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Sample records for academic family physicians

  1. Exploring family physician stress

    PubMed Central

    Lee, F. Joseph; Brown, Judith Belle; Stewart, Moira

    2009-01-01

    ABSTRACT OBJECTIVE To explore the nature of professional stress and the strategies used by family physicians to deal with this stress. DESIGN Qualitative study. SETTING Kitchener-Waterloo, Ont. PARTICIPANTS Ten key-informant family physicians. METHODS In-depth interviews were conducted with key informants. A total of 40 key informants were identified, based on selected criteria; 24 provided consent. The potential participants were rank-ordered for interviews to provide maximum variation in age, sex, and years in practice. Interviews were conducted, audiotaped, transcribed verbatim, and analyzed until thematic saturation was reached, as determined through an iterative process. This occurred after 10 in-depth interviews. Immersion and crystallization techniques were used. MAIN FINDINGS The participants described professional stresses and strategies at the personal, occupational, and health care system levels. Personal stressors included personality traits and the need to balance family and career, which were countered by biological, psychological, social, and spiritual strategies. Occupational stressors included challenging patients, high workload, time limitations, competency issues, challenges of documentation and practice management, and changing roles within the workplace. Occupational stressors were countered by strategies such as setting limits, participating in continuing medical education, soliciting support from colleagues and staff, making use of teams, improving patient-physician relationships, exploring new forms of remuneration, and scheduling appropriately. Stressors affecting the wider health care system included limited resources, imposed rules and regulations, lack of support from specialists, feeling undervalued, and financial concerns. CONCLUSION Family physicians face a multitude of challenges at personal, occupational, and health care system levels. A systems approach provides a new framework in which proactive strategies can augment more than

  2. Family Homeostasis and the Physician

    PubMed Central

    Jackson, Don D.

    1965-01-01

    Physical illness, including psychosomatic disorders, often play an unexpected role in maintaining emotional balances within the family. The outbreak of such disorders, conversely, can be utilized by the physician as a barometer of family emotional difficulties. PMID:5828172

  3. Family physicians and dementia in Canada

    PubMed Central

    Pimlott, Nicholas J.G.; Persaud, Malini; Drummond, Neil; Cohen, Carole A.; Silvius, James L.; Seigel, Karen; Hollingworth, Gary R.; Dalziel, William B.

    2009-01-01

    ABSTRACT OBJECTIVE To assess Canadian family physicians’ awareness of, attitudes toward, and use of the 1999 Canadian Consensus Conference on Dementia (CCCD) clinical practice guidelines (CPGs); to explore the barriers and enablers to implementing dementia CPGs in clinical practice; and to identify more effective strategies for future dementia guideline development and dissemination. DESIGN Qualitative study using focus groups. SETTING Academic family practice clinics in Calgary, Alta, Ottawa, Ont, and Toronto, Ont. PARTICIPANTS Eighteen family physicians. METHODS Using a semistructured interview guide, we conducted 4 qualitative focus groups of 4 to 6 family physicians whose practices we had audited in a previous study. Transcripts were coded using an inductive data analytic strategy, and categories and themes were identified and described using the principles of thematic analysis. MAIN FINDINGS Four major themes emerged from the focus group discussions. Family physicians 1) were minimally aware of the existence and the detailed contents of the CCCD guidelines; 2) had strong views about the purposes of guidelines in general; 3) expressed strong concerns about the role of the pharmaceutical industry in the development of such guidelines; and 4) had many ideas to improve future dementia guidelines and CPGs in general. CONCLUSION Family physicians were minimally aware of the 1999 CCCD CPGs. They acknowledged, however, the potential of future CPGs to assist them in patient care and offered many strategies to improve the development and dissemination of future dementia guidelines. Future guidelines should more accurately reflect the day-to-day practice experiences and challenges of family physicians, and guideline developers should also be cognizant of family physicians’ perceptions that pharmaceutical companies’ funding of CPGs undermines the objectivity and credibility of those guidelines. PMID:19439707

  4. Internet resources for family physicians.

    PubMed Central

    Anthes, D. L.; Berry, R. E.; Lanning, A.

    1997-01-01

    PROBLEM BEING ADDRESSED: The internet has experienced tremendous growth over the past few years and has many resources in the field of family medicine. However, many family physicians remain unaware of how the Internet can be used to enhance their practice and of how to gain access to this powerful tool. OBJECTIVE OF PROGRAM: To characterize components of the Internet, to explore how family physicians can use the Internet to enhance practice, and to increase awareness of how to gain access to Internet sites relevant to family medicine. MAIN COMPONENTS OF THE PROGRAM: An on-line search through the World Wide Web was conducted using multiple search engines including Lycos, WebCrawler, OpenText, and Yahoo as well as a conventional MEDLINE search of Internet publications for the past 5 years. A website containing an evolving selection of resources can be found at http:@dfcm 18.med.utoronto.ca/anthes/hpgdfcm1.htm. CONCLUSION: The Internet has useful applications and resources for family physicians including rapid communication between physicians, access to medical literature, continuing medical education programs, and lists of patient support and discussion groups. PMID:9189299

  5. Senior academic physicians and retirement considerations.

    PubMed

    Moss, Arthur J; Greenberg, Henry; Dwyer, Edward M; Klein, Helmut; Ryan, Daniel; Francis, Charles; Marcus, Frank; Eberly, Shirley; Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Gillespie, John; Goldstein, Robert; Haigney, Mark; Krone, Ronald; Lichstein, Edgar; Locati, Emanuela; Oakes, David; Thomsen, Poul Erik Bloch; Zareba, Wojciech

    2013-01-01

    An increasing number of academic senior physicians are approaching their potential retirement in good health with accumulated clinical and research experience that can be a valuable asset to an academic institution. Considering the need to let the next generation ascend to leadership roles, when and how should a medical career be brought to a close? We explore the roles for academic medical faculty as they move into their senior years and approach various retirement options. The individual and institutional considerations require a frank dialogue among the interested parties to optimize the benefits while minimizing the risks for both. In the United States there is no fixed age for retirement as there is in Europe, but European physicians are initiating changes. What is certain is that careful planning, innovative thinking, and the incorporation of new patterns of medical practice are all part of this complex transition and timing of senior academic physicians into retirement. PMID:23621971

  6. Academic family health teams

    PubMed Central

    Carroll, June C.; Talbot, Yves; Permaul, Joanne; Tobin, Anastasia; Moineddin, Rahim; Blaine, Sean; Bloom, Jeff; Butt, Debra; Kay, Kelly; Telner, Deanna

    2016-01-01

    Abstract Objective To explore patients’ perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)—interprofessional PC teams delivering care where family medicine and other health professional learners are trained—focusing on patients’ perceptions of access and patients’ satisfaction with services. Design Self-administered survey. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Answers to questions about access from the Primary Care Assessment Tool Adult Expanded Version, the Primary Care Assessment Survey, and research team questions. Results The response rate was 47.3% (1026 of 2167). The mean (SD) Primary Care Assessment Tool first-contact accessibility score was 2.28 (0.36) out of 4, with 96.5% of patients rating access less than 3, which was the minimum expected level of care. Two-thirds (66.6%) indicated someone from their aFHTs would definitely or probably see them the same day if they were sick, 56.8% could definitely or probably get advice quickly by telephone, and 14.5% indicated it was definitely or probably difficult to be seen by their primary health care provider (HCP). Additionally, 46.9% indicated they would like to get medical advice by e-mail. For a routine or follow-up visit, 73.4% would be willing to see another aFHT physician if their regular provider were unavailable, while only 48.3% would see a nonphysician HCP. If sick, 88.2% would see another aFHT physician and 55.2% would see a nonphysician HCP. Most (75.3%) were satisfied with access to their regular HCP. Conclusion Although patients are generally satisfied with care, there is room for improvement in access. Strategies are needed to enhance access to care, including addressing appropriate roles and scopes of practice for nonphysician HCPs. The accessibility challenges for aFHTs will likely affect new family physicians and other HCPs training in

  7. Physicians in the Academic Marketplace.

    ERIC Educational Resources Information Center

    Burke, Dolores L.

    This book explores the medical professoriate, in particular medical faculty mobility in and out of academic positions as it relates to the organization of academic medicine in United States universities. The work is based on interviews conducted with 300 faculty members in six major medical schools over a period of 6 months in late 1988 and early…

  8. Developing physician leaders in academic medical centers.

    PubMed

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.* PMID:10164266

  9. Physician attitudes and family planning in Nigeria.

    PubMed

    Covington, D L; Otolorin, E O; Janowitz, B; Gates, D S; Lamptey, P; Ladipo, O A

    1986-01-01

    This study examines family planning attitudes and practices of 681 Nigerian physicians selected from cities in which large university teaching hospitals are located. About half of the physicians were practicing family planning; the method of choice was the IUD. Obstetrician/gynecologists and general practitioners were more likely to provide methods to their patients than were other types of physicians. The physicians were concerned about population growth and favored family planning, yet a substantial minority believed that family planning is foreign to the culture and that it promotes promiscuity. Physicians were reluctant to promote family planning on a wide scale; many disapproved of non-physicians providing oral contraceptives or IUDs. PMID:3750358

  10. Professional Bankruptcy for the Academic Physician

    PubMed Central

    Thornburg, Loralei L.; Glantz, J. Christopher; Caprio, Thomas V.; Gillespie, Suzanne M.

    2010-01-01

    In modern academic medicine, the amount of academic time is decreasing as the workload and commitments are increasing. As physicians take on so many professional obligations that there is no way to meet all of the demands of the ever-expanding responsibilities, the question becomes: Should academic physicians ever consider filing for their own “professional bankruptcy”? Presented here are 10 steps to successful academic bankruptcy for the overextended junior faculty. Although somewhat fanciful, this method allows faculty to take an honest and critical assessment of their personal and professional goals and to align their career with these goals. With a critical eye to the future, this alignment will allow faculty to decrease their workload while maintaining productivity. PMID:21976103

  11. Professional bankruptcy for the academic physician.

    PubMed

    Thornburg, Loralei L; Glantz, J Christopher; Caprio, Thomas V; Gillespie, Suzanne M

    2010-09-01

    In modern academic medicine, the amount of academic time is decreasing as the workload and commitments are increasing. As physicians take on so many professional obligations that there is no way to meet all of the demands of the ever-expanding responsibilities, the question becomes: Should academic physicians ever consider filing for their own "professional bankruptcy"? Presented here are 10 steps to successful academic bankruptcy for the overextended junior faculty. Although somewhat fanciful, this method allows faculty to take an honest and critical assessment of their personal and professional goals and to align their career with these goals. With a critical eye to the future, this alignment will allow faculty to decrease their workload while maintaining productivity. PMID:21976103

  12. Family physicians: importance and relevance.

    PubMed

    Yeravdekar, Rajiv; Yeravdekar, Vidya Rajiv; Tutakne, M A

    2012-07-01

    Due to rapid advancement in medical technology and knowledge patients today prefer treatment from specialists, if they can afford it. Medical treatment has become a purchasable commodity, to be procured as and when required, based on cost and availability.This is unfortunate but true. Specialisation tends to divide the patients into'parts' and increases the cost of treatment. Moreover no single physician is in charge of the patient as a whole to maintain long term continuity and coordinate the treatments given by different specialists. Since long term dependence on 'family doctor' has reduced, trust deficit in the profession has started creeping in. It is essential to rejuvenate the concept of family doctors equipped with skills suitable for modern technology and practice, to restore the faith of patients in medical professionals. Family doctor can provide a 'single window clearance' for all healthcare needs of an individual. Exploitation of gullible patient can be prevented when the family doctor becomes the friend and guide for all treatments being given to the individual. Society should be educated on the benefits of getting the treatment through the family doctor. The family doctor then becomes the Authorised Medical Attendant (AMA), responsible for all treatments beings provided to the patients. The Medical Council of India (MCI) may consider incorporating this in code of medical ethics. PMID:23520678

  13. Academic family health teams

    PubMed Central

    Carroll, June C.; Talbot, Yves; Permaul, Joanne; Tobin, Anastasia; Moineddin, Rahim; Blaine, Sean; Bloom, Jeff; Butt, Debra; Kay, Kelly; Telner, Deanna

    2016-01-01

    Abstract Objective To explore patients’ perceptions of primary care (PC) in the early development of academic family health teams (aFHTs)—interprofessional PC teams delivering care where family medicine and other health professional learners are trained—focusing on the 4 core domains of PC. Design Self-administered survey using the Primary Care Assessment Tool Adult Expanded Version (PCAT), which addresses 4 core domains of PC (first contact, continuity, comprehensiveness, and coordination). The PCAT uses a 4-point Likert scale (from definitely not to definitely) to capture patients’ responses about the occurrence of components of care. Setting Six aFHTs in Ontario. Participants Adult patients attending appointments and administrators at each of the aFHTs. Main outcome measures Mean PCAT domain scores, with a score of 3 chosen as the minimum expected level of care. Multivariate log binomial regression models were used to estimate the adjusted relative risks of PCAT score levels as functions of patient- and clinic-level characteristics. Results The response rate was 47.3% (1026 of 2167). The mean age of respondents was 49.6 years, and most respondents were female (71.6%). The overall PC score (2.92) was just below the minimum expected care level. Scores for first contact (2.28 [accessibility]), coordination of information systems (2.67), and comprehensiveness of care (2.83 [service available] and 2.36 [service provided]) were below the minimum. Findings suggest some patient groups might not be optimally served by aFHTs, particularly recent immigrants. Characteristics of aFHTs, including a large number of physicians, were not associated with high performance on PC domains. Distributed practices across multiple sites were negatively associated with high performance for some domains. The presence of electronic medical records was not associated with improved performance on coordination of information systems. Conclusion Patients of these aFHTs rated several

  14. PCBs and the Family Physician

    PubMed Central

    Cappon, I.D.

    1986-01-01

    Pcbs are widespread environmental contaminants present in virtually every mammal on earth. Great controversy and debate has been evoked over the past two decades concerning their potential toxicity. They, along with other organochlorine compounds such as DDT, have been reasonably well studied in field and experimental situations. In general, PCBs are not very toxic, especially in concentrations to which most people are exposed, even those who work in the industrial setting or who eat contaminated fish. In terms of environmental hazards to health, PCBs should be considered as relatively low on the list. The public cannot depend on media information as a source of objective knowledge on controversial compounds like PCBs. The family physician should be able to provide to concerned individuals objective information on the definition, sources and relative toxicity of PCBs. PMID:21267326

  15. Rural Idaho Family Physicians' Scope of Practice

    ERIC Educational Resources Information Center

    Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat

    2010-01-01

    Context: Scope of practice is an important factor in both training and recruiting rural family physicians. Purpose: To assess rural Idaho family physicians' scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status. Methods: A survey instrument was developed based on a literature…

  16. Family Physician Perspectives on Primary Immunodeficiency Diseases

    PubMed Central

    Orange, Jordan S.; Seeborg, Filiz O.; Boyle, Marcia; Scalchunes, Christopher; Hernandez-Trujillo, Vivian

    2016-01-01

    Primary immunodeficiency diseases (PIDs) include over 250 diverse disorders. The current study assessed management of PID by family practice physicians. The American Academy of Allergy, Asthma, and Immunology Primary Immunodeficiency Committee and the Immune Deficiency Foundation conducted an incentivized mail survey of family practice physician members of the American Medical Association and the American Osteopathic Association in direct patient care. Responses were compared with subspecialist immunologist responses from a similar survey. Surveys were returned by 528 (of 4500 surveys mailed) family practice physicians, of whom 44% reported following ≥1 patient with PID. Selective immunoglobulin A deficiency (21%) and chronic granulomatous disease (11%) were most common and were followed by significantly more subspecialist immunologists (P < 0.05). Use of intravenously administered immunoglobulin and live viral vaccinations across PID was significantly different (P < 0.05). Few family practice physicians were aware of professional guidelines for diagnosis and management of PID (4 vs. 79% of subspecialist immunologists, P < 0.05). Family practice physicians will likely encounter patients with PID diagnoses during their career. Differences in how family practice physicians and subspecialist immunologists manage patients with PID underscore areas where improved educational and training initiatives may benefit patient care. PMID:27066486

  17. Family Physician Perspectives on Primary Immunodeficiency Diseases.

    PubMed

    Orange, Jordan S; Seeborg, Filiz O; Boyle, Marcia; Scalchunes, Christopher; Hernandez-Trujillo, Vivian

    2016-01-01

    Primary immunodeficiency diseases (PIDs) include over 250 diverse disorders. The current study assessed management of PID by family practice physicians. The American Academy of Allergy, Asthma, and Immunology Primary Immunodeficiency Committee and the Immune Deficiency Foundation conducted an incentivized mail survey of family practice physician members of the American Medical Association and the American Osteopathic Association in direct patient care. Responses were compared with subspecialist immunologist responses from a similar survey. Surveys were returned by 528 (of 4500 surveys mailed) family practice physicians, of whom 44% reported following ≥1 patient with PID. Selective immunoglobulin A deficiency (21%) and chronic granulomatous disease (11%) were most common and were followed by significantly more subspecialist immunologists (P < 0.05). Use of intravenously administered immunoglobulin and live viral vaccinations across PID was significantly different (P < 0.05). Few family practice physicians were aware of professional guidelines for diagnosis and management of PID (4 vs. 79% of subspecialist immunologists, P < 0.05). Family practice physicians will likely encounter patients with PID diagnoses during their career. Differences in how family practice physicians and subspecialist immunologists manage patients with PID underscore areas where improved educational and training initiatives may benefit patient care. PMID:27066486

  18. Physician Impairment: Is It Relevant to Academic Psychiatry?

    ERIC Educational Resources Information Center

    Myers, Michael F.

    2008-01-01

    Objective: This article examines the relevance of physician impairment to the discipline of academic psychiatry. Method: The author reviews the scientific literature, the proceedings of previous International Conferences on Physician Health, and held discussions with experts in the physician health movement, department chairs, program directors,…

  19. Female Physicians and the Work-Family Conflict.

    PubMed

    Treister-Goltzman, Yulia; Peleg, Roni

    2016-05-01

    There has been a dramatic increase in the number of female physicians in all fields and specializations of medicine, but this increase has not resulted in a redistribution of domestic tasks and responsibilities. Reviewing the literature of the last two decades (April 1994 to April 2014) on how female physicians cope with the challenge of balancing their family and professional lives for the duration of their professional careers revealed that they suffer from the work-family conflict more than other professionals and that it has a more negative effect on women than on men. Women physicians consider work-family balance significantly when making career choices. These considerations affect their career success, their productivity as faculty members, their marital life, and parenthood. Having a supportive spouse at home and a facilitating mentor at work are important for a positive work-family balance among female physicians. Special career-supporting measures, such as flexible work schedules and expanded support for childcare over the course of work and when taking part in academic activities, are critical for female physicians. PMID:27430080

  20. New Tools and Approaches for Family Physicians.

    PubMed

    Seehusen, Dean A; Bowman, Marjorie A; Neale, Anne Victoria

    2015-01-01

    This issue of the journal is filled with useful information for practicing family physicians. Several articles introduce new ideas for family physicians to use in the care of their patients, whereas other articles cover new approaches to old problems. Several studies report on procedures performed by family physicians: battlefield acupuncture, colonoscopy, and ultrasound. Some unique alternative care models are described and evaluated. An innovative method of delivering diabetes education seems to work well. Ways to use technology to improve patient care, an update on chronic hepatitis B, and a novel use of social media to understand a rare disease are also included. Readers will come away from this issue with many ideas to consider implementing in their own practices. PMID:26546641

  1. The surgical role of family physicians.

    PubMed Central

    Mainen, M W

    1982-01-01

    A sample of Board-certified family physicians was surveyed regarding their role in providing operative surgical care. Twenty-one per cent reported operating and 40 per cent assisting at surgery. The percentage operating was 10 per cent in the East and 29 per cent in the West, while assisting was 22 per cent in the East and 57 per cent in the West. The frequency with which family doctors functioned as surgical operators was found to be inversely related to the perceived number of surgeons practicing in the local community, ranging from 16 per cent in communities where respondents perceived many surgeons to 56 per cent in communities with no surgeons. An interaction effect between geography and the relative number of surgeons in the local community appeared to influence whether the family physician functioned as operator or assistant. There was no independent relationship between community population size and operating by family physicians. The study suggests that the surgical role of the family physician develops in response to his local practice setting, and that the role cannot be defined from data averaged on a national scale. PMID:7137433

  2. Innovative generalist programs: academic health care centers respond to the shortage of generalist physicians.

    PubMed

    Urbina, C; Hickey, M; McHarney-Brown, C; Duban, S; Kaufman, A

    1994-04-01

    Academic health care centers increasingly are exploring innovative ways to increase the supply of generalist physicians. The authors review successful innovations at representative academic health centers in the areas of recruitment and admissions, undergraduate medical education, residency training, and practice support. Lessons learned focus on those areas that have demonstrated improvements in the number and quality of physicians trained in family practice, general pediatrics, and general internal medicine. Successful recruitment of generalism-oriented applicants requires identification and tracking of rural, minority, and other special groups of students at the high school and college levels. Academic health care centers that provide early, sustained, community-based, ambulatory experiences for medical students and residents encourage trainees to maintain and choose generalist careers. Finally, academic health care centers that link with community providers and with state government encourage the retention of generalist physicians through continuing education and teaching networks. PMID:8014749

  3. The Adolescent, the Family and the Physician

    PubMed Central

    Brennan, Michael

    1971-01-01

    The family physician is the ideal medical practitioner to treat the adolescent, since he has to retain a holistic concept of the person in his family and in society. We have to remember that each person has his or her own rate of development, so that what might be obnoxious to one teenager is still acceptable to another. An understanding of the psychological and social aspects of separation from the parent is necessary in treating the conflicts that arise within the adolescent. There is no point in attempting to use teenage jargon to gain confidence, because the young will find this phoney and the physician will not be able to keep up with the rapid rate of change in slang. PMID:20468670

  4. A Family Physician's Guide to Sewage Sludge

    PubMed Central

    Connop, Peter J.

    1983-01-01

    The potential environmental and personal health effects from the agricultural uses of domestic sewage sludge may increasingly require the guidance of the family physician, especially in farming communities. This article summarizes the potential health hazards and outlines the tripartite risk phenomenon—hazard identification, risk assessment, and social evaluation. For the agricultural use of dewatered sewage sludge, strict adherence to regulated procedures should not increase risk beyond that of agriculture generally. Confirmation by prospective epidemiological studies is recommended. PMID:21283298

  5. Family physicians' approach to psychotherapy and counseling. Perceptions and practices.

    PubMed Central

    Swanson, J. G.

    1994-01-01

    To determine how family physicians perceive the support they get for psychotherapy and counseling, we surveyed a random sample of Ontario College of Family Physicians members. Of 100 physicians who had family medicine residency training with psychotherapy experience, 43% indicated that such training was inadequate for their current needs. Because family physicians often provide psychotherapy and counseling, their training should reflect the needs found in practice. PMID:8080505

  6. An international glossary for primary care. Report of the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA).

    PubMed

    1981-10-01

    Precise definitions of terms that describe the process of primary care are essential to the collection of primary health care data. Whenever possible, these definitions should be uniform and unambiguous. Research workers who wish to collaborate with or interpret work of colleagues from other countries can benefit from a standard glossary of commonly used health terms. In response to these needs, the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians present this international glossary for primary care. Consensus on the definitions was reached by the Classification Committee with consultation from general practice-family practice organizations and individuals. Existing primary care glossaries from several countries and the World Health Organization were also consulted. The definitions provided are intended as guidelines, rather than absolute dicta, for primary care providers and researchers who desire comparability. New knowledge, drifts in use of language with time, and new processes will inevitably require revision of definitions and the addition of new terms. A comprehensive dictionary is not intended, but rather terms most commonly used are included. Equivalent terms are enclosed in parentheses with the country or origin bracketed. It should be understood, however, that exact equivalence may not be present. It was not always possible to include fine shades of differences of meaning. For convenience, the male pronouns have been used throughout. PMID:7024465

  7. Burnout among faculty physicians in an academic health science centre

    PubMed Central

    Wright, James Gardner; Khetani, Nicole; Stephens, Derek

    2011-01-01

    BACKGROUND: Burnout experienced by physicians is concerning because it may affect quality of care. OBJECTIVE: To determine the frequency of burnout among physicians at an academic health science centre and to test the hypothesis that work hours are related to burnout. METHODS: All 300 staff physicians, contacted through their personal e-mail, were provided an encrypted link to an anonymous questionnaire. The primary outcome measure, the Copenhagen Burnout Inventory, has three subscales: personal, work related and patient related. RESULTS: The response rate for the questionnaire was 70%. Quantitative demands, insecurity at work and job satisfaction affected all three components of burnout. Of 210 staff physicians, 22% (n=46) had scores indicating personal burnout, 14% (n=30) had scores indicating work-related burnout and 8% (n=16) had scores indicating patient-related burnout. The correlation between total hours worked and total burnout was only 0.10 (P=0.14) DISCUSSION: Up to 22% of academic paediatric physicians had scores consistent with mild to severe burnout. A simple reduction in work hours is unlikely to be successful in reducing burnout and, therefore, quantitative demands, job satisfaction and work insecurity may require attention to address burnout among academic physicians. PMID:22851895

  8. Knowledge resource preferences of family physicians.

    PubMed

    Connelly, D P; Rich, E C; Curley, S P; Kelly, J T

    1990-03-01

    Because of the pivotal role of medical knowledge in clinical problem solving, it is important to understand how clinicians decide to seek additional knowledge for patient care decisions and how they choose among the resources available to them. Using a self-administered questionnaire, 126 family physicians reported their use of 11 types of knowledge resources for answering patient-specific questions arising in clinical practice. They reported almost daily use of the Physicians' Desk Reference and more often than weekly use of colleagues. There was little use reported of Index Medicus or computer-based bibliographic retrieval systems. The research literature of medicine was used infrequently and rated among the lowest of resources in terms of credibility, availability, searchability, understandability, and applicability. In deciding among a subset of knowledge resources for answering a clinical practice question, resource cost variables related to clinical availability and applicability of the information to the problem at hand appeared to be more influential in the minds of physicians than factors related to quality of the resource. These findings have important implications for the development and deployment of knowledge resources intended to be useful and used in clinical practice. PMID:2248632

  9. When Patients Divorce: The Family Physician's Legal Position

    PubMed Central

    Mesbur, Ruth E.

    1983-01-01

    When divorce and family disintegration loom, the family physician is often the first outsider on the scene. The family physician may, indeed, have a critical role to play in handling the crisis; he may advise, refer to other professionals like therapists or lawyers, or appear in court as an expert witness. The physician must consider his legal position. Is reconciliation counselling confidential, privileged information? Can he recommend a lawyer for a patient? What is the physician's vulnerability as an expert witness in divorce and custody proceedings? Knowledge, understanding and skillful handling of the legal and human processes involved can limit family destruction and help maintain the physician/patient relationship. PMID:21283420

  10. Comparison of prescribing indicators of academic versus non-academic specialist physicians in Urmia, Iran

    PubMed Central

    Sadigh-Rad, Laya; Majdi, Leila; Javaezi, Mehrnush; Delirrad, Mohammad

    2015-01-01

    Objective: As chief prescribers, physicians could have a key role in rational drug use. Core prescribing indicators of all physicians have been evaluated in the Islamic Republic of Iran for several years, but no study has assessed the effects of academic status of doctors on their prescribing behaviors. We aimed to compare prescribing indicators of two groups of academic and non-academic specialist physicians working in Urmia, Iran. Methods: In this cross-sectional study, prescribing indicators of the total number of 37 academic and 104 non-academic specialist physicians in six medical specialties (infectious diseases, psychiatry, otorhinolaryngology, gynecology, pediatrics and general surgery) were studied during 2012 using Rx-analyzer, a dedicated computer application. A set of five quality indicators was used based on the World Health Organization and International Network for Rational Use of Drugs recommendations. Findings: Totally, 709,771 medications in 269,660 prescriptions were studied. For academic and non-academic specialist physicians, the average number of medications per prescription was 2.26 and 2.65, respectively. Similarly, patients’ encounters with injectable pharmaceuticals were 17.37% and 26.76%, respectively. The corresponding figures for antimicrobial agents were 33.12% and 45.46%, respectively. The average costs of every prescription were 6.53 and 3.30 United States Dollar for academic and non-academic specialist physicians, respectively. All the above-mentioned differences were statistically significant. Conclusion: Better prescribing patterns were observed in academic specialist physicians. However, they prescribed medications that were more expensive, while the reason was not investigated in this study. Further studies may reveal the exact causes of these differences. PMID:25984540

  11. Promoting participatory research by family physicians.

    PubMed

    Macaulay, Ann C

    2007-01-01

    In the past, researchers have inadvertently caused stigmatization of various populations, first by not involving community members and then through publishing negative findings. In contrast, participatory research, which is based on a partnership between researchers and those affected by the issue being studied, promotes the voice of those being researched. This essay highlights key principles, processes, complexities, and challenges of participatory research and outlines when participatory research is not appropriate. It also reflects on the training and skills of family physicians that make them especially suited to participatory research. Family physicians have established clinical partnerships with their patients and sometimes entire communities, are trained in patient-centered care-a good basis for community centered research-and are accustomed to working with uncertainty. In addition, they are frequently pragmatic, interested in questions arising from their patients and communities, and likely to respond well to community requests. The main challenges to participatory research are lack of funding, expertise, and time, which may improve as more funding agencies and universities support this approach to research. PMID:18025494

  12. Resources available to help family physicians provide advice to travellers.

    PubMed Central

    Lechky, O

    1995-01-01

    Because many Canadians are travelling to exotic destinations, family physicians may be asked for advice on immunization and health tips to prevent illnesses such as malaria, altitude disease, meningitis and schistosomiasis. A Toronto family physician who is on staff at a travel clinic says a few guiding principles and good resources can help family physicians ensure that their patients are healthy when they return from a trip. PMID:7553504

  13. Family Physicians and Teaching Hospitals: A Litany of Woes

    PubMed Central

    Hansen, Niels H.

    1984-01-01

    Retreat of family physicians from caring for their patients in teaching hospitals has been partly imposed and partly passively accepted. Confusion of patient, family doctor and consultant relationships has resulted. Town/gown and family physician/specialist communication problems disrupt a proper model of care. Family physicians need to take individual and group action to initiate change, but little action has been evident. Everyone is the loser. We should reinstitute a model in which family physicians are the closest professionals to their patients, wherever they are in the health care system. Demonstrating the value of family physician coordination of care and continuity of care will positively affect the current financial `loss leader' status of this work. PMID:21279057

  14. Engagement of family physicians seven years into maintenance of certification.

    PubMed

    Puffer, James C; Bazemore, Andrew W; Newton, Warren P; Makaroff, Laura; Xierali, Imam M; Green, Larry A

    2011-01-01

    Transitioning Family Physicians to continuous Maintenance of Certification (MOC) was intended to support the quality improvement movement nationally, but it also risked decreasing their engagement due to the increased requirements for retaining certification. However, after completing the transition of all family physicians into MOC in 2010, participation appears higher than ever. PMID:21900427

  15. Autism: A review for family physicians.

    PubMed

    Karande, Sunil

    2006-05-01

    Autism is a complex neurodevelopmental disorder characterized by qualitative impairments in social interaction and communication, with restricted, repetitive, stereotyped patterns of behavior, interests and activities. These behaviors manifest along a wide spectrum and commence before 36 months of age. Diagnosis of autism is made by ascertaining whether the child's specific behaviors meet the Diagnostic and Statistical Manual of Mental Disorders-IV-Revised criteria. Its etiology is still unclear but recent studies suggest that genetics plays a major role in conferring susceptibility. Recent neuroimaging research studies indicate that autism may be caused by atypical functioning in the central nervous system, particularly in the limbic system: amygdala and hippocampus. In a third of autistic children, loss of language and/or social skills occurs during the second year of life, usually between 15 and 21 months of age. Comorbidity with mental retardation, epilepsy, disruptive behaviors and learning difficulty is not uncommon. Although there is currently no known cure for autism there is evidence to suggest that early intervention therapy can improve functioning of autistic children. Judicious use of psychotropic drugs is necessary to manage associated aggression, hyperactivity, self-mutilation, temper tantrums; but drugs are not a substitute for behavioral and educational interventions. The family physician can play an important role in detecting autism early, coordinating its assessment and treatment, counseling the parents and classroom teacher, and monitoring the child's progress on a long term basis. PMID:16733293

  16. Nutrition Education Practices and Opinions of Alberta Family Physicians

    PubMed Central

    Kelly, S. Ann; Joffres, Michel R.

