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annual wellness exam checklist: The Rational Clinical Examination: Evidence-Based Clinical Diagnosis David L. Simel, Drummond Rennie, 2008-04-30 The ultimate guide to the evidence-based clinical encounter This book is an excellent source of supported evidence that provides useful and clinically relevant information for the busy practitioner, student, resident, or educator who wants to hone skills of physical diagnosis. It provides a tool to improve patient care by using the history and physical examination items that have the most reliability and efficiency.--Annals of Internal Medicine The evidence-based examination techniques put forth by Rational Clinical Examination is the sort that can be brought to bear on a daily basis – to save time, increase confidence in medical decisions, and help decrease unnecessary testing for conditions that do not require absolute diagnostic certainty. In the end, the whole of this book is greater than its parts and can serve as a worthy companion to a traditional manual of physical examination.--Baylor University Medical Center (BUMC)Proceedings 5 STAR DOODY'S REVIEW! Physical diagnosis has been taught to every medical student but this evidence-based approach now shows us why, presenting one of medicine's most basic tenets in a new and challenging light. The format is extraordinary, taking previously published material and updating the pertinent evidence since the initial publication, affirming or questioning or refining the conclusions drawn from the data. This is a book for everyone who has studied medicine and found themselves doubting what they have been taught over the years, not that they have been deluded, but that medical traditions have been unquestionably believed because there was no evidence to believe otherwise. The authors have uncovered the truth. This extraordinary, one-of-a-kind book is a valuable addition to every medical library.--Doody's Review Service Completely updated with new literature analyses, here is a uniquely practical, clinically relevant approach to the use of evidence in the content of physical examination. Going far beyond the scope of traditional physical examination texts, this invaluable resource compiles and presents the evidence-based meanings of signs, symptoms, and results from physical examination maneuvers and other diagnostic studies. Page after page, you'll find a focus on actual clinical questions and presentations, making it an incomparably practical resource that you'll turn to again and again. Importantly, the high-yield content of The Rational Clinical Examination is significantly expanded and updated from the original JAMA articles, much of it published here for the first time. It all adds up to a definitive, ready-to-use clinical exam sourcebook that no student or clinician should be without. FEATURES Packed with updated, new, and previously unpublished information from the original JAMA articles Standardized template for every issue covered, including: Case Presentation; Why the Issue Is Clinically Important; Research and Statistical Methods Used to Find the Evidence Presented; The Sensitivity and Specificity of Each Key Result; Resolution of the Case Presentation; and the Clinical Bottom Line Completely updated with all-new literature searches and appraisals supplementing each chapter Full-color format with dynamic clinical illustrations and images Real-world focus on a specific clinical question in each chapter, reflecting the way clinicians approach the practice of evidence-based medicine More than 50 complete chapters on common and challenging clinical questions and patient presentations Also available: JAMAevidence.com, a new interactive database for the best practice of evidence based medicine |
annual wellness exam checklist: Best Care at Lower Cost Institute of Medicine, Committee on the Learning Health Care System in America, 2013-05-10 America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions. |
annual wellness exam checklist: The Medicare Handbook , 1988 |
annual wellness exam checklist: Guide for Aviation Medical Examiners , 1992 |
annual wellness exam checklist: Prime Time Marilyn Hughes Gaston, Gayle K. Porter, 2003 Today seven million African American women are living in their prime, experiencing the joys and challenges of middle age. Now, at last, here is the book that addresses ourtotalhealth needs—physical, emotional, and spiritual. Written by a distinguished physician and a clinical psychologist,Prime Timeis the first complete guide that empowers us to take charge of our lives and attain the well-being we deserve. In many ways, it’s true that we are better off today than our foremothers were: We earn more money, command more respect. Yet in spite of these advances, we still experience more chronic health problems, endure more stress, and live shorter lives than women of other races. That’s whyPrime Timeis both urgent and essential. This groundbreaking book not only lays out a detailed, practical plan for overall healing and for maintaining wellness, it also addresses the underlying attitudes and assumptions that lead so many of us to neglect ourselves and undermine our own health.Prime Timewill help you • Reframe priorities to put yourself and your own health needs first • Interpret the latest medical findings on the Big Four killers and how they affect black women in middle age • Profile your current health with worksheets, quizzes, and assessment tools • Renew sex at midlife by eliminating restricting myths and taboos and finding new paths to pleasure • Reduce anger and “attitude” that block you from attaining good health • Identify the nontraditional signs of depression and anxiety common to African American women Comprehensive, straight-talking, and grounded in science and spiritual truth,Prime Timeis at once a guide to total health in middle age and a celebration of the strength, wisdom, and beauty of African American women in their second half of life. |
annual wellness exam checklist: Geriatrics, An Issue of Physician Assistant Clinics Steven G. Johnson, 2018-09-07 This issue of Physician Assistant Clinics, devoted to Geriatrics, is guest edited by Steven D. Johnson, PA-C. Articles in this issue include: Falls and the Older Adult: Prevention and evaluation; Cognitive Decline and Dementia; Shared Medical Appointments for Older Adults; Advanced Care Planning and Physician Orders for Life-Sustaining Treatment Program (POLST); Palliative Care; Home Care; Successful Aging; Functional Assessment and Pain Management; and more! CME is also available for subscribers to the series. |
