notes of JFerrara http://members.tripod.com/~uncljoedoc/index.html

skills in ambulatory care
        clinical epidemiology
                incidence -     of a condition, proportion of population
                                newly affected in a specific interval of time
                prevalence-     of a condition, proportion of population 
                                affected at a particular instant of time
                sensitivity-    of a test, the percentage of affected
                                individuals that will have a positive test
                                (the true positive rate
                specificity-    of a test, the percentage of non-affected
                                individuals that will have a negative test
                                (the true negative rate)
                predictive value- posttest probability of a test.  The
                                probability that the patient will be found
                                to have a condition after having a positive
                                test for that condition (positive predictive
                                value; or found not to be affect after 
                                a negative test (negative predictive value)




        clinical pharmacology
                practical information about initiating a drug
                        modifications in dose and schedule 
                                due to age
                                due to concurrently administered drugs
                                due to diseases affecting drug metabolism
                        time interval for effects of drug to be apparent
                        duration of the course of a drug (when not maintenance)
                        how to assess impact of the drug
                        potential interaction with concurrent drugs
                        the cost of the drug and ability of patient to pay 
                side effects, 
                        timing- when to anticipate them
                        management

                reasons for inadequate response to the medication
                        nonadherence
                        insufficient dose
                        antagonism by patient's behavior or concurrent drugs
                        primary refractoriness to the drug
                        recognition and management of these problems
        communication skills
                interview and history taking skills
                patient education
        record keeping
                social profile
                problem list
                preventive care profile (risk factors...)
                progress notes

        coordination of care
                explain tests and procedures and referrals to patient
                explain reason for referral to consultant
                
        containing costs

from PRINCIPLES OF AMBULATORY CARE Barker third ed.