    1990-01-01

    A questionnaire was mailed to a random sample of 532 members of the Alberta Chapter of the College of Family Physicians in order to assess the role of physicians in providing nutrition education to their patients. Of the 255 respondents (53% response rate), over 97% agreed that “educating patients about nutrition is an important role for physicians.” Physicians most often gave nutrition information on obesity, constipation, heart disease and hypertension, alcohol, coffee, infant feeding, osteoporosis, and prenatal nutrition. Female physicians gave nutrition information significantly more often than male physicians on four maternal and child health topics. Perceived barriers to nutrition education included lack of reimbursement for physicians (86%), lack of time (48%), and limited access to patient information (42%). Most physicians often informed patients on the seven most common nutrition topics despite these concerns. PMID:21249103

  17. Family physician practice visits arising from the Alberta Physician Achievement Review

    PubMed Central

    2013-01-01

    Background Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. PMID:24010980

  18. Use of information sources by family physicians: a literature survey.

    PubMed Central

    Verhoeven, A A; Boerma, E J; Meyboom-de Jong, B

    1995-01-01

    Analysis of the use of information sources by family physicians is important for both practical and theoretical reasons. First, analysis of the ways in which family physicians handle information may point to opportunities for improvement. Second, such efforts may lead to improvements in the methodology of literature research in general. This article reports on a survey of the literature on information use by family physicians. Eleven relevant research publications could be found. The data showed that family physicians used colleagues most often as information sources, followed by journals and books. This outcome corresponded with results in other professions. Several factors influenced the use of information sources by family physicians, including the physical, functional, and intellectual accessibility of the source; the physician's age; participation by the physician in research or education; the social context of the physician; practice characteristics; and the stage of the information-gathering process. The publications studied suggested ways to improve information gathering in the areas of computerization, education, library organization, and journal articles. PMID:7703946

  19. What Should a Family Physician Know About Neurology?

    PubMed Central

    Murray, T.J.

    1990-01-01

    Ten per cent of patients visiting their family physician have a neurological complaint, and 1% to 2% eventually are diagnosed as having a definite neurological problem. Although most neurological problems can be managed effectively by the family physician, many physicians have trouble conducting a neurological examination confidently, interpreting the results of their findings, or deciding what tests should be done. The author outlines what the family practitioner should know about the field, including certain basic concepts about the nervous system, the appropriate attitude toward neurological problems and patients, characteristics of an efficient, high-yield neurological screening examination, and emergency management of common and treatable neurological conditions. PMID:21234042

  20. Immigration, ethnicity, and accessibility to culturally diverse family physicians.

    PubMed

    Wang, Lu

    2007-09-01

    The study concerns ethnicity, spatial equity, and healthcare access in the context of diversity and integration. The paper first explores how Chinese immigrants in the Toronto Census Metropolitan Area choose between ethnic Chinese family physicians and other family physicians, based on a probability survey. It then applies and modifies gravity-type accessibility measures, of which a special type is the so-called floating catchment area (FCA) method, to evaluate three types of geographical accessibility in family physician utilization. The study suggests a certain degree of spatial inequality among Chinese immigrants in accessing culturally sensitive care. The paper yields important methodological and policy implications. PMID:17174590

  1. Family Physician attitudes about prescribing using a drug formulary

    PubMed Central

    Suggs, L Suzanne; Raina, Parminder; Gafni, Amiram; Grant, Susan; Skilton, Kevin; Fan, Aimei; Szala-Meneok, Karen

    2009-01-01

    Background Drug formularies have been created by third party payers to control prescription drug usage and manage costs. Physicians try to provide the best care for their patients. This research examines family physicians' attitudes regarding prescription reimbursement criteria, prescribing and advocacy for patients experiencing reimbursement barriers. Methods Focus groups were used to collect qualitative data on family physicians' prescribing decisions related to drug reimbursement guidelines. Forty-eight family physicians from four Ontario cities participated. Ethics approval for this study was received from the Hamilton Health Sciences/Faculty of Health Sciences Research Ethics Board at McMaster University. Four clinical scenarios were used to situate and initiate focus group discussions about prescribing decisions. Open-ended questions were used to probe physicians' experiences and attitudes and responses were audio recorded. NVivo software was used to assist in data analysis. Results Most physicians reported that drug reimbursement guidelines complicated their prescribing process and can require lengthy interpretation and advocacy for patients who require medication that is subject to reimbursement restrictions. Conclusion Physicians do not generally see their role as being cost-containment monitors and observed that cumbersome reimbursement guidelines influence medication choice beyond the clinical needs of the patient, and produce unequal access to medication. They observed that frustration, discouragement, fatigue, and lack of appreciation can often contribute to family physicians' failure to advocate more for patients. Physicians argue cumbersome reimbursement regulations contribute to lower quality care and misuse of physicians' time increasing overall health care costs by adding unnecessary visits to family physicians, specialists, and emergency rooms. PMID:19835601

  2. Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

    ERIC Educational Resources Information Center

    Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael

    2009-01-01

    Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United…

  3. Office Management of Chemical Dependency by Family Physicians

    PubMed Central

    Baker, Ray

    1991-01-01

    Family physicians are in an ideal position to identify, intervene with, and treat substance use disorders. If family physicians position themselves to reflect objective evidence of consequences of substance use and offer suggestions for change while leaving responsibility for recovery with the patient, patients often choose to recover. Because the disease is characterized by exacerbations, remissions, and relapses, continued involvement with the recovering patient ensures the greatest chance of recovery. PMID:21228969

  4. When Academe Is a Family Affair.

    ERIC Educational Resources Information Center

    Schneider, Alison

    1999-01-01

    Discusses the special situations of college professors who are the offspring of academics, including forging an independent identity when a parent is eminent in the same field, advantages of the family connection, and nepotism. Most such academic offspring report that the advantages of the family connection outweigh the disadvantages. (DB)

  5. The academic occupational physician as consultant. A 10-year perspective.

    PubMed

    McCunney, R J

    1994-04-01

    The academic community has long served the private sector in a consultant capacity in engineering and in the sciences. With respect to occupational medicine, physicians, when working for industry, have generally practiced in a health care setting. Within the past 10 years, however, the business sector has placed more attention on the health implications of its operations as a result of regulations, liability, and rising health care costs. These issues, which go beyond traditional clinical responsibilities, have furthered the need for businesses to receive strategic medical advice to effectively operate and to maintain a competitive edge. One particular business sector, the chemical industry, has been challenged seriously because of legitimate as well as perceived health risks associated with the production and use of its products. This paper describes the professional experiences over a 10-year period (1983 to 1993) of an occupational physician working as a consultant to an international chemical company. Services have related to epidemiology, health policy, toxicology, plant oversight as well as serving as a health advisor on matters involving the relation between business and health. An academic affiliation with an occupational medicine residency program has facilitated access to related occupational health professionals to assist in problem solving and research. Opportunities for consulting in occupational medicine will depend upon the nature of the organization as well as the personal and professional characteristics of the physician. Requests for these types of services, however, are likely to expand in the near future, primarily as a result of wider awareness of the implications of work on health, increased litigation, and government regulations. PMID:8014716

  6. Family physician enabling attitudes: a qualitative study of patient perceptions

    PubMed Central

    2013-01-01

    Background Family physicians frequently interact with people affected by chronic diseases, placing them in a privileged position to enable patients to gain control over and improve their health. Soliciting patients’ perceptions about how their family physician can help them in this process is an essential step to promoting enabling attitudes among these health professionals. In this study, we aimed to identify family physician enabling attitudes and behaviours from the perspective of patients with chronic diseases. Methods We conducted a descriptive qualitative study with 30 patients, 35 to 75 years of age presenting at least one common chronic disease, recruited in primary care clinics in two regions of Quebec, Canada. Data were collected through in-depth interviews and were analyzed using thematic analysis. Results Family physician involvement in a partnership was perceived by participants as the main attribute of enablement. Promoting patient interests in the health care system was also important. Participants considered that having their situation taken into account maximized the impact of their physician’s interventions and allowed the legitimization of their feelings. They found their family physician to be in a good position to acknowledge and promote their expertise, and to help them maintain hope. Conclusions From the patient’s perspective, their partnership with their family physician is the most important aspect of enablement. PMID:23305144

  7. [Smoking behavior of Dutch family physicians in 1983-1988].

    PubMed

    Adriaanse, H; van Reek, J; Rabier, J R

    1990-08-01

    General practitioners' smoking behaviour in The Netherlands is described on the basis of survey data collected in the period 1983-1988. Until 1983 a large majority of the Dutch family physicians were smokers (1957: 82%, 1983: 56%). The smoking prevalence then was higher among physicians than among the male population. After 1983 a new development set in. Three inquiries showed that among Dutch physicians the smoking prevalence in 1988 was lower than that among the male general population (29 versus 37%). Dutch family physicians have stopped smoking to a larger extent than the physicians in any other EC-country (43% ex-smokers). Young entry-level doctors more and more tend to be never-smokers. PMID:2392168

  8. A new, but old business model for family physicians: cash.

    PubMed

    Weber, J Michael

    2013-01-01

    The following study is an exploratory investigation into the opportunity identification, opportunity analysis, and strategic implications of implementing a cash-only family physician practice. The current market dynamics (i.e., increasing insurance premiums, decreasing benefits, more regulations and paperwork, and cuts in federal and state programs) suggest that there is sufficient motivation for these practitioners to change their current business model. In-depth interviews were conducted with office managers and physicians of family physician practices. The results highlighted a variety of issues, including barriers to change, strategy issues, and opportunities/benefits. The implications include theory applications, strategic marketing applications, and managerial decision-making. PMID:23924222

  9. Is burnout in family physicians in Croatia related to interpersonal quality of care?

    PubMed

    Ožvačić Adžić, Zlata; Katić, Milica; Kern, Josipa; Soler, Jean Karl; Cerovečki, Venija; Polašek, Ozren

    2013-06-01

    The impact of physician burnout on the quality of patient care is unclear. This cross-sectional study aimed to investigate the prevalence of burnout in family physicians in Croatia and its association with physician and practice characteristics, and patient enablement as a consultation outcome measure. Hundred and twenty-five out of 350 family physicians responded to our invitation to participate in the study. They were asked to collect data from 50 consecutive consultations with their adult patients who had to provide information on patient enablement (Patient Enablement Instrument). Physicians themselves provided their demographic and professional data, including workload, job satisfaction, consultation length, and burnout [Maslach Burnout Inventory-Human Services Survey (MBI-HSS)]. MBI-HSS scores were analysed in three dimensions: emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA). Of the responding physicians, 42.4% scored high for EE burnout, 16.0% for DP, and 15.2% for PA. Multiple regression analysis showed that low job satisfaction and more patients per day predicted high EE scores. Low job satisfaction, working more years at a current workplace, and younger age predicted high DP scores. Lack of engagement in education and academic work, shorter consultations, and working more years at current workplace predicted low PA scores, respectively (P<0.05 for each). Burnout is common among family physicians in Croatia yet burnout in our physicians was not associated with patient enablement, suggesting that it did not affect the quality of interpersonal care. Job satisfaction, participation in educational or academic activities and sufficient consultation time seem to reduce the likelihood of burnout. PMID:23819934

  10. Role Expectations in Dementia Care Among Family Physicians and Specialists

    PubMed Central

    Hum, Susan; Cohen, Carole; Persaud, Malini; Lee, Joyce; Drummond, Neil; Dalziel, William; Pimlott, Nicholas

    2014-01-01

    Background The assessment and ongoing management of dementia falls largely on family physicians. This pilot study explored perceived roles and attitudes towards the provision of dementia care from the perspectives of family physicians and specialists. Methods Semi-structured, one-to-one interviews were conducted with six family physicians and six specialists (three geriatric psychiatrists, two geriatricians, and one neurologist) from University of Toronto-affiliated hospitals. Transcripts were subjected to thematic content analysis. Results Physicians’ clinical experience averaged 16 years. Both physician groups acknowledged that family physicians are more confident in diagnosing/treating uncomplicated dementia than a decade ago. They agreed on care management issues that warranted specialist involvement. Driving competency was contentious, and specialists willingly played the “bad cop” to resolve disputes and preserve long-standing therapeutic relationships. While patient/caregiver education and support were deemed essential, most physicians commented that community resources were fragmented and difficult to access. Improving collaboration and communication between physician groups, and clarifying the roles of other multi-disciplinary team members in dementia care were also discussed. Conclusions Future research could further explore physicians’ and other multi-disciplinary members’ perceived roles and responsibilities in dementia care, given that different health-care system-wide dementia care strategies and initiatives are being developed and implemented across Ontario. PMID:25232368

  11. The Family Physician in the Witness Box

    PubMed Central

    Emson, H. E.

    1983-01-01

    The doctor appearing in court must learn a new language and be prepared to deal with the legal profession, which is quite different from his own. Adequate preparation for a court case can make it less confusing; this article gives guidelines for doctors occasionally called to give evidence, or who are accused of malpractice. Doctors called as witnesses must consult with lawyers early, to determine exactly what information the court wants and the form a report should take. Physicians should carefully study and summarize all their evidence in non-technical language before a court appearance. By learning some legal language, they can also understand and adequately answer lawyers' questions. A physician accused of negligence must make no admissions before the case and have no contact with the plaintiff other than to formally acknowledge the charge. The Canadian Medical Protective Association should be contacted as soon as possible. PMID:21283283

  12. Family and personal correlates of academic achievement.

    PubMed

    García Bacete, F J; Rosel Remírez, J

    2001-04-01

    Researchers and educators raise the question of whether pupils' academic performance can be improved through parental involvement in academic activities. The main objective of the following study is to verify whether parental involvement in school activities and family socioeconomic status are associated with children's academic achievement. 150 Spanish seventh grade pupils completed intelligence tests, and their teachers assessed parents' involvement in the school and estimated parents' cultural levels. To measure academic achievement the pupil's overall grade was taken from the Pupils' Final Evaluation Registers. The education and professional level of the mother and father and home size were obtained from the Pupil Personal Register; these variables define the family socioeconomic status. The data, analyzed through application of structural equations, suggest that academic achievement is directly influenced by the cultural level of the family and the child's intelligence but is indirectly influenced by parental involvement in school activities and the socioeconomic status of the child's family. PMID:11351904

  13. Family physicians and patients: is effective nutrition interaction possible?

    PubMed

    Truswell, A S

    2000-01-01

    This article summarizes presentations from an international workshop held in Heelsum, Netherlands, 14-16 December 1998 that was sponsored by the Dutch Dairy Foundation on Nutrition and Health, the Department of Nutrition at Wageningen Agricultural University, the Dutch College of General Practitioners, and the International Union of Nutritional Sciences. Twenty-one speakers and 12 other participants were invited from 9 countries: the Netherlands, the United States, the United Kingdom, Australia, Canada, Denmark, New Zealand, Spain, and Sweden. The workshop was chaired by GJAJ Hautvast and the scientific secretary was GJ Hiddink. Family physicians are highly trusted. Many consultations include a nutritional aspect, but physicians do not discuss nutrition with their patients as often as they could. Major barriers include short visit times, the paucity of nutrition teaching in medical schools, and poor compliance of patients with physicians' dietary prescriptions. Problems, practicalities, operational research, and some solutions were discussed at this meeting of leading family doctors with interested nutritionists. Family physicians have to distill the essentials for their patients from many different specialties ranging from ophthalmology to podiatry. They look for clarity of recommendations from nutrition researchers. Among developments discussed at the meeting that can increase nutritional work in family medicine are 1) new opportunities to teach nutrition in vocational training programs, 2) some manuals and a new journal specially written by nutritional scientists for family physicians, 3) nutritional advice being incorporated into computer software for family physicians, 4) more dietitians working with family physicians, and 5) nutrition training for practice nurses in some countries. PMID:10617940

  14. Do People with Disabilities Have Difficulty Finding a Family Physician?

    PubMed Central

    McColl, Mary Ann; Aiken, Alice; Schaub, Michael

    2015-01-01

    Primary care has been ideally characterized as the medical home for all citizens, and yet recent data shows that approximately 6% do not have a family physician, and only 17.5% of family practices are open to new patients. Given acknowledged shortages of family physicians, this research asks the question: Do people with disabilities have particular difficulty finding a family physician? Health Care Connect (HCC) is a government-funded agency in Ontario Canada, designed to “help Ontarians who are without a family health care provider to find one”. Using data from HCC, supplemented by interviews with HCC staff, the study explores the average wait time for patients with disabilities to be linked with a primary care physician, and the challenges faced by agency staff in doing so. The study found that disabled registrants with the program are only slightly disadvantaged in terms of wait times to find a family physician, and success rates are ultimately comparable; however, agency staff report that there are a number of significant challenges associated with placing disabled patients. PMID:25927477

  15. Fundamentals of financial statement analysis for academic physician managers.

    PubMed

    Danzi, J T; Boom, M L

    1998-04-01

    Academic medical centers (i.e., teaching hospitals) and academic medical practices are under pressure to control costs to compete with for-profit health care institutions. The authors explain how academic physician managers who want to control costs wisely must first understand the cost structure of the medical center or practice and compare that structure with those of for-profit institutions. Doing this requires a firm understanding of how to use a valuable tool, financial statement analysis, to assess an institution's health and performance. Such analysis consists of calculating a variety of financial ratios (e.g., operating income divided by revenues; net income divided by total assets) and then comparing them with the corresponding ratios that are considered industry norms. Three types of financial statements (defined in detail) lend themselves to this approach: the balance sheet, income statement, and statement of cash flows. The authors define standard financial ratios, point out their uses and limitations, and emphasize that a ratio's meaning derives from comparing it with the corresponding benchmark ratio in the industry as a whole. Ratios should be used not as the end point of assessing financial status, but as ways to identify possible problems that require further investigation. Analysis of trends of ratios over time within an institution is a complementary approach. The authors then discuss the use of ratios in three standard types of institutional evaluation: of performance, of liquidity and leverage, and of strategic planning. In addition, they present the financial statement of a fictitious academic medical center as an example of how to use ratios for financial statement analysis. The authors emphasize that the key to using the ratios they discuss and hundreds of others is first to decide what question needs answering and then to choose the relevant ratios to provide a basis for finding the answer. PMID:9580712

  16. Clinical practice guidelines. New-to-practice family physicians' attitudes.

    PubMed Central

    Ferrier, B. M.; Woodward, C. A.; Cohen, M.; Williams, A. P.

    1996-01-01

    OBJECTIVE: To examine the attitudes toward clinical practice guidelines of a group of family physicians who had recently entered practice in Ontario, and to compare them with the attitudes of a group of internists from the United States. DESIGN: Mailed questionnaire survey of all members of a defined cohort. SETTING: Ontario family practices. PARTICIPANTS: Certificants of the College of Family Physicians of Canada who received certification in 1989, 1990, and 1991 and who were practising in Ontario. Of 564-cohort members, 395 (70%) responded. Men (184) and women (211) responded at the same rate. MAIN OUTCOME MEASURES: Levels of agreement with 10 descriptive statements about practice guidelines and analyses of variance of these responses for several physician characteristics. RESULTS: Of respondents in independent practice, 80% were in group practice. Women were more likely to have chosen group practice, in which they were more likely to use practice guidelines than men. Generally favourable attitudes toward guidelines were observed. Physician characteristics occasionally influenced agreement with the descriptors. The pattern of agreement was similar to that noted in the study of American internists, but, in general, Ontario physicians were more supportive. CONCLUSIONS: This group of relatively new-to-practice Ontario family physicians shows little resistance to guidelines and appears to read less threat of external control in them than does the US group. PMID:8616286

  17. Approaching families for organ donation: physicians are willing.

    PubMed

    Exley, M H; Serbin, M F; Goldstein, R M

    1992-09-01

    While current literature documents a critical disparity between the increasing demand for organs for transplantation and the relatively static supply, reasons for the shortage of donors are not well understood. Public opinion surveys describe a population willing to donate, but consent rates reported by organ procurement organizations suggest problems in the process of approaching families. This study of Texas physicians regarding their knowledge of laws related to brain death and to routine inquiry for organ donation and their attitudes toward the critical step of seeking consent from families indicates that physicians need more information about questions asked by families, would benefit from more structured hospital policies on routine inquiry, feel that physicians rather than nurses should approach families, and believe that the public is not well informed about donation. PMID:1462270

  18. Evaluation of Academic Detailing for Primary Care Physician Dementia Education

    PubMed Central

    Cameron, Marcia J.; Horst, Micki; Lawhorne, Larry W.; Lichtenberg, Peter A.

    2011-01-01

    The objective of this evaluation study was to assess the effect of academic detailing (AcD) as a strategy to increase early detection of dementia in primary care practice and to improve support and management of Alzheimer’s disease and other dementia disorders by increasing communication and referrals to local community agencies. As designed for dementia education, AcD consisted of 15-minute educational sessions delivered in primary care practice offices. Twenty-nine visits were conducted by trained teams comprised of a physician and representatives of the Alzheimer’s Association (AA) and Area Agency on Aging (AAA). A key outcome of the visits was increased knowledge of the specific programs and services available. In all, 77.4% rated the visit very effective, and follow-up evaluation suggests visits led to an increase in referral to these agencies (55%) and potentially enhanced early detection of dementia by physicians as measured by 35% making changes in the way they identify at-risk patients. PMID:20228361

  19. Ankle injuries and the family physician.

    PubMed

    Birrer, R B

    1988-01-01

    In transmitting the body's weight, the ankle is subject to frequent static and dynamic injury due to concentrated stresses during standing and movement. The frequency of athletic ankle injuries ranges from 10 to 90 percent, with the highest rate occurring in basketball players. There is prolonged disability and recurrent instability for months to years for 25 to 40 per cent of these patients. Because most of this trauma is handled by primary care physicians, this review presents the mechanism of injury, relevant anatomy, physical examination, and appropriate therapeutic intervention in the acute and rehabilitative phases. PMID:3146894

  20. The physician's role in discussing organ donation with families.

    PubMed

    Williams, Michael A; Lipsett, Pamela A; Rushton, Cynda H; Grochowski, Eugene C; Berkowitz, Ivor D; Mann, Stephen L; Shatzer, John H; Short, M Priscilla; Genel, Myron

    2003-05-01

    Federal Conditions of Participation from the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) introduced in 1998 require that all families be presented the option of organ and tissue donation when death is imminent. The perception that physicians were being excluded from participating in this process led to a resolution at the American Medical Association House of Delegates meeting in December 1999, calling on the American Medical Association Council on Scientific Affairs to review the Conditions of Participation "to ensure that there is no prohibition of physician involvement in the organ donation process..." The number of organs procured for transplantation in the United States is insufficient to meet needs. Families' hospital experiences significantly affect their decisions to donate organs. Discussing severe brain injury, brain death, and organ donation after brain death with families is a specialized form of end-of-life decision-making and care in the intensive care unit; however, the knowledge, skills, and attitudes necessary for physicians and nurses to promote good end-of-life decision-making are widely variable. The federal Conditions of Participation require that those making requests of families for organ donation receive specific training. They do not prohibit physician involvement in initiating organ donation requests, provided these individuals are properly trained. Physicians have an important role in caring for patients and families in these circumstances, and the care they provide is enhanced through training, attention to the special issues involved, and collaboration with organ procurement organization personnel. PMID:12771634

  1. Standardized or narrative discharge summaries. Which do family physicians prefer?

    PubMed Central

    van Walraven, C.; Duke, S. M.; Weinberg, A. L.; Wells, P. S.

    1998-01-01

    OBJECTIVES: To determine whether family physicians prefer discharge summaries in narrative or standardized format and to determine factors affecting this preference. DESIGN: Mailed survey. SETTING: Internal medicine ward at a teaching hospital. PARTICIPANTS: Random sample of 180 family physicians practising in the Ottawa-Carleton area. Of the original sample, 20 were not family physicians and were excluded. Of the 160 physicians remaining, 126 responded for a response rate of 78.8%. INTERVENTION: For a stratified random sample of patients, medical records and narrative discharge summaries were abstracted using a data acquisition form to capture essential information. Information on completed forms was transformed into standardized summaries. Physicians were sent both narrative and standardized summaries. MAIN OUTCOME MEASURE: Physicians' format preference as indicated on an ordinal 7-point scale. RESULTS: The standardized format was preferred with a score of 4.28 versus 3.84 for the narrative (P < .05). Responses indicated the standardized format provided information most relevant to ongoing care, with a mean score of 4.82 (95% confidence interval [CI] 4.48 to 5.15), and easier access to summary information (5.60, CI 5.30 to 5.89). The narrative summary better described patients' admission (3.54, CI 3.18 to 3.90). Preference for standardized summaries correlated with lengthier narrative summary (P < .05), shorter length of stay (P < .05), and physicians' dissatisfaction with previous summaries (P < .001). Standardized discharge summaries were significantly shorter (302 versus 619 words, P = .004) than narrative summaries. CONCLUSIONS: Physicians preferred a standardized format for discharge summaries. Format preference is influenced by physician, patient, and discharge summary characteristics. PMID:9481464

  2. Discrimination against gay, lesbian and bisexual family physicians by patients

    PubMed Central

    Druzin, P; Shrier, I; Yacowar, M; Rossignol, M

    1998-01-01

    BACKGROUND: Discrimination against gay, lesbian and bisexual (GLB) patients by physicians is well known. Discrimination against GLB physicians by their colleagues and superiors is also well known and includes harassment, denial of positions and refusal to refer patients to them. The purpose of this study was to identify and quantify the attitudes of patients toward GLB physicians. METHODS: Telephone interviews were conducted with 500 randomly selected people living in a large urban Canadian city. Subjects were asked if they would refuse to see a GLB family physician and, if so, to describe the reason why. They were then given a choice of 6 reasons obtained from consultation with 10 GLB people and 10 heterosexual people. RESULTS: Of the 500 subjects 346 (69.2%) were reached and agreed to participate. Of the 346 respondents 41 (11.8%) stated that they would refuse to see a GLB family physician. The 2 most common reasons for the discrimination (prevalence rate more than 50%) were that GLB physicians would be incompetent and the respondent would feel "uncomfortable" having a GLB physician. Although more male than female respondents discriminated against GLB physicians, the difference was not statistically significant. The proportion of male and female respondents who discriminated increased with age (p < 0.01). CONCLUSIONS: The observed prevalence of patient discrimination against GLB family physicians is significant. The results suggest that the discrimination is based on emotional reasons and is not related to such factors as misinformation about STDs and fear of being thought of sexually. Therefore, educational efforts should be directed against general perceptions of homosexuality rather than targeting specific medical concerns. PMID:9526472

  3. "Why Give up Something That Works so Well?": Retirement Expectations among Academic Physicians

    ERIC Educational Resources Information Center

    Silver, Michelle Pannor; Pang, N. Celeste; Williams, Sarah A.

    2015-01-01

    For individuals with strong work identities, the decision to retire can be particularly challenging. For academic physicians, retirement is an important personal decision that also has far-reaching implications for the healthcare system. This is because academic physicians are responsible for producing the research from which key medical decisions…

  4. Moving from Clinical Practice to Academe: An Analysis of Career Change for Physician Assistants

    ERIC Educational Resources Information Center

    Marciano, Gerard Jude

    2013-01-01

    Recruitment of qualified and motivated faculty for physician assistant education programs is difficult. While the causes of the difficulty may be many, the primary one is the physician assistants (PAs) must choose between clinical and academic practice in order to pursue a career in academe. Little if any research has been conducted in this area.…

  5. Psychological Factors Explaining the Referral Behavior of Iranian Family Physicians

    PubMed Central

    Mohaghegh, Bahram; Seyedin, Hesam; Rashidian, Arash; Ravaghi, Hamid; Khalesi, Nader; Kazemeini, Hossein

    2014-01-01

    Background: The recently developed policy of the family practice program in rural regions of Iran faced some challenges such as inefficient referral system. The health insurance organizations (purchaser) and health policy makers are concerned about the high rate of patient referrals from family physicians to specialists due to imposing unnecessary services and costs. Objectives: This study examined utility of the theory of planned behavior to explain intention of Iranian family physicians to reduce referral rate of patients with respiratory diseases to medical specialist. Patients and Methods: An exploratory cross-sectional study, employing a correlational design directed by the theory of planned behavior was conducted. A questionnaire was developed based on an eliciting study and review of literature. One hundred and seventy-four family physicians working at primary care centers in two provinces of Iran completed the questionnaire (response rate of 86%). Results: The finding revealed that intention of family physicians to reduce referral rate of patients to specialists was significantly related to two theory-based variables of subjective norms (r = 0.38, P < 0.001) and perceived behavioral control (r = 0.43, P < 0.001), and not to attitudes. A stepwise regression entering direct measures of the theory variables explained 35% of the variance on the intention, with perceived behavioral control being the strongest predictor. Adding background variables to the model achieved further 5% by variables of practice size and past referral rate behavior. Conclusions: The results indicated that psychological variables of the theory of planned behavior could explain a noticeable proportion of variance in family physician's intention to decrease the rate of referring patients with respiratory diseases to medical specialists. The intention is primarily influenced by normative and control considerations. These findings contribute to a better understanding of referral decisions by

  6. Patient Satisfaction with the Family Physician Program in Sabzevar, Iran

    PubMed Central

    Ghorbani, Alireza; Raeissi, Pouran; Saffari, Ehsan; Reissi, Nahid

    2016-01-01

    Background and Objectives: Patient satisfaction with the family physician program is an important factor for more favorable treatment results. Evaluation of patient satisfaction improves the services and approximates them to patient’s preferences. The family physician program has been executed since late March, 2005 in Iran. This study aimed to measure patient satisfaction with family physician services and determines factors affecting the level of satisfaction in order to propose appropriate suggestions for providing medical services based on patients’ expectations. Methods: Forty-one centers provide healthcare services in rural and urban areas. The participants in this study comprised 1263 people. The data were collected by an inventory with 11 items about demographic specifications, waiting time and the importance of physician’s sex and 40 items for assessing the level of patient satisfaction. Results: A total of 1199 patients participated in the current study, 72.1% of them were female and 19.6% waited 10-20 minutes for receiving services. About 55.72% of the participants chose high and very high for the items of the inventory. Total satisfaction with the family physician program decreased with age (p-value= 0.029).Moreover, total satisfaction did not show any significant differences in different groups in terms of sex, place of residence, education level and marital status. Also family physicians’ sex did not affect patient satisfaction significantly. Based on results of regression model, an increase in patients’ age by one year decreased their satisfaction by 0.12 and level of satisfaction in rural patients was lower than that in urban patients by 7.93. Conclusions: The level of patient satisfaction with family physician services was moderate, which mostly arose from the components of the family physician program and services such as the waiting time, costs, welfare facilities, accessibility and the service-providing team rather than patients

  7. Prevalence of abusive encounters in the workplace of family physicians

    PubMed Central

    Miedema, Baukje; Hamilton, Ryan; Lambert-Lanning, Anita; Tatemichi, Sue R.; Lemire, Francine; Manca, Donna; Ramsden, Vivian R.