annual wellness exam checklist: Honest Aging Rosanne M. Leipzig, 2023-01-10 Your indispensable guide to taking charge of the second half of your life. From Dr. Rosanne M. Leipzig, a top doctor with more than 35 years of experience caring for older people, Honest Aging is an indispensable guide to the second half of life, describing what to expect physically, psychologically, functionally, and emotionally as you age. Leipzig, an expert in evidence-based geriatrics, highlights how 80-year-olds differ from 60-year-olds and why knowing this is important for your health. With candor, humor, and empathy, this book will provide you with the knowledge and practical advice to optimize aging. The book • helps you recognize age-related changes in your body and mind and understand what's typical with aging and what's not; • offers guidance for common health concerns, including problems with memory, energy, mood, sleep, incontinence, mobility and falls, hearing and vision, aches and pains, gastrointestinal problems, weight, and sex; • shares advice on how to make decisions about health care, driving, and where to live; • includes helpful checklists and lists of medications to prepare for doctor and hospital visits; • recommends the best technology options, such as mobility devices, emergency device systems, and more; • counters common myths about aging; and • offers resources for additional information, self-help, and support. Enriched by illustrations, patient stories, and deep dives into science and the latest research, Honest Aging gives you the tools to take control of your health and well-being as you age. |
annual wellness exam checklist: Educating Your Clients from A to Z Nan Boss, 2011 |
annual wellness exam checklist: Pathways to a Successful Accountable Care Organization Peter A. Gross, 2020-08-18 A valuable guide to starting and running a successful accountable care organization. Health care in America is undergoing great change. Soon, accountable care organizations—health care organizations that tie provider reimbursements to quality metrics and reductions in the cost of care—will be ubiquitous. But how do you set up an ACO? How does an ACO function? And what are the keys to creating a profitable ACO? Pathways to a Successful Accountable Care Organization will help guide you through the complicated process of establishing and running an ACO. Peter A. Gross, MD, who has firsthand experience as the chairman of a successful ACO, breaks down how he did it and describes the pitfalls he discovered along the way. In-depth essays by a group of expert authors touch on • the essential ingredients of a successful ACO • monitoring and submitting Group Practice Reporting Option quality measures • mastering your patients' responses to the Consumer Assessment of Health Plans Survey • how bundled payments and CPC+ can meld with your ACO • how MACRA and MIPS affect your ACO • the role of an ACO/CIN • the complexities of post-acute care • data analytics • engaging and integrating physician practices Dr. Gross and his colleagues are in a perfect position to guide other health care leaders through the ACO process while also providing excellent case studies for policy professionals who are interested in how their work influences health care delivery. Readers will come away with the necessary knowledge to thrive and be rewarded with cost savings. Contributors: Joshua Bennett, Allison Brennan, Glen Champlin, Kris Corwin, Guy D'Andrea, Joseph F. Damore, Mitchel Easton, Andy Edeburn, Seth Edwards, Jennifer Gasperini, Kris Gates, Shawn Griffin, Peter A. Gross, Brent Hardaway, Mark Hiller, Beth Ireton, Thomas Kloos, Jeremy Mathis, Miriam McKisic, Morey Menacker, Denise Patriaco, Elyse Pegler, John Pitsikoulis, Michael Schweitzer, Bryan F. Smith |
annual wellness exam checklist: Fair Play Eve Rodsky, 2021-01-05 AN INSTANT NEW YORK TIMES BESTSELLER • A REESE'S BOOK CLUB PICK Tired, stressed, and in need of more help from your partner? Imagine running your household (and life!) in a new way... It started with the Sh*t I Do List. Tired of being the “shefault” parent responsible for all aspects of her busy household, Eve Rodsky counted up all the unpaid, invisible work she was doing for her family—and then sent that list to her husband, asking for things to change. His response was...underwhelming. Rodsky realized that simply identifying the issue of unequal labor on the home front wasn't enough: She needed a solution to this universal problem. Her sanity, identity, career, and marriage depended on it. The result is Fair Play: a time- and anxiety-saving system that offers couples a completely new way to divvy up domestic responsibilities. Rodsky interviewed more than five hundred men and women from all walks of life to figure out what the invisible work in a family actually entails and how to get it all done efficiently. With 4 easy-to-follow rules, 100 household tasks, and a series of conversation starters for you and your partner, Fair Play helps you prioritize what's important to your family and who should take the lead on every chore, from laundry to homework to dinner. “Winning” this game means rebalancing your home life, reigniting your relationship with your significant other, and reclaiming your Unicorn Space—the time to develop the skills and passions that keep you interested and interesting. Stop drowning in to-dos and lose some of that invisible workload that's pulling you down. Are you ready to try Fair Play? Let's deal you in. |
annual wellness exam checklist: Clinical Case Studies for the Family Nurse Practitioner Leslie Neal-Boylan, 2011-11-28 Clinical Case Studies for the Family Nurse Practitioner is a key resource for advanced practice nurses and graduate students seeking to test their skills in assessing, diagnosing, and managing cases in family and primary care. Composed of more than 70 cases ranging from common to unique, the book compiles years of experience from experts in the field. It is organized chronologically, presenting cases from neonatal to geriatric care in a standard approach built on the SOAP format. This includes differential diagnosis and a series of critical thinking questions ideal for self-assessment or classroom use. |
annual wellness exam checklist: Selected Practice Recommendations for Contraceptive Use World Health Organization. Reproductive Health and Research, World Health Organization, World Health Organization. Family and Community Health, 2005 This document is one of two evidence-based cornerstones of the World Health Organization's (WHO) new initiative to develop and implement evidence-based guidelines for family planning. The first cornerstone, the Medical eligibility criteria for contraceptive use (third edition) published in 2004, provides guidance for who can use contraceptive methods safely. This document, the Selected practice recommendations for contraceptive use (second edition), provides guidance for how to use contraceptive methods safely and effectively once they are deemed to be medically appropriate. The recommendations contained in this document are the product of a process that culminated in an expert Working Group meeting held at the World Health Organization, Geneva, 13-16 April 2004. |
annual wellness exam checklist: Everyone's Guide to Cancer Therapy Malin Dollinger, Ernest H. Rosenbaum, Greg Cable, 1991 Provides information on how cancer is diagnosed, treated, and managed day to day. |
