Social and economic factors in patients with coronary disease.
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Biomedical subjects
Publications and source records attributed to M Menken.
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There is a consensus that technology is not always used appropriately in many medical care situations. In this article, a social and epidemiologic approach looks beyond biomedical issues to examine short- and long-term social consequences of using newer technology, particularly as related to neurologic disease. The prevailing belief that noninvasive neurodiagnostic testing is harmless for the patient often overlooks important physical and behavioral effects. High-technology subspecialization within neurology affects the matrix of patient care as well as the character of the specialty. The principles of clinical epidemiology and social medicine can help practitioners use neurotechnology more rationally.
Sixteen Indian neurologists saw 1,850 patients over a sample 6-day working week. The average daily workload comprised 19 patients including 11 new cases. Epilepsy (27.0%), headache (19.0%) and cerebrovascular disorders (7.8%) were the commonest problems. Only 2.5% fell in the ICD-9-CM categories 780-799 consisting of symptoms, signs and ill-defined conditions. In 43% it was felt that the neurologic consult was not necessary. In the Indian setting this would suggest that emphasis should be on neurologic education of primary care physicians and internists for the appropriate utilization of limited resources.
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