    2010-01-01

    ABSTRACT OBJECTIVE To examine the career prevalence of abusive encounters for family physicians in Canada. DESIGN A 7-page cross-sectional mailed survey in English and French. SETTING Canada. PARTICIPANTS A total of 3802 randomly selected practising family physicians who were members of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES Demographic characteristics of survey participants, career prevalence of abusive encounters, and perpetrators of abuse. MAIN FINDINGS Twenty percent (20.4%) of the surveys (n = 774) were returned. Of the respondents, 44% were men and 56% were women. Most were in private practice in urban settings. The average number of years in practice was 15. The career prevalence of abusive encounters was divided into “minor,” “major,” and “severe” incidents. Of all the respondents, 98% had experienced at least 1 incident of minor abuse, 75% had experienced at least 1 incident of major abuse, and 39% had experienced at least 1 incident of severe abuse. Using χ2 analysis, a number of demographic variables were found to be significantly associated with abuse including the physician’s race and sex. Patients were the most common perpetrators of abuse. Ninety percent of family physicians surveyed reported that they had been abused by patients, while 70% reported that they had been abused by family members of patients. CONCLUSION Approximately 2 in 5 family physicians surveyed were subjected to a considerable amount of severe abuse during practice. Abuse in the office setting might have grave consequences for the health and well-being of the victimized physicians and might hinder service retention where the risk of abuse is greatest. PMID:20228289

  8. Comparison of burnout pattern between hospital physicians and family physicians working in Suez Canal University Hospitals

    PubMed Central

    Kotb, Amany Ali; Mohamed, Khalid Abd-Elmoez; Kamel, Mohammed Hbany; Ismail, Mosleh Abdul Rahman; Abdulmajeed, Abdulmajeed Ahmed

    2014-01-01

    Introduction The burnout syndrome is characterized by emotional exhaustion, depersonalization, and low personal accomplishment. It is associated with impaired job performance. Methods This descriptive study examined 171 physicians for the presence of burnout and its related risk factors. The evaluation of burnout was through Maslach Burnout Inventory (MBI). The participant was considered to meet the study criteria for burnout if he or she got a “high“ score on at least 2 of the three dimensions of MBI. Results In the current study, the prevalence of burnout in hospital physicians (53.9%) was significantly higher than family physicians (41.94%) with (p=0.001). Participants who work in the internal medicine department scored the highest prevalence (69.64%) followed by Surgeons (56.50%) and Emergency doctors (39.39%). On the other hand, Pediatricians got the lowest prevalence (18.75%). Working in the teaching hospital and being married are strong predictors for occurrence of burnout. Conclusion There is a significant difference of burnout between hospital physicians and family physicians among the study subjects. Working in the teaching hospital and being married are strong predictors for occurrence of burnout. PMID:25422682

  9. Academic Correlates of Exposure to Family Violence.

    ERIC Educational Resources Information Center

    Moore, Timothy E.; Andres, Joy; Pepler, Debra J.

    Children's exposure to family violence may lead to increased school difficulties, as shown in studies demonstrating the relationship between children's adjustment disorders and stressful family events. To examine the unique effects of violence on children's cognition, this study compared the academic performance and conflict levels of two groups…

  10. Family Physician Support for a Family With a Mentally Ill Member.

    PubMed

    McBride, J LeBron

    2016-09-01

    Mentally ill family members can have a formidable impact on the families in which they reside. Family physicians can intervene in powerful ways when they are sensitive to those who are mentally ill and their families and can provide much needed compassionate support. PMID:27621163

  11. The Family Physician and the Prevention of Psychiatric Disorders

    PubMed Central

    Jones, Robert O.

    1971-01-01

    Behaviour disorders can occur as a result of the patient's inability to weather various crises. This article identifies various stages in a patient's life, which, if badly managed, could lead to emotional disturbance. If the family physician is aware of the emotional dangers attending certain circumstances, he may do a lot to promote good “mental hygiene”, both by the cautious use of drugs and by constant reassurance of the patient and his family. PMID:20468627

  12. Understanding the Careers of Physician Educators in Family Medicine.

    ERIC Educational Resources Information Center

    Simpson, Deborah E.; Rediske, Virginia A.; Beecher, Ann; Bower, Douglas; Meurer, Linda; Lawrence, Steven; Wolkomir, Michael

    2001-01-01

    Interviewed physician educators in family medicine to discover variables that draw them into education and sustain their vitality, and challenges that can support or derail their careers. Found that career decisions emanate from values associated with "making the world better"; that they seek challenging positions consistent with these values; and…

  13. Family Practice Physicians: Training Needs in Regards to Substance Abuse.

    ERIC Educational Resources Information Center

    Eliason, Michele J.; Skinstad, Anne Helene

    2002-01-01

    Family medicine physicians were surveyed about their knowledge of substance abuse and wishes for continuing education. Results showed 10% had no substance abuse training in medical school, 15% had none during residency, and 21% had no continuing education on substance abuse. Most preferred continuing education programs as part of an annual…

  14. Exercise-induced asthma. What family physicians should do.

    PubMed Central

    D'Urzo, A.

    1995-01-01

    Exercise-induced asthma is described as a transitory increase in airway resistance during or after vigorous exercise. Nearly 90% of patients with chronic asthma and 40% of allergic nonasthmatic patients have the condition. Family physicians should try to educate patients about their asthma and, barring contraindications, encourage them to participate in regular physical activity. PMID:8563507

  15. Family physicians and sports-injury care. Perceptions of coaches.

    PubMed Central

    Vergeer, I.

    1997-01-01

    OBJECTIVE: To describe coaches' education in injury care and management and their club's access to medical care, to describe coaches' perceptions of how family physicians care for sports injuries, and to describe strategies used for overcoming perceived poor advice. DESIGN: A telephone survey using both closed and open-ended questions was conducted. Information was collected as background information to a larger study investigating coaches' decisions about allowing injured athletes to compete. SETTING: All 28 competitive gymnastics clubs in the province of Alberta. The clubs trained athletes for all competitive levels. PARTICIPANTS: All 70 coaches registered with the Alberta Gymnastics Federation as working with female gymnasts were approached; 64 coaches were interviewed. MAIN OUTCOME MEASURES: Injury education, access to medical care, perceptions of sports-injury treatment provided by family physicians, strategies employed for overcoming perceived poor advice. RESULTS: Education in injury care and management was varied, as was access to medical care. Direct access to sport-specific medical care was available at three of the five elite-level clubs, an arrangement stemming from dissatisfaction with the conventional health care system. At all competitive levels, most coaches were dissatisfied with the recommendations they received from family physicians. Various strategies were employed to acquire more suitable advice. CONCLUSIONS: The results point to a need for improved communication between family physicians and coaches. PMID:9356756

  16. Work Values and Job Satisfaction of Family Physicians

    ERIC Educational Resources Information Center

    Bouwkamp-Memmer, Jennifer C.; Whiston, Susan C.; Hartung, Paul J.

    2013-01-01

    Theory and prior research suggest linkages between work values and job satisfaction. The present study examined such linkages in a group of workers in a professional occupation. Family physicians (134 women, 206 men, 88% Caucasian) responded to context-specific measures of work values and job satisfaction. ANOVA results indicated a work values…

  17. Enhancing family physician capacity to deliver quality palliative home care

    PubMed Central

    Marshall, Denise; Howell, Doris; Brazil, Kevin; Howard, Michelle; Taniguchi, Alan

    2008-01-01

    ABSTRACT PROBLEM BEING ADDRESSED Family physicians face innumerable challenges to delivering quality palliative home care to meet the complex needs of end-of-life patients and their families. OBJECTIVE OF PROGRAM To implement a model of shared care to enhance family physicians’ ability to deliver quality palliative home care, particularly in a community-based setting. PROGRAM DESCRIPTION Family physicians in 3 group practices (N = 21) in Ontario’s Niagara West region collaborated with an interprofessional palliative care team (including a palliative care advanced practice nurse, a palliative medicine physician, a bereavement counselor, a psychosocial-spiritual advisor, and a case manager) in a shared-care partnership to provide comprehensive palliative home care. Key features of the program included systematic and timely identification of end-of-life patients, needs assessments, symptom and psychosocial support interventions, regular communication between team members, and coordinated care guided by outcome-based assessment in the home. In addition, educational initiatives were provided to enhance family physicians’ knowledge and skills. CONCLUSION Because of the program, participants reported improved communication, effective interprofessional collaboration, and the capacity to deliver palliative home care, 24 hours a day, 7 days a week, to end-of-life patients in the community. PMID:19074714

  18. Factors influencing palliative care. Qualitative study of family physicians' practices.

    PubMed Central

    Brown, J. B.; Sangster, M.; Swift, J.

    1998-01-01

    OBJECTIVE: To examine factors that influence family physicians' decisions to practise palliative care. DESIGN: Qualitative method of in-depth interviews. SETTING: Southwestern Ontario. PARTICIPANTS: Family physicians who practise palliative care on a full-time basis, who practise on a part-time basis, or who have retired from active involvement in palliative care. METHOD: Eleven in-depth interviews were conducted to explore factors that influence family physicians' decisions to practise palliative care and factors that sustain their interest in palliative care. All interviews were audiotaped and transcribed verbatim. The analysis strategy used a phenomenological approach and occurred concurrently rather than sequentially. All interview transcriptions were read independently by the researchers, who then compared and combined their analyses. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. MAIN OUTCOME FINDINGS: The overriding theme was a common philosophy of palliative care focusing on acceptance of death, whole person care, compassion, communication, and teamwork. Participants' philosophies were shaped by their education and by professional and personal experiences. In addition, participants articulated personal and systemic factors currently affecting their practice of palliative care. CONCLUSIONS: Participants observed that primary care physicians should be responsible for their patients' palliative care within the context of interdisciplinary teams. For medical students to be knowledgeable and sensitive to the needs of dying patients, palliative care should be given higher priority in the curriculum. Finally, participants argued compellingly for transferring the philosophy of palliative care to the overall practice of medicine. PMID:9612588

  19. Pod people. Response of family physicians and family practice nurses to Kosovar refugees in Greenwood, NS.

    PubMed Central

    Twohig, P. L.; Burge, F.; MacLachlan, R.

    2000-01-01

    OBJECTIVE: To explore roles of family physicians and family practice nurses who provided care to Kosovar refugees at Greenwood, NS. DESIGN: Qualitative study based on individual interviews with family physicians and family practice nurses. SETTING: Family practices in Halifax, NS. PARTICIPANTS: Six family practice nurses, four physician faculty members, four community-based family physicians, and two family medicine residents were interviewed. Participants were purposefully chosen from the roster of service providers. METHOD: All interviews were conducted by one of the researchers and were semistructured. Interviews lasted approximately 30 minutes and were immediately transcribed. Key words and phrases were identified and compared with subsequent interviews until saturation was achieved. MAIN FINDINGS: Data yielded four analytical categories: the clinical encounter, expectation and experience, role and team functioning, and response. Participants reported how providing care in the context of a refugee camp was both similar to and different from their daily activities in family practice, as were their working relationships with other health care professionals. CONCLUSION: Primary care for refugees during complex health emergencies is often underreported in the literature. Yet family practice physicians and nurses recounted that they had the requisite skills to provide care in such a context. Images Figure 1 Figure 2 PMID:11143581

  20. Modeling spatial accessibility of immigrants to culturally diverse family physicians.

    PubMed

    Wanga, Lu; Roisman, Deborah

    2011-01-01

    This article uses accessibility as an analytical tool to examine health care access among immigrants in a multicultural urban setting. It applies and improves on two widely used accessibility models—the gravity model and the two-step floating catchment area model—in measuring spatial accessibility by Mainland Chinese immigrants in the Toronto Census Metropolitan Area. Empirical data on physician-seeking behaviors are collected through two rounds of questionnaire surveys. Attention is focused on journey to physician location and utilization of linguistically matched family physicians. Based on the survey data, a two-zone accessibility model is developed by relaxing the travel threshold and distance impedance parameters that are traditionally treated as a constant in the accessibility models. General linear models are used to identify relationships among spatial accessibility, geography, and socioeconomic characteristics of Mainland Chinese immigrants. The results suggest a spatial mismatch in the supply of and demand for culturally sensitive care, and residential location is the primary factor that determines spatial accessibility to family physicians. The article yields important policy implications. PMID:21488318

  1. Academic characteristics of orthopedic team physicians affiliated with high school, collegiate, and professional teams.

    PubMed

    Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S

    2015-11-01

    We conducted a study to determine the academic involvement and research productivity of orthopedic team physicians at high school, college, and professional levels of sport. Through Internet and telephone queries, we identified 1054 team physicians from 362 institutions, including 120 randomly selected high schools and colleges and 122 professional teams (baseball, basketball, football, hockey). For all physicians included in the study, we performed a comprehensive search of the Internet and of a citation database to determine academic affiliations, number of publications, and h-index values. Of the 1054 physicians, 678 (64%) were orthopedic surgeons. Percentage of orthopedic team physicians affiliated with an academic medical center was highest in professional sports (64%; 173/270) followed by collegiate sports (36%; 98/275) and high school sports (20%; 27/133). Median number of publications per orthopedic team physician was significantly higher in professional sports (30.6) than in collegiate sports (10.7) or high school sports (6). Median number of publications by orthopedic physicians also varied by sport, with the highest number in Major League Baseball (37.9; range, 0-225) followed by the National Basketball Association (32.0; range, 0-227) and the National Football League (30.4; range, 0-460), with the lowest number within the National Hockey League (20.7; range, 0-144). Academic affiliation and research productivity of orthopedic team physicians vary by competition level and professional sporting league. PMID:26566551

  2. The Family Physician's Role in Preventing Early Termination of Breastfeeding

    PubMed Central

    Livingstone, Verity H.

    1986-01-01

    Despite the high rate of breastfeeding among mothers as they leave the hospital, early termination of breastfeeding continues to be a problem. A new mother needs considerable education, support and, often, early intervention, not only to initiate breastfeeding successfully, but also to prevent breastfeeding problems occurring and to continue breastfeeding successfully for several months. Knowledgeable health-care providers are the key to promoting and protecting breastfeeding, yet in the community, many of these mothers, lacking the support of such knowledgeable advisers, often terminate early. Family physicians are in a key position to help the nursing dyad. This article looks at the role that family physicians can play in advising and helping mothers, and discusses the management of common breastfeeding difficulties. PMID:21267318

  3. Monthly incidence rates of abusive encounters for canadian family physicians by patients and their families.

    PubMed

    Miedema, Baukje Bo; Hamilton, Ryan; Tatemichi, Sue; Lambert-Lanning, Anita; Lemire, Francine; Manca, Donna; Ramsden, Vivian R

    2010-01-01

    Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. Methods. A 7-page cross-sectional survey. Results. Of the entire study sample (N = 720), 29% of the physicians reported having experienced an abusive event in the last month by a patient or patient family member. Abusive incidents were classified as minor, major, or severe. Of the physician participants who reported having been abused, all reported having experienced a minor event, 26% a major, and 8% a severe event. Of the physicians who experienced an abusive event, 55% were not aware of any policies to protect them, 76% did not seek help, and 64% did not report the abusive event. Conclusion. Family physicians are subjected to significant amounts of abuse in their day-to-day practices. Few physicians are aware of workplace policies that could protect them, and fewer report abusive encounters. Physicians would benefit from increased awareness of institutional policies that can protect them against abusive patients and their families and from the development of a national policy. PMID:22332007

  4. Effectiveness of "Primary Bereavement Care" for Widows: A Cluster Randomized Controlled Trial Involving Family Physicians

    ERIC Educational Resources Information Center

    García, Jesus A.; Landa, Victor; Grandes, Gonzalo; Pombo, Haizea; Mauriz, Amaia

    2013-01-01

    Thirty-one family physicians, from 19 primary care teams in Biscay (Spain), were randomly assigned to intervention or control group. The 15 intervention family physicians, after training in primary bereavement care, saw 43 widows for 7 sessions, from the 4th to 13th month after their loss. The 16 control family physicians, without primary…

  5. Key Elements of Clinical Physician Leadership at an Academic Medical Center

    PubMed Central

    Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-01-01

    Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

  6. Abuse of family physicians by patients seeking controlled substances

    PubMed Central

    Saveland, Christine; Hawker, Leisha; Miedema, Baukje; MacDougall, Peter

    2014-01-01

    Abstract Objective To examine family physicians’ career prevalence and monthly incidence of workplace abuse by controlled substance prescription seekers. Design A 4-page cross-sectional survey. Setting A family medicine continuing medical education event in Halifax, NS. Participants The survey was distributed to 316 family physicians attending the continuing medical education event. Main outcome measures Career prevalence and monthly incidence of workplace abuse related to the act of prescribing controlled substances. Results Fifty-six percent (n = 178) of the 316 surveys were returned completed. Half the study participants were men (49%). Most study participants were in private practice and lived in Nova Scotia, and approximately half (51%) practised in urban settings. On average, the study participants had 20 years of practice experience. The career prevalence of abusive encounters related to controlled substance prescribing was divided into “minor,” “major,” and “severe” incidents. Overall, 95% of study participants reported having experienced at least 1 incident of minor abuse; 48% had experienced at least 1 incident of major abuse; and 17% had experienced at least 1 incident of severe abuse during their careers. Further, 30% reported having been abused in the past month; among those, the average number of abusive encounters was 3. Most (82%) of the abusers were male with a history of addiction (85%) and mental illness (39%). Opioids were the most frequently sought controlled substance. Conclusion Abuse of family physicians by patients seeking controlled substances is substantial. Family physicians who prescribe controlled substances are at risk of being subjected to minor, major, or even severe abuse. Opioids were the most often sought controlled substance. A national discussion to deal with this issue is needed. PMID:24522691

  7. Developing physician leaders in academic medical centers. Part 1: Their changing role.

    PubMed

    Bachrach, D J

    1996-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management, intramurally conducted courses in leadership skill development; management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. This article article was prepared by the author from research into and presentation of a thesis entitled. "The Importance of Leadership Training And Development For Physicians In Academic Medical Centers In An Increasingly Complex Healthcare Environment, " prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in the College (ACHE). Part 2 will appear in the next issue of the Journal. PMID:10162876

  8. Are people in Tehran prepared for the family physician program?

    PubMed Central

    Majidi, Azam; Loori, Nina; Shahandeh, Khandan; Jamshidi, Ensiyeh; Majdzadeh, Reza

    2014-01-01

    Background: Upon successful experiences of family physician program in the rural regions, Iranian Ministry of Health and Medical Education (MOHME) made a decision to expand this program to urban areas. For this reason a pilot program were designated and some cities have been selected to determine dos and don’ts of performing family physician program in the cities. Various studies were published during this period demonstrating the advantages and disadvantages of family physicians’ care in these cities. After this process in 2012 and 2013 MOHME announced implementation of family physician program in Tehran. Our study investigated public attitudes, knowledge and practice about the newly introduced program. Methods: This cross-sectional study was performed in Tehran during November to December 2012. A telephone survey was carried out using the Random Digit Dialing (RDD) method and data was gathered by a researcher designed questionnaire. A total of 386 residents aged 18 years and over participated in the study. To compare the differences between various groups’ knowledge scores data were analyzed performing Chi-square test, t-test, ANOVA, and logistic regression by SPSS software version 17, to find factors that affected individuals’ agreement with the program. Results: Among all samples 214(57.4%) knew about the program and almost 120(85.1%) of these aware people were planning to participate in the program. Television and Radio were the major information resources. After adjusting for Educational status, Access to Internet and Socio Economic Status(SES) those people who didn’t have any kind of health coverage systems(Health insurance) were most likely to accept the program and agree with that[OR= 2.38(1.05-5.38)]. Conclusions: The fact that despite low levels of information, most of aware people intend to enroll in the new program reveals that expanding informative programs would bring more participation and involvement among community. PMID:25489446

  9. Multiple family member visits to family physicians. Terminology, classification, and implications.

    PubMed

    Knishkowy, B; Furst, A; Fassberg, Y; Anor, E; Matthews, S; Paz, Y

    1991-01-01

    A study was designed to investigate "the family as the unit of care" in family medicine consultations from the patient's end of the physician-patient axis, unlike most previous related studies, which have concentrated on it from the physician's perspective. During 2 separate weeks in November 1987 and February 1988, nine Israeli family physicians collected demographic and family-related data concerning the spontaneous visiting patterns generated by 1156 persons (899 patients and 257 nonpatients) who attended 796 separate consultations at their clinics during this time. More than one patient attended 12% of the consultations, and more than one person, patient or nonpatient, was present at 36%. At 31% of the consultations children alone or children and adults were recorded as patients (child consultations), and at 69% only adult patients were present (adult consultations). Adults were recorded as second or third patients at 19% of the child consultations but at only 5% of the adult consultations. The child consultations alone yielded 86% of all the nonpatients documented. Basic terminology and methodology for investigating such multiple family member visits to family physicians is discussed as well as the composition of the different family units encountered and their possible significance. PMID:1985136

  10. Physician Dismissal of Families Who Refuse Vaccination: An Ethical Assessment.

    PubMed

    Diekema, Douglas S

    2015-01-01

    Thousands of U.S. parents choose to refuse or delay the administration of selected vaccines to their children each year, and some choose not to vaccinate their children at all. While most physicians continue to provide care to these families over time, using each visit as an opportunity to educate and encourage vaccination, an increasing number of physicians are choosing to dismiss these families from their practice unless they agree to vaccinate their children. This paper will examine this emerging trend along with the reasons given by those who advocate such an approach. I will argue that the strategy of refusing to allow families into a clinic unless they agree to vaccinate their children is misguided, and the arguments for doing so fail to stand up to close scrutiny. Such a strategy does not benefit the child or the health of the community, and may have a negative impact on both. Furthermore, some of the arguments in support of dismissal policies ignore the importance of professional obligation and appear to favor self-interest over the interest of the patient. PMID:26479574

  11. Family medicine as a model of transition from academic medicine to academic health care: Estonia's experience.

    PubMed

    Maaroos, Heidi-Ingrid

    2004-10-01

    This paper presents the development of academic family medicine in an environment of traditional academic medicine at the Tartu University, Estonia. The introduction of university family medicine teachers to everyday practice and practitioners to academic teaching and research helps bridge the gap between theory and practice, and it shows changed approach to academic medicine. PMID:15495281

  12. Solo and Group Physician Practices, Family-Physician Relationships and Unmet Critical Health Need in Rural Areas.

    ERIC Educational Resources Information Center

    Ritchey, Ferris J.

    Family-physician relationships were examined in terms of solo vs group physician practices in two rural southern counties of different socioeconomic status. Comparatively speaking, County B was poorer, had a much higher representation of blacks, had lost considerable population during 1960-70, depended to a much lesser degree on manufacturing, and…

  13. The Family Physician and Facial Trauma From Road Accidents

    PubMed Central

    Franchebois, Pierre

    1972-01-01

    The family physician must feel concerned with the growing number of facial trauma from road accidents. He must play his role in prophylaxy by contributing to public education, about both the danger of driving under the influence of alcohol, and the usefulness of seat belts for facial protection. He must also know everything about first aid to traffic casualties, mostly right at the accident spot: not only the heroic gestures which will save lives and permit wounded people to reach the hospital, but the principles of facial traumatology, in order to protect both the fragile structure of the face, and its esthetic qualities. PMID:20468831

  14. Certification status of family physicians in the initial cohort entering maintenance of certification.

    PubMed

    Puffer, James C; Bazemore, Andrew W; Phillips, Robert L; Beebe, Diane K

    2014-01-01

    There existed considerable concern that participation in Maintenance of Certification by board-certified physicians would be less than optimal when it was introduced by the American Board of Medical Specialties in 2000. However, family physicians who entered the first 10-year Maintenance of Certification for Family Physicians cycle in 2003 participated at levels consistent with historical norms. PMID:25201927

  15. Free Fecal Immunochemical Test Disbursement in Eight Family Physician Offices

    PubMed Central

    Daly, Jeanette M.; Levy, Barcey T.; Xu, Yinghui

    2016-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death. CRC screening with a fecal immunochemical test (FIT) is important as occult blood may be detected. To offer Iowa Research Network members in family physician offices the opportunity to provide FITs at no charge to patients in need and determine how many of the tests would be handed out to patients and how many would be returned to the office. Eight family physician offices agreed to participate and 50 two-day FITs were provided, potentially providing 400 patients a CRC screening test. One hundred and eighty (45 %) of the 400 FITs were handed out to patients. Of the 92 (51 %) patients who returned at least one card, 77 (84 %) had negative results, 13 (14 %) were positive, and 2 (2 %) were indeterminate. Of 13 patients with a positive result, 11 (85 %) had a follow-up colonoscopy. Providing 400 FITs at no charge to the offices was an expensive endeavor. Implementing this forced a change in office routine and the type of fecal occult blood test used. Less than half of the FITs were given out to patients and of those given out, about half of the patients returned a FIT. For those who returned FITs and had positive findings, 85 % followed-up with a colonoscopy. Office nurses implementing the CRC screening need to be included in the planning of the type of fecal occult blood test used and receptive to the project PMID:25980522

  16. Free Fecal Immunochemical Test Disbursement in Eight Family Physician Offices.

    PubMed

    Daly, Jeanette M; Levy, Barcey T; Xu, Yinghui

    2015-10-01

    Colorectal cancer (CRC) is the second leading cause of cancer death. CRC screening with a fecal immunochemical test (FIT) is important as occult blood may be detected. To offer Iowa Research Network members in family physician offices the opportunity to provide FITs at no charge to patients in need and determine how many of the tests would be handed out to patients and how many would be returned to the office. Eight family physician offices agreed to participate and 50 two-day FITs were provided, potentially providing 400 patients a CRC screening test. One hundred and eighty (45%) of the 400 FITs were handed out to patients. Of the 92 (51%) patients who returned at least one card, 77 (84%) had negative results, 13 (14%) were positive, and 2 (2 %) were indeterminate. Of 13 patients with a positive result, 11 (85%) had a follow-up colonoscopy. Providing 400 FITs at no charge to the offices was an expensive endeavor. Implementing this forced a change in office routine and the type of fecal occult blood test used. Less than half of the FITs were given out to patients and of those given out, about half of the patients returned a FIT. For those who returned FITs and had positive findings, 85% followed-up with a colonoscopy. Office nurses implementing the CRC screening need to be included in the planning of the type of fecal occult blood test used and receptive to the project. PMID:25980522

  17. Investigating the barriers to teaching family physicians' and specialists' collaboration in the training environment: a qualitative study

    PubMed Central

    Beaulieu, Marie-Dominique; Samson, Louise; Rocher, Guy; Rioux, Marc; Boucher, Laurier; Del Grande, Claudio

    2009-01-01

    Background Collaboration between physicians in different specialties is often taken for granted. However, poor interactions between family physicians and specialists contribute significantly to the observed discontinuity between primary and specialty care. The objective of this study was to explore how collaboration between family physicians and specialists was conceptualised as a competency and experienced in residency training curricula of four faculties of medicine in Canada. Methods This is a multiple-case study based on Abbott's theory of professions. Programs targeted were family medicine, general psychiatry, radiology, and internal medicine. The content of the programs' objectives was analyzed. Associate deans of postgraduate studies, program directors, educators, and residents were interviewed individually or in focus groups (47 residents and 45 faculty members). Results The training objectives related to family physicians-specialists collaboration were phrased in very general terms and lacked specificity. Obstacles to effective collaboration were aggregated under themes of professional responsibility and questioned expertise. Both trainees and trainers reported increasing distances between specialty and general medicine in three key fields of the professional system: the workplace arena, the training setting, and the production of academic knowledge. Conclusion The challenges of developing collaborating skills between generalists and specialist physicians are comparable in many ways to those encountered in inter-professional collaboration and should be given more consideration than they currently receive if we want to improve coordination between primary and specialty care. PMID:19500409

  18. Mobile tablet use among academic physicians and trainees.

    PubMed

    Sclafani, Joseph; Tirrell, Timothy F; Franko, Orrin I

    2013-02-01

    The rapid adoption rate and integration of mobile technology (tablet computing devices and smartphones) by physicians is reshaping the current clinical landscape. These devices have sparked an evolution in a variety of arenas, including educational media dissemination, remote patient data access and point of care applications. Quantifying usage patterns of clinical applications of mobile technology is of interest to understand how these technologies are shaping current clinical care. A digital survey examining mobile tablet and associated application usage was administered via email to all ACGME training programs. Data regarding respondent specialty, level of training, and habits of tablet usage were collected and analyzed. 40% of respondents used a tablet, of which the iPad was the most popular. Nearly half of the tablet owners reported using the tablet in clinical settings; the most commonly used application types were point of care and electronic medical record access. Increased level of training was associated with decreased support for mobile computing improving physician capabilities and patient interactions. There was strong and consistent desire for institutional support of mobile computing and integration of mobile computing technology into medical education. While many physicians are currently purchasing mobile devices, often without institutional support, successful integration of these devices into the clinical setting is still developing. Potential reasons behind the low adoption rate may include interference of technology in doctor-patient interactions or the lack of appropriate applications available for download. However, the results convincingly demonstrate that physicians recognize a potential utility in mobile computing, indicated by their desire for institutional support and integration of mobile technology into medical education. It is likely that the use of tablet computers in clinical practice will expand in the future. Thus, we believe

  19. Mobile Tablet Use among Academic Physicians and Trainees

    PubMed Central

    Sclafani, Joseph; Tirrell, Timothy F.

    2014-01-01

    The rapid adoption rate and integration of mobile technology (tablet computing devices and smartphones) by physicians is reshaping the current clinical landscape. These devices have sparked an evolution in a variety of arenas, including educational media dissemination, remote patient data access and point of care applications. Quantifying usage patterns of clinical applications of mobile technology is of interest to understand how these technologies are shaping current clinical care. A digital survey examining mobile tablet and associated application usage was administered via email to all ACGME training programs. Data regarding respondent specialty, level of training, and habits of tablet usage were collected and analyzed. 40 % of respondents used a tablet, of which the iPad was the most popular. Nearly half of the tablet owners reported using the tablet in clinical settings; the most commonly used application types were point of care and electronic medical record access. Increased level of training was associated with decreased support for mobile computing improving physician capabilities and patient interactions. There was strong and consistent desire for institutional support of mobile computing and integration of mobile computing technology into medical education. While many physicians are currently purchasing mobile devices, often without institutional support, successful integration of these devices into the clinical setting is still developing. Potential reasons behind the low adoption rate may include interference of technology in doctor-patient interactions or the lack of appropriate applications available for download. However, the results convincingly demonstrate that physicians recognize a potential utility in mobile computing, indicated by their desire for institutional support and integration of mobile technology into medical education. It is likely that the use of tablet computers in clinical practice will expand in the future. Thus, we believe

  20. Informed consent: law, clinical reality, and the role of the family physician.

    PubMed

    Cotsonas, C E

    1992-01-01

    Informed consent is typically seen as most relevant to surgical and other invasive specialties. Although family physicians perform fewer high-risk procedures, they are nonetheless extensively involved in the informed consent process because of the comprehensive and continuing nature of the family physician-patient relationship. Family physicians have a particularly important role in helping their patients to understand what diagnostic or therapeutic alternatives are available. Family physicians have an independent role in the informed consent process, as well as a collaborative role in the context of consultation and referral. Legal rules that require disclosure of alternatives to the patient by the treating physician are examined in the context of the family physician's role as a coordinator of patient care. Practical suggestions regarding discussion of alternatives, extent of disclosure, coordination with consulting physicians, and encouragement of patients' participation in discussions are offered. PMID:1575073

  1. Solution-focused therapy. Counseling model for busy family physicians.

    PubMed Central

    Greenberg, G.; Ganshorn, K.; Danilkewich, A.

    2001-01-01

    OBJECTIVE: To provide family doctors in busy office practices with a model for counseling compatible with patient-centred medicine, including the techniques, strategies, and questions necessary for implementation. QUALITY OF EVIDENCE: The MEDLINE database was searched from 1984 to 1999 using the terms psychotherapy in family practice, brief therapy in family practice, solution-focused therapy, and brief psychotherapy. A total of 170 relevant articles were identified; 75 abstracts were retrieved and a similar number of articles read. Additional resources included seminal books on solution-focused therapy (SFT), bibliographies of salient articles, participation in workshops on SFT, and observation of SFT counseling sessions taped by leaders in the field. MAIN MESSAGE: Solution-focused therapy's concentration on collaborative identification and amplification of patient strengths is the foundation upon which solutions to an array of problems are built. Solution-focused therapy offers simplicity, practicality, and relative ease of application. From the perspective of a new learner, MECSTAT provides a framework that facilitates development of skills. CONCLUSION: Solution-focused therapy recognizes that, even in the bleakest of circumstances, an emphasis on individual strength is empowering. In recognizing patients as experts in self-care, family physicians support and accentuate patient-driven change, and in so doing, are freed from the hopelessness and burnout that can accompany misplaced feelings of responsibility. PMID:11768927

  2. Empowering women in a violent society. Role of the family physician.

    PubMed Central

    Archer, L. A.