annual wellness exam checklist: The Cambridge Examination for Mental Disorders of the Elderly: CAMDEX Martin Roth, F. A. Huppert, E. Tym, C. Q. Mountjoy, A. Diffident-Brown, D. J. Shoesmith, 1988-10-27 |
annual wellness exam checklist: Medical and Dental Expenses , 1990 |
annual wellness exam checklist: The Real Life Body Book Hope Ricciotti, Monique Doyle Spencer, 2010-11-24 When you have questions about your health, you want answers from a trustworthy source. In The Real Life Body Book, a Harvard ob-gyn has joined forces with a humor writer to explain the full range of health issues facing young women today. This comprehensive and authoritative guide focuses on whole body wellness and prevention, from the skin (acne, piercing, tattooing) and the head (mental health, hormones, stress) to the bones, heart, and stomach (diet and digestion), plus sex and reproductive wellness. If you’re between the ages of twenty-one and thirty-five and you want the latest facts about your health in a language you can understand, The Real Life Body Book is the go-to resource for keeping your body healthy today and for the rest of your life. |
annual wellness exam checklist: Nutrition-Focused Physical Exam Peggy Hipskind, Marianne Galang, Andrea K. JeVenn, Cassie Pogatschnik, 2017-02 |
annual wellness exam checklist: Evidence-Based Physical Examination Kate Sustersic Gawlik, DNP, APRN-CNP, FAANP, Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, Alice M. Teall, DNP, APRN-CNP, FAANP, 2020-01-27 The first book to teach physical assessment techniques based on evidence and clinical relevance. Grounded in an empirical approach to history-taking and physical assessment techniques, this text for healthcare clinicians and students focuses on patient well-being and health promotion. It is based on an analysis of current evidence, up-to-date guidelines, and best-practice recommendations. It underscores the evidence, acceptability, and clinical relevance behind physical assessment techniques. Evidence-Based Physical Examination offers the unique perspective of teaching both a holistic and a scientific approach to assessment. Chapters are consistently structured for ease of use and include anatomy and physiology, key history questions and considerations, physical examination, laboratory considerations, imaging considerations, evidence-based practice recommendations, and differential diagnoses related to normal and abnormal findings. Case studies, clinical pearls, and key takeaways aid retention, while abundant illustrations, photographic images, and videos demonstrate history-taking and assessment techniques. Instructor resources include PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank. This is the physical assessment text of the future. Key Features: Delivers the evidence, acceptability, and clinical relevance behind history-taking and assessment techniques Eschews “traditional” techniques that do not demonstrate evidence-based reliability Focuses on the most current clinical guidelines and recommendations from resources such as the U.S. Preventive Services Task Force Focuses on the use of modern technology for assessment Aids retention through case studies, clinical pearls, and key takeaways Demonstrates techniques with abundant illustrations, photographic images, and videos Includes robust instructor resources: PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank Purchase includes digital access for use on most mobile devices or computers |
annual wellness exam checklist: E/M Auditing Step - E-Book Carol J. Buck, 2012-12-14 Building your skills as a professional coder and auditor, E/M Auditing Step, 3rd Edition provides a thorough review of the 17 Evaluation and Management (E/M) subsections presented in the Current Procedural Terminology (CPT) manual. Real-life scenarios let you practice coding with cases taken from actual documentation. An outline format includes plenty of practice questions, making it easy to review and prepare for E/M certification exams. Written by coding author and educator Carol J. Buck, this edition covers both ICD-9 and ICD-10 code sets, and helps you gain the accuracy and proficiency you need for success in auditing records and in E/M coding. - A convenient outline format provides easy-to-follow, efficient coverage of E/M coding. - An introduction to E/M coding describes how to fill out the main audit form used in the book, then breaks down each of the 17 E/M CPT subsections separately. - Follow-up questions and reports test your comprehension of the E/M subsections and allow you to build confidence. - An examination with answers prepares you for the professional environment with 17 real-life cases covering E/M codes. - 1995 and 1997 E/M Documentation Guidelines, along with an Internet Only Manual, provide a quick reference to all E/M coding variations. - Useful appendices include answers to Unit 1 questions and the Unit 2 exam, blank audit forms for practice, abbreviations, and additional resources. - UPDATED content lets you practice using the 2013 code sets. - Dual coding includes answers for both ICD-9 and ICD-10, preparing you for the diagnosis coding sets of both today and tomorrow. |
annual wellness exam checklist: NIH MedlinePlus , 2013 |
annual wellness exam checklist: Ask a Manager Alison Green, 2018-05-01 From the creator of the popular website Ask a Manager and New York’s work-advice columnist comes a witty, practical guide to 200 difficult professional conversations—featuring all-new advice! There’s a reason Alison Green has been called “the Dear Abby of the work world.” Ten years as a workplace-advice columnist have taught her that people avoid awkward conversations in the office because they simply don’t know what to say. Thankfully, Green does—and in this incredibly helpful book, she tackles the tough discussions you may need to have during your career. You’ll learn what to say when • coworkers push their work on you—then take credit for it • you accidentally trash-talk someone in an email then hit “reply all” • you’re being micromanaged—or not being managed at all • you catch a colleague in a lie • your boss seems unhappy with your work • your cubemate’s loud speakerphone is making you homicidal • you got drunk at the holiday party Praise for Ask a Manager “A must-read for anyone who works . . . [Alison Green’s] advice boils down to the idea that you should be professional (even when others are not) and that communicating in a straightforward manner with candor and kindness will get you far, no matter where you work.”—Booklist (starred review) “The author’s friendly, warm, no-nonsense writing is a pleasure to read, and her advice can be widely applied to relationships in all areas of readers’ lives. Ideal for anyone new to the job market or new to management, or anyone hoping to improve their work experience.”—Library Journal (starred review) “I am a huge fan of Alison Green’s Ask a Manager column. This book is even better. It teaches us how to deal with many of the most vexing big and little problems in our workplaces—and to do so with grace, confidence, and a sense of humor.”—Robert Sutton, Stanford professor and author of The No Asshole Rule and The Asshole Survival Guide “Ask a Manager is the ultimate playbook for navigating the traditional workforce in a diplomatic but firm way.”—Erin Lowry, author of Broke Millennial: Stop Scraping By and Get Your Financial Life Together |
