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Out of PracticeFighting for Primary Care Medicine in America$
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Frederick M. MD Barken

Print publication date: 2011

Print ISBN-13: 9780801449765

Published to Cornell Scholarship Online: August 2016

DOI: 10.7591/cornell/9780801449765.001.0001

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Out of Practice

Frederick M. Barken

Cornell University Press

This chapter discusses the prospects for primary care provided to patients with mild cognitive impairment (MCI). People with MCI have more than a benign degree of forgetfulness, yet they are not truly demented. They are not quite right either. Compared with a person who is level-headed, a patient with MCI is “a bubble off.” The chapter reflects on the future of primary care, and especially geriatric care, for people with MCI. The chapter predicts that the primary care physician's job will become much harder than it is already. It argues that it is the alteration of a patient's personality that makes primary care of the elderly with MCI or mild dementia so difficult. The chapter presents a number of examples to show that it is the earliest phase of cognitive dysfunction that proves the most distressing and challenging for both families and physicians. Finally, it asks whether there can be a relationship between a severely demented patient and his physician.

Keywords:   primary care, patients, mild cognitive impairment, geriatric care, dementia, cognitive dysfunction, physicians

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