    1994-01-01

    Despite erosion of key societal institutions, family physicians have remained a focal point for many troubled individuals--particularly women. The prevalence and types of abuse women experience and the effects on women's lives are summarized. Disclosures of abuse can affect family physicians. Increased awareness of gender role socialization messages for women is also relevant to family practice. PMID:8038640

  3. Improving bicycle safety: The role of paediatricians and family physicians.

    PubMed

    Leblanc, John C; Huybers, Sherry

    2004-05-01

    Cycling is a complex activity requiring motor, sensory and cognitive skills that develop at different rates from childhood to adolescence. While children can successfully ride a two-wheeled bicycle at age five or six, judgment of road hazards are poor at that age and matures slowly until adult-like judgment is reached in early adolescence. Safe cycling depends on the care, skills and judgment of cyclists and motorists; roadway design that promotes safe coexistence of bicycles and motor vehicles; and the use of safety devices, including bicycle helmets, lights and reflective tape. Whereas, research into optimal roadway design and educational programs for drivers to improve road safety has yielded contradictory results, the benefits of bicycle helmet use and programs to enhance their use have been clearly shown. This paper has the following objectives for paediatricians and family physicians: To understand the relationship between bicycle safety and children's motor and cognitive skills.To understand the effectiveness and limitations of strategies to improve bicycle safety.To describe activities to promote bicycle safety that physicians can undertake in clinical settings and in the community. PMID:19657515

  4. Feasibility of physician peer assessment in an academic health sciences centre.

    PubMed

    Ferrari, Sharon; Vozzolo, Ben; Daneman, Denis; Macgregor, Daune

    2011-01-01

    Peer assessment has become an important component of physician evaluation. In an academic health sciences centre, in addition to clinical care there is a significant focus on education, training and research. The literature suggests that the use of a 360-degree evaluation can provide physicians with valuable information on many aspects of their practice and can inform both professional and personal development. We conducted a pilot study to determine the feasibility of using peer assessment as part of the evaluation of our academic physicians. To maintain anonymity, an outside company was engaged to conduct the study. Participants completed a self-assessment and provided the names of eight physician peers and eight non-physician peers who were then requested to complete an evaluation. In addition, 25 patients were asked to provide their feedback. All questionnaires were forwarded directly to the outside company, which then compiled the data and provided each participant with a final report. Results indicate that it is feasible to carry out peer assessment within an academic health sciences centre. Participants noted the value of the process for career development and quality improvement. PMID:21301240

  5. Muscle relaxation techniques: a therapeutic tool for family physicians.

    PubMed Central

    Rapp, M. S.; Thomas, M. R.; Leith, M. G.

    1984-01-01

    Muscle relaxation techniques are important adjunctive therapy for anxiety-related conditions. Family physicians can learn to teach the techniques so as to try helping anxious patients themselves rather than automatically referring them to a psychiatrist. The exercises are generally acceptable to patients, are easy to learn and do not require expensive equipment. They are beneficial in insomnia and tension headache, of some value in chronic anxiety states and a useful adjunct in hypertension. In this paper the evidence supporting the value of muscle relaxation therapy is briefly reviewed, methods of teaching and of practising the techniques are described in detail, and answers to some of the questions and problems that may arise are presented. PMID:6365300

  6. Computer-using patients want Internet services from family physicians.

    PubMed

    Grover, Fred; Wu, H David; Blanford, Christal; Holcomb, Sherry; Tidler, Diana

    2002-06-01

    Patients are increasingly using the Internet to obtain medical information. Few practice Web sites provide services beyond information about the clinic and common medical diseases. We surveyed computer-using patients at 4 family medicine clinics in Denver, Colorado, by assessing their desire for Internet services from their providers. Patients were especially interested in getting e-mail reminders about appointments, online booking of appointments in real time, and receiving updates about new advances in treatment. Patients were also interested in virtual visits for simple and chronic medical problems and for following chronic conditions through virtual means. We concluded that computer-using patients desire Internet services to augment their medical care. As growth and communication via the Internet continue, primary care physicians should move more aggressively toward adding services to their practices' Internet Web sites beyond the simple provision of information. PMID:12100783

  7. Family Income, School Attendance, and Academic Achievement in Elementary School

    ERIC Educational Resources Information Center

    Morrissey, Taryn W.; Hutchison, Lindsey; Winsler, Adam

    2014-01-01

    Low family income is associated with poor academic achievement among children. Higher rates of school absence and tardiness may be one mechanism through which low family income impacts children's academic success. This study examines relations between family income, as measured by receipt of free or reduced-price lunch, school attendance, and…

  8. Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study

    ERIC Educational Resources Information Center

    Tanaka, Masaaki; Watanabea, Yasuyoshi

    2012-01-01

    Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

  9. E-Learning Readiness in Medicine: Turkish Family Medicine (FM) Physicians Case

    ERIC Educational Resources Information Center

    Parlakkiliç, Alaattin

    2015-01-01

    This research investigates e-learning readiness level of family medicine physicians (FM) in Turkey. The study measures the level of e-learning readiness of Turkish FM physicians by an online e-learning readiness survey. According to results five areas are ready at Turkish FM physicians but need a few improvements:…

  10. Cryosurgery for common skin lesions. Treatment in family physicians' offices.

    PubMed Central

    Wetmore, S. J.

    1999-01-01

    OBJECTIVE: To review the principles of use, common techniques, and effectiveness of cryosurgery for common skin lesions that can be treated by family physicians in their offices. QUALITY OF EVIDENCE: MEDLINE and the Cochrane Database controlled trials register (1998 version) were searched. Much of the evidence for the effectiveness of cryosurgery or cryotherapy is based on of cryosurgery for treating common warts, external genital warts, lentigines, and basal cell carcinomas. Many of the trials reviewed were conducted in specialty clinics and, therefore, the results might not apply accurately to family practice. MAIN MESSAGE: Evidence from case report and series suggests that cryosurgery is effective for actinic keratoses, seborrheic keratoses, dermatofibroma, keloids, molluscum contagiosum, and benign nevi. Randomized comparative trials show that, for external genital warts, cryosurgery is more effective than podophyllin treatment, better than or equal to trichloroacetic acid, but less effective than electrodesiccation or surgical removal. Prospective randomized trials of cryosurgery for common warts showed that weekly cryotherapy produced more rapid cures, but the overall cure rate depended on number of treatments. Two freeze-thaw cycles and paring before freezing improved the cure rate for plantar warts. Images Figure 1 Figure 3 Figure 4 Figure 5 PMID:10216795

  11. Interprofessional primary care in academic family medicine clinics

    PubMed Central

    Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

    2012-01-01

    Abstract Objective To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Design Focus group interviews using a purposive sampling procedure. Setting Four academic family medicine clinics in Alberta. Participants Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Methods Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Main findings Our data supported the D’Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model’s main “factors” (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent “elements.” It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. Conclusion The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care. PMID:22893347

  12. The development of a guideline implementability tool (GUIDE-IT): a qualitative study of family physician perspectives

    PubMed Central

    2014-01-01

    useful, but urged to involve “regular” or community family physicians in the process, and suggested that an online system would be the most efficient way to deliver it. Conclusions Our study identified facilitators and barriers of guideline implementability from the perspective of community and academic family physicians that will be used to build our GUIDE-IT prototype. Our findings build on current knowledge by showing that family physicians perceive guideline uptake mostly according to factors that are in the control of guideline developers. PMID:24476491

  13. Nurse-physician collaboration in an academic medical centre: The influence of organisational and individual factors.

    PubMed

    Bowles, Darci; McIntosh, Georgia; Hemrajani, Reena; Yen, Miao-Shan; Phillips, Allison; Schwartz, Nathan; Tu, Shin-Ping; Dow, Alan W

    2016-09-01

    Ineffective physician-nurse collaboration has been recognised to adversely impact patient and organisational outcomes, and some studies suggest an underlying factor may be that nurses and physicians have different perceptions of interprofessional collaboration (IPC). The objectives of this study were to evaluate for a difference in the perception of IPC between physicians and nurses and to explore potential contributing factors at the individual and organisational levels to any observed difference. Data including measures of perceptions of IPC were collected from a convenience sample of resident physicians (n = 47), attending physicians (n = 18), and nurses (n = 54) providing care for internal medicine patients in a large tertiary care academic medical centre. Regression analysis revealed significantly lower perceptions of IPC scores for nurses in comparison to the scores of both the resident and attending physician groups (p = .0001 for both). Although demographic and workload factors also differed by profession, only profession and workload remained significant in regression analysis. Given the known relationships between effective physician-nurse collaboration and superior patient and organisational outcomes, better defining the individual and organisational predictors of IPC scores may support development of more effective interventions targeting improvements in IPC. PMID:27388560

  14. Team Development Curriculum. Family Nurse Practitioner/Physician Assistant Program.

    ERIC Educational Resources Information Center

    Dostal, Lori

    A curriculum consisting of four modules is presented to help nurse practitioners, physician assistants, and physicians develop team practices and improve and increase the utilization of nurse practitioners and physician assistants in primary care settings. The curriculum was prepared in 1981-1982 by the California Area Health Education Center…

  15. Death by request in The Netherlands: facts, the legal context and effects on physicians, patients and families

    PubMed Central

    2010-01-01

    In this article I intend to describe an issue of the Dutch euthanasia practice that is not common knowledge. After some general introductory descriptions, by way of formulating a frame of reference, I shall describe the effects of this practice on patients, physicians and families, followed by a more philosophical reflection on the significance of these effects for the assessment of the authenticity of a request and the nature of unbearable suffering, two key concepts in the procedure towards euthanasia or physician-assisted suicide. This article does not focus on the arguments for or against euthanasia and the ethical justification of physician-assisted dying. These arguments have been described extensively in Kimsma and Van Leeuwen (Asking to die. Inside the Dutch debate about euthanasia, Kluwer Academic Publishers, Dordrecht, 1998). PMID:20668949

  16. Management of hip fracture: the family physician's role.

    PubMed

    Rao, Shobha S; Cherukuri, Manjula

    2006-06-15

    The incidence of hip fracture is expected to increase as the population ages. One in five persons dies in the first year after sustaining a hip fracture, and those who survive past one year may have significant functional limitation. Although surgery is the main treatment for hip fracture, family physicians play a key role as patients' medical consultants. Surgical repair is recommended for stable patients within 24 to 48 hours of hospitalization. Antibiotic prophylaxis is indicated to prevent infection after surgery. Thromboprophylaxis has become the standard of care for management of hip fracture. Effective agents include unfractionated heparin, low-molecular-weight heparin, fondaparinux, and warfarin. Optimal pain control, usually with narcotic analgesics, is essential to ensure patient comfort and to facilitate rehabilitation. Rehabilitation after hip fracture surgery ideally should start on the first postoperative day with progression to ambulation as tolerated. Indwelling urinary catheters should be removed within 24 hours of surgery. Prevention, early recognition, and treatment of contributing factors for delirium also are crucial. Interventions to help prevent future falls, exercise and balance training in ambulatory patients, and the treatment of osteoporosis are important strategies for the secondary prevention of hip fracture. PMID:16836036

  17. Family physician perceptions of working with LGBTQ patients: physician training needs

    PubMed Central

    Beagan, Brenda; Fredericks, Erin; Bryson, Mary

    2015-01-01

    Background Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. Method In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women. PMID:26451226

  18. Moving towards an electronic patient record: a survey to assess the needs of community family physicians.

    PubMed Central

    Strasberg, H. R.; Tudiver, F.; Holbrook, A. M.; Geiger, G.; Keshavjee, K. K.; Troyan, S.

    1998-01-01

    OBJECTIVE: To determine the needs of community family physicians regarding electronic patient records (EPRs). DESIGN: A comprehensive survey was sent to 101 community family physicians in Hamilton, Ontario, who had expressed an interest in EPRs. RESULTS: 46 physicians responded (46%). 87% felt that an EPR would result in their providing better patient care. A wide variety of items were deemed to be important to be included on the EPR "front page". Desired functionality emphasized labs, medications, consultation, hospital follow-up and health maintenance. Family physicians tended to prefer templates to other data entry methods such as typing and dictating. Respondents were more willing to view information from the hospital than to let the hospital view information from their own offices. CONCLUSION: This survey provided useful information on the perceived EPR needs of community-based family physicians. It will be repeated post-computerization. PMID:9929216

  19. Boundary issues. What do they mean for family physicians?

    PubMed Central

    Linklater, D.; MacDougall, S.

    1993-01-01

    Clear boundaries between physicians and patients help prevent abusive behaviour. Enforced boundaries help physicians fulfil their legal, ethical, and professional tasks. We review common elements in boundary violations: role reversal, secrecy, double binds, and indulgence of professional privilege. We also outline the legal and licensing issues of boundary violations and offer examples of nine boundaries. PMID:8292932

  20. How far does family physician supply correlate with district health system performance?

    PubMed Central

    Mash, Robert; Naledi, Tracey

    2015-01-01

    Background Since 2011, a new cadre of family physicians, with 4 years of postgraduate training, was deployed in the district health services of the Western Cape, and tasked with a considerable range of duties aimed at a general improvement in care and health outcomes. There is a need to evaluate the contribution of these family physicians to the district health system. Aim To develop a methodology for describing the correlation between family physician supply and district health system performance, clinical processes and outcomes, and to measure this correlation at baseline. Method A cross-sectional study was undertaken that analysed data at an ecological level for the period of 01 April 2011 to 31 March 2012. This was a pilot project analysing data from the first year of a 4-year project. The correlations between family physician supply and 18 health system indicators were assessed within a logic model. The supplies of other categories of staff were also measured. Results Although most of the correlations with family physicians were positive, the study was unable to demonstrate any strong or statistically significant correlations at baseline. There were significant correlations with other categories of staff. Conclusions This study developed a methodology for monitoring the relationship between family physician supply using routinely collected indicators of health system performance, clinical processes and outcomes over time. Additional research will also be needed to investigate the impact of family physicians and triangulate findings as this methodology has many limitations and potential confounding factors. PMID:26245612

  1. Promoting conversations between physicians and families about childhood obesity: evaluation of physician communication training within a clinical practice improvement initiative.

    PubMed

    Shue, Carolyn K; Whitt, Justin K; Daniel, Linda; Shue, Christian B

    2016-01-01

    Childhood obesity rates have incrementally increased since the 1980s, sparking calls for initiatives focused on addressing this public health concern. In response, the family medicine residency clinic profiled in this research designed, executed, and evaluated a practice improvement initiative focused on physician communication behaviors and clinic processes that impact the management of unhealthy pediatric weight. The results of the evaluation effort demonstrated increased physician knowledge of communication principles, improvements in weight management counseling rates, and opportunities for health delivery system changes to promote the effective clinical management of unhealthy pediatric weight. PMID:26362560

  2. Employed Family Physician Satisfaction and Commitment to Their Practice, Work Group, and Health Care Organization

    PubMed Central

    Karsh, Ben-Tzion; Beasley, John W; Brown, Roger L

    2010-01-01

    Objective Test a model of family physician job satisfaction and commitment. Data Sources/Study Setting Data were collected from 1,482 family physicians in a Midwest state during 2000–2001. The sampling frame came from the membership listing of the state's family physician association, and the analyzed dataset included family physicians employed by large multispecialty group practices. Study Design and Data Collection A cross-sectional survey was used to collect data about physician working conditions, job satisfaction, commitment, and demographic variables. Principal Findings The response rate was 47 percent. Different variables predicted the different measures of satisfaction and commitment. Satisfaction with one's health care organization (HCO) was most strongly predicted by the degree to which physicians perceived that management valued and recognized them and by the extent to which physicians perceived the organization's goals to be compatible with their own. Satisfaction with one's workgroup was most strongly predicted by the social relationship with members of the workgroup; satisfaction with one's practice was most strongly predicted by relationships with patients. Commitment to one's workgroup was predicted by relationships with one's workgroup. Commitment to one's HCO was predicted by relationships with management of the HCO. Conclusions Social relationships are stronger predictors of employed family physician satisfaction and commitment than staff support, job control, income, or time pressure. PMID:20070386

  3. Physician clinical alignment and integration: a community-academic hospital approach.

    PubMed

    Salas-Lopez, Debbie; Weiss, Sandra Jarva; Nester, Brian; Whalen, Thomas

    2014-01-01

    An overwhelming need for change in the U.S. healthcare delivery system, coupled with the need to improve clinical and financial outcomes, has prompted hospitals to direct renewed efforts toward achieving high quality and cost-effectiveness. Additionally, with the dawn of accountable care organizations and increasing focus on patient expectations, hospitals have begun to seek physician partners through clinical alignment. Contrary to the unsuccessful alignment strategies of the 1990s, today's efforts are more mutually beneficial, driven by the need to achieve better care coordination, increased access to infrastructure, improved quality, and lower costs. In this article, we describe a large, academic, tertiary care hospital's approach to developing and implementing alignment and integration models with its collaboration-ready physicians and physician groups. We developed four models--short of physicians' employment with the organization--tailored to meet the needs of both the physician group and the hospital: (1) medical directorship (group physicians are appointed to serve as medical directors of a clinical area), (2) professional services agreement (specific clinical services, such as overnight admissions help, are contracted), (3) co-management services agreement (one specialty group co-manages all services within the specialty service lines), and (4) lease arrangement (closest in scope to employment, in which the hospital pays all expenses and receives all revenue). Successful hospital-physician alignment requires careful planning and the early engagement of legal counsel to ensure compliance with federal statutes. Establishing an integrated system with mutually identified goals better positions hospitals to deliver cost-effective and high-quality care under the new paradigm of healthcare reform. PMID:24988674

  4. Perceptions of Practice Problems Encountered by Family Physicians, Pediatricians, and Orthopedic Surgeons.

    ERIC Educational Resources Information Center

    Xu, Gang; And Others

    1993-01-01

    Information about practice problems was solicited through a structured questionnaire completed by 59 family physicians, 101 pediatricians, and 102 orthopedic surgeons. Across all three groups, a lack of personal time was the major concern. Practice concerns vary among the specialties, a finding of interest to physician education. (SLD)

  5. A Critical Look at the Family Physician's Role in Preventing Childhood Injuries

    PubMed Central

    Rosser, W.; Feldman, W.; McGrath, P.

    1987-01-01

    Childhood injuries stand as the most common causes of death among Canadian children. Physician advice and advocacy of appropriate legislation, parent education and legislative action could reduce this toll. There is a role for family physicians in the important process of providing a safer environment for our children. PMID:21263865

  6. Academic Achievements of Children in Immigrant Families

    ERIC Educational Resources Information Center

    Han, Wen-Jui

    2006-01-01

    Utilizing data on approximately 16,000 children from the Early Childhood Longitudinal Survey-Kindergarten Cohort and a rich set of mediating factors on 16 immigrant groups, this paper examined the associations between children's immigrant generation status and their academic performance. The changes in academic achievements during kindergarten and…

  7. Preparing the personal physician for practice: changing family medicine residency training to enable new model practice.

    PubMed

    Green, Larry A; Jones, Samuel M; Fetter, Gerald; Pugno, Perry A

    2007-12-01

    After two years of intensive study, in 2004 the Future of Family Medicine report concluded that the current U.S. health care system is inadequate and unsustainable, and called for changes within the specialty of family medicine to ensure the future health of the American public. With guidance and encouragement from many disciplines and health experts, a set of 10 recommendations was established to accomplish a transformative change in how family physicians serve their patients and how the essential function of primary care is achieved. From these recommendations came a period of innovation and experimentation in the training of family physicians, entitled Preparing the Personal Physician for Practice (P4). The P4 project is a carefully designed and evaluated initiative led by the American Board of Family Medicine and the Association of Family Medicine Residency Directors and administered by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. Fourteen family medicine programs were chosen to participate and will put their innovations into practice from 2007 to 2012, during which time regular evaluation will be conducted. The purpose of P4 is to learn how to improve the graduate medical education of family physicians such that they are prepared to be outstanding personal physicians and to work in the new models of practice now emerging. The innovations tested by P4 residencies are expected to inspire substantial changes in the content, structure, and locations of training of family physicians and to guide future revisions in accreditation and certification requirements. PMID:18046133

  8. The Internet and Academics' Workload and Work-Family Balance

    ERIC Educational Resources Information Center

    Heijstra, Thamar M.; Rafnsdottir, Gudbjorg Linda

    2010-01-01

    The aim of this article is to analyse whether the Internet and other ICT technologies support a work-family balance amongst academics. The study is based on 20 in-depth interviews with academics in Iceland and analysed according to the Grounded Theory Approach. This study challenges the notion that the Internet, as part of ICT technology, makes it…

  9. Work-Family Balance and Academic Advancement in Medical Schools

    ERIC Educational Resources Information Center

    Fox, Geri; Schwartz, Alan; Hart, Katherine M.

    2006-01-01

    Objective: This study examines various options that a faculty member might exercise to achieve work-family balance in academic medicine and their consequences for academic advancement. Method: Three data sets were analyzed: an anonymous web-administered survey of part-time tenure track-eligible University of Illinois College of Medicine (UI-COM)…

  10. Irritable bowel syndrome. Strategy for the family physician.

    PubMed Central

    Thompson, W. G.

    1994-01-01

    Irritable bowel syndrome is one of the most common reasons for disability and health care seeking. A sensible strategy for management incorporates a confident diagnosis based upon history, physical examination, and pertinent tests. The physician can then reassure the patient, offer dietary and stress management advice, and recommend bran to relieve constipation and to evoke the placebo response. Patients who do not respond could require supportive psychotherapy or a drug for the dominant symptom. A few require careful referral, but overall responsibility should remain with the primary physician. Images Figures 1-2 PMID:8130678

  11. Birth order, family environments, academic and affective outcomes.

    PubMed

    Marjoribanks, Kevin

    2003-06-01

    Relations were examined among birth order, family social status, family learning environments, and a set of affective and academic outcomes. Data were collected as part of an Australian longitudinal study (4,171 females and 3,718 males). Analysis suggested that birth order continued to have small but significant associations with adolescents' self-concept and educational aspirations and with young adults' educational attainment, after taking into account differences in family social status and family learning environments. PMID:12931949

  12. The future role of the family physician in the United States: a rigorous exercise in definition.

    PubMed

    Phillips, Robert L; Brundgardt, Stacy; Lesko, Sarah E; Kittle, Nathan; Marker, Jason E; Tuggy, Michael L; Lefevre, Michael L; Borkan, Jeffrey M; Degruy, Frank V; Loomis, Glenn A; Krug, Nathan

    2014-01-01

    As the U.S. health care delivery system undergoes rapid transformation, there is an urgent need to define a comprehensive, evidence-based role for the family physician. A Role Definition Group made up of members of seven family medicine organizations developed a statement defining the family physician's role in meeting the needs of individuals, the health care system, and the country. The Role Definition Group surveyed more than 50 years of foundational manuscripts including published works from the Future of Family Medicine project and Keystone III conference, external reviews, and a recent Accreditation Council on Graduate Medical Education Family Medicine Milestones definition. They developed candidate definitions and a "foil" definition of what family medicine could become without change. The following definition was selected: "Family physicians are personal doctors for people of all ages and health conditions. They are a reliable first contact for health concerns and directly address most health care needs. Through enduring partnerships, family physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals. Family physicians and their staff adapt their care to the unique needs of their patients and communities. They use data to monitor and manage their patient population, and use best science to prioritize services most likely to benefit health. They are ideal leaders of health care systems and partners for public health." This definition will guide the second Future of Family Medicine project and provide direction as family physicians, academicians, clinical networks, and policy-makers negotiate roles in the evolving health system. PMID:24821896

  13. The Foreigner Talk of a Family Physician: An Observational Study.

    ERIC Educational Resources Information Center

    Nelson, Dana Kristine

    A study analyzed the characteristics of one male physician's foreigner talk over the telephone with non-native speakers (NNSs) of English and compared it to that of native speakers (NSs). The conversations all related to requests that patients come into the office for a periodic, preventative physical exam. Data came from tape recordings of the…

  14. Canadian family physicians' decision to collaborate: age, period and cohort effects.

    PubMed

    Sarma, Sisira; Devlin, Rose Anne; Thind, Amardeep; Chu, Man-Kee

    2012-11-01

    One of the core primary care reform initiatives seen across provinces in Canada is the introduction of inter-professional primary healthcare teams in which family physicians are encouraged to collaborate with other health professionals. Although a higher proportion of physicians are collaborating with various health professionals now compared to the previous decade, a substantial number of physicians still do not work in a collaborative setting. The objective of this paper is to examine the age, period and cohort effects of Canadian family physicians' decisions to collaborate with seven types of health professionals: specialists, nurse practitioners, nurses, dieticians, physiotherapists, psychologists and occupational therapists. To this end, this paper employs a multivariate probit model consisting of seven equations and a cross-classified fixed-effects strategy to explain the collaborative decisions of family physicians. Utilizing three cross-sectional physician surveys from Canada over the 2001-2007 period, cohorts are defined over five-year intervals according to their year of graduation from medical school. We find that newer cohorts of physicians are more likely to collaborate with dieticians, physiotherapists, psychologists and occupational therapists; newer female cohorts are more likely to collaborate with nurses while newer male cohorts are less likely to collaborate with nurses but more likely to collaborate with specialists. Older physicians are more likely to collaborate with specialists, physiotherapists, psychologists, and occupational therapists; the age effect for nurses is U-shaped for male physicians while it is inverse U-shaped for females. Family physicians are collaborating more with all seven health professionals in 2004 and 2007 compared to 2001. Belonging to a group practice has a largely positive influence on collaborations; and being paid by a fee-for-service remuneration scheme exerts a negative influence on collaboration, ceteris

  15. Oncologists and family physicians. Using a standardized letter to improve communication.

    PubMed Central

    Braun, Ted C.; Hagen, Neil A.; Smith, Colum; Summers, Nancy

    2003-01-01

    PROBLEM BEING ADDRESSED: Communication between oncologists at a regional cancer centre and family physicians caring for palliative cancer patients in the community was ineffective. OBJECTIVE OF PROGRAM: To improve communication between oncologists and family physicians by routine use of a template for dictated letters concerning follow-up care. PROGRAM DESCRIPTION: A consultation letter template was constructed and tested at a single clinic. The template was designed to guide oncologists dictating letters to family physicians for patients' follow-up visits. Effectiveness of the standardized letter was evaluated with a before-after survey. CONCLUSION: Using the template letter improved communication with respect to the relevance, timeliness, format, and amount of information. As care for patients at the end of life increasingly shifts to the community, ongoing efforts are required to improve communication between cancer centres and primary care physicians. PMID:12901484

  16. Noise-induced hearing loss: the family physician's role

    SciTech Connect

    Dobie, R.A.

    1987-12-01

    Noise is an environmental health problem that has not received sufficient attention. Physicians should become knowledgeable about the medical consequences of excessive noise, support legislation to reduce the problem and promote programs aimed at noise control and prevention of hearing loss. Questions about noise and hearing should be incorporated into the medical history, and pure-tone audiometry should be a part of periodic physical evaluations.

  17. Family Structure and Academic Skills among Finnish Adolescents

    ERIC Educational Resources Information Center

    Bjorn, Piia Maria; Kyttala, Minna

    2011-01-01

    This study investigated whether family structure accounts for adolescent academic performance in Finland in the analysis. The thirteen- to fourteen-year-old (grade 8) students' (N = 171) literacy skills were measured and their mathematical performance was tested. Information about family structure was gathered via a questionnaire sent to their…

  18. Genealogy and Family History in the Academic Library.

    ERIC Educational Resources Information Center

    Null, David G.

    1985-01-01

    Addresses public and scholarly interest in the fields of family history and genealogy. Highlights include attitudes before and after publication of Alex Haley's "Roots," library literature on genealogy, history of the family as a field of study, and academic library collection development and services. Twenty-five references are provided. (EJS)

  19. Family Religious Involvement, Parenting Practices and Academic Performance in Adolescents

    ERIC Educational Resources Information Center

    Park, Hae Seong; Bonner, Patricia

    2008-01-01

    This project investigated the impacts of family religious involvement and family religious affiliations on parenting practices and academic performance. This study utilized data from the base-year and first follow-up of the Education Longitudinal Study: 2002/2004 (ELS). A series of statistical techniques were incorporated to examine the nature of…

  20. Classification of complementary and alternative medical practices: Family physicians' ratings of effectiveness.

    PubMed

    Fries, Christopher J

    2008-11-01

    ABSTRACTOBJECTIVETo develop a classification of complementary and alternative medicine (CAM) practices widely available in Canada based on physicians' effectiveness ratings of the therapies.DESIGNA self-administered postal questionnaire asking family physicians to rate their "belief in the degree of therapeutic effectiveness" of 15 CAM therapies.SETTINGProvince of Alberta.PARTICIPANTSA total of 875 family physicians.MAIN OUTCOME MEASURESDescriptive statistics of physicians' awareness of and effectiveness ratings for each of the therapies; factor analysis was applied to the ratings of the 15 therapies in order to explore whether or not the data support the proposed classification of CAM practices into categories of accepted and rejected.RESULTSPhysicians believed that acupuncture, massage therapy, chiropractic care, relaxation therapy, biofeedback, and spiritual or religious healing were effective when used in conjunction with biomedicine to treat chronic or psychosomatic indications. Physicians attributed little effectiveness to homeopathy or naturopathy, Feldenkrais or Alexander technique, Rolfing, herbal medicine, traditional Chinese medicine, and reflexology. The factor analysis revealed an underlying dimensionality to physicians' effectiveness ratings of the CAM therapies that supports the classification of these practices as either accepted or rejected.CONCLUSIONThis study provides Canadian family physicians with information concerning which CAM therapies are generally accepted by their peers as effective and which are not. PMID:19005130

  1. Cancer in remission. Challenge in collaboration for family physicians and oncologists.

    PubMed Central

    Wood, M. L.; McWilliam, C. L.

    1996-01-01

    OBJECTIVE: To explore oncologists' perspectives on the process of cancer patient follow up and to identify what oncologists need from family physicians during the remission stage of cancer disease. DESIGN: Qualitative study with in-depth interviews. SETTING: Regional cancer centre serving a catchment area of 1.4 million people. PARTICIPANTS: A purposive sample of 10 oncologists. One was unable to participate because of sabbatical leave. The nine who participated represented both radiation and medical oncology. Oncologists who had practised at the cancer centre for less than 2 years were excluded from the study. MAIN OUTCOME MEASURES: Existing barriers to communication and collaboration between oncologists and family physicians in cancer patient follow up. RESULTS: Oncologists described roles for themselves in reassuring patients, detecting recurrence, monitoring toxicity of treatment, and gathering data for clinical trials. Collaboration with family physicians in the remission phase was identified as desirable but inhibited by variable and unpredictable interest, poor communication with family physicians, and patients' own preferences for follow up. Oncologists perceived the cancer system structure as a "black box" within which multidisciplinary teams worked well but seldom included family physicians. Oncologists expressed a need to see healthy patients and to have more understanding and support from family physicians, preferably through sharing follow-up care. Developing dialogue and a more collaborative approach were suggested. CONCLUSIONS: Family physicians should maintain a role in remission follow-up. However, a more collaborative approach with oncologists is warranted. Communication barriers, patient preferences, and misperceptions between groups must be addressed before roles are redefined. PMID:8688693

  2. Physician attitudes toward dissemination of optical spectroscopy devices for cervical cancer control: An Industrial-Academic collaborative study

    PubMed Central

    Shinn, Eileen; Qazi, Usman; Gera, Shalini; Brodovsky, Joan; Simpson, Jessica; Follen, Michele; Basen-Engquist, Karen; MacAulay, Calum

    2012-01-01

    Introduction Optical Spectroscopy has been studied for biologic plausisbility, technical efficacy, clinical effectiveness, patient satisfaction and cost-effectiveness. We sought to identify healthcare provider attitudes or practices that might act as barriers or to the dissemination of this new technology. Methods Through an academic-industrial partnership, we conducted a series of focus groups to examine physician barriers to optical diagnosis. The study was conducted in two stages. First, a pilot group of ten physicians (8 obstetrician gynecologists and two family practitioners) was randomly selected from 8 regions of the US and interviewed individually. They were presented with the results of a large trial (N=980) testing the accuracy of a spectroscopy based device in the detection of cervical neoplasia. They were also shown a prototype of the device and were given a period of time to ask questions and receive answers regarding the device. They were also asked to provide feedback of a questionnaire (provided in Appendix A) which was then revised and presented to three larger focus groups (n=13, 15, 17 for a total n=45). The larger focus groups were conducted during national scientific meetings with 20 obstetrician gynecologists and 25 primary care physicians (family practitioners and internists). Results When asked about the dissemination potential of the new cervical screening technology, all study groups tended to rely on established clinical guidelines from their respective professional societies with regard to the screening and diagnosis of cervical cancer. In addition, study participants consistently agreed that real-time spectroscopy would be viewed positively by their patients. Participants were positive about the new technology's potential as an adjunct to colposcopy and agreed that the improved accuracy would result in reduced healthcare costs (due to decreased biopsies and decreased visits). However, while all saw the potential of real-time diagnosis

  3. THE INTERNET AND THE WORLD WIDE WEB: APPLICATIONS FOR FAMILY PHYSICIANS IN SAUDI ARABIA

    PubMed Central

    Sebiany, Abdulaziz M.