annual wellness exam checklist: The Improvement Guide Gerald J. Langley, Ronald D. Moen, Kevin M. Nolan, Thomas W. Nolan, Clifford L. Norman, Lloyd P. Provost, 2009-06-03 This new edition of this bestselling guide offers an integrated approach to process improvement that delivers quick and substantial results in quality and productivity in diverse settings. The authors explore their Model for Improvement that worked with international improvement efforts at multinational companies as well as in different industries such as healthcare and public agencies. This edition includes new information that shows how to accelerate improvement by spreading changes across multiple sites. The book presents a practical tool kit of ideas, examples, and applications. |
annual wellness exam checklist: Males With Eating Disorders Arnold E. Andersen, 2014-06-17 First published in 1990. The subject of anorexia nervosa and, more recently, bulimia nervosa in males has been a source of interest and controversy in the fields of psychiatry and medicine for more than 300 years. These disorders, sometimes called eating disorders, raise basic questions concerning the nature of abnormalities of the motivated behaviors: Are they subsets of more widely recognized illnesses such as mood disorders? Are they understandable by reference to underlying abnormalities of biochemistry or brain function? In what ways are they similar to and in what ways do they differ from anorexia nervosa and bulimia nervosa in females? This book will be of interest to a wide variety of people—physicians, psychologists, nurses, social workers, occupational therapists, nutritionists, educators, and all others who may be interested for personal or professional reasons. |
annual wellness exam checklist: The Oxford Handbook of Work and Aging Jerry W. Hedge, Walter C. Borman, 2012-04-19 Global aging, technological advances, and financial pressures on health and pension systems are sure to influence future patterns of work and retirement. This handbook offers an international, multi-disciplinary perspective, examining the aging workforce from an individual worker, organization, and societal perspective. |
annual wellness exam checklist: What to Expect: The Second Year Heidi Murkoff, 2012-03-01 The international super-successful What to Expectbrand has delivered again - announcing the arrival of a brand-new member of family: What to Expect the Second Year. This essential sequel to What to Expect the First Year picks up the action at baby's first birthday, and takes parents through what can only be called 'the wonder year' - 12 jam-packed (and jam-smeared) months of memorable milestones (from first steps to first words, first scribbles to first friends), lightning-speed learning, endless explorations driven by insatiable curiosity. Not to mention a year of challenges, both for toddlers and the parents who love them, but don't always love their behaviour (picky eating, negativity, separation anxiety, bedtime battles, biting, and tantrums). Comprehensive, reassuring, empathetic, realistic and practical, What to Expect the Second Yearis filled with solutions, strategies, and plenty of parental pep talks. It helps parents decode the fascinating, complicated, sometimes maddening, always adorable little person last year's baby has become. From the first birthday to the second, this must-have book covers everything parents need to know in an easy-to-access, topic-by-topic format, with chapters on growth, feeding, sleeping, behaviours of every conceivable kind, discipline (including teaching right from wrong), and keeping a toddler healthy and safe as he or she takes on the world. There's a developmental time line of the second year plus special 'milestone' boxes throughout that help parents keep track of their toddler's development. Thinking of travelling with tot in tow? There's a chapter for that, too. |
annual wellness exam checklist: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system. |
annual wellness exam checklist: Patient Safety and Quality Ronda Hughes, 2008 Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043). - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/ |
annual wellness exam checklist: Cancer Nursing Connie Yarbro, Debra Wujcik, Barbara Holmes Gobel, 2011 A new and revised version of this best-selling reference! For over eighteen years, best-selling Cancer Nursing: Principles and Practice has provided oncology nurses with the latest information on new trends in the rapidly changing science of oncology. Now, in its Seventh Edition, Cancer Nursing has been completely revised and updated to reflect key new developments. New topics covered include targeted therapy, hypersensitivity reactions, mucositis, and family and caregiver issues. With 27 new chapters featuring insights from key authors, the Seventh Edition is a must-have resource for every oncology nurse. |
annual wellness exam checklist: Never Saw It Coming Karen A. Cerulo, 2008-09-15 People—especially Americans—are by and large optimists. They're much better at imagining best-case scenarios (I could win the lottery!) than worst-case scenarios (A hurricane could destroy my neighborhood!). This is true not just of their approach to imagining the future, but of their memories as well: people are better able to describe the best moments of their lives than they are the worst. Though there are psychological reasons for this phenomenon, Karen A.Cerulo, in Never Saw It Coming, considers instead the role of society in fostering this attitude. What kinds of communities develop this pattern of thought, which do not, and what does that say about human ability to evaluate possible outcomes of decisions and events? Cerulo takes readers to diverse realms of experience, including intimate family relationships, key transitions in our lives, the places we work and play, and the boardrooms of organizations and bureaucracies. Using interviews, surveys, artistic and fictional accounts, media reports, historical data, and official records, she illuminates one of the most common, yet least studied, of human traits—a blatant disregard for worst-case scenarios. Never Saw It Coming, therefore, will be crucial to anyone who wants to understand human attempts to picture or plan the future. “In Never Saw It Coming, Karen Cerulo argues that in American society there is a ‘positive symmetry,’ a tendency to focus on and exaggerate the best, the winner, the most optimistic outcome and outlook. Thus, the conceptions of the worst are underdeveloped and elided. Naturally, as she masterfully outlines, there are dramatic consequences to this characterological inability to imagine and prepare for the worst, as the failure to heed memos leading up to both the 9/11 and NASA Challenger disasters, for instance, so painfully reminded us.”--Robin Wagner-Pacifici, Swarthmore College “Katrina, 9/11, and the War in Iraq—all demonstrate the costliness of failing to anticipate worst-case scenarios. Never Saw It Coming explains why it is so hard to do so: adaptive behavior hard-wired into human cognition is complemented and reinforced by cultural practices, which are in turn institutionalized in the rules and structures of formal organizations. But Karen Cerulo doesn’t just diagnose the problem; she uses case studies of settings in which people effectively anticipate and deal with potential disaster to describe structural solutions to the chronic dilemmas she describes so well. Never Saw It Coming is a powerful contribution to the emerging fields of cognitive and moral sociology.”--Paul DiMaggio, Princeton University |
