Helsebibliotekets Research Archive
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Indremedisinens rolle i helsetjenesten - moderfaget som må på gamlehjem?
No full textInternal medicine is more than a hundred years old, even in Norway. Its intellectual fundament originates from nineteenth century medicine in Germany. Traditionally, these German physicians covered the entire field of medicine. However, due to lack of therapeutic remedies their main emphasis was on diagnosis and prognosis. During the last sixty years the tremendous increase in medical knowledge has led to a strong tendency towards organ specialization. The generalists in hospitals have met competition from general practitioners and specialists in geriatrics. At the same time their domain has steadily shrunk as the number of medical hospital beds has been reduced. Although not to the advantage of the patients, progress is wiping out the hospital generalists. Most (90%) hospital doctors are now organ specialists, although the majority of patients admitted to medical departments have diseases in more than one organ system. Therefore, generalists should be at least as equally appreciated as the organ specialists. To save the generalists the educational system must be changed. The two types of specialists should follow their own educational paths qualifying to separate and independent competence areas (general or organ-specific). Medical departments should be encouraged to maintain general sections in addition to the organ-specific sections. The generalist and the organ specialist should be professionally united in their efforts to develop internal medicine as a discipline
Infarktbehandling - status ved norske sykehus
No full textPresent routines for examination, treatment and follow-up of myocardial infarction were registered at all hospitals in Norway. Heparin and salicylic acid are given as standard treatment. Streptokinase is given regularly to patients with a short case-history, while beta-blockers are used mostly in secondary prevention. Patients with unstable angina pectoris are offered acute coronary by-pass operation in 90% of the hospitals. The hospitalization period is short, varying from approximately ten days for patients with large myocardial infarctions, to seven days for patients with small infarctions. Most hospitals have a progressive rehabilitation program which stimulates early discharge of the patients. In general, Norwegian hospitals follow "modern" principles in the treatment of myocardial infarction. The routines are fairly similar in small and large hospitals, and in various parts of the country