    2001-01-01

    The introduction of the World Wide Web has revolutionized the applications of the computer and the Internet in the medical field. The Web provides an easy and cost-effective way of retrieving medical information and a more flexible way of communicating with patients and colleagues. Family practice is a specialty in which care is given to persons as individuals and members of families regardless of their age, gender or specific problems. To provide quality family practice, a family physician should be a good communicator, a critical thinker, a resource and information manager, a life-long learner, a care giver and a community advocate. Providing such high quality care requires that family practice be an information-sensitive specialty. However, the expansion of the new electronic resources on the Internet and the Web poses a real challenge to the family physician. Family physician in Saudi Arabia need to have basic skills and knowledge for easily retrieving and finding reliable Internet information for his professional development and the care of his patients. This article addresses the Web applications for family physicians in Saudi Arabia, giving examples of the most important Websites. PMID:23008644

  4. The Family physician and the Terminally Ill Elderly

    PubMed Central

    Eaton, Bill

    1989-01-01

    Palliative care rests on the three pillars of symptom control, communication, and family support. As our patient population ages, we family doctors will be increasingly involved in the care of the terminally ill elderly at home. Terminal illnesses are much more common in the elderly, and often death can be predicted. Family doctors have a most important role in co-ordinating the home-support services, in providing comfort care, and in supporting the family members who are caring for the terminally ill elderly at home. PMID:21248995

  5. A proposal for the curriculum and evaluation for training rural family physicians in enhanced surgical skills

    PubMed Central

    Caron, Nadine; Iglesias, Stuart; Friesen, Randall; Berjat, Vanessa; Humber, Nancy; Falk, Ryan; Prins, Mark; Haines, Victoria Vogt; Geller, Brian; Janke, Fred; Woollard, Robert; Batchelor, Bret; Van Bussel, Jared

    2015-01-01

    Summary Rural western Canada relies heavily on family physicians with enhanced surgical skills (ESS) for surgical services. The recent decision by the College of Family Physicians of Canada (CFPC) to recognize ESS as a “community of practice” section offers a potential home akin to family practice anesthesia and emergency medicine. To our knowledge, however, a skill set for ESS in Canada has never been described formally. In this paper the Curriculum Committee of the National ESS Working Group proposes a generic curriculum for the training and evaluation of the ESS skill set. PMID:26574835

  6. Difficulties faced by family physicians in primary health care centers in Jeddah, Saudi Arabia

    PubMed Central

    Mumenah, Sahar H.; Al-Raddadi, Rajaa M.

    2015-01-01

    Aim: The aim was to determine the difficulties faced by family physicians, and compare how satisfied those working with the Ministry of Health (MOH) are with their counterparts who work at some selected non-MOH hospitals. Methods: An analytical, cross-sectional study was conducted at King Abdulaziz University Hospital, King Faisal Specialist Hospital and Research Center (KFSH and RC), and 40 MOH primary health care centers across Jeddah. A structured multi-item questionnaire was used to collect demographic data and information on the difficulties family physicians face. The physicians’ level of satisfaction and how it was affected by the difficulties was assessed. Results: Women constituted 71.9% of the sample. Problems with transportation formed one of the main difficulties encountered by physicians. Compared to non-MOH physician, a significantly higher proportion of MOH physicians reported unavailability of radiology technicians (P = 0.011) and radiologists (P < 0.001), absence of the internet and computer access (P < 0.001), unavailability of laboratory services (P = 0.004), reagents (P = 0.001), X-ray equipment (P = 0.027), ultrasound equipment (P < 0.001), an electronic medical records system (P < 0.001), insufficient laboratory tests (P = 0.0001), and poor building maintenance (P < 0.001). Family physicians with the MOH were less satisfied with their jobs compared with non-MOH physicians (P = 0.032). Conclusion: MOH family physicians encountered difficulties relating to staff, services, and infrastructure, which consequently affected their level of satisfaction. PMID:26392794

  7. After the "Doc Fix": Implications of Medicare Physician Payment Reform for Academic Medicine.

    PubMed

    Rich, Eugene C; Reschovsky, James D

    2016-07-01

    The Medicare Access and CHIP Reauthorization Act (MACRA) introduces incentives for clinicians serving Medicare patients to move away from traditional "fee-for-service" and into alternative payment models (APMs) such as accountable care organizations and bundled payment arrangements. Thus, MACRA creates strong reasons for various teaching clinical services to participate in APMs, not only for Medicare patients but for other public and private payers as well. Unfortunately, different APMs may be more or less applicable to the diverse teaching physician roles, academic clinical programs, and patient populations served by medical schools and teaching hospitals. Therefore, this time of transition will complicate the work of academic clinical program leaders endeavoring to sustain the tripartite mission of patient care, health professional education, and research. Nonetheless, payment reforms promoted by MACRA can reward efforts to reinvent medical education to better incorporate value into medical decision making, as well as to give clinical learners the tools and insights needed to recognize their personal financial (and other) conflicts and navigate these to meet their patients' needs. This post-MACRA environment may intensify the need for researchers in academic medicine to stay independent of the short-term financial interests of affiliated clinical institutions. Health sciences scholars must be able to study effectively and speak forcefully regarding the actual benefits, risks, and costs of health care services so that educators and clinicians can identify high-value care and deliver it to their patients. PMID:27224297

  8. Academic Growth Trajectories and Family Relationships among African American Youth

    PubMed Central

    Dotterer, Aryn M.; Lowe, Katie; McHale, Susan M.

    2016-01-01

    This study explored trajectories of African American youths’ academic functioning and assessed whether changes in parent-adolescent relationships were associated with changes in youths’ academic functioning. The data were drawn from a three-year longitudinal study of gender socialization and development in two-parent African American families and included 197 families. Findings revealed gender differences in achievement trajectories and indicated that boys not only had lower levels of academic achievement compared to girls, but also experienced steeper declines in school self-esteem during adolescence. Changes in parent-adolescent relationship quality were linked to changes in academic functioning: Increases in conflict were related to decreases in GPA, school bonding, and school self-esteem and increases in warmth were related to increases in school bonding and school self-esteem. PMID:27122959

  9. "Sometimes I feel overwhelmed": educational needs of family physicians caring for people with intellectual disability.

    PubMed

    Wilkinson, Joanne; Dreyfus, Deborah; Cerreto, Mary; Bokhour, Barbara

    2012-06-01

    Primary care physicians who care for adults with intellectual disability often lack experience with the population, and patients with intellectual disability express dissatisfaction with their care. Establishing a secure primary care relationship is particularly important for adults with intellectual disability, who experience health disparities and may rely on their physician to direct/coordinate their care. The authors conducted semistructured interviews with 22 family physicians with the goal of identifying educational needs of family physicians who care for people with intellectual disability. Interviews were transcribed and coded using tools from grounded theory. Several themes related to educational needs were identified. Physician participants identified themes of "operating without a map," discomfort with patients with intellectual disability, and a need for more exposure to/experience with people with intellectual disability as important content areas. The authors also identified physician frustration and lack of confidence, compounded by anxiety related to difficult behaviors and a lack of context or frame of reference for patients with intellectual disability. Primary care physicians request some modification of their educational experience to better equip them to care for patients with intellectual disability. Their request for experiential, not theoretical, learning fits well under the umbrella of cultural competence (a required competency in U.S. medical education). PMID:22731973

  10. Length of stay and hospital costs among patients admitted to hospital by family physicians

    PubMed Central

    Wen, Chuck K.; Chambers, Catharine; Fang, Dianne; Mazowita, Garey; Hwang, Stephen W.

    2012-01-01

    Abstract Objective To compare length of stay and total hospital costs among patients admitted to hospital under the care of family physicians who were their usual health care providers in the community (group A) and patients admitted to the same inpatient service under the care of family physicians who were not their usual health care providers (group B). Design Retrospective observational study. Setting A large urban hospital in Vancouver, BC. Participants All adult admissions to the family practice inpatient service between April 1, 2006, and June 30, 2008. Main outcome measures Ratio of length of stay to expected length of stay and total hospital costs per resource intensity weight unit. Multivariate linear regression was performed to determine the effect of admitting group (group A vs group B) on the natural logarithm transformations of the outcomes. Results The median acute length of stay was 8.0 days (interquartile range [IQR] 4.0 to 13.0 days) for group A admissions and 8.0 days (IQR 4.0 to 15.0 days) for group B admissions. The median (IQR) total hospital costs were $6498 ($4035 to $11 313) for group A admissions and $6798 ($4040 to $12 713) for group B admissions. After adjustment for patient characteristics, patients admitted to hospital under the care of their own family physicians did not significantly differ in terms of acute length of stay to expected length of stay ratio (percent change 0.6%, P = .942) or total hospital costs per resource intensity weight unit (percent change −2.0%, P = .722) compared with patients admitted under the care of other family physicians. Conclusion These findings suggest that having networks of family physicians involved in hospital care for patients is not less efficient than having family physicians provide care for their own patients. PMID:22518905

  11. Online Medical Literature Consultation Habits of Academic Teaching Physicians in the EU and CIS Countries: A Cross-Sectional Study

    PubMed Central

    van der Voort, Chiel T. M.; Swenne, Cees A.; van der Hoorn-van Velthoven, Catharina A. M.; Belt, Johannes H. J.

    2012-01-01

    Background Both in the Commonwealth of Independent States (CIS) and in the European Union (EU2004), ample availability of up to date medical scientific literature is important for progress in medical science and for the education of the next generation of healthcare workers. The aim of this research is to assess if the use of online medical literature among academic teaching (AT) physicians is at the same level in the CIS as in the EU2004. Methodology/Principal Findings In the capital cities of the CIS and the EU2004 member states, AT physicians holding an academic position at least equivalent to an associate professor and performing the three classical tasks in academic medicine (teaching, research and patient care) were interviewed about their use of and familiarity with the Internet and 9 online literature services, including journals and bibliographical databases such as PubMed (Medline), The Cochrane Library and Web of Science. Library staff members were interviewed about the availability of these online literature services at their libraries. About 750 physicians and 40 library staff members were invited for participation. Eventually 124 AT physicians and 22 library staff members participated. Internet was everywhere available, but used daily by more AT physicians in the EU2004 (71% versus 48% in the CIS, P = .005). AT physicians in the EU2004 accessed a higher percentage of all articles online (74% versus 43% in the CIS, P<.001). PubMed (P<.001), The Cochrane Library (P<.001) and Web of Science (P<.003) were used more frequently in the EU2004. In the EU2004 more AT physicians were familiar with Open Access journals (89% versus 51% in the CIS, P<.001). Conclusions/Significance AT physicians in the CIS use online medical literature less than in the EU2004. It is recommended that the awareness of freely available online literature services such as Open Access journals is enhanced among AT physicians and library staff members, especially in the CIS. PMID

  12. [GPs' self-perception of their own role compared with hospital, ambulatory, academic, and health organisation physicians].

    PubMed

    Daghio, Maria Monica; Gaglianò, Giuseppe; Bevini, Massimo; Cadioli, Tiziano; Delvecchio, Carlo; Guidetti, Patrizia; Lorenzetti, Manuela; Fattori, Giuseppe; Ciardullo, Anna Vittoria

    2005-05-01

    Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'. PMID:15977651

  13. Adoption of open-access scheduling in an academic family practice

    PubMed Central

    Cameron, Stewart; Sadler, Laura; Lawson, Beverley

    2010-01-01

    ABSTRACT PROBLEM ADDRESSED Patients have to wait too long to see their family physicians. Open access, a new approach to office scheduling, has shown promise in reducing patient wait times to see primary care physicians. OBJECTIVE OF PROGRAM To offer same-day appointments to most patients who call the office, thus reducing wait times as measured by the third available appointment. Reductions in no-show rates have also been reported by those who have adopted the open-access system. PROGRAM DESCRIPTION Following extensive preparation, a 2-site academic practice in Halifax, NS, adopted open-access booking in October 2008. Data on third available appointment times, no-show appointments, and patient volumes were tracked before and during the yearlong implementation. CONCLUSION The clinics recorded a substantial, sustained reduction in third available appointment time, indicating improved patient access. There was also a decline in no-show appointments. Patient volumes were unaffected. PMID:20841595

  14. Satisfaction and Dissatisfaction Toward Urban Family Physician Program: A Population Based Study in Shiraz, Southern Iran

    PubMed Central

    Honarvar, Behnam; Lankarani, Kamran Bagheri; Ghahramani, Sulmaz; Akbari, Maryam; Tabrizi, Reza; Bagheri, Zahra; Poostforoushfard, Sima

    2016-01-01

    Background: A national project of extending a family physician program to urban areas has been started since May 2013 in Iran. The present study aimed to detect correlates of people's satisfaction and dissatisfaction about urban family physician program. Methods: This cross-sectional and population-based study was conducted in Shiraz, Southern Iran. Multistage and proportional to size random sampling were used. Different items about satisfaction and dissatisfaction toward urban family physician program were queried. Single variable and then multiple variable analyses of data were done using SPSS software (Chicago, IL. USA). Results: Mean age of 1257 participants in the study was 38.1 ± 13.2 years. Respondents included men (634; 50.4%), married (882; 70.2%), those who were educated at universities (529; 42%) and self-employed groups (405; 32.2%). One thousand fifty-eight (84.1%) were covered by the family physician program. Mean of referral times to a family physician was 2.2 ± 2.9 during the year before the study. Satisfaction toward urban family physician program was high in 198 (15.8%), moderate in 394 (31.3%), and low in 391 (31.1%). Dissatisfaction about this program was more among younger than 51-year-old groups (for 31–50 years odds ratio [OR] =2.3, 95% confidence interval [CI] =1.4–3.7, P < 0.001 and for 18–30 years OR = 2, 95% CI = 1.2–3.4, P = 0.005), less knowledgeable ones (OR = 2.2, 95% CI = 1.3–3.6, P = 0.001), singles (OR = 2.1, 95% CI = 1.2–3.4, P = 0.003), and those with more than 4 of family members (OR = 1.3, 95% CI = 1–1.7, P = 0.05). Conclusions: Overall, the majority of the people are not very satisfied with the urban family physician program. This shows the need for a multi-disciplinary approach including training, improvement of infrastructures and referral system, continuous supervision, and frequent monitoring of user's and provider's feedback about this program. According the results, the family physician program should be

  15. Factors Impacting Transgender Patients’ Discomfort with Their Family Physicians: A Respondent-Driven Sampling Survey

    PubMed Central

    Bauer, Greta R.; Zong, Xuchen; Scheim, Ayden I.; Hammond, Rebecca; Thind, Amardeep

    2015-01-01

    Background Representing approximately 0.5% of the population, transgender (trans) persons in Canada depend on family physicians for both general and transition-related care. However, physicians receive little to no training on this patient population, and trans patients are often profoundly uncomfortable and may avoid health care. This study examined factors associated with patient discomfort discussing trans health issues with a family physician in Ontario, Canada. Methods 433 trans people age 16 and over were surveyed using respondent-driven sampling for the Trans PULSE Project; 356 had a family physician. Weighted logistic regression models were fit to produce prevalence risk ratios (PRRs) via average marginal predictions, for transmasculine (n = 184) and transfeminine (n = 172) trans persons. Results Among the 83.1% (95% CI = 77.4, 88.9) of trans Ontarians who had a family physician, approximately half reported discomfort discussing trans health issues. 37.2% of transmasculine and 38.1% of transfeminine persons reported at least one trans-specific negative experience. In unadjusted analysis, sociodemographics did not predict discomfort, but those who planned to medically transition sex, but had not begun, were more likely to report discomfort (transmasculine: PRR = 2.62 (95% CI = 1.44, 4.77); transfeminine: PRR = 1.85 (95% CI = 1.08, 3.15)). Adjusted for other factors, greater perceived physician knowledge about trans issues was associated with reduced likelihood of discomfort, and previous trans-specific negative experiences with a family physician with increased discomfort. Transfeminine persons who reported three or more types of negative experiences were 2.26 times as likely, and transmasculine persons 1.61 times as likely, to report discomfort. In adjusted analyses, sociodemographic associations differed by gender, with being previously married or having higher education associated with increased risk of discomfort among transfeminine persons, but

  16. The prescribing patterns of Wisconsin family physicians surrounding saline nasal irrigation for upper respiratory conditions

    PubMed Central

    Rabago, David; Zgierska, Aleksandra; Peppard, Paul; Bamber, Amy

    2009-01-01

    Context Upper respiratory conditions are common and have a significant impact on patient quality of life, medical resource expenditure and antibiotic use. Saline nasal irrigation (SNI) is an adjunctive therapy for upper respiratory conditions; clinical studies suggest that use of SNI may be effective for symptoms upper respiratory conditions, and its popularity seems to be growing. The prescribing patterns of physicians regarding SNI have not been studied. Objective To assess the use among family physicians in Wisconsin of SNI, determine how and for which conditions they recommend SNI and the degree to which they experience clinical success with SNI. Design Electronic questionnaire Participants 330 practicing family physicians in the Wisconsin Academy of Family Physicians and Wisconsin Research and Education Network Intervention/Outcome Not applicable Results Analysis showed that 286 of 330 respondents (87%) have used SNI as adjunctive care for a variety of upper respiratory conditions including chronic rhinosinusitis (91%), acute bacterial rhinosinusitis (67%), seasonal allergic rhinitis (66%), viral upper respiratory infection (59%), other allergic rhinitis (48%), irritant based congestion (48%) and rhinitis of pregnancy (17%). Respondents also reported having used SNI prior to antibiotics for acute bacterial rhinosinusitis (77%). Use patterns varied regarding type of SNI administration, dosing frequency, saline concentration and patient education. Conclusions This questionnaire-based study suggests that SNI is used by family physicians for a variety of upper respiratory conditions though recommendation and patient education styles, dosing schedules, and solution types vary. PMID:19552352

  17. Patient health information materials in waiting rooms of family physicians: do patients care?

    PubMed Central

    Moerenhout, Tania; Borgermans, Liesbeth; Schol, Sandrina; Vansintejan, Johan; Van De Vijver, Erwin; Devroey, Dirk

    2013-01-01

    Background Patient health information materials (PHIMs), such as leaflets and posters are widely used by family physicians to reinforce or illustrate information, and to remind people of information received previously. This facilitates improved health-related knowledge and self-management by patients. Objective This study assesses the use of PHIMs by patient. It also addresses their perception of the quality and the impact of PHIMs on the interaction with their physician, along with changes in health-related knowledge and self-management. Methods Questionnaire survey among patients of family practices of one town in Belgium, assessing: (1) the extent to which patients read PHIMs in waiting rooms (leaflets and posters) and take them home, (2) the patients’ perception of the impact of PHIMs on interaction with their physician, their change in health-related knowledge and self-management, and (3) the patients judgment of the quality of PHIMs. Results We included 903 questionnaires taken from ten practices. Ninety-four percent of respondents stated they read PHIMs (leaflets), 45% took the leaflets home, and 78% indicated they understood the content of the leaflets. Nineteen percent of respondents reportedly discussed the content of the leaflets with their physician and 26% indicated that leaflets allowed them to ask fewer questions of their physician. Thirty-four percent indicated that leaflets had previously helped them to improve their health-related knowledge and self-management. Forty-two percent reportedly discussed the content of the leaflets with others. Patient characteristics are of significant influence on the perceived impact of PHIMS in physician interaction, health-related knowledge, and self-management. Conclusion This study suggests that patients value health information materials in the waiting rooms of family physicians and that they perceive such materials as being helpful in improving patient–physician interaction, health-related knowledge, and

  18. Academic I.D. in jeopardy: the erosion of time, professional values, and physician satisfaction.

    PubMed

    Wenzel, Richard P; Edmond, Michael B

    2015-04-01

    The American public entrusts academic medicine with a varied portfolio of critical responsibilities: the thoughtful mentoring of future generations of doctors, the engagement of cutting edge discoveries, and the empathic treatment of patients with complicated illnesses. The erosion of time to perform these duties has led to an estrangement of our key professional values and thus a loss of public trust, the inability to recognize new diseases, reduced communication in our ranks, and physician dissatisfaction. Much of this is driven by an unbalanced focus on the business model of medicine, highlighting rapid patient transactions linked to professional income with financial incentives for high-volume care. Reversing the current trends requires a new type of leadership committed to long-held professional values and a recognition of what drives professional excellence. As internists and infectious diseases specialists without procedures in our practice, we are especially vulnerable to these trends. PMID:25690849

  19. FEE-SCHEDULE INCREASES IN CANADA: IMPLICATION FOR SERVICE VOLUMES AMONG FAMILY AND SPECIALIST PHYSICIANS.

    PubMed

    Ariste, Ruolz

    2015-01-01

    Physician spending has substantially increased over the last few years in Canada to reach $27.4 billion in 2010. Total clinical payment to physicians has grown at an average annual rate of 7.6% from 2004 to 2010. The key policy question is whether or not this additional money has bought more physician services. So, the purpose of this study is to understand if we are paying more for the same amount of medical services in Canada or we are getting more bangs for our buck. At the same time, the paper attempts to find out whether or not there is a productivity difference between family physician services and surgical procedures. Using the Baumol theory and data from the National Physician Database for the period 2004-2010, the paper breaks down growth in physician remuneration into growth in unit cost and number of services, both from the physician and the payer perspectives. After removing general inflation and population growth from the 7.6% growth in total clinical payment, we found that real payment per service and volume of services per capita grew at an average annual rate of 3.2% and 1.4% respectively, suggesting that payment per service was the main cost driver of physician remuneration at the national level. Taking the payer perspective, it was found that, for the fee-for-service (FFS) scheme, volume of services per physician decreased at an average annual rate of -0.6%, which is a crude indicator that labour productivity of physicians on FFS has fallen during the period. However, the situation differs for the surgical procedures. Results also vary by province. Overall, our finding is consistent with the Baumol theory, which hypothesizes higher productivity growth in technology-driven sectors. PMID:26897992

  20. Should Medical Anthropology be Required for Family Physicians?

    PubMed Central

    Deagle, George L.

    1992-01-01

    The educational preparation of practitioners might change as family medicine shifts its emphasis to a more humanistic approach. Medical anthropology offers particular promise as a training experience. Learning about the role of culture, including beliefs and values surrounding illness, can supplement basic science training. Improved delivery of health care is likely if caregivers are sensitive to cultural dimensions of patients' illnesses. Imagesp1178-ap1179-ap1180-a PMID:21221336

  1. Differential Effects of Economic Factors on Specialist and Family Physician Distribution in Illinois: A County-Level Analysis

    ERIC Educational Resources Information Center

    Mistretta, Martin J.

    2007-01-01

    Context: Uneven distribution of physicians across geographic areas of the United States remains a significant problem that may have implications for health. Purpose: To develop a statistical model of physician distribution in Illinois counties that predicts where specialists and family physicians practice, and to suggest policy strategies for…

  2. Nurses versus physicians' knowledge, attitude, and performance on care for the family members of dying patients

    PubMed Central

    Abdollahimohammad, Abdolghani; Firouzkouhi, Mohammadreza; Amrollahimishvan, Fatemeh; Alimohammadi, Nasrollah

    2016-01-01

    Purpose: Nurses and physicians must be competent enough to provide care for the clients. As a lack of knowledge and a poor attitude result in a low performance of delivering care, this study aimed to explore the nurses versus physicians’ knowledge, attitude, and performance on care for the family members of dying patients (FMDPs). Methods: This descriptive study was conducted at the educational hospitals in Isfahan, Iran. The samples were 110 nurses and 110 physicians. The data were collected through a convenience sampling method and using a valid and reliable questionnaire. Results: The average knowledge, attitude, and performance on care for the FMDPs were not significantly different between nurses and physicians (p>0.05). The majority of nurses (55.4%) and physician (63.6%) were at a moderate and a fair level of knowledge of care for the FMDPs. Most of the nurses (81%) and physicians (87.3%) had a positive attitude towards caring the FMDPs. Most of the nurses (70%) and physicians (86.3%) had a moderate and fair performance. Conclusion: Having enough knowledge and skills, and a positive attitude are necessary for caring the FMDPs. Nurses’ and physicians' competencies must be improved through continuing educational programs and holding international and national conferences with a focus on the palliative care. PMID:26838571

  3. Family Meals and Child Academic and Behavioral Outcomes

    ERIC Educational Resources Information Center

    Miller, Daniel P.; Waldfogel, Jane; Han, Wen-Jui

    2012-01-01

    This study investigates the link between the frequency of family breakfasts and dinners and child academic and behavioral outcomes in a panel sample of 21,400 children aged 5-15. It complements previous work by examining younger and older children separately and by using information on a large number of controls and rigorous analytic methods to…

  4. Ethnicity, Family Environment, School Attitudes and Academic Achievement.

    ERIC Educational Resources Information Center

    Marjoribanks, Kevin

    1978-01-01

    Regression surface analysis was used to examine relations between family environment, assessed in parent interviews, and measures of academic achievement at different levels of school-related attitudes for 800 11-year-old children from lower and middle class groups: Anglo Australian, Greek, recent English immigrants, and Southern Italian.…

  5. Social Determinants of Health and Beyond: Information to Help Family Physicians Improve Patient Care.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria; Seehusen, Dean A

    2016-01-01

    Social determinants of health (SDOHs) are a theme in this issue. In addition, we include a series of clinical articles to inform family medicine. One helps to demystify the process of obtaining hearing care. Another provides a case report of how a vanishing twin can confuse a newly available test. We also share articles on the early symptoms and signs of femoral insufficiency fractures and a simple test to help diagnose basal cell carcinomas. Family physicians provide their views on point-of-care tests. Positive outcomes are reported for behavioral health integration into family medicine offices and for diabetes education among patients cared for within patient-centered medical homes. A questionnaire can help family physicians identify and facilitate conversations with their patients about adverse childhood experiences. PMID:27170784

  6. Caring for patients with HIV infection. Management plan for family physicians.

    PubMed Central

    Bally, G.

    1993-01-01

    Caring for and treating patients living with human immunodeficiency virus is challenging for busy family physicians. I present one strategy for managing patients with this complex infectious disease. Using averaged T4 blood cell counts as a marker of disease progression, I use antiretroviral treatment and preventive drug therapy against the complications of HIV infection. PMID:8219865

  7. The Snow Machine and the Family Physician (Medical and Social Aspects)

    PubMed Central

    Eaid, C. R.

    1970-01-01

    The snow machine is here to stay. The family physician must acquaint himself with possible increasing numbers of trauma. Etiology is important. College of Family Physicians with other bodies should conduct a symposium on the dangers of this sport before 1970-71 season. Family physician should cooperate in reporting all injuries; their cause and possible prevention. Prevention is combined responsibility of organized medicine, manufacturer and the operator. Club activity is endorsed over private activity. Snow machines induce special type of trauma. Increased soft tissue damage. Shock more prominent feature due to chill factor and possible delay in reaching treatment centre. Major cause of death is head injury and brain damage. Present helmets are less than adequate. Manufacturers to be increasingly safety conscious. Safety is joint effort of the former, the profession and legislation. Snow machining is a recreation, not an exercise. It is not recommended for certain restricted groups. Family physician has a special role in treatment, evaluation and recommendations. More statistical analysis and co-operation required. Snow machine can be a killer and a source of major trauma. Imagesp43-ap44-ap44-bp45-ap45-b PMID:20468483

  8. Advantages and Disadvantages of Educational Email Alerts for Family Physicians: Viewpoint

    PubMed Central

    Badran, Hani; Grad, Roland

    2015-01-01

    Background Electronic knowledge resources constitute an important channel for accredited Continuing Medical Education (CME) activities. However, email usage for educational purposes is controversial. On the one hand, family physicians become aware of new information, confirm what they already know, and obtain reassurance by reading educational email alerts. Email alerts can also encourage physicians to search Web-based resources. On the other hand, technical difficulties and privacy issues are common obstacles. Objective The purpose of this discussion paper, informed by a literature review and a small qualitative study, was to understand family physicians’ knowledge, attitudes, and behavior in regard to email in general and educational emails in particular, and to explore the advantages and disadvantages of educational email alerts. In addition, we documented participants’ suggestions to improve email alert services for CME. Methods We conducted a qualitative descriptive study using the “Knowledge, Attitude, Behavior” model. We conducted semi-structured face-to-face interviews with 15 family physicians. We analyzed the collected data using inductive-deductive thematic qualitative data analysis. Results All 15 participants scanned and prioritized their email, and 13 of them checked their email daily. Participants mentioned (1) advantages of educational email alerts such as saving time, convenience and valid information, and (2) disadvantages such as an overwhelming number of emails and irrelevance. They offered suggestions to improve educational email. Conclusions The advantages of email alerts seem to compensate for their disadvantages. Suggestions proposed by family physicians can help to improve educational email alerts. PMID:25803184

  9. Effects of Child Age and Level of Developmental Delay on Family Practice Physicians' Diagnostic Impressions.

    ERIC Educational Resources Information Center

    Epps, Susan; Kroeker, Rose

    1995-01-01

    This study of the effects of child age (20 and 40 months) and level of developmental delay (mild and severe) on identification of developmental disorders by 155 family practice physicians provided evidence that identification of developmental delay was generally high across conditions, with mild delay being less likely to be detected. (Author/JDD)

  10. Barriers to Physician Identification and Treatment of Family Violence: Lessons from Five Communities.

    ERIC Educational Resources Information Center

    Cohen, Stu; And Others

    1997-01-01

    A study involving over 480 interviews in five diverse communities (Atlanta, Georgia; Duluth, Minnesota; Providence, Rhode Island; Riverside, California; Roswell, New Mexico) identified barriers facing physicians and other health care providers in identifying, treating, and referring victims of family violence, and illuminated the relationships of…

  11. Urban family physician plan in Iran: challenges of implementation in Kerman

    PubMed Central

    Dehnavieh, Reza; Kalantari, Ali Reza; Jafari Sirizi, Mohammad

    2015-01-01

    Background: The Family Physician Plan has recently been implemented in three provinces of Iran on a pilot basis and is going to be implemented throughout Iran in the future. Through a qualitative design, this study aims to determine probable implementation challenges of Family Physician Plan in Kerman. Methods: This study was conducted in Kerman in 2013. Data were collected through interviews with 21 experts in the field. Sampling continued until data saturation level was achieved. All interviews were recorded and then analyzed, and main themes and subgroups were extracted from them based on a framework analysis model. Results: most prevalent establishment challenges of Family Physician Plan were classified into policy-making, financial supply, laws and resources. Conclusion: The urban Family Physician Plan can be carried out more effectively by implementing this plan step by step, highlighting the relationships between the related organizations, using new payment mechanisms e.g Per Capita, DRG, make national commitment and proper educational programs for providers, development the health electronic Record, justifying providers and community about advantages of this plan, clarifying regulatory status about providers' Duties and most importantly considering a specific funding source. PMID:26913266

  12. Dutch physicians on the role of the family in continuous sedation.

    PubMed

    van Tol, Donald G; Kouwenhoven, Pauline; van der Vegt, Bea; Weyers, Heleen

    2015-03-01

    In order to relieve intractable suffering of a terminal patient, doctors may decide to continuously sedate a patient until the end of life. Little research is done on the role the family plays during the process of continuous sedation. This study aims to get a view of doctors' experiences with continuous sedation, and the role of the family throughout that process. We held in-depth interviews with 48 doctors (19 general practitioners, 16 nursing home doctors and 18 medical specialists). Participants were selected varying in experience and opinions concerning end-of-life decisions. Dutch physicians experience the role of family in continuous sedation as important and potentially difficult. Difficulties may rise especially during the final stages when the patient is no longer conscious and family members are waiting for death to come. Disagreement may arise between physician and family, concerning the dignity of the dying process or the question whether the sedated patient is suffering or not. Some physicians report they hastened the dying process, in order to relieve the families' suffering. PMID:24595486

  13. Patient satisfaction with breast cancer follow-up care provided by family physicians

    PubMed Central

    Thind, Amardeep; Liu, Yihang; Maly, Rose

    2011-01-01

    Purpose There is little evidence to document patient satisfaction with follow up care provided by family physicians/general practitioners (FP/GP) to breast cancer patients. We aimed to identify determinants of satisfaction with such care in low-income medically underserved women with breast cancer. Methods Cross sectional study of 145 women who reported receiving follow up care from a FP/GP. Women were enrolled in California’s Breast and Cervical Cancer Treatment Program and were interviewed by phone 3 years after breast cancer diagnosis. Cleary and McNeil’s model, which states that patient satisfaction is a function of patient characteristics, structure of care, and processes of care, was used to understand the determinants of satisfaction. Stepwise logistic regression was used to identify significant predictors. Results 73.4% reported that they were extremely satisfied with their treatment by the family physician/general practitioner. Women who were able to ask their family physicians questions about their breast cancer had six times greater odds of being extremely satisfied compared to women who were not able to ask any questions. Women who scored the family physician higher on the ability to explain things in a way she could understand had a higher odds of being extremely satisfied compared to women who scored their family physicians lower. Conclusions FP/GPs providing follow up care for breast cancer patients should encourage patients to ask questions, and must communicate in a way that patients understand. These recommendations are congruent with the characteristics of patient centered communication for cancer patients enunciated in a recent NCI monograph. PMID:22086814

  14. Palliative care by family physicians in the 1990s. Resilience amid reform.

    PubMed Central

    Burge, F.; McIntyre, P.; Twohig, P.; Cummings, I.; Kaufman, D.; Frager, G.; Pollett, A.