annual wellness exam checklist: Retooling for an Aging America Institute of Medicine, Board on Health Care Services, Committee on the Future Health Care Workforce for Older Americans, 2008-08-27 As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs. |
annual wellness exam checklist: Age-Friendly Health Systems Terry Fulmer, Leslie Pelton, Jinghan Zhang, 2022-02 According to the US Census Bureau, the US population aged 65+ years is expected to nearly double over the next 30 years, from 43.1 million in 2012 to an estimated 83.7 million in 2050. These demographic advances, however extraordinary, have left our health systems behind as they struggle to reliably provide evidence-based practice to every older adult at every care interaction. Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA), designed Age-Friendly Health Systems to meet this challenge head on. Age-Friendly Health Systems aim to: Follow an essential set of evidence-based practices; Cause no harm; and Align with What Matters to the older adult and their family caregivers. |
annual wellness exam checklist: Ham's Primary Care Geriatrics Richard J. Ham, Philip D. Sloane, 2013-12-01 Employing a unique case-based approach, Ham's Primary Care Geriatrics continues to be your comprehensive source of clinical solutions for this challenging population. This gerontology medical reference book features an interdisciplinary perspective that empowers you with team-oriented knowledge on the best diagnosis, treatment, and management strategies available to address the complex needs of older adults.Overall this is a useful, well written, practical elderly medicine book, ideal for use in primary care. It is reasonable priced and an excellent addition to the bookshelf, virtual or real.Reviewed by: Dr Harry Brown, July 2014 Effectively treat your geriatric patients, and provide helpful guidance to their families, through engaging geriatric case studies that illustrate the principles and key clinical information you need. Form a definitive diagnosis and create the best treatment plans possible using the evidence-based medicine guidelines throughout. Find the information you need quickly and efficiently with a 2-color layout and consistent format, and test your knowledge with USMLE-style questions in every chapter. Offer your geriatric patients the most up-to-date treatment options available with six new chapters addressing Principles of Primary Care of Older Adults, Interprofessional Team Care, Billing and Coding, Frailty, Pressure Ulcers, and Anemia. Access the complete geriatric text online anytime, anywhere at Expert Consult, along with an online Cognitive Status Assessment with four tests and patient teaching guides, a dermatology quiz, and informative videos on Gait and Balance and Dizziness. |
annual wellness exam checklist: Guidelines for Perinatal Care American Academy of Pediatrics, American College of Obstetricians and Gynecologists, 1997 This guide has been developed jointly by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, and is designed for use by all personnel involved in the care of pregnant women, their foetuses, and their neonates. |
annual wellness exam checklist: Addiction Treatment Matching David R. Gastfriend, 2004 Also appearing as Journal of Addictive Diseases, v. 22, supplement number 1 (2003), this book contains ten research studies by experts in mental health and addiction services. It specifically examines the ASAM Patient Placement Criteria, with an eye toward its effect on health plans, treatment programs, and patients. The editor is a medical doctor affiliated with the addiction research program at Massachusetts General Hospital and a professor at Harvard Medical School. Annotation : 2004 Book News, Inc., Portland, OR (booknews.com). |
annual wellness exam checklist: Comprehensive Review for the NCLEX-PN® Examination - E-Book HESI, 2022-10-11 HESI Comprehensive Review for the NCLEX-PN® Examination, 7th Edition provides a complete, all-in-one review of the information that you need to know. Written in an easy-to-read outline format, this study guide reviews content by concepts and clinical areas. Along the way, valuable tips from HESI® help you apply principles of clinical decision-making and clinical judgment. With almost 1,000 practice questions in both study and exam formats, the companion Evolve website enables you to practice test-taking in the same electronic format you will experience on nursing school exit exams and on the NCLEX-PN exam. - HESI Hint boxes spotlight important clinical information and concepts commonly tested on the NCLEX-PN® exam. - Chapters organized by clinical area enable you to easily search for various topics to review. - Clinical judgment study questions with rationales reinforce key concepts and content. - Consistent format and chapter organization make it easy to move between topics when reviewing. - UPDATED! Content incorporates clinical updates and reflects the latest NCLEX-PN® test plan. - UPDATED! Enhanced Evolve companion website with over 100 new questions for the NGN and almost 900 review questions for the NCLEX provides you with additional test-taking practice. - NEW! Illustrated NCSBN Clinical Judgment Measurement Model with corresponding Test-Taking Strategies highlight how to apply clinical judgment. - NEW! Questions for the Next-Generation NCLEX® (NGN) prepare you for the biggest change to the NCLEX-PN® test plan to date. - NEW! All-new editorial board rejuvenates this classic text with fresh perspectives and expertise to make a great book even better. |
