adapted to women?].

The control of blood pressure in men and women differs due to different physiological pathways. Moreover, conditions increasing the risk of hypertension, such as pre-eclampsia, exposure to oral contraceptives are specific to women. Men have a higher blood pressure than women from pubertal growth to advanced age.

[What shall I do with a patient with elevated liver tests?].

In this article you will find a short reminder on the lab tests of the hepatic function and of the hepatic diseases. It shall help treat a patient with elevated liver tests. We will distinguish between an elevation of the liver enzymes of more/equal 5x and less than 5x the norm.

[The place of the clinic in primary case--the TOPIC study].

We know very little about the importance of history and physical examination compared to the importance of paraclinical tests in the diagnostic process in primary care. To answer this question, we examined prospectively 672 consecutive patients with chest pain in primary care. We recorded the timing and the clinical characteristics of the most frequent diagnosis.

[Innovations in ambulatory care].

During 2008, we selected 8 studies of interest. It seems important to continue to treat high tension for old patients. To give a good medication against pain, to maintain activity and to reassure patient is the treatment for acute back pain; surgery for spinal stenosis has better results than other treatments at two years of evolution.

[Innovations in ambulatory care: screening, treatment and iatrogenicity].

This year we have selected six studies useful for the day to day practice. A mammography in women 40 to 49 years of age should be evaluated taking into account the patient's profile and the possible risks and benefits of this exam. In patients over 65 years of age, a systematic atrial fibrillation screening, with pulse rate measuring then ECG (if irregular beat) should be realised on a regular basis.

[Thoracic pain in primary care. Don't forget the patients without heart disease].

Thoracic pain in primary care. Don't forget the patients without heart disease Thoracic pain is a frequent medical complaint. Diagnostic and therapeutic guidelines have been developed and evaluated mostly in emergency and hospital settings.

[News in internal ambulatory medicine].

Since 2005, the chief residents of the University Outpatient Clinic of Lausanne have established a database of articles chosen from miscellaneous reviews and electronic journals and selected for their scientific value and practical usefulness. This first review is based on articles published in 2006 and covering five topics useful for the primary care physician: chronic daily headaches are frequent in women, isolated vertigo is only exceptionally a sign of stroke and a bipolar disorder must be investigated in case of depression. HIV testing in a medical setting is at present more satisfactory than rapid HIV testing at home and finally watchful waiting of inguinal hernia is possible in asymptomatic or pauci-symptomatic men.

[Is there a future for women and part-time doctors in primary care?].

We tried to understand the extent and the consequences of the feminization of medicine and of the upcoming of part-time jobs in primary care. In 2003, 52% of medical graduates are women, with an increase of 80% of women studying medicine and a decrease of 30% of men, since 1980. The women practice rather in group practices, in the cities and part-time.

A pair of monozygotic twins with anomalous pancreaticobiliary junction and pancreatitis.

The authors describe a pair of white 7-year-old monozygotic twin girls with the same anomaly of the pancreaticobiliary junction (APBJ), in whom the clinical presentation and disease evolution are slightly divergent. The pathogenesis and genetic control of the disease are discussed.