    2001-01-01

    OBJECTIVE: To explore issues family physicians face in providing community-based palliative care to their patients in the context of a changing health care system. DESIGN: Focus groups. SETTING: Small (< 10,000 population), medium-sized (10,000 to 50,000), and large (> 50,000) communities in Nova Scotia. PARTICIPANTS: Twenty-five men and women physicians with varying years of practice experience in both solo and group practices. METHOD: A semistructured approach was used, asking physicians to reflect on recent palliative care experiences in order to explore issues of care. MAIN FINDINGS: Five themes emerged from the discussions: resources needed, availability of family support, time and money supporting physicians' activities, symptom control for patients, and physicians' emotional reactions to caring for dying patients. CONCLUSION: With downsizing of hospitals and greater emphasis on community-based care, the issues identified in this study will need attention, particularly in designing an integrated service delivery model for palliative care. PMID:11723593

  15. Evaluating the Content of Family Physician Websites in the United States.

    PubMed

    Alpert, Jordan M

    2015-01-01

    The Internet provides easier access to health information and has become a powerful resource for managing one's health. In addition to websites that provide general health information, physicians create personalized websites to give patients an overview of their practice. The purpose of this study was to evaluate characteristics of family physician websites to determine the type of content provided. Over 900 family physicians from the US News & World Reports' best doctors list were reviewed to determine if a website existed. Then, each website was measured against seven main categories: information about the practice, medical information provided, communication, functionality, links, advertisements, and advanced tools. Although the majority provided basic information, only 21.4% had a website and most failed to provide additional information such as medical education, staff details, and accepted insurance. Furthermore, most physician websites were devoid of web 2.0 applications, despite the popularity of more tech-savvy services such as booking online appointments, social networking platforms, and patient portals. Because patients are becoming more consumer-centric about their health, physicians must keep up with technology in order to match patient expectations and preferences. Doing so will help attract new patients and has the ability to enhance the patient-provider relationship. PMID:24417564

  16. Promoting and measuring family caregiver self-efficacy in caregiver-physician interactions.

    PubMed

    Moore, Crystal Dea; Cook, Kevin M

    2011-01-01

    This article describes the development of a 5-item scale that assesses family caregivers' self-efficacy in communicating with physicians about ill family members (Perceived Efficacy in Caregiver-Physician Interactions-PECPI) in the context of an evaluation study of an online training in health care communication skills for caregivers. A national sample of 197 self-identified family caregivers participated in an online webinar and completed a brief evaluation instrument before and immediately after the training. Results indicated that the webinar was effective in increasing perceived self-efficacy and self-reported knowledge about and level of preparation for medical visits. Principal component analysis indicates that the PECPI is unidimensional with a Cronbach's alpha of .91. PMID:22136346

  17. Family income, school attendance, and academic achievement in elementary school.

    PubMed

    Morrissey, Taryn W; Hutchison, Lindsey; Winsler, Adam

    2014-03-01

    Low family income is associated with poor academic achievement among children. Higher rates of school absence and tardiness may be one mechanism through which low family income impacts children's academic success. This study examines relations between family income, as measured by receipt of free or reduced-price lunch, school attendance, and academic achievement among a diverse sample of children from kindergarten to 4th grade (N = 35,419) using both random and within-child fixed-effects models. Generally, results suggest that the receipt of free or reduced-price lunch and duration of receipt have small but positive associations with school absences and tardies. Poor attendance patterns predict poorer grades, with absences more associated with grades than tardies. Given the small associations between receipt of free or reduced-price lunch and school attendance, and between the duration of receipt of free or reduced-price lunch and children's grades, results do not provide strong evidence that absences and tardies meaningfully attenuate relations between the duration of low family income and student achievement; poorer attendance and persistent low income independently predict poorer grades. Implications for policy and future research are discussed. PMID:23914750

  18. Knowledge, Attitude, Practice, and Perceived Barriers of Colorectal Cancer Screening among Family Physicians in National Guard Health Affairs, Riyadh

    PubMed Central

    2014-01-01

    Objectives. The objective of this study is to explore the current knowledge, attitude, and practice of family physicians working in family medicine clinics in National Guard Health Affairs (NGHA), Riyadh, toward colorectal cancer (CRC) screening and to identify the barriers of the screening. Methods. Data were collected using a validated self-administered questionnaire adopted from the National Cancer Institute in USA, customized by adding and eliminating questions to be in line with the institution (NGHA) characteristics. Results. Of the 130 physicians, 56.2% of the physicians were not practicing CRC screening although 94.6% considered CRC screening effective. Board certified physicians had higher knowledge score and were practicing CRC screening more when compared to other physicians. Physicians who reported practicing CRC screening scored more on the knowledge score than those not practicing. Male physicians scored better on attitude score than female physicians. The study found that barriers were cited in higher rates among physicians not practicing CRC screening compared with practicing physicians. Lack of patients' awareness was the most cited barrier. Conclusion. Large percentage of family physicians in this study do not practice CRC screening, despite the knowledge level and the positive attitude. PMID:25328703

  19. Compensating and providing incentives for academic physicians: balancing earning, clinical, research, teaching, and administrative responsibilities.

    PubMed

    Ceriani, P J

    1992-04-01

    Providing a comprehensive compensation and incentive plan for a group of faculty members in a department with multiple goals provides a challenge that few administrators may take. Many academic departments have given up on implementing a comprehensive compensation and incentive plan since department goals generate competing uses of a faculty member's time. Whatever the plan design your department adopts, you can be sure that it will generate controversy. The JPN department has attempted to reward and encourage faculty members to pursue scholarly activities balanced with clinical activities. As a result, this strategy has only considered physicians who can generate both clinical income and research funding. Thus far, the JPN department faculty have embraced the plan. Long-term effects are not known as this is the first year of the plan. The measure of a successful total compensation program is one that develops a sense of entrepreneurship among its members to develop new clinical programs, to pursue new research collaborations, and to devise innovative methods of training. The program described in this article is not intended to serve as the ideal model for all departments, even in academic institutions, but rather to provide a strategy that may have applicability to many other departments where the goals induce inherent conflict for faculty members attempting to decide where to place their time commitments. In addition, this strategy does not work well on an individual basis for young, beginning faculty members but does work well in the collective--to promote the goals of the department. Be prepared, however, to modify your plan after a trial period of perhaps two years. You must allow time to monitor the effects of your compensation plan and its impact on the goals and direction of the department. PMID:10118362

  20. Medical Manpower Projections and Proposals: The Federal/Provincial/Territorial Report and Its Implications for Family Physicians

    PubMed Central

    Moore, Carl A.

    1986-01-01

    The Federal/Provincial/Territorial Advisory Committee on Health Manpower has projected a surplus of 4,870 family physicians in Canada by the year 2000. Among the committee's recommendations are proposals to reduce the number of family physicians in the future, and to decrease the undergraduate enrollment in Canadian medical schools by 17%. Too many physicians could lead to excessive costs for the government, and to overservicing, underemployment, low morale, and decreased incomes for physicians themselves. A shortfall in physician supply is easily overcome by opening the doors to immigrant physicians. However, quality of care may be sacrificed. The status and quality of family practice will be directly affected by the action ensuing from the advisory committee's report. PMID:21267265

  1. How Do Physicians Assess Their Family Physician Colleagues' Performance? Creating a Rubric to Inform Assessment and Feedback

    ERIC Educational Resources Information Center

    Sargeant, Joan; MacLeod, Tanya; Sinclair, Douglas; Power, Mary

    2011-01-01

    Introduction: The Colleges of Physicians and Surgeons of Alberta and Nova Scotia (CPSNS) use a standardized multisource feedback program, the Physician Achievement Review (PAR/NSPAR), to provide physicians with performance assessment data via questionnaires from medical colleagues, coworkers, and patients on 5 practice domains: consultation…

  2. Community resources for psychiatric and psychosocial problems. Family physicians' referral patterns in urban Ontario.

    PubMed Central

    Craven, M. A.; Allen, C. J.; Kates, N.

    1995-01-01

    OBJECTIVE: To document the number and pattern of psychiatric and psychosocial referrals to community resources by family physicians (FPs) and to determine whether referral practices correlate with physician variables. DESIGN: Cross-sectional survey of referrals by FPs to 34 key psychiatric and psychosocial community resources identified by a panel of FPs, psychiatric social workers, psychiatric nurses, public health nurses, and the local community information service. SETTING: Regional municipality of 434,000 persons in Ontario. PARTICIPANTS: Twenty-seven of 34 (79%) community agencies identified 261 FPs who made 4487 referrals to participating agencies (range 0 to 65, median 15, mean 17.19 +/- 13.42). MAIN OUTCOME MEASURES: Number of referrals to all agencies; variables, such as physician sex, school of graduation, year of graduation, and certificate status in the College of Family Physicians of Canada, related to referral patterns. RESULTS: Referrals to outpatient psychiatric clinics, support services, and general counseling services accounted for 96% of all referrals. Physicians' average annual referral profile was as follows: 8.6 patients to a support service, 6.3 to an outpatient psychiatric service, 1.6 to a counseling service, and 0.46 to a substance abuse service. Referral profiles of individual physicians varied greatly. Female FPs made fewer referrals than male FPs to support services, but both made similar numbers of referrals to psychiatric, counseling, and substance abuse services. The more recent the year of graduation, the greater the number of referrals to psychiatric (r = 0.158, P = 0.0107) and counseling services (r = 0.137, P = 0.0272) and the higher the fraction of referrals to psychiatric services (r = 0.286, P = 0.0001). CONCLUSIONS: Family physicians in Hamilton-Wentworth made few referrals to psychiatric and psychosocial services. Only physician sex and year of graduation correlated significantly with numbers of referrals made. Recent

  3. The quality assessment of family physician service in rural regions, Northeast of Iran in 2012

    PubMed Central

    Vafaee-Najar, Ali; Nejatzadegan, Zohreh; Pourtaleb, Arefeh; Kaffashi, Shahnaz; Vejdani, Marjan; Molavi-Taleghani, Yasamin; Ebrahimipour, Hosein

    2014-01-01

    Background: Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients’ expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. Methods: This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. Results: The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference (P≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services (P≤ 0.05). Conclusion: There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients’ expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employees. PMID:24757691

  4. The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study

    PubMed Central

    Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

    2016-01-01

    Background When a country’s health system is faced with fundamental flaws that require the redesign of financing and service delivery, primary healthcare payment systems are often reformed. Objectives This study was conducted with the purpose of exploring the experiences of risk-adjusted capitation payment of urban family physicians in Iran when it comes to providing primary health care (PHC). Materials and Methods This is a qualitative study using the framework method. Data were collected via digitally audio-recorded semi-structured interviews with 24 family physicians and 5 executive directors in two provinces of Iran running the urban family physician pilot program. The participants were selected using purposive and snowball sampling. The codes were extracted using inductive and deductive methods. Results Regarding the effects of risk-adjusted capitation on the primary healthcare setting, five themes with 11 subthemes emerged, including service delivery, institutional structure, financing, people’s behavior, and the challenges ahead. Our findings indicated that the health system is enjoying some major changes in the primary healthcare setting through the implementation of risk-adjusted capitation payment. Conclusions With regard to the current challenges in Iran’s health system, using risk-adjusted capitation as a primary healthcare payment system can lead to useful changes in the health system’s features. However, future research should focus on the development of the risk-adjusted capitation model. PMID:27340558

  5. Family Background and Academic Achievement: Does Self-Efficacy Mediate Outcomes?

    ERIC Educational Resources Information Center

    Weiser, Dana A.; Riggio, Heidi R.

    2010-01-01

    Research indicates both family background and self-efficacy influence academic outcomes; however, family background also impacts self-efficacy development. The purpose of the current study was to establish whether self-efficacy mediates the relationship between family background and academic achievement. Results indicated family background…

  6. Relationship between Size of Broken and Intact Families and Academic Achievement.

    ERIC Educational Resources Information Center

    Cherian, Varghese I.

    1991-01-01

    Compares relationship between family size and academic achievement of children from broken and intact families among Black African Xhosa-speaking children between the ages of 13 and 17. Results indicate a negative relationship between family size and academic achievement, regardless of broken or intact families. (Author/NL)

  7. Promoting academic achievement: the role of peers and family in the academic engagement of african american adolescents.

    PubMed

    Stanard, Pia; Belgrave, Faye Z; Corneille, Maya A; Wilson, Karen D; Owens, Kristal

    2010-01-01

    While grades are frequently used as indicators of academic achievement, they provide little information about the processes that encourage academic success. Academic engagement, on the other hand, evaluates thoughts, motivations, and behaviors that predict achievement and helps elucidate achievement mechanisms. Understanding academic engagement can facilitate an examination of the forces influencing and hindering achievement and can guide researchers and educators in developing and evaluating effective interventions for increasing academic success. Grounded in ecological theory, this study attempts to understand the influence of family cohesion and peer risky behavior on academic engagement. First, the study explores how socializing with peers who engage in risky behaviors (e.g., sexual behaviors, truancy, or substance use) influences academic engagement and its components (i.e., interest in school, education utility value, and academic effort). Second, the study assesses whether family cohesion buffers the relationship between socializing with these peers and academic engagement. The findings from hierarchical linear regression indicate that socializing with peers who engage in risky behaviors has a significant, negative impact on academic engagement. Family cohesion also was significantly associated with academic engagement over and beyond the effects of risky peers. Implications for families, schools, communities, and programming are discussed. PMID:20658436

  8. An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center.

    PubMed

    Schrijver, Iris; Brady, Keri J S; Trockel, Mickey

    2016-01-01

    Background. Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians' perceptions about their work-related wellness, including the following questions: (a) What are the workplace barriers and facilitators to their wellness? (b) What workplace solutions do theythinkwouldimprove their wellness? (c)What motivates their work? and (d) What existing wellness programs are they aware of? Methods. A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants entered their answers into a web-based survey program that enabled anonymous data collection. The initial survey component was followed by semi-structured focus group discussion. Data analysis of this qualitative study was informed by the general inductive approach as well as a review of extant literature through September 2015 on physician wellness, professional fulfillment, satisfaction, dissatisfaction, burnout and work-life. Results. Factors intrinsic to the work of physicians dominated the expressed reasons for work motivation. These factors all related to the theme of overall contribution, with categories of meaningful work, patient care, teaching, scientific discovery, self-motivation and matching of career interests. Extrinsic factors such as perceptions of suboptimal goal alignment, inadequate support, restricted autonomy, lack of appreciation, and suboptimal compensation and benefits dominated the risk of professional dissatisfaction. Discussion. Our findings indicate that the

  9. [Support for cancer caregivers during the palliative, hospice, and bereavement phases: the role of family physicians].

    PubMed

    Oshiro, Hisako; Oshiro, Tatsuo; Tanimizu, Masahito

    2014-12-01

    The family caregivers of cancer patients are at an increased risk of physical and mental morbidity. The purpose of this study is to capture the needs of the caregivers before and during the years after the loss of the patient. A survey was conducted among 229 consecutive advanced cancer patients in our family clinic. Seventy percent of the patients died in their homes, the median overall survival was 15.1 months, and the median survival time was 3 months from the beginning of the coordination with oncologists. While 28%of the patients received the best possible supportive care alone and 50%of them were admitted after the cessation of chemotherapy, in 22%of the patients, the coordination with oncologists began during the chemotherapy phase. During times of active cancer treatment, the caregivers were provided with various types of support from the family physicians. In the post-death bereavement phase, 124 caregivers were admitted to our family care clinic. The family physician can play an important role in aiding the caregivers during the palliative, hospice, and bereavement phases. PMID:25595070

  10. Defining the eHealth Information Niche in the Family Physician/Patient Examination and Knowledge Transfer Process

    ERIC Educational Resources Information Center

    Ellington, Virginia Beth Elder

    2012-01-01

    This research study was undertaken to gain a richer understanding of the use of patient-introduced online health information during the physician/patient examination and knowledge transfer process. Utilizing qualitative data obtained from ten family physician interviews and workflow modeling using activity diagrams and task structure charts, this…

  11. Sponsoring Institutions with Five or Fewer Residency Programs Produce a Larger Proportion of General Internists and Family Physicians.

    PubMed

    Hemeida, Sarah; Klink, Kathleen; Bazemore, Andrew; Petterson, Stephen; Peterson, Lars

    2016-01-01

    Policymakers are increasingly interested in addressing the US primary care physician shortage and achieving measurable accountability for the products of the nation's $15 billion investment in graduate medical education (GME). Using one such measure, we found that sponsoring institutions (SIs) with ≤5 residency programs produce a higher percentage of general internists and family physicians than larger SIs. PMID:27170786

  12. Acceptability of Physician Directed Academic Detailing to Increase Colorectal Cancer Screening: an Application of the RESPECT Approach

    PubMed Central

    Lawson, Gwen; Basch, Corey H.; Zybert, Patricia; Wolf, Randi L.; Basch, Charles E.

    2015-01-01

    Background: In developing effective interventions to increase colorectal cancer (CRC) screening in at risk populations, a necessary first requirement is feasibility. This paper describes how the RESPECT approach to health education guided the conceptualization and implementation of physician-directed academic detailing (AD) to increase practice-wide CRC screening uptake. Methods: Physician-directed AD was one intervention component in a large educational randomized controlled trial to increase CRC screening uptake. Study participants, primarily urban minority, were aged 50 or older, insured for CRC screening with no out-of-pocket expense and out of compliance with current screening recommendations. The trial was conducted in the New York City metropolitan area. Participants identified their primary care physician; 564 individuals were recruited, representing 459 physician practices. Two-thirds of the physician practices were randomized to receive AD. The RESPECT approach, modified for AD, comprises: 1) Rapport, 2) Educate, but don’t overwhelm, 3) Start with physicians where they are, 4) Philosophical orientation based on a humanistic approach to education, 5) Engagement of the physician and his/her office staff, 6) Care and show empathy, and 7) Trust. Feasibility was assessed as rate of AD delivery. Results: The AD was delivered to 283 (92.5%) of the 306 practices assigned to receive it; 222/283 (78.4%) delivered to the doctor. Conclusion: The AD was feasible and acceptable to implement across a range of clinical settings. The RESPECT approach offers a framework for tailoring educational efforts, allowing flexibility, as opposed to strict adherence to a highly structured script or a universal approach. PMID:26634194

  13. Academic procrastination: associations with personal, school, and family variables.

    PubMed

    Rosário, Pedro; Costa, Marta; Núñez, José Carlos; González-Pienda, Julio; Solano, Paula; Valle, Antonio

    2009-05-01

    Procrastination is a common behavior, mainly in school settings. Only a few studies have analyzed the associations of academic procrastination with students' personal and family variables. In the present work, we analyzed the impact of socio-personal variables (e.g., parents' education, number of siblings, school grade level, and underachievement) on students' academic procrastination profiles. Two independent samples of 580 and 809 seventh to ninth graders, students attending the last three years of Portuguese Compulsory Education, have been taken. The findings, similar in both studies, reveal that procrastination decreases when the parents' education is higher, but it increases along with the number of siblings, the grade level, and the underachievement. The results are discussed in view of the findings of previous research. The implications for educational practice are also analyzed. PMID:19476225

  14. Comparing the Performance of Allopathically and Osteopathically Trained Physicians on the American Board of Family Medicine's Certification Examination

    ERIC Educational Resources Information Center

    O'Neill, Thomas R.; Royal, Kenneth D.; Schulte, Bradley M.; Leigh, Terrence

    2009-01-01

    Background: Two medical specialty boards offer certification in family medicine: the American Board of Family Medicine (ABFM) and the American Osteopathic Board of Family Physicians (AOBFP). The AOBFP certification is offered only to graduates of osteopathic colleges; however, graduates of both osteopathic and allopathic medical schools who have…

  15. An exploration of key issues and potential solutions that impact physician wellbeing and professional fulfillment at an academic center

    PubMed Central

    Brady, Keri J.S.; Trockel, Mickey

    2016-01-01

    Background. Physician wellness is a vital element of a well-functioning health care system. Not only is physician wellness empirically associated with quality and patient outcomes, but its ramifications span individual, interpersonal, organizational, and societal levels. The purpose of this study was to explore academic physicians’ perceptions about their work-related wellness, including the following questions: (a) What are the workplace barriers and facilitators to their wellness? (b) What workplace solutions do theythinkwouldimprove their wellness? (c)What motivates their work? and (d) What existing wellness programs are they aware of? Methods. A multi-method design was applied to conduct a total of 19 focus group sessions in 17 clinical departments. All academic faculty ranks and career lines were represented in the 64 participating physicians, who began the sessions with five open-ended survey questions pertaining to physician wellness in their work environment. Participants entered their answers into a web-based survey program that enabled anonymous data collection. The initial survey component was followed by semi-structured focus group discussion. Data analysis of this qualitative study was informed by the general inductive approach as well as a review of extant literature through September 2015 on physician wellness, professional fulfillment, satisfaction, dissatisfaction, burnout and work-life. Results. Factors intrinsic to the work of physicians dominated the expressed reasons for work motivation. These factors all related to the theme of overall contribution, with categories of meaningful work, patient care, teaching, scientific discovery, self-motivation and matching of career interests. Extrinsic factors such as perceptions of suboptimal goal alignment, inadequate support, restricted autonomy, lack of appreciation, and suboptimal compensation and benefits dominated the risk of professional dissatisfaction. Discussion. Our findings indicate that the

  16. Reducing surgery in management of spontaneous abortions. Family physicians can make a difference.

    PubMed Central

    Wiebe, E.; Janssen, P.

    1999-01-01

    OBJECTIVE: To test the effectiveness of physician and patient education in reducing the rate of surgery in management of spontaneous abortions in family practice. DESIGN: A before-after intervention trial. SETTING: Urban and suburban family doctors' practices in greater Vancouver, BC. PARTICIPANTS: Family practice patients (56 physicians contributed 417 patients) who had spontaneous abortions between June 1997 and August 1998. INTERVENTIONS: Seminars for doctors and educational pamphlets for patients. MAIN OUTCOME MEASURES: Rate of surgeries, and rates of referrals and complications. RESULTS: In the 2 years before the intervention, the rate of surgery was 45.8% (n = 299); after, it was 32.2% (n = 118). No transfusions were required. Before the intervention, 17% of women had hemorrhages; after, 13%. Rates of infection were 3.7% and 0.8%, respectively. Rates of referral to gynecologists were 54.0% and 40.2%, respectively. CONCLUSIONS: Patients of family doctors who attended seminars and agreed to join the study had significantly reduced rates of surgery after spontaneous abortions. Rates of referral for these patients were also lower, and there was no increase in complications. PMID:10540696

  17. Do family physicians know the costs of medical care? Survey in British Columbia.

    PubMed Central

    Allan, G. Michael; Innes, Grant D.

    2004-01-01

    OBJECTIVE: To determine the cost of 46 commonly used investigations and therapies and to assess British Columbia family doctors' awareness of these costs. DESIGN: Mailed survey asking about costs of 23 investigations and 23 therapies relevant to family practice. A random sample of 600 doctors was asked to report their awareness of costs and to estimate costs of the 46 items. SETTING: British Columbia. PARTICIPANTS: Six hundred family physicians. MAIN OUTCOME MEASURES: Estimates within 25% of actual cost were considered correct. Associations between cost awareness and respondents'characteristics (eg, sex, practice location) were sought. Degree of error in estimates was also assessed. RESULTS: Overall, 283 (47.2%) surveys were returned and 259 analyzed. Few respondents estimated costs within 25% of true cost, and estimates were highly variable. Physicians underestimated costs of expensive drugs and laboratory investigations and overestimated costs of inexpensive drugs. Cost awareness did not correlate with sex, practice location, College certification, faculty appointment, or years in practice. CONCLUSION: Family doctors in British Columbia have little awareness of the costs of medical care. PMID:15000338

  18. Women’s impressions of their inpatient birth care as provided by family physicians in the Shizuoka Family Medicine Training Program in Japan

    PubMed Central

    2013-01-01

    Background Even though Japan faces serious challenges in women’s health care such as a rapidly aging population, attrition of obstetrical providers, and a harsh legal climate, few family medicine residency training programs in Japan include training in obstetrics, and the literature lacks research on women’s views of intra-partum pregnancy care by family physicians. Findings In this exploratory study, we conducted semi-structured qualitative interviews with five women who received their admission, intrapartum, delivery and discharge care from family medicine residents in the obstetrics ward of a community training hospital. Four women had vaginal births, and one had a Cesarean section. Three were primiparous, and two multiparous. Their ages ranged from 22–33. They found value in family physician medical knowledge and easy communication style, though despite explanation, some had trouble understanding the family physician’s scope of work. These women identified negative aspects of the hospital environment, and wanted more anticipatory guidance about what to expect physically after birth, but were enthusiastic about seeing a family doctor after discharge. Conclusions These results demonstrate the feasibility of family medicine residents providing inpatient birth care in a community hospital, and that patients are receptive to family physicians providing that care as well after discharge. Women’s primary concerns relate mostly to hospital environment issues, and better understanding the care family physicians provide. This illustrates-areas for family physicians to work for improvements. PMID:23698036

  19. Screening and Treatment for Alcohol, Tobacco and Opioid Use Disorders: A Survey of Family Physicians across Ontario

    PubMed Central

    Loheswaran, Genane; Soklaridis, Sophie; Selby, Peter; Le Foll, Bernard

    2015-01-01

    Introduction As a primary point of contact within the health care system, family physicians are able to play a vital role in identifying individuals with substance use disorders and connecting them to the appropriate treatment. However, there is very little data available on whether family physicians are actively screening for and treating substance use disorders. The objective of the current survey was to assess whether family physicians in Ontario are screening for alcohol, opioid and tobacco use disorders, using validated tools and providing treatment. Methods An online survey consisting of a series of 38 primarily close-ended questions was circulated to family physicians in Ontario. Rates of screening for alcohol, opioid and tobacco dependence, use of validated tools for screening, providing treatment for dependent individuals and the current barriers to the prescription of pharmacotherapies for these drug dependences were assessed. Results The use of validated screening tools was limited for all three substances. Screening by family physicians for the substance use disorders among adolescents was much lower than screening among adults. Pharmacotherapy was more commonly used as an intervention for tobacco dependence than for alcohol and opioid dependence. This was explained by the lack of knowledge among family physicians on the pharmacotherapies for alcohol and opioid dependence. Conclusions Findings from the current study suggest there is a need for family physicians to integrate screening for substance use disorders using validated tools into their standard medical practice. Furthermore, there is a need for increased knowledge on pharmacotherapies for alcohol and opioid use disorders. It is important to note that the low response rate is a major limitation to this study. One possible reason for this low response rate may be a lack of interest and awareness among family physicians on the importance of screening and treatment of substance use disorders in

  20. Who steers the ship? Rural family physicians' views on collaborative care models for patients with dementia.

    PubMed

    Kosteniuk, Julie; Morgan, Debra; Innes, Anthea; Keady, John; Stewart, Norma; D'Arcy, Carl; Kirk, Andrew

    2014-01-01

    Little is known about the views of rural family physicians (FPs) regarding collaborative care models for patients with dementia. The study aims were to explore FPs' views regarding this issue, their role in providing dementia care, and the implications of providing dementia care in a rural setting. This study employed an exploratory qualitative design with a sample of 15 FPs. All rural FPs indicated acceptance of collaborative models. The main disadvantages of practicing rural were accessing urban-based health care and related services and a shortage of local health care resources. The primary benefit of practicing rural was FPs' social proximity to patients, families, and some health care workers. Rural FPs provided care for patients with dementia that took into account the emotional and practical needs of caregivers and families. FPs described positive and negative implications of rural dementia care, and all were receptive to models of care that included other health care professionals. PMID:23552172

  1. [The role of the team of family physician in prevention of changing risk factors important in development of arterial hypertension].