annual wellness exam checklist: The Beginner’s Guide to Raising Goats Amber Bradshaw, 2020-07-14 Make bucks (and plenty of kids) by raising goats. Whether you're looking to be self-sufficient, or you want to make some money on the side, goats are perfect for milk and cheese, meat, and fiber. Taking care of goats could be your newest summer activity. The Beginner's Guide to Raising Goats can help you get the most out of these hearty herd animals with step-by-step instructions and easy-to-follow tips for newcomers. From Angoras to Nigerian Dwarfs, this beginner's guide to raising goats will break down the dos and don'ts to starting your herd. Learn how to pick the right kind of goat for your homestead's needs, build fences and shelters, feed and breed them, and more. Raising goats can be a wonderful adventure in family fun this summer, that not only teaches valuable life skills to the younger ones but also delivers a valuable resource to your table. There's even a recipe section in the back that shows you how to use their fresh meat and milk to make tasty home-cooked meals like Goat Chili and Goat Mac N' Cheese. The Beginner's Guide to Raising Goats features: Goats 101—Discover an in-depth overview that gives you everything you need to know about raising goats. Share your bounty—Explore practical tips that show you how to start a side business selling goat milk, cheese, and meat. Dollars & sense—Get a cost estimate and approximate timelines for raising animals, making dairy products, and selling them for profit. Learn how goats can help create a more sustainable life with this essential beginner's guide. |
annual wellness exam checklist: Goldman-Cecil Medicine E-Book Lee Goldman, Kathleen A. Cooney, 2023-07-15 For more than 95 years, Goldman-Cecil Medicine has been the authoritative source for internal medicine and the care of adult patients. Every chapter is written by acclaimed experts who, with the oversight of our editors, provide definitive, unbiased advice on the diagnosis and treatment of thousands of common and uncommon conditions, always guided by an understanding of the epidemiology and pathobiology, as well as the latest medical literature. But Goldman-Cecil Medicine is not just a textbook. It is designed to optimize electronic searches that will rapidly take you to exactly the information you are seeking. Throughout the lifetime of each edition, periodic updates continually include the newest information from a wide range of journals. Furthermore, Goldman-Cecil Medicine is available for all users of ClinicalKey, Elsevier's full library of subspecialty textbooks that can be accessed by readers who may want even more in-depth information. - More than 400 chapters authored by a veritable Who's Who of modern medicine - A practical, templated organization with an emphasis on up-to-date, evidence-based references - New chapters on Population Health, Effects of Climate Change on Health, Bradycardias, Transgender Medicine, Whipple Disease, COVID-19 Virology and Pathobiology, COVID-19 Epidemiology/Clinical Manifestations/Diagnosis/Community Prevention, COVID-19 Treatment and Vaccination, Polyomaviruses, and more - Thousands of algorithms, figures, and tables that make its information readily accessible - Over 100 supplementary videos, heart sounds, and key references - Available in print and on a variety of electronic devices - Continuously updated by Lee Goldman, MD - An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. |
annual wellness exam checklist: CPT 2015 American Medical Association, 2014 This codebook helps professionals remain compliant with annual CPT code set changes and is the AMAs official coding resource for procedural coding rules and guidelines. Designed to help improve CPT code competency and help professionals comply with current CPT code changes, it can help enable them to submit accurate procedural claims. |
annual wellness exam checklist: Bright Futures American Academy of Pediatrics, 2017 This essential resource provides key background information and recommendations for 12 health promotion themes, including 3 brand-new topics : promoting lifelong health for families and communities, promoting health for children and youth with special health care needs, and promoting the healthy and safe use of social media. Also included in this essential resource are well-child supervision standards for 31 age-based visits, from newborn through 21 years. The result : more efficient visits, stronger partnerships with children and families, and enhanced ability to keep up with changes in family, communities, and society that affect a child's health.--Page 4 de la couverture. |
annual wellness exam checklist: CPT 2021 Professional Edition American Medical Association, 2020-09-17 CPT® 2021 Professional Edition is the definitive AMA-authored resource to help health care professionals correctly report and bill medical procedures and services. Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, everchanging standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly. FEATURES AND BENEFITS The CPT® 2021 Professional Edition codebook covers hundreds of code, guideline and text changes and features: CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations -- provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set E/M 2021 code changes - gives guidelines on the updated codes for office or other outpatient and prolonged services section incorporated A comprehensive index -- aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Anatomical and procedural illustrations -- help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section -- improve your understanding of the nuances of the code set Enhanced codebook table of contents -- allows users to perform a quick search of the codebook's entire content without being in a specific section Section-specific table of contents -- provides users with a tool to navigate more effectively through each section's codes Summary of additions, deletions and revisions -- provides a quick reference to 2020 changes without having to refer to previous editions Multiple appendices -- offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families, multianalyte assays and telemedicine services Comprehensive E/M code selection tables -- aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs -- allow you to flag those sections and pages most relevant to your work More full color procedural illustrations Notes pages at the end of every code set section and subsection |
Annual Credit Report.com - Home Page
Get a free copy of your credit report every 12 months from each credit reporting company. Ensure that the information on all of your credit reports is correct and up to date.
ANNUAL Definition & Meaning - Merriam-Webster
The meaning of ANNUAL is covering the period of a year. How to use annual in a sentence.
ANNUAL | English meaning - Cambridge Dictionary
ANNUAL definition: 1. happening once every year: 2. relating to a period of one year: 3. a book or magazine…. Learn more.
ANNUAL Definition & Meaning | Dictionary.com
Annual definition: of, for, or pertaining to a year; yearly.. See examples of ANNUAL used in a sentence.
ANNUAL definition and meaning | Collins English Dictionary
An annual is a book or magazine that is published once a year. I looked for Wyman's picture in my high-school annual. He tried the various almanacs, annuals and gazettes which were held in …
annual adjective - Definition, pictures, pronunciation and ...
