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For more than a century, the American medical profession insisted that doctors be rigorously trained in medical science and dedicated to professional ethics. Patients revered their doctors as representatives of a sacred vocation. Do we still trust doctors with the same conviction? In Trusting Doctors, Jonathan Imber attributes the development of patients' faith in doctors to the inspiration and influence of Protestant and Catholic clergymen during the nineteenth and early twentieth centuries. He explains that as the influence of clergymen waned, and as reliance on medical technology increased, patients' trust in doctors steadily declined. Trusting Doctors discusses the emphasis that Protestant clergymen placed on the physician's vocation; the focus that Catholic moralists put on specific dilemmas faced in daily medical practice; and the loss of unchallenged authority experienced by doctors after World War II, when practitioners became valued for their technical competence rather than their personal integrity. Imber shows how the clergy gradually lost their impact in defining the physician's moral character, and how vocal critics of medicine contributed to a decline in patient confidence. The author argues that as modern medicine becomes defined by specialization, rapid medical advance, profit-driven industry, and ever more anxious patients, the future for a renewed trust in doctors will be confronted by even greater challenges. Trusting Doctors provides valuable insights into the religious underpinnings of the doctor-patient relationship and raises critical questions about the ultimate place of the medical profession in American life and culture.

AbstractSince 1995, the Government has encouraged people to establish Centre of Development and Implementation of Traditional Medicine or Sentra Pengembangan dan Penerapan Pengobatan Tradisional (SP3T) through the Ministry of Health's decree No. 0584/Menkes/SK/VI/1995. At the moment several centers have been realized and provided herbal medicine (HM) in their service. The aim of the survey was to get the picture of the perception and the usage of HM by medical doctors. Questionnaires were distributed by online system to 267 doctors. The results showed that 53% respondents were 41-55 years old, whereas 47% were 40 or younger, more than half (59%) were female. With regards to their medical specializations 29% were GPs, 18%, internists, 6% neurologists and obstetricians, and 41% other specializations. Sixty five percent respondents did not prescribe HM but 35% prescribed occasionally. Those who are not practicing or prescribing HM to their patients stated that they never learnt it (41%), were doubtful to its efficacy (41%), knew nothing about HM (29%), and were concern about the quality (18%). Although HM is relatively cheaper than modern medicine (59%), but 82% respondents stated that information on HM is lacking. They proposed that awareness about HM should be increased through seminars (88%), courses/workshops (53%), journal publication (63%), brochures and leaflets (24%), and medical representative (18%). The use of HM by respondents is mainly for non-specific diarrhea (63%), hypertension and rheumatoid arthritis (38%), hypercholesterolemia (25%) and diabetes mellitus (13%). Respondents agreed that HM should be taught in medical schools (94%) for at least one semester (60%) or two semesters (40%).Keywords: phytopharmaca, medical education, perception, herbal medicine AbstrakSesuai dengan Keputusan Menteri Kesehatan No. 0584/Menkes/SK/VI/1995, sejak 1995 Pemerintah telah menganjurkan masyarakat untuk membentuk Sentra Pengembangan dan Penerapan Pengobatan Tradisional (SP3T). Saat ini sudah ada beberapa pusat pelayanan pengobatan herba. Tujuan survei ini untuk mendapatkan gambaran tentang persepsi dan penggunaan obat herba (OH) oleh para dokter. Kuesioner disebarkan secara daring kepada 267 alumni dan non-alumni Fakultas Kedokteran UKI. Hasilnya memperlihatkan 53% responden berusia 41-55 tahun, 47% berusia sampai 40 tahun, serta 59% terdiri atas perempuan. Dari segi spesialisasi didapatkan 29% dokter umum, 18% spesialis penyakit dalam, 6% spesialis penyakit syaraf dan ahli kandungan sedangkan 41% memiliki spesialisasi lain. Enam puluh lima persen responden tidak meresepkan OH dan hanya 35% responden yang meresepkan secara tidak rutin. Hal itu karena mereka tidak pernah belajar OH (41%), tidak yakin akan efikasinya (41%), tidak tahu sama sekali tentang OH (29%) dan tidak yakin akan mutunya (18%). Meskipun OH relatif lebih murah daripada obat konvensional (59%) tapi 82% responden menyatakan informasi tentang OH sangat kurang. Mereka mengusulkan agar informasi OH ditingkatkan melalui seminar (88%), kursus/lokakarya (53%), publikasi lewat jurnal (63%), brosur dan liflet (24%) dan medical representative (18%). Penggunaan OH oleh responden terutama untuk diare non-spesifik (63%), hipertensi dan artritis reumatoid (38%), hiperkolesterolemia (25%) dan diabetes mellitus (13%). Responden setuju agar OH diajarkan di fakultas kedokteran (94%) sekurang-kurangnya satu semester (60%) atau dua semester (40%).Kata kunci: fitofarmaka, pendidikan kedokteran, persepsi, obat herba

BACKGROUND: Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. OBJECTIVE: To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. METHOD: Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teams to ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached. RESULTS: 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. CONCLUSION: A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.

We now have good information about family medicine in terms of content, principles, and practice load. Undergraduate, residency and continuing education are improving, but some family medicine programs still have limited support from their university's faculty and governments. Residency in-training assessment and the certification process are better developed than is evaluation of new family doctors' practice performance. Research in the family medicine base is expanding, and residents are increasingly involved in projects. Family medicine teachers are now on a par with other clinical faculty, because they must meet tougher criteria for appointment and promotion. The political leadership of family medicine education, shared by the College of Family Physicians of Canada and academic departments, requires strong consensus and persistent activity.

Objectives We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us.Design Questionnaire surveyParticipants 3479 contactable UK-trained medical graduates of 1993.Setting UK.Main outcome measures Comments made by doctors about their work, and their views about medical careers and training in the UK.Method Postal and email questionnaires.Results Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance.Conclusions Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.