    PubMed

    Beganlić, Azijada; Batić-Mujanović, Olivera; Tulumović, Ajsa; Zilzić, Muharem

    2005-01-01

    Arterial hypertension (AH) is one of the commonest noninfective chronic disease according to its important and the role in the morbidity and mortality, which is the reason for patients coming to the family phisician. Detection and treatment of high blood pressure are the major responsibility of physician in the primary care. If the family physician team (physician and nurse) make a good assessment of the risk factors which is important in development of arterial hypertension, the appearance of disease and its complications can be prevented or delayed. The most important for prevention of arterial hypertension is adoption a healthy lifestyle and it is nonseparate part of arterial hypertension treatment. PMID:16268072

  2. A Manual for Prioritizing the Topics of Clinical Practice Guidelines for Family Physicians

    PubMed Central

    Mounesan, Leila; Sayarifard, Azadeh; Haghjou, Leila; Ghadirian, Laleh; Rajabi, Fatemeh; Nedjat, Saharnaz

    2016-01-01

    Background: Development of a manual or well-defined criterion for prioritizing the topics of clinical practice guidelines (CPGs) will help validate and organize this process evermore. This study was conducted to design an applicable manual that would prioritize the CPG topics for family physicians. Methods: This study was a multi-stage method using a qualitative approach that was conducted for the manual developing. The manual development process took place in four steps, as follows: Literature review, interviews with ten experts, preparing a list of criteria and determining its appropriateness by applying the RAND/UCLA Appropriateness method, and development of the final draft of the manual and pilot study. Results: Interview transcripts went under content analysis and were classified into eight main groups, 12 subgroups, and 85 themes. A comprehensive list consisting of fifty preliminary criteria were extracted. After summarizing and classifying the criteria, 12 appropriate criteria were evaluated using the RAND appropriateness method. Eventually, based on the literature review and our own results of the interview analysis, a manual consisting of five main sections and one clause on ethics was developed. Later, a pilot study was conducted on ten family physician topics, and prioritized by nine experts. Conclusions: The manual can be eyed as a tool ensuring the quality of the process of prioritizing CPG topics for family physicians, as it takes into account the issues involved in priority-setting. Selecting informed stakeholders for rating the criteria and ranking the topics was an issue that was greatly emphasized by the experts. Eventually, the application of this manual can be the first step toward systematizing the process of prioritizing CPG topics in the country. PMID:27141283

  3. Dosing variability in prescriptions of acetaminophen to children: comparisons between pediatricians, family physicians and otolaryngologists

    PubMed Central

    2013-01-01

    Background To estimate the extents of dosing variability in prescriptions of acetaminophen to children among pediatricians, family physicians and otolaryngologists. Methods The acetaminophen prescriptions in the systematic sampling datasets from the National Health Insurance Research Database in Taiwan were analyzed. The distribution of dosages was measured and expressed in terms of coefficient of variation (CV). The analyses were stratified by patient’s age, prescriber’s specialty and preparation form. Results From 13,868 prescribed items of acetaminophen in 2009, liquids accounted only for 11.1% (n = 1544). More than half (56.9%) of liquids were prescribed by pediatricians. The median dose (83.3 mg, n = 1683) of acetaminophen prescriptions in infants is around half of that in preschool children (166.7 mg, n = 3921), one-third in children (250.0 mg, n = 4926) and one-sixth in adolescents (500.0 mg, n = 3338). In infants, the prescriptions by pediatricians had the highest CV (86.7%), followed by family physicians (82.3%) and otolaryngologists (70.3%). The patterns were similar in preschool children and children, but the difference of CV among specialties narrowed down with the patient’s age. Conclusions In acetaminophen prescriptions to children, pediatricians had a wider variability of dosages and a higher ratio of liquid preparations than family physicians and otolaryngologists. Further investigations can be undertaken to estimate the accuracy of dosing variability as an indicator of prescribing quality. Besides, child-suitable drug preparations should be promoted to ensure patient safety. PMID:23617266

  4. Interprofessional education in academic family medicine teaching units

    PubMed Central

    Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E.; Dykeman, Lynn

    2009-01-01

    ABSTRACT PROBLEM ADDRESSED The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. OBJECTIVE OF PROGRAM To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. PROGRAM DESCRIPTION The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. CONCLUSION This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration. PMID:19752260

  5. Mining reflective continuing medical education data for family physician learning needs.

    PubMed

    Lewis, Denice Colleen; Pluye, Pierre; Rodriguez, Charo; Grad, Roland

    2016-01-01

    A mixed methods research (sequential explanatory design) studied the potential of mining the data from the consumers of continuing medical education (CME) programs, for the developers of CME programs. The quantitative data generated by family physicians, through applying the information assessment method to CME content, was presented to key informants from the CME planning community through a qualitative description study.The data were revealed to have many potential applications including supporting the creation of CME content, CME program planning and personal learning portfolios. PMID:27348489

  6. Prostate cancer decision-making, health services, and the family physician workforce.

    PubMed

    Bowman, Marjorie A; Neale, Anne Victoria

    2012-01-01

    Does untreated cancer equal death? Does having a registered nurse versus a licensed practical nurse versus a medical assistant affect diabetes quality outcomes? Do physicians caring for stressed patients experience vicarious traumatic stress? Oregon presents an operationalized definition of a patient-centered medical home for their state. Lots of important clinical topics in family medicine--adult attention deficit disorder office questionnaire; Bell palsy; cancer screening and treatment decisions; lubrication during Papanicolaou testing; changes in maternity care training by residencies; changing prescribing patterns for thiazide diuretics; and night sweats remain a mystery. PMID:23136310

  7. Importance of telemedicine in diabetes care: Relationships between family physicians and ophthalmologists

    PubMed Central

    Romero-Aroca, Pedro; Sagarra-Alamo, Ramon; Pareja-Rios, Alicia; López, Maribel

    2015-01-01

    Diabetic retinopathy (DR) is the worldwide leading cause of legal blindness. In 2010, 1.9% of diabetes mellitus (DM) patients were legally blind and 10.2% had visual impairment. The control of DM parameters (glycemia, arterial tension and lipids) is the gold standard for preventing DR complications, although, unfortunately, DR still appeared in a 25% to 35% of patients. The stages of severe vision threading DR, include proliferative DR (6.96%) and diabetic macular edema (6.81%). This review aims to update our knowledge on DR screening using telemedicine, the different techniques, the problems, and the inclusion of different professionals such as family physicians in care programs. PMID:26240697

  8. Restructuring the primary health care services and changing profile of family physicians in Turkey.

    PubMed

    Ersoy, F; Sarp, N

    1998-12-01

    A new health-reform process has been initiated by Ministry of Health in Turkey. The aim of that reform is to improve the health status of the Turkish population and to provide health care to all citizens in an efficient and equitable manner. The restructuring of the current health system will allow more funds to be allocated to primary and preventive care and will create a managed market for secondary and tertiary care. In this article, we review the current and proposed primary care services models and the role of family physicians therein. PMID:10078801

  9. 19th-century academic examinations for physicians in the United States Army Medical Department.

    PubMed Central

    Sohn, A P

    1994-01-01

    During the latter half of the 19th century, the United States Army commissioned medical officers or hired civilian physicians to serve its troops. The civilian physician signed a contract for services, and the candidate for a commission was subjected to rigorous examinations before becoming an officer. The rigorous testing of prospective medical officers was necessary because of the lack of standardization in the education of physicians. Examples of the test, statistics, and individual records show how the Army dealt with unqualified candidates. Images PMID:8048241

  10. Evidence-based cardiovascular care. Family physicians' views of obstacles and opportunities.

    PubMed Central

    Putnam, Wayne; Twohig, Peter L.; Burge, Frederick I.; Jackson, Lois A.; Cox, Jafna L.

    2004-01-01

    OBJECTIVE: To explore obstacles to and opportunities for applying specific lifestyle and pharmacologic recommendations on chronic ischemic heart disease. DESIGN: Qualitative study. SETTING: Rural, town, and city settings in Nova Scotia. PARTICIPANTS: Fifty family physicians caring for patients with cardiovascular (CV) disease. METHOD: Nine focus groups were conducted, audiotaped, and transcribed. Seven recommendations had been selected for discussion based on their relevance to primary care, strength, and class of supporting evidence. Analysis was guided by grounded-theory methodology. MAIN FINDINGS: "Ischemic events" can be powerful motivators for change, whereas the asymptomatic nature of CV risks and distant outcomes can form obstacles. Trust built through previous experiences and the opportunity to repeat important messages can facilitate application of evidence, but patient-physician relationships can also pose obstacles. CONCLUSION: Physicians can take steps to improve care, but success at reducing CV risks depends upon active involvement of many health professionals and community resources. Future guideline implementation should focus on patient-oriented issues, such as comorbidity and treatment preferences. PMID:15526877

  11. The Family-Study Interface and Academic Outcomes: Testing a Structural Model

    ERIC Educational Resources Information Center

    Meeuwisse, Marieke; Born, Marise Ph.; Severiens, Sabine E.

    2011-01-01

    Expanding on family-work and work-study models, this article investigated a model for family-study conflict and family-study facilitation. The focus of the study was the relationship of family-study conflict and family-study facilitation with students' effortful behaviors and academic performance among a sample of university students (N = 1,656).…

  12. Evaluation of Continuing Professional Development Program for Family Physicians

    PubMed Central

    Karim, Syed Irfan; Irfan, Farhana; Qureshi, Riaz; Naeem, Naghma; Alfaris, Eiad Abdel Mohsen

    2013-01-01

    Objectives: To evaluate the King Saud University Continuing Professional Development (CPD) Program for Family Physicians in relation to the Convenience, Relevance, Individualization, Self-Assessment, Interest, Speculation and Systematic (CRISIS) criteria. Methodology: A descriptive study was conducted at King Saud University (KSU) in Riyadh, Saudi Arabia. The authors used the six strategies of Convenience, Relevance, Individualization, Self-Assessment, Interest, Speculation and Systematic (CRISIS) for evaluation. The program was independently analyzed by the three authors using CRISIS framework. The results were synthesized. The suggestions were discussed and agreed upon and documented. Results: The results indicate that KSU-CPD program meets the CRISIS criteria for effective continuing professional development and offers a useful approach to learning. The course content covers specific areas of practice, but some shortcomings were found that need to be improved like self assessment area and individual learning needs analysis. Conclusion: This program is suitable for Family Physicians, as it is well planned and utilizes most of the principles of CRISIS, but there is still room for improvement. Designing a program for general practitioners using hybrid model that offers a blend of e-learning as well as face-to-face learning opportunities would be an ideal solution. PMID:24353556

  13. Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

    PubMed Central

    Fuß, Isabelle; Nübling, Matthias; Hasselhorn, Hans-Martin; Schwappach, David; Rieger, Monika A

    2008-01-01

    Background Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF) – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Methods Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. Results German hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p < .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p < .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast

  14. “Sometimes I Feel Overwhelmed”: Educational Needs of Family Physicians Caring for People with Intellectual Disability

    PubMed Central

    Wilkinson, Joanne; Dreyfus, Deborah; Cerreto, Mary; Bokhour, Barbara

    2013-01-01

    Primary care physicians who care for adults with intellectual disability often lack experience with the population, and patients with intellectual disability express dissatisfaction with their care. Establishing a secure primary care relationship is particularly important for adults with intellectual disability, who experience health disparities and may rely on their physician to direct/coordinate their care. The authors conducted semistructured interviews with 22 family physicians with the goal of identifying educational needs of family physicians who care for people with intellectual disability. Interviews were transcribed and coded using tools from grounded theory. Several themes related to educational needs were identified. Physician participants identified themes of “operating without a map,” discomfort with patients with intellectual disability, and a need for more exposure to/experience with people with intellectual disability as important content areas. The authors also identified physician frustration and lack of confidence, compounded by anxiety related to difficult behaviors and a lack of context or frame of reference for patients with intellectual disability. Primary care physicians request some modification of their educational experience to better equip them to care for patients with intellectual disability. Their request for experiential, not theoretical, learning fits well under the umbrella of cultural competence (a required competency in U.S. medical education). PMID:22731973

  15. Academic Achievement Trajectories of Adolescents from Mexican and East Asian Immigrant Families in the United States

    ERIC Educational Resources Information Center

    Jeong, Yu-Jin; Acock, Alan C.

    2014-01-01

    Drawing on the National Educational Longitudinal Survey 1988 (NELS:88), this study identified (1) the growth pattern of academic achievement of adolescent children from Mexican and East Asian immigrant families; (2) investigated to what extent ethnicity and family capital influenced the trajectories in the academic achievement of children from…

  16. iPad Use in Iowa Research Network Family Physician Offices

    PubMed Central

    Daly, Jeanette M.; Xu, Yinghui; Levy, Barcey T.

    2015-01-01

    Background Through a cancer research infrastructure building grant, iPads were given to healthcare providers in family physician offices. The purpose of this study was to determine the use and application of iPads in the Iowa Research Network. Methods A Qualtrics survey was sent to 81 iPad recipients after Institutional Review Board approval. Results Fifty-nine percent responded and 85% reported they have used the iPad. The main reason for use of the iPad was browsing the World Wide Web for healthcare information. Open-ended comments supported use of the iPad for photographic documentation of wound and other skin lesions for insertion into the medical record and it helped improve clinic flow by making it easier to put orders in the system through the iPad. Conclusions Tablet uses are variable in physician offices with provider’s gathering health care information from the Internet and securing education material for patients as the frequent usages. PMID:25398430

  17. Use and perceptions of information among family physicians: sources considered accessible, relevant, and reliable

    PubMed Central

    Kosteniuk, Julie G.; Morgan, Debra G.; D'Arcy, Carl K.

    2013-01-01

    Objectives: The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs. Methods: A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008. Results: Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access). Conclusions: When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information. PMID:23405045

  18. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    PubMed Central

    Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael

    2014-01-01

    Background A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Conclusion Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients. PMID:24648834

  19. Factors Affecting Leave out of General Practitioners from Rural Family Physician Program: A Case of Kerman, Iran

    PubMed Central

    Amiresmaili, Mohammadreza; Khosravi, Sajad; Feyzabadi, Vahid Yazdi

    2014-01-01

    Background: Rural family physician program as the new reform in the Iranian health system has been implemented since 2005. Its success depends much on physicians’ retention. The present study aimed to identify influential factors on physicians’ willingness to leave out this program in Kerman province. Methods: The present cross-sectional study was performed in Kerman province in 2011. All family physicians working in this program (n = 271) were studied using a questionnaire. Data analysis was carried out using descriptive statistics and logistic regression through SPSS version 18.0. Results: Twenty-six percent (70) of the physicians had left out the program in the past. In addition, 77.3% (208) intended to leave out in the near future. Opportunity for continuing education, inappropriate and long working hours, unsuitable requirements of salary, irregular payments, lack of job security and high working responsibility were regarded as the most important reasons for leaving out the program in the past and intention to leave out in future orderly. According to univariate logistic regression, younger physicians (odds ratio [OR] =2.479; 95% confidence interval [CI]: 1.261-4.872) and physicians who had older children (OR = 4.743; 95% CI: 1.441-15.607) were more willing to leave out the plan in the near future, however it was not significant in multivariate logistic regression. Conclusions: Physician retention in family physician program is faced with serious doubts due to different reasons. The success of the program is endangered because of the pivotal role of human resources. Hence, the revision of human resources policies of the program seems necessary in order to reduce physicians leave out and improving its effectiveness. PMID:25400891

  20. In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada

    PubMed Central

    2012-01-01

    Background Most Canadians receive basic health services from a family physician and these physicians are particularly critical in the management of chronic disease. Canada, however, has an endemic shortage of family physicians. Physician shortages and turnover are particularly acute in rural regions, leaving their residents at risk of needing to transition between family physicians. The knowledge base about how patients manage transitioning in a climate of scarcity remains nascent. The purpose of this study is to explore the experience of transitioning for chronically ill, rurally situated Canadian women to provide insight into if and how the system supports transitioning patients and to identify opportunities for enhancing that support. Methods Chronically ill women managing rheumatic diseases residing in two rural counties in the province of Ontario were recruited to participate in face-to-face, semi-structured interviews. Interview transcripts were analysed thematically to identify emergent themes associated with the transitioning experience. Results Seventeen women participated in this study. Ten had experienced transitioning and four with long-standing family physicians anticipated doing so soon. The remaining three expressed concerns about transitioning. Thematic analysis revealed the presence of a transitioning trajectory with three phases. The detachment phase focused on activities related to the termination of a physician-patient relationship, including haphazard notification tactics and the absence of referrals to replacement physicians. For those unable to immediately find a new doctor, there was a phase of unattachment during which patients had to improvise ways to receive care from alternative providers or walk-in clinics. The final phase, attachment, was characterized by acceptance into the practice of a new family physician. Conclusions Participants often found transitioning challenging, largely due to perceived gaps in support from the health care

  1. The duty of the physician to care for the family in pediatric palliative care: context, communication, and caring.

    PubMed

    Jones, Barbara L; Contro, Nancy; Koch, Kendra D

    2014-02-01

    Pediatric palliative care physicians have an ethical duty to care for the families of children with life-threatening conditions through their illness and bereavement. This duty is predicated on 2 important factors: (1) best interest of the child and (2) nonabandonment. Children exist in the context of a family and therefore excellent care for the child must include attention to the needs of the family, including siblings. The principle of nonabandonment is an important one in pediatric palliative care, as many families report being well cared for during their child's treatment, but feel as if the physicians and team members suddenly disappear after the death of the child. Family-centered care requires frequent, kind, and accurate communication with parents that leads to shared decision-making during treatment, care of parents and siblings during end-of-life, and assistance to the family in bereavement after death. Despite the challenges to this comprehensive care, physicians can support and be supported by their transdisciplinary palliative care team members in providing compassionate, ethical, and holistic care to the entire family when a child is ill. PMID:24488541

  2. A Follow-up Survey of Family Physicians' Interest in and Knowledge of Nutrition.

    ERIC Educational Resources Information Center

    Jack, Brian W.; And Others

    1990-01-01

    Physicians (N=71) completed a questionnaire about 33 nutrition topics. Perceived knowledge significantly increased except for nutritional biochemistry. Physicians wished to learn more only in the areas of nutrition counseling and nutrition in the life cycle. (DB)

  3. Developing a Career in Global Health: Considerations for Physicians-in-Training and Academic Mentors

    PubMed Central

    Nelson, Brett D.; Kasper, Jennifer; Hibberd, Patricia L.; Thea, Donald M.; Herlihy, Julie M.

    2012-01-01

    Background Global health is an expansive field, and global health careers are as diverse as the practice of medicine, with new paths being forged every year. Interest in global health among medical students, residents, and fellows has never been higher. As a result, a greater number of these physicians-in-training are participating in global health electives during their training. However, there is a gap between the level of trainee interest and the breadth and depth of educational opportunities that prepare them for a career in global health. Objective Global health experiences can complement and enhance each step of traditional physician training, from medical school through residency and fellowship. Global health experiences can expose trainees to patients with diverse pathologies, improve physical exam skills by decreasing reliance on laboratory tests and imaging, enhance awareness of costs and resource allocation in resource-poor settings, and foster cultural sensitivity. The aim of this article is to describe issues faced by physicians-in-training and the faculty who mentor them as trainees pursue careers in global health. Methods We conducted a narrative review that addresses opportunities and challenges, competing demands on learners' educational schedules, and the need for professional development for faculty mentors. Conclusions A widening gap between trainee interest and the available educational opportunities in global health may result in many medical students and residents participating in global health experiences without adequate preparation and mentorship. Without this essential support, global health training experiences may have detrimental consequences on both trainees and the communities hosting them. We discuss considerations at each training level, options for additional training, current career models in global health, and challenges and potential solutions during training and early career development. PMID:23997872

  4. Family physicians' perceptions and use of electronic clinical decision support during the first year of implementation.

    PubMed

    Heselmans, Annemie; Aertgeerts, Bert; Donceel, Peter; Geens, Siegfried; Van de Velde, Stijn; Ramaekers, Dirk

    2012-12-01

    An electronic decision support system (the EBMeDS system) was integrated in one of the Electronic Medical Records (EMR) of Belgian family physicians (Feb 2010). User acceptance of the system is considered as a necessary condition for the effective implementation of any IT project. Facilitators, barriers and issues of non-acceptance need to be understood in view of a successful implementation and to minimize unexpected adoption behavior. Objectives of the study were the assessment of users' perceptions towards the recently implemented EBMeDS system, the investigation of user-interactions with the system and possible relationships between perceptions and use. A mixed evaluation approach was performed consisting of a qualitative and a quantitative analysis. The technology acceptance model of UTAUT was used as a structural model for the development of our questionnaire to identify factors that may account for acceptance and use of the EBMeDS system (seven-point Likert scales). A quantitative analysis of computer-recorded user interactions with the system was performed for an evaluation period of 3 months to assess the actual use of the system. Qualitative and quantitative analysis were linked to each other. Thirty-nine family physicians (12 %) completed the survey. The majority of respondents (66 %) had a positive attitude towards the system in general. Mean intention to keep using the system was high (5,91 ± 1,33). Their perception of the ease of use of the system (mean 5,04 ± 1,41), usefulness (mean 4,69 ± 1,35) and facilitating conditions (4,43 ± 1,13) was in general positive. Only 0,35 % of reminders were requested on demand, the other 99,62 % of reminders displayed automatically. Detailed guidelines (long) were requested for 0,47 % of reminders automatically shown versus 16,17 % of reminders on request. The script behind the reminders was requested for 8,4 % of reminders automatically shown versus 13,6 % of reminders on request. The majority of respondents

  5. Physician-Patient Encounters: The Structure of Performance in Family and General Office Practice

    ERIC Educational Resources Information Center

    Wenghofer, Elizabeth F.; Williams, A. Paul; Klass, Daniel J.; Faulkner, Daniel

    2006-01-01

    Introduction: The College of Physicians and Surgeons of Ontario, the regulatory authority for physicians in Ontario, Canada, conducts peer assessments of physicians' practices as part of a broad quality assurance program. Outcomes are summarized as a single score and there is no differentiation between performance in various aspects of care. In…

  6. Alzheimer's Disease and Other Dementias: An Organizational Approach to Identifying and Addressing Practices and Learning Needs of Family Physicians

    ERIC Educational Resources Information Center

    Allen, Michael; Ferrier, Suzanne; Sargeant, Joan; Loney, Elaine; Bethune, Graeme; Murphy, Gerard

    2005-01-01

    Caring for patients with dementia is complex and demanding. Since family physicians (FPs) provide much of this care, we examined their practices, learning needs, and barriers to care concerning Alzheimer's disease and other dementias. We surveyed 392 (approximately 50%) Nova Scotia FPs and conducted focus groups and interviews with: FPs; staff of…

  7. A Correlational Study of Self-Directed Learning Readiness and Learning Activity Preference for Continuing Medical Education among Family Physicians

    ERIC Educational Resources Information Center

    Barrett, Theresa J.

    2014-01-01

    This quantitative, nonexperimental, correlational study sought to determine whether a relationship exists between family physicians' levels of self-directed learning readiness (SDLR) and their preferences for continuing medical education (CME) activities. The study also sought to determine whether years in clinical practice or size of clinical…

  8. A Prospective Study of Mexican American Adolescents’ Academic Success: Considering Family and Individual Factors

    PubMed Central

    Roosa, Mark W.; O’Donnell, Megan; Cham, Heining; Gonzales, Nancy A.; Zeiders, Katherine H.; Tein, Jenn-Yun; Knight, George P.; Umaña-Taylor, Adriana

    2011-01-01

    Mexican American youth are at greater risk of school failure than their peers. To identify factors that may contribute to academic success in this population, this study examined the prospective relationships from 5th grade to 7th grade of family (i.e., human capital [a parent with at least a high school education], residential stability, academically and occupationally positive family role models, and family structure) and individual characteristics (i.e., externalizing symptoms, bilingualism, gender, and immigrant status) to the academic performance of 749 Mexican American early adolescents (average age = 10.4 years and 48.7% were girls in 5th grade) from economically and culturally diverse families as these youth made the transition to junior high school. Results indicated that while controlling for prior academic performance, human capital and positive family role models assessed when adolescents were in in 5th grade positively related to academic performance in 7th grade. Further, being a girl also was related to greater 7th grade academic success, whereas externalizing symptoms were negatively related to 7th grade academic performance. No other variables in the model were significantly and prospectively related to 7th grade academic performance. Implications for future research and interventions are discussed. PMID:21863379

  9. Profile of Julie Phillips, MD, MPH: Family physician, medical educator, researcher, poet.

    PubMed

    Fogarty, Colleen T; Shapiro, Johanna

    2015-12-01

    Dr. Julie Phillips, an Associate Professor of Family Medicine at Michigan State University College of Human Medicine, has contributed several poems to Families, Systems, and Health over the last 2 years. This month's issue features her fourth poem in this journal, titled "Autumn Chores" (Phillips, 2015). We were interested in learning more about Julie's creative writing, why she writes poetry, how she balances writing and a demanding academic medical career, and what she hopes her poems might contribute to clinical practice and medical education. Colleen Fogarty interviewed her to find out the answers in this article. Julie's poems are indeed, as she says, carved from small moments in time, but they have a disproportionately large emotional impact. Her poems tackle issues such as the tension between medical and parental authority; professional boundaries; worklife balance; the still-gaping holes in our health care system; and what it means to care for others. To read her work, please search the journal index. (PsycINFO Database Record PMID:26641866

  10. THE BUDGET, THE FAMILY PHYSICIAN AND THE PATIENT A DIFFERENT APPROACH.

    PubMed

    Keidar, Ilan

    2014-10-01

    Modern medicine offers better health and longer life expectancy, yet consumes huge budgets. The Israeli Health Insurance Law (IHIL) regulates the delivery of health services to all Israel's residents through Health Maintenance Organizations (HMOS). These organizations confront constant struggles with their budgets and have to reduce expenses as much as possible (without harming the health level rendered). In the constant necessity to restrain expenses are embedded difficulties that might cause unrest to the Public Health System (PHS). At the edge of the public health spear are the Family Physicians (FPS) who have not only to supply the best possible medicine to their patients, and at the same time confront budgetary constraints that have the potential to hinder the level of rendered medicine, but also have, at times, to mediate between the conflicting interests of their patients' wish to receive the best available health measures, the FP own medical believes, the HMO's directives and, between the FPS wish, to keep up the number of their (content) patients. One of the World Health Organization's (WHO) concepts, like Israel's one, is that soul and body are inseparable and must be addressed simultaneously in the process of healing. Real life at the Family Physicians' clinics shows, at times, that despite the Israeli physicians' very high professional level, and the Israeli Health System (IHS)'s high efficiency, such a process, due to budgetary constraints, workload and various other reasons, does not always take place and, on the personal level, there are patients who feel that the "system" has treated them incorrectly and in an unsatisfactory manner. Unsatisfied and restless patients might cause undesirable consequences to the "system", like losing faith in one's FP and HMO, which might lead to the patients' reduced cooperation in the healing process, lawsuits amplification, patients leaving their FPS and their HMOs etc. Addressing the patient's soul and body as an

  11. Work Valence as a Predictor of Academic Achievement in the Family Context

    ERIC Educational Resources Information Center

    Porfeli, Erik; Ferrari, Lea; Nota, Laura

    2013-01-01

    This study asserts a theoretical model of academic and work socialization within the family setting. The presumed associations between parents' work valences, children's work valences and valence perceptions, and children's academic interest and achievement are tested. The results suggest that children's perceptions of parents…

  12. Children at Risk for Academic Failure: A Model of Individual and Family Factors

    ERIC Educational Resources Information Center

    Quilliams, Laura; Beran, Tanya

    2009-01-01

    The purpose of this study was to identify individual and family risk factors that may explain why some students are at risk for academic failure. Students' self-concept, academic motivation, and their parents' involvement in education were reported by both students and teachers. A latent variable path model fit the data well (Comparative Fit Index…

  13. Visiting family physicians and naturopathic practitioners. Comparing patient-practitioner interactions.

    PubMed Central

    Boon, Heather; Stewart, Moira; Kennard, Mary Ann; Guimond, Jessica

    2003-01-01

    OBJECTIVE: To explore similarities and differences in patient visits with family physicians (FPs) and naturopathic practitioners (NPs). DESIGN: Exploratory study combining quantitative and qualitative methods. SETTING: Southern Ontario. PARTICIPANTS: A purposeful sample of 10 practitioners (five FPs and five NPs matched for age, sex, and number of years in practice): each agreed to recruit three consecutive patients with new complaints to participate in the study. MAIN OUTCOME MEASURES: Patient and visit characteristics; qualitative (content analysis of audiotaped interactions) and quantitative (ie, patient-centred care scores) information was gathered and analyzed. RESULTS: Qualitative analysis revealed that information gathering and treatment planning were very similar whether patients were visiting FPs or NPs. Most important differences were length of interaction (mean 54 minutes for NPs and 16.5 minutes for FPs) and patients' reasons for visits. Naturopathic practitioners were more likely to recommend medications (usually natural health products) than FPs. Quantitative data suggested that patients perceived no differences in patient-centred care from FPs and NPs. CONCLUSION: Overall, there were more similarities than differences in visits to the two types of practitioners. PMID:14649987

  14. Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians.

    PubMed

    Portincasa, Piero; Di Ciaula, Agostino; Grattagliano, Ignazio

    2016-07-01

    Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case-controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting. PMID:27468338

  15. Prenatal care: a comparative evaluation of nurse-midwives and family physicians.

    PubMed Central

    Buhler, L; Glick, N; Sheps, S B

    1988-01-01

    We evaluated the prenatal care provided to 44 low-risk women by nurse-midwives (NMs) at a special clinic of a large obstetric referral hospital and a sample of 88 low-risk women attended by family physicians (FPs) in their offices. The women were matched on the basis of date of delivery, age, parity, number of previous miscarriages, gravidity, socioeconomic status and delivery after 32 weeks' gestation. The Burlington Randomized Controlled Trial criteria, which reflect community standards of care, were updated and used to assess the information, which was provided on standard provincial prenatal care forms. Scoring was carried out blindly, and interrater reliability was high. A highly significant difference was found in the proportions of NM and FP charts that were rated adequate, superior or inadequate: 77% v. 24%, 7% v. 16% and 16% v. 60% respectively. The rate at which procedures were omitted (leading to an inadequate score) in the categories of initial assessment, monitoring and management also varied between the two patient groups. These findings, even when considered in terms of several biases that may have resulted in the high proportion of NM charts rated at least adequate, suggest that NMs provide prenatal care to low-risk women that is comparable, if not superior, to the care provided by FPs. PMID:3214491

  16. Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study

    PubMed Central

    Munce, Sarah E. P.; Allin, Sonya; Carlin, Leslie; Sale, Joanna; Hawker, Gillian; Kim, Sandra; Butt, Debra A.; Polidoulis, Irene; Tu, Karen; Jaglal, Susan B.

    2016-01-01

    Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario's family physicians (FPs). Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk). Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted. PMID:26904357

  17. Preventing a Mass Disease: The Case of Gallstones Disease: Role and Competence for Family Physicians

    PubMed Central

    Di Ciaula, Agostino; Grattagliano, Ignazio

    2016-01-01

    Gallstone formation is the result of a complex interaction between genetic and nongenetic factors. We searched and reviewed the available literature to define how the primary prevention of gallstones (cholesterol gallstones in particular) could be applied in general practice. Electronic bibliographical databases were searched. Prospective and retrospective cohort studies and case–controlled studies were analyzed and graded for evidence quality. The epidemiological data confirmed that genetic factors are estimated to account for only approximately 25% of the overall risk of gallstones, while metabolic/environmental factors are at least partially modifiable in stone-free risk groups, and are thus modifiable by primary prevention measures related to diet, lifestyle, and environmental factors (i.e., rapid weight loss, bariatric surgery, somatostatin or analogues therapy, transient gallbladder stasis, and hormone therapy). There is no specific recommendation for the secondary prevention of recurrent gallstones. Family physicians can contribute to preventing gallstones due to their capability to identify and effectively manage several risk factors discussed in this study. Although further studies are needed to better elucidate the involvement of epigenetic factors that may regulate the effect of environment and lifestyle on gene expression in the primary prevention of gallstone formation, preventive interventions are feasible and advisable in the general practice setting. PMID:27468338

  18. Same-Sex Parent Families and Children's Academic Achievement

    ERIC Educational Resources Information Center

    Potter, Daniel

    2012-01-01

    Children in traditional families (i.e., married, 2 biological parents) tend to do better than their peers in nontraditional families. An exception to this pattern appears to be children from same-sex parent families. Children with lesbian mothers or gay fathers do not exhibit the poorer outcomes typically associated with nontraditional families.…

  19. Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial

    PubMed Central

    O’Brien, M.A.; Grunfeld, E.; Sussman, J.; Porter, G.; Mobilio, M. Hammond

    2015-01-01

    Background The U.S. Institute of Medicine recommends that cancer patients receive survivorship care plans, but evaluations to date have found little evidence of the effectiveness of such plans. We conducted a qualitative follow-on study to a randomized controlled trial (rct) to understand the experiences of family physicians using survivorship care plans to support the follow-up of breast cancer patients. Methods A subset of family physicians whose patients were enrolled in the parent rct in Ontario and Nova Scotia were eligible for this study. In interviews, the physicians discussed survivorship care plans (intervention) or usual discharge letters (control), and their confidence in providing follow-up cancer care. Results Of 123 eligible family physicians, 18 (10 intervention, 8 control) were interviewed. In general, physicians receiving a survivorship care plan found only the 1-page care record to be useful. Physicians who received only a discharge letter had variable views about the letter’s usefulness; several indicated that it lacked information about potential cancer- or treatment-related problems. Most physicians were comfortable providing care 3–5 years after diagnosis, but desired timely and informative communication with oncologists. Conclusions Although family physicians did not find extensive survivorship care plans useful, discharge letters might not be sufficiently comprehensive for follow-up breast cancer care. Effective strategies for two-way communication between family physicians and oncologists are still lacking. PMID:26300663

  20. [An unrivalled physician? Family strategies for child care in the late 19th century South Tyrolean countryside].