Definition of annual adjective in Oxford Advanced Learner's Dictionary. Meaning, pronunciation, picture, example sentences, grammar, usage notes, synonyms and more.
Anual or Annual – Which is Correct? - Two Minute English
Apr 19, 2025 · Here "annual" describes events or publications that occur once every year. Let’s look at some more examples: The organization holds an annual general meeting. Many people …
Annual - definition of annual by The Free Dictionary
Define annual. annual synonyms, annual pronunciation, annual translation, English dictionary definition of annual. adj. 1. Recurring, done, or performed every year; yearly: an annual …
annual - Wiktionary, the free dictionary
Apr 7, 2025 · annual (plural annuals) An annual publication; a book, periodical, journal, report, comic book, yearbook, etc., which is published serially once a year, which may or may not be …
Annual Definition & Meaning - YourDictionary
Annual definition: Recurring, done, or performed every year; yearly.
Adult health checklist – Make preventive care a priority
Adult health checklist Make preventive care a priority Take control of your health today for a healthier tomorrow. Use this checklist to keep screenings and . visits top of mind. Preventive …
Pediatric Wellness Visit Checklist - Human Resources
Oct 15, 2019 · Frequent wellness visits due to rapid growth and change Weight, height, and head circumference until 2 then BMI annually Newborn hearing screen and follow-up as needed …
Annual Care Checklist - NMRHCA
Exam to detect diabetes-related issues for eyes Exam to detect diabetes-related issues for feet Hemoglobin A1c (HbA1c) LDL cholesterol Statin medication, if clinically appropriate Urine test …
2025 Preventive Schedule - Highmark
Pelvic Exam Screening (including clinical breast exam) • Once a year as part of Pap/pelvic exam Colorectal Cancer Screening (including colonoscopy) • Ages 45 and older: Every 1–10 years, …
Medicare Wellness Visits Frequently-Asked Questions
8. How are the Welcome to Medicare Visit and the Annual Wellness Visit different from a yearly physical? An annual physical is a much more extensive examination than the Welcome to …
Annual care checklist - Aetna
Annual care checklist Please discuss these important topics with your health care provider Any problems with balance and falling Concerns about feeling down, your mental wellness and …
Medicare Wellness Visits
A N N U A L W E L L N E S S V I S I T ( AW V ) H E A LT H R I S K A S S E S S M E N T ( H R A ) The AWV includes a HRA. The following table includes a summary of the minimum elements …
Medicare Visita anual de bienestar Evaluación de riesgos de …
Medicare Annual Wellness Visit HRA (SPANISH, Rev.2, August 1, 2022) 1 Medicare – Visita anual de bienestar Medicare Annual Wellness Visit (Spanish) Nombre /Name _____ Marque …
Annual Wellness Visit Playbook
Scheduling a patient for an Annual Wellness Visit. 11 • Flowchart for scheduling an AWV. • Scripting examples for schedulers. Preparing for an Annual Wellness Visit (pre-visit planning). …
PREVENTIVE HEALTH SCREENINGS, BY AGE
Screening includes a physical exam and PSA blood test. Frequency determined by physician based on personal risk. Anyone who has smoked the equivalent of one pack a day for 20 …
Medicare Initial Annual Wellness Visit - UW Medicine
Medicare Initial Annual Wellness Visit . 1 | Page . Name _____ Birthdate_____ Please fill out the following questionnaire. It will allow the provider to focus on your main concerns during the …
Annual Wellness Exam - Carepatron
Annual Wellness Exam Date of assessment: _____ Patient information Name: Date of birth: Age: Gender: Height: Weight: Contact information: Health risk assessment ... Breast exam Pelvic …
Medicare Annual Wellness Visit Questionnaire
Medicare Annual Wellness Visit Questionnaire Hearing Loss Screening Do you have trouble hearing the TV or Radio? Do you have trouble understanding conversations? Function/Fall …
Wellness Guide Live Heal - webstatic.bcbsms.com
an annual wellness visit with your Healthy You! Network Provider. This wellness benefit is paid at 100% with no deductible, copay or coinsurance when you use your Healthy You! Network …
Medicare Preventive Services
Sep 15, 2021 · Annual Wellness Visit. 9/15/2021. 2355_0821 . Today’s Presenters. 2 Arlene Dunphy, CPC Provider Outreach and Education Consultant ... • Includes brief written plan …
ANNUAL WELLNESS CHECKLIST
ANNUAL WELLNESS CHECKLIST Your annual wellness visit is a great way to create and stay on track with your care plan. At this visit, your ... Dilated ey e exam . Kidney fun ction test …
Annual Wellness Visit Checklist - University of Texas System
Jul 31, 2024 · Eye exam and retinal exam (if needed) Hearing Dental Check this list to keep up with your wellbeing each year. Annual Wellness Visit Checklist. This document is for …
YOUR MEDICARE ANNUAL WELLNESS VISIT CHECKLIST
Retinal Eye Exam (As recommended by doctor) Medicare Recommended Preventive Screenings Recommended Vaccines YOUR MEDICARE ANNUAL WELLNESS VISIT CHECKLIST …
Medicare Wellness Visits: Initial Preventive Physical Exam …
The Initial Preventive Physical Exam (IPPE) and Annual Wellness Visit (AWV) are personalized and supportive preventive Medicare Wellness Visits provided to patients to help assess and …
Annual Wellness Visit - Humana
Annual Wellness Visit, and if you’re a Medicare member, it’s typically covered under your plan and available at no extra cost. What is an Annual Wellness Visit? While both are very important, a …
WELLNESS WISDOM - Aging Research
Create a written schedule with a checklist of recommended preventive screenings and vaccines based on your health, history, and risk factors Health Advice, Resources, and ... and …
Preventive Services Checklist - Medicare Planning
Yearly “Wellness” Visit - 1 2 mont hs af t er your “Wel come t o Medi care” prevent i ve vi si t or 12 mont hs af t er your P art B eff ect i ve dat e Abdominal Aortic Aneurysm Screening - O nce i n …
Annual Wellness Visit - Centers for Medicare & Medicaid …
Annual Wellness Visit Keywords: Annual Wellness Visit Created Date: 10/30/2020 2:35:35 PM ...
