Yale Studies of Patient Care : I. The Evaluation of the Febrile Patient 2

Observations are reported on the variation in evaluation and management of 216 episodes of fever in 690 patients on four services of a university hospital. Twenty-two percent of febrile episodes were not commented upon in the medical record. Thirty percent of all fevers and 14% of antibiotic-treated fevers were not evaluated with microbiologic cultures. The extent of evaluation varied with service and varied directly with the height of the fever and the clinical recording of abnormality in temperature.     

The Anxious Patient

Anxiety appears in many disguises and mimics most other afflictions. Once the anxious patient has been recognized as such and a proper diagnosis is made, management of him is easily carried out within the framework of the medical transaction. Lack of awareness of underlying anxiety in a patient who presents with somatic complaints can lead to poor results for the patient and frustration for the physician. It is not the physician''s role to remove all anxiety. Rather, it is his mission to manage the anxious patient so as to mediate the anxiety allowing for integrated adaptive function.