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A Dermatologic Diary: Portrait of a Practice (Cutis. 1994;54:69-76)

Shelley WB, Shelley ED

In their June 1994 journal entries, the Shelleys travel to Tulsa, Oklahoma, for a continuing medical education course at the Oklahoma State University College of Osteopathic Medicine. Here Dr. E.D. Shelley lectured on dermatologic cases linked to foods, bugs, and drugs.

After reading the results of a survey of internists who reported they have serious concerns over the effects of practice guidelines on clinical autonomy, health care costs, and their own satisfaction with clinical practice, the Shelleys added: "Guidelines are the outlines we memorized in medical school. In the real world of medical care they often have to be displaced by intuitive, imaginative, and unconventional therapy. Our concern thus is with the effect practice guidelines will have on clinical outcomes!"

The Shelleys remark on the importance of analyzing potential offending drugs that may be the cause of photodermatitis and other drug eruptions.


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