Annual Care Checklist - UnitedHealthcare
Annual Care Checklist Preventive care screening guidelines and counseling services for kids Get the care you need when you need it. Take this checklist with you to your child’s next …
arrive 20 minutes prior to your scheduled appointment, If you …
A Checklist for Your Medicare Wellness Annual Visit Please complete this checklist before seeing your doctor or nurse. Your answers will help you receive the best health care possible. 1. Are …
General Wellness Guidelines - Florida Blue
Children & Adolescents (Birth – 18 years of age) Wellness Schedule Routine Health Guide Wellness Exam and Autism/Development Behavioral Assessment Newborn up to age 3: …
Checkups, screenings, and tests help you stay healthy
Healthy checklist for adults Put your health and safety first throughout your life by staying current with shots, screenings, and exams. 2 Your doctor may recommend certain tests, depending on …
Medicare Wellness checkup - wcfamilypractice.org
Medicare Wellness checkup Please complete this checklist before seeing your doctor or nurse. Your responses will help you receive the best health and health care possible. Your name: …
TX Medicare Advantage Annual Wellness Visit Guide - Blue …
4 Annual Wellness Visit Guide Specific Minimum Coding Requirements Initial Preventive Physical Examination (G0402) 9 Qualified provider means a physician who is a doctor of medicine or …
Understanding annual physical exams and annual wellness …
date of your previous annual wellness visit. • You’re eligible to schedule your annual wellness visit when you’ve had Medicare Part B coverage for 12 months. Note: When a sign or symptom of …
Medicare Wellness: Patient Packet - Boulder Community Health
IMPORTANT: The three Medicare-created *wellness visits* are focused on wellness, risk- factor reduction, and prevention. They are not the same as a “routine physical checkup” or “routine …
Adult Preventive Health Care Schedule: Recommendations …
Adult Preventive Health Care Schedule: Recommendations from the USPSTF . -. . . in .
Annual Wellness Exam Checklist - uploads.strikinglycdn.com
Download Annual Wellness Exam Checklist pdf. Download Annual Wellness Exam Checklist doc. Certain conditions if a checklist on the awv within these levels of training each of normal or …
Medicare Annual Wellness Visit (AWV) Note Template
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PREMIERMED FAMILY AND SPORTS MEDICINE Annual …
Annual Wellness Visit (AWV) Scheduled for: Date: ____/____/_____ This visit is covered every 12 months to help you stay healthy This visit includes a review of medications/vitamins and …
The ABCs of the Initial Preventive Physical Exam and the …
Physical Exam and the Annual Wellness Visit. National Provider Call July 21, 2011. 1. Today’s Panel of Experts. Jamie Hermansen Health Insurance Specialist ... plan such as a checklist, …
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Schedule your Annual Wellness Exam today and earn a gift card through our Rewards and Incentives Program! By completing your Annual Wellness Exam, you can earn up to $100*. …
Annual Wellness Visit Checklist - The University of Texas …
Jul 31, 2024 · Eye exam and retinal exam (if needed) Hearing Dental Check this list to keep up with your wellbeing each year. Annual Wellness Visit Checklist. This document is for …
THE MEDICARE ANNUAL WELLNESS VISIT:
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2024 Annual Care Checklist - Banner Health Network
2024 Annual Care Checklist All recommendations except mammogram are from the U.S. Preventive Services Task Force. Screenings may be more frequent depending on risk factors. …
Get It Checked. - Men’s Health Month
Physical Exam Review overall health status, perform a thorough physical exam, and discuss health related topics. Blood Pressure High blood pressure (hypertension) has no symptoms, …
2024-2025 Medicare Advantage Annual Wellness Visit Guide …
4 Annual Wellness Visit Guide Specific Minimum Coding Requirements Initial Preventive Physical Examination (G0402) 9 Qualified provider means a physician who is a doctor of medicine or …
2025 Preventive Schedule - Highmark
Recommended annual services are based on a calendar year resetting January 1 of every year. Some services and their frequency may depend on your doctor’s advice. That’s why it’s …
Cheatsheets: Preventive Health Services for Older Adults
of Medicare's Annual Wellness Visit. • How often: N/A for USPSTF. Covered yearly as part of Medicare's Annual Wellness Visit. • Notes: Medicare's guide for doctors says clinicians should …
Wellness Checklist for Women - Vanderbilt Health
Schedule annual wellness visits that include personal history, physical exam, and emotional evaluation, preventative screening, and counseling. Check your blood pressure, body mass …
Wellness Checklist for Men - Vanderbilt Health
qSchedule annual wellness visits that include personal history, physical exam and emotional evaluation, preventative screening and counseling. Check your blood pressure, body mass …
Highmark Wholecare Medicare Assured Guide on Annual …
Jan 1, 2011 · Guide on Annual Wellness Visits . Overview . As of January 1, 2011 preventive services are covered by Medicare and; therefore, are a covered benefit under all ...
2024-2025 Medicare Advantage Annual Wellness Visit Guide
4 Annual Wellness Visit Guide Specific Minimum Coding Requirements Initial Preventive Physical Examination (G0402) 9 Qualified provider means a physician who is a doctor of medicine or …