    PubMed

    Unterkircher, Alois

    2012-01-01

    Who was responsible for the treatment of sick children in the countryside during the second half of the 19th century? This paper investigates the medical complaint accusing the rural population of only reluctantly bringing their sick offspring to academic physicians. The following analyses the role Franz v. Ottenthal (1818-1899), a 'representative' of a private rural medical practice, played in the specialised medical market attending to childhood diseases. An exemplary survey of Ottenthal's medical records for patients from the age of one to 14 years throughout the 1890s has shown that children contributed a relevant percentage of the whole of the physician's patient distribution. It may therefore be assumed that Ottenthal knew how to successfully merchandise his specific therapies. On the demand side, however, parents of sick children were not solely reliant upon this physician. Evidence from the medical records provides information as to when parents regarded medical self-help as no longer supporting the recovery of their children, the cures of lay healers failed, or cases when parents were not satisfied with the therapeutic treatments other physicians had to offer and therefore consulted Ottenthal. PMID:23320379

  1. The Effects of Family Size, Birth Order, Sibling Separation and Crowding on the Academic Achievement of Boys and Girls

    ERIC Educational Resources Information Center

    Nuttall, Ena Vazquez; And Others

    1976-01-01

    Family constellation variables such as family size, birth order, spacing of children, and crowding were significantly associated with academic achievement when IQ was controlled. The effects of family constellation variables were found to be sex specific. (RC)

  2. Use of email in a family practice setting: opportunities and challenges in patient- and physician-initiated communication

    PubMed Central

    Virji, Ayaz; Yarnall, Kimberly SH; Krause, Katrina M; Pollak, Kathryn I; Scannell, Margaret A; Gradison, Margaret; Østbye, Truls

    2006-01-01

    Background Electronic mail (email) has the potential to improve communication between physicians and patients. Methods We conducted two research studies in a family practice setting: 1) a brief, anonymous patient survey of a convenience sample to determine the number of clinic patients receptive to communicating with their physician via email, and 2) a randomized, controlled pilot study to assess the feasibility of providing health education via email to family practice patients. Results Sixty-eight percent of patients used email, and the majority of those (80%) were interested in using email to communicate with the clinic. The majority also reported that their email address changed less frequently than their home address (65%, n = 173) or telephone number (68%, n = 181). Forty-two percent were willing to pay an out-of-pocket fee to have email access to their physicians. When evaluating email initiated by the clinic, 26% of otherwise eligible patients could not participate because they lacked email access; those people were more likely to be black and to be insured through Medicaid. Twenty-four subjects agreed to participate, but one-third failed to return the required consent form by mail. All participants who received the intervention emails said they would like to receive health education emails in the future. Conclusion Our survey results show that patients are interested in email communication with the family practice clinic. Our feasibility study also illustrates important challenges in physician-initiated electronic communication. The 'digital divide' – decreased access to electronic technologies in lower income groups – is an ethical concern in the use of email for patient-physician communication. PMID:16911780

  3. Outcomes of deliveries by family physicians or obstetricians: a population-based cohort study using an instrumental variable

    PubMed Central

    Aubrey-Bassler, Kris; Cullen, Richard M.; Simms, Alvin; Asghari, Shabnam; Crane, Joan; Wang, Peizhong Peter; Godwin, Marshall

    2015-01-01

    Background: Previous research has suggested that obstetric outcomes are similar for deliveries by family physicians and obstetricians, but many of these studies were small, and none of them adjusted for unmeasured selection bias. We compared obstetric outcomes between these provider types using an econometric method designed to adjust for unobserved confounding. Methods: We performed a retrospective population-based cohort study of all Canadian (except Quebec) hospital births with delivery by family physicians and obstetricians at more than 20 weeks gestational age, with birth weight greater than 500 g, between Apr. 1, 2006, and Mar. 31, 2009. The primary outcomes were the relative risks of in-hospital perinatal death and a composite of maternal mortality and major morbidity assessed with multivariable logistic regression and instrumental variable–adjusted multivariable regression. Results: After exclusions, there were 3600 perinatal deaths and 14 394 cases of maternal morbidity among 799 823 infants and 793 053 mothers at 390 hospitals. For deliveries by family physicians v. obstetricians, the relative risk of perinatal mortality was 0.98 (95% confidence interval [CI] 0.85–1.14) and of maternal morbidity was 0.81 (95% CI 0.70–0.94) according to logistic regression. The respective relative risks were 0.97 (95% CI 0.58–1.64) and 1.13 (95% CI 0.65–1.95) according to instrumental variable methods. Interpretation: After adjusting for both observed and unobserved confounders, we found a similar risk of perinatal mortality and adverse maternal outcome for obstetric deliveries by family physicians and obstetricians. Whether there are differences between these groups for other outcomes remains to be seen. PMID:26303244

  4. The Value of Family Routines for the Academic Success of Vulnerable Adolescents

    ERIC Educational Resources Information Center

    Roche, Kathleen M.; Ghazarian, Sharon R.

    2012-01-01

    This study examined associations between mother reports of family routines and adolescent academic success. The authors used prospective data from "Welfare, Children, and Families: A Three City Study" (N = 1,147), a study of low-income urban youth and mothers. The vast majority of youth were African American (43%) or Latino (47%); youth were an…

  5. Adolescents' Reports of Parental Engagement and Academic Achievement in Immigrant Families

    ERIC Educational Resources Information Center

    Plunkett, Scott W.; Behnke, Andrew O.; Sands, Tovah; Choi, Brian Y.

    2009-01-01

    The purpose of this study was to add to the understanding of the effects of perceived parental engagement on adolescents' academic achievement in immigrant families. Self-report data were collected from 1,245 adolescents in immigrant families from four high schools in Los Angeles County. The sample characteristics follow: 13-16 years old (M =…

  6. Gender Inequities in Academe and Faculty Perceptions of Family-Friendly Policies

    ERIC Educational Resources Information Center

    Ramirez, Susan M.

    2010-01-01

    This study explored faculty members' perceived importance of family-friendly policies in academia, the extent to which faculty perceive academic institutions as having a social responsibility to make the academy more family-friendly, participants' endorsement of gender-biased norms, and whether the faculty members who participated in this study…

  7. Relations between Early Family Risk, Children's Behavioral Regulation, and Academic Achievement

    ERIC Educational Resources Information Center

    Sektnan, Michaella; McClelland, Megan M.; Acock, Alan; Morrison, Frederick J.

    2010-01-01

    This study examined relations among early family risk, children's behavioral regulation at 54 months and kindergarten, and academic achievement in first grade using data on 1298 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Family risk was indexed by ethnic…

  8. Personality, Family Satisfaction, and Demographic Factors That Help Mexican American Students Succeed Academically

    ERIC Educational Resources Information Center

    Cornelius-White, Jeffrey H. D.; Garza, Aida C.; Hoey, Ann T.

    2004-01-01

    This study examined 122 high academic achieving Mexican American seniors from 7 schools in South Texas. The results found that fathers' education, families' equal use of English and Spanish, family support of students' growth into areas of their own particular interests, and students' openness to experience had the highest correlations with…

  9. Investigating whether and when Family Ethnic/Race Socialization Improves Academic Performance

    ERIC Educational Resources Information Center

    Brown, Tony N.; Tanner-Smith, Emily E.; Lesane-Brown, Chase L.

    2009-01-01

    This study examined the link between family ethnic/race socialization and Black kindergarteners' and first graders' academic performance as measured by their general knowledge, math, and reading assessment scores. Drawing on identity theory, the authors predicted that repeated instances of family ethnic/race socialization would increase academic…

  10. Postdivorce Family Stability and Changes in Adolescents' Academic Performance: A Growth-Curve Model

    ERIC Educational Resources Information Center

    Sun, Yongmin; Li, Yuanzhang

    2009-01-01

    Three waves of panel data from 7,897 adolescents in the National Education Longitudinal Studies have been used to investigate whether a stabilized postdivorce family environment benefits adolescents' academic performance trajectories. The analyses indicate that compared with peers who grow up in stable postdivorce families, children of divorce who…

  11. Socioeconomic Stress and Academic Adjustment among Asian American Adolescents: The Protective Role of Family Obligation

    ERIC Educational Resources Information Center

    Kiang, Lisa; Andrews, Kandace; Stein, Gabriela L.; Supple, Andrew J.; Gonzalez, Laura M.

    2013-01-01

    Socioeconomic stress has long been found to place youth at risk, with low family income conferring disadvantages in adolescents' school achievement and success. This study investigates the role of socioeconomic stress on academic adjustment, and pinpoints family obligation as a possible buffer of negative associations. We examined direct and…

  12. What keeps family physicians busy in Portugal? A multicentre observational study of work other than direct patient contacts

    PubMed Central

    Granja, Mónica; Ponte, Carla; Cavadas, Luís Filipe

    2014-01-01

    Objectives To quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction. Design Cross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted. Setting Multicentric in 104 Portuguese family practices. Participants A convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study. Main outcomes measured Time spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction. Results FP (n=155) spent a mean of 143.6 min/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks. Conclusions FP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age. PMID:24934208

  13. Family influences and academic success: the perceptions of individuals using AAC.

    PubMed

    Rackensperger, Tracy

    2012-06-01

    Positive family influences have a significant impact on addressing school barriers to academic success for students from socially disadvantaged backgrounds. Due to inequities and attitudes toward people with complex communication needs, positive family influences may be critical in the academic success of students using AAC. This study asked the following question of eight United States high school graduates who have used augmentative and alternative communication (AAC): How do family influences positively affect the ability of students who use AAC to succeed in the secondary academic environment? Five themes emerged from the qualitative analysis of participants' narratives: (a) the impact of the family in seeking appropriate education, (b) homework as a challenge that was made easier through the involvement of the family, (c) the role of the family in communicating the importance of education, (d) mothers as driving forces of support, and (e) family encouragement for self-determination. This research allows families and schools to recognize the needs of students and to take action to meet them. It identifies the needs of families and schools in establishing relationships with each other, in terms of supporting requirements for accommodation, learning, motivation, and self-determination of students with complex commmunication needs. PMID:22670728

  14. Family Socioeconomic Status and Academic Achievement among Korean Adolescents: Linking Mechanisms of Family Processes and Adolescents' Time Use

    ERIC Educational Resources Information Center

    Bae, Dayoung; Wickrama, K. A. S.

    2015-01-01

    This study examined pathways through which family socioeconomic status may influence adolescents' academic achievement. We focused on parental monitoring and adolescents' after-school time-use patterns as linking mechanisms. Participants were 441 twelve- to fourteen-year-old Korean adolescents who participated in the Korea Welfare Panel Study.…

  15. Smoking cessation with young women in public family planning clinics: the impact of physician messages and waiting room media.

    PubMed

    Li, V C; Coates, T J; Spielberg, L A; Ewart, C K; Dorfman, S; Huster, W J

    1984-09-01

    This study evaluated the impact of a media program and a physician-delivered message in encouraging smoking cessation among young black women in public family planning clinics. Incorporated into the clinic visit, the 3- to 5-min physician message was intended to elicit a commitment from participants to take steps toward quitting, namely, to think about quitting, set a target date, enlist the help of family and friends, throw away matches and cigarettes, and to then quit "cold turkey." The media program consisted of specially designed posters in waiting rooms showing models of people in the process of quitting and a continuously run movie dealing with women and smoking. A total of 1,179 female smokers were recruited into the study when they came to three separate clinics in Baltimore, Maryland, to receive gynecological examinations and/or contraceptive services. Four separate interventions were tested: (I) a baseline questionnaire about smoking habits and related information; (II) baseline questionnaire plus media program; (III) baseline questionnaire plus physician message; and (IV) baseline questionnaire plus media program plus physician message. Conditions I and II were administered in Clinic A on alternating weeks, Condition III was administered in Clinic B, and Condition IV was administered in Clinic C. Follow-up was conducted at 3 and 12 months. Follow-up rates were 88.1% at 3 months, 79.9% at 12 months, and 84.1% for both 3 and 12 months. Among women receiving the physician message (Conditions III and IV), 9.9% reported not smoking at 12 months; the lowest selfreported cessation rate was 3.1% in Condition I. When verified through analyzing cotinine in saliva, quit rates were 0.09% in Condition I, 2.4% in Condition II, 3.7% in Condition III, and 2.1% in Condition IV. The fact that participants receiving the physician message quit smoking at a significantly greater rate than those who did not indicates the need for further study of the impact of physician

  16. Academic Achievement of Children from Monogamous and Polygynous Families.

    ERIC Educational Resources Information Center

    Cherian, Varghese I.

    1990-01-01

    Reports a study of 1,021 urban and rural Black children in Transkei, South Africa between the ages of 13 and 17. Findings showed scores on the Standard Seven external examinations were significantly lower among children from polygynous families and that these families were prone to conflict, emotional stress, and anxiety. Suggests teachers can…

  17. Can community retail pharmacist and diabetes expert support facilitate insulin initiation by family physicians? Results of the AIM@GP randomized controlled trial

    PubMed Central

    2013-01-01

    Background Limited evidence exists on the effectiveness of external diabetes support provided by diabetes specialists and community retail pharmacists to facilitate insulin-prescribing in family practice. Methods A stratified, parallel group, randomized control study was conducted in 15 sites across Canada. Family physicians received insulin initiation/titration education, a physician-specific ‘report card’ on the characteristics of their type 2 diabetes (T2DM) population, and a registry of insulin-eligible patients at a workshop. Intervention physicians in addition received: (1) diabetes specialist/educator consultation support (active diabetes specialist/educator consultation support for 2 months [the educator initiated contact every 2 weeks] and passive consultation support for 10 months [family physician initiated as needed]); and (2) community retail pharmacist support (option to refer patients to the pharmacist(s) for a 1-hour insulin-initiation session). The primary outcome was the insulin prescribing rate (IPR) per physician defined as the number of insulin starts of insulin-eligible patients during the 12-month strategy. Results Consenting, eligible physicians (n = 151) participated with 15 specialist sites and 107 community pharmacists providing the intervention. Most physicians were male (74%), and had an average of 81 patients with T2DM. Few (9%) routinely initiated patients on insulin. Physicians were randomly allocated to usual care (n = 78) or the intervention (n = 73). Intervention physicians had a mean (SE) IPR of 2.28 (0.27) compared to 2.29 (0.25) for control physicians, with an estimated adjusted RR (95% CI) of 0.99 (0.80 to 1.24), p = 0.96. Conclusions An insulin support program utilizing diabetes experts and community retail pharmacists to enhance insulin prescribing in family practice was not successful. Too few physicians are appropriately intensifying diabetes management through insulin initiation, and aggressive

  18. Financial Strain, Major Family Life Events, and Parental Academic Involvement During Adolescence.

    PubMed

    Camacho-Thompson, Daisy E; Gillen-O'Neel, Cari; Gonzales, Nancy A; Fuligni, Andrew J

    2016-06-01

    Parental academic involvement-whether through school participation and communication, or supervision and assistance at home-often has been cited as a way to enhance academic achievement. Yet, little is known about how the financial and life pressures faced by families can compromise parents' ability to become involved in their adolescents' education. In the current study, these dynamics were examined among Mexican-origin families, who often may face challenging financial and familial circumstances, and whose students may have more difficulty in secondary school. Parents of Mexican-origin ninth and tenth grade students from two high schools in Los Angeles (N = 428; 50 % female) completed quantitative interviews. The results revealed that financial strain predicted less involvement at school, and major family life events predicted less involvement at home, even after controlling for potentially confounding factors. Moreover, both of the associations between parental stress and parental academic involvement were mediated by lower levels of relationship quality between parents and adolescents, but not by conflict within the parent-adolescent dyad or parental depressive and somatic symptoms. The findings suggest that stress may limit parents' ability to become involved their adolescents' education, and highlight the importance of understanding family dynamics when examining parental academic involvement among Mexican-origin families. PMID:26951508

  19. Recognition and management of common acute conditions of the oral cavity resulting from tooth decay, periodontal disease, and trauma: an update for the family physician.

    PubMed

    Edwards, Paul C; Kanjirath, Preetha

    2010-01-01

    This article presents an overview of common and/or significant diseases of the oral cavity that the family physician is likely to encounter, with an emphasis on pathogenesis, recognition, complications, and management. Topics reviewed include the sequelae of dental caries, periodontal disease, and trauma. Prevention and early intervention strategies are emphasized. Recent updates and practical issues for the family physician are highlighted. PMID:20453174

  20. Awareness and Treatment of Alcohol Dependence in Japan: Results from Internet-Based Surveys in Persons, Family, Physicians and Society

    PubMed Central

    Taguchi, Yurie; Takei, Yoshiyuki; Sasai, Ryoko; Murteira, Susana

    2014-01-01

    Aims: To understand current awareness of, and views on, treatment of alcohol dependence in Japan. Methods: (a) Nationwide internet-based survey of 520 individuals, consisting of 52 diagnosed alcohol-dependent (AD) persons, 154 potentially alcohol-dependent (ADP) persons, 104 family members and 106 friends/colleagues of AD persons, and 104 general individuals, derived from a consumer panel where the response rate was 64.3%. We enquired into awareness about the treatment of alcohol dependence and patient pathways through the healthcare network. (b) Nationwide internet-based survey of physicians (response rate 10.1% (2395/23,695) to ask 200 physicians about their management of alcohol use disorders). Results: We deduced that 10% of alcohol-dependent Japanese persons had ever been diagnosed with alcohol dependence, with only 3% ever treated. Regarding putative treatment goals, 20–25% of the AD and ADP persons would prefer to attempt to abstain, while 60–75% preferred ‘reduced drinking.’ A half of the responding physicians considered abstinence as the primary treatment goal in alcohol dependence, while 76% considered reduced drinking as an acceptable goal. Conclusion: AD and ADP persons in Japan have low ‘disease awareness’ defined as ‘understanding of signs, symptoms and consequences of alcohol use disorders,’ which is in line with the overseas situation. The Japanese drinking culture and stigma toward alcohol dependence may contribute to such low disease awareness and current challenging treatment environment. While abstinence remains the preferred treatment goal among physicians, reduced drinking seems to be an acceptable alternative treatment goal to many persons and physicians in Japan. PMID:24893604

  1. "Sometimes I Feel Overwhelmed": Educational Needs of Family Physicians Caring for People with Intellectual Disability

    ERIC Educational Resources Information Center

    Wilkinson, Joanne; Dreyfus, Deborah; Cerreto, Mary; Bokhour, Barbara

    2012-01-01

    Primary care physicians who care for adults with intellectual disability often lack experience with the population, and patients with intellectual disability express dissatisfaction with their care. Establishing a secure primary care relationship is particularly important for adults with intellectual disability, who experience health disparities…

  2. Like Father, like Son? Familial Aggregation of Physicians among Medical and Psychology Students

    ERIC Educational Resources Information Center

    Voracek, Martin; Tran, Ulrich S.; Fischer-Kern, Melitta; Formann, Anton K.; Springer-Kremser, Marianne

    2010-01-01

    Various research findings, mostly from Anglo-American countries, evidence the medical profession to be strongly familial and further suggest that a medical family background may be associated with study success in medical undergraduates. This study explored the familial aggregation of the medical profession among 1-year cohort samples of medical…

  3. Heritability, family, school and academic achievement in adolescence.

    PubMed

    Pokropek, Artur; Sikora, Joanna

    2015-09-01

    We demonstrate how genetically informed designs can be applied to administrative exam data to study academic achievement. ACE mixture latent class models have been used with Year 6 and 9 exam data for seven cohorts of Polish students which include 24,285 pairs of twins. Depending on a learning domain and classroom environment history, from 58% to 88% of variance in exam results is attributable to heritability, up to 34% to shared environment and from 8% to 15% depends on unique events in students' lives. Moreover, between 54% and 66% of variance in students' learning gains made between Years 6 and 9 is explained by heritability. The unique environment accounts for between 34% and 46% of that variance. However, we find no classroom effects on student progress made between Years 6 and 9. We situate this finding against the view that classroom peer groups and teachers matter for adolescent learning. PMID:26188439

  4. What makes a top research medical school? A call for a new model to evaluate academic physicians and medical school performance.

    PubMed

    Goldstein, Matthew J; Lunn, Mitchell R; Peng, Lily

    2015-05-01

    Since the publication of the Flexner Report in 1910, the medical education enterprise has undergone many changes to ensure that medical schools meet a minimum standard for the curricula and clinical training they offer students. Although the efforts of the licensing and accrediting bodies have raised the quality of medical education, the educational processes that produce the physicians who provide the best patient care and conduct the best biomedical research have not been identified. Comparative analyses are powerful tools to understand the differences between institutions, but they are challenging to carry out. As a result, the analysis performed by U.S. News & World Report (USN&WR) has become the default tool to compare U.S. medical schools. Medical educators must explore more rigorous and equitable approaches to analyze and understand the performance of medical schools. In particular, a better understanding and more thorough evaluation of the most successful institutions in producing academic physicians with biomedical research careers are needed. In this Perspective, the authors present a new model to evaluate medical schools' production of academic physicians who advance medicine through basic, clinical, translational, and implementation science research. This model is based on relevant and accessible objective criteria that should replace the subjective criteria used in the current USN&WR rankings system. By fostering a national discussion about the most meaningful criteria that should be measured and reported, the authors hope to increase transparency of assessment standards and ultimately improve educational quality. PMID:25607941

  5. Family conflict and academic performance of first-year Asian American undergraduates.

    PubMed

    Bahrassa, Nazneen F; Syed, Moin; Su, Jenny; Lee, Richard M

    2011-10-01

    This three-study investigation examined risk and protective factors for poor academic performance among Asian American first-year undergraduates. Students were surveyed prior to starting college and their GPA was collected after their first semester in college. Family conflict as a significant risk factor for poor academic performance was examined in all three studies. The results indicate that higher family conflict prior to college was related to lower first-semester college GPA, after controlling for standardized test scores and high school rank (Studies 1-3). Even though psychological distress was related to both family conflict and GPA, it did not mediate the relationship between family conflict and GPA (Studies 2 and 3). In terms of protective factors, the results indicate that life satisfaction buffered the negative effects of family conflict on first-semester college GPA (Study 3). Together, these findings support the need to take into account family variables and psychological well-being in the academic performance of Asian American students as they transition from high school to college. PMID:21823785

  6. Faculty Writing Groups: A Support for Women Balancing Family and Career on the Academic Tightrope

    ERIC Educational Resources Information Center

    Penney, Sharon; Young, Gabrielle; Badenhorst, Cecile; Goodnough, Karen; Hesson, J.; Joy, Rhonda; McLeod, Heather; Pickett, Sarah; Stordy, Mary; Vaandering, Dorothy

    2015-01-01

    This qualitative research project explored the experiences of women who juggle the demands of family or parenthood while engaging in academic careers at a faculty of education. The researcher-participants consisted of 11 women; 9 women provided a written narrative, and all women participated in the data analysis. The data consisted of the…

  7. National Academic Award Winners over Time: Their Family Situation, Education and Interpersonal Relations

    ERIC Educational Resources Information Center

    Sekowski, Andrzej; Siekanska, Malgorzata

    2008-01-01

    The article presents the results of a study focusing on the family situation, education and interpersonal relations of adults (26-35 years old) who in their adolescence (16-19 years old) displayed exceptional giftedness. One group of those surveyed were national academic award winners (90). The control group consisted of 90 people of no…

  8. Socioeconomic stress and academic adjustment among Asian American adolescents: the protective role of family obligation.

    PubMed

    Kiang, Lisa; Andrews, Kandace; Stein, Gabriela L; Supple, Andrew J; Gonzalez, Laura M

    2013-06-01

    Socioeconomic stress has long been found to place youth at risk, with low family income conferring disadvantages in adolescents' school achievement and success. This study investigates the role of socioeconomic stress on academic adjustment, and pinpoints family obligation as a possible buffer of negative associations. We examined direct and interactive effects at two time points in the same sample of Asian American adolescents-early high school (N = 180 9th-10th graders; 60 % female) and 2 years later in late high school (N = 156 11th-12th graders; 87% of original sample). Results suggest that socioeconomic stress is indeed associated with poor academic adjustment, measured broadly through self-reported GPA, importance of academic success, and educational aspirations and expectations. Family obligation was positively related to adjustment, and also was found to buffer the negative effects of socioeconomic stress, but only during adolescents' later high school years. Adolescents reporting more family obligation experienced less of the negative effects of financial stress on academic outcomes than those reporting lower obligation. Cultural and developmental implications are discussed in light of these direct and moderating effects. PMID:23371003

  9. Mother-Adolescent Language Proficiency and Adolescent Academic and Emotional Adjustment among Chinese American Families

    ERIC Educational Resources Information Center

    Liu, Lisa L.; Benner, Aprile D.; Lau, Anna S.; Kim, Su Yeong

    2009-01-01

    This study examined the role of adolescents' and mothers' self-reports of English and heritage language proficiency in youth's academic and emotional adjustment among 444 Chinese American families. Adolescents who were proficient in English tended to exhibit higher reading achievement scores, math achievement scores, and overall GPA. Mothers who…

  10. Explaining the Relation between Academic Motivation and Substance Use: Effects of Family Relationships and Self Esteem.

    ERIC Educational Resources Information Center

    Andrews, Judy A.; And Others

    The inverse relation between academic motivation and substance use has been well established, but the direction of the influence remains to be specified; two possible influences are the mediating and moderating effects of family relationships and self-esteem. In this study, investigators used General Estimating Equation (GEE) models based on data…

  11. Family and Child Influences on Early Academic and Emotion Regulatory Behaviors

    ERIC Educational Resources Information Center

    Supplee, Lauren H.; Shaw, Daniel S.; Hailstones, Karen; Hartman, Kerri

    2004-01-01

    Research on child and family factors in early childhood has shown that both are associated with social and instrumental functioning at school entry. The present study sought to examine the direct and indirect effects of child negative emotionality, maternal education, depression, IQ, and quality of maternal instruction on children's academic and…

  12. A Prospective Study of Mexican American Adolescents' Academic Success: Considering Family and Individual Factors

    ERIC Educational Resources Information Center

    Roosa, Mark W.; O'Donnell, Megan; Cham, Heining; Gonzales, Nancy A.; Zeiders, Katherine H.; Tein, Jenn-Yun; Knight, George P.; Umana-Taylor, Adriana

    2012-01-01

    Mexican American youth are at greater risk of school failure than their peers. To identify factors that may contribute to academic success in this population, this study examined the prospective relationships from 5th grade to 7th grade of family (i.e., human capital [a parent with at least a high school education], residential stability,…

  13. Parenting Practices and Children's Academic Success in Low-SES Families

    ERIC Educational Resources Information Center

    Mayo, Aziza; Siraj, Iram

    2015-01-01

    Given the disadvantaged position of working-class children in the education system, it is important to understand how parents and families might support their children to succeed academically. This paper reports on 35 case studies that were conducted as part of the Effective Provision of Pre-School, Primary and Secondary Education (EPPSE 3-16)…

  14. Parental Beliefs Concerning Development and Education, Family Educational Practices and Children's Intellectual and Academic Performances

    ERIC Educational Resources Information Center

    Tazouti, Youssef; Malarde, Amelie; Michea, Aurelie

    2010-01-01

    The present study examines the relationships between parental beliefs relating to development and education, parenting practices, and the intellectual and academic performances of children. Data were collected for 128 families with a child in the second or third year of primary school. Investigations of the factors affecting the children's…

  15. Family Functioning and Academic Achievement in Middle School: A Social-Emotional Perspective.

    ERIC Educational Resources Information Center

    Wentzel, Kathryn R.

    1994-01-01

    Reviews literature on links between parenting and children's cognitive competence, proposing that social and emotional adjustment might play a critical role in mediating the relationship between these variables. Describes a program of research on family functioning, emotional distress, self-restraint, and academic performance. Explores future…

  16. Effects of Family Structure Type and Stability on Children's Academic Performance Trajectories

    ERIC Educational Resources Information Center

    Sun, Yongmin; Li, Yuanzhang

    2011-01-01

    Using five waves of panel data from 8,008 children in the ECLS-K, the current study compared children's academic performance growth curves from kindergarten through fifth grade among three types of nondisrupted and three types of disrupted families. The analyses found that children in nondisrupted two-biological-parent and nondisrupted stepparent…

  17. Empowering family physicians to impart proper inhaler teaching to patients with chronic obstructive pulmonary disease and asthma

    PubMed Central

    Leung, Janice M; Bhutani, Mohit; Leigh, Richard; Pelletier, Dan; Good, Cathy; Sin, Don D

    2015-01-01

    BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) and asthma depend on inhalers for management, but critical errors committed during inhaler use can limit drug effectiveness. Outpatient education in inhaler technique remains inconsistent due to limited resources and inadequate provider knowledge. OBJECTIVE: To determine whether a simple, two-session inhaler education program can improve physician attitudes toward inhaler teaching in primary care practice. METHODS: An inhaler education program with small-group hands-on device training was instituted for family physicians (FP) in British Columbia and Alberta. Sessions were spaced one to three months apart. All critical errors were corrected in the first session. Questionnaires surveying current inhaler teaching practices and attitudes toward inhaler teaching were distributed to physicians before and after the program. RESULTS: Forty-one (60%) of a total 68 participating FPs completed both before and after program questionnaires. Before the program, only 20 (49%) reported providing some form of inhaler teaching in their practices, and only four (10%) felt fully competent to teach patients inhaler technique. After the program, 40 (98%) rated their inhaler teaching as good to excellent. Thirty-four (83%) reported providing inhaler teaching in their practices, either by themselves or by an allied health care professional they had personally trained. All stated they could teach inhaler technique within 5 min. Observation of FPs during the second session by certified respiratory educators found that none made critical errors and all had excellent technique. CONCLUSION: A physician inhaler education program can improve attitudes toward inhaler teaching and facilitate implementation in clinical practices. PMID:26436910

  18. Routine programs of health care systems as an opportunity toward communication skills training for family physicians: A randomized field trial

    PubMed Central

    Zamani, Ahmad Reza; Motamedi, Narges; Farajzadegan, Ziba

    2015-01-01

    Background: To have high-quality primary health care services, an adequate doctor–patient communication is necessary. Because of time restrictions and limited budget in health system, an effective, feasible, and continuous training approach is important. The aim of this study is to assess the appropriateness of a communication skills training program simultaneously with routine programs of health care system. Materials and Methods: It was a randomized field trial in two health network settings during 2013. Twenty-eight family physicians through simple random sampling and 140 patients through convenience sampling participated as intervention and control group. The physicians in the intervention group (n = 14) attended six educational sessions, simultaneous organization meeting, with case discussion and peer education method. In both the groups, physicians completed communication skills knowledge and attitude questionnaires, and patients completed patient satisfaction of medical interview questionnaire at baseline, immediately after intervention, and four months postintervention. Physicians and health network administrators (stakeholders), completed a set of program evaluation forms. Descriptive statistics and Chi-square test, t-test, and repeated measure analysis of variance were used to analyze the data. Results: Use of routine program as a strategy of training was rated by stakeholders highly on “feasibility” (80.5%), “acceptability” (93.5%), “educational content and method appropriateness” (80.75%), and “ability to integrating in the health system programs” (approximate 60%). Significant improvements were found in physicians’ knowledge (P < 0.001), attitude (P < 0.001), and patients’ satisfaction (P = 0.002) in intervention group. Conclusions: Communication skills training program, simultaneous organization meeting was successfully implemented and well received by stakeholders, without considering extra time and manpower. Therefore it can be

  19. An Asclepiad family - The Chamberlens and DeLaunes, 1569-1792: Five generations of surgeons, physicians, accoucheurs and apothecaries.

    PubMed

    Russell, Lesley

    2014-06-26

    When in 1747 Dr Peter Chamberlen wrote in his apologia, 'A Voice in Rhama', that he was nursed up (as from the Cradle) to all Parts of Physick, and that in Asclepiad-Families, he was not referring simply to his father and uncle, the Peters (Younger and Elder) Chamberlen of obstetric forceps' fame. They were surgeons and accoucheurs; his mother's family counted clergymen as well as physicians and apothecaries among their number and the young Peter must indeed have grown up in a family steeped in both medical practice and religious study. Both families were refugees from the religious terrors of sixteenth century France, arriving in England in the second half of the reign of Elizabeth l. Both were to find fortune and royal patronage as they became established in their new lives. One was to found a medical dynasty that lasted through five generations, the other to produce a generation whose varied accomplishments died as the eldest son outlived all his siblings, only one of whose children became an apothecary - and he was to predecease his uncle. This is a brief biography of these two families, bound together by the ties of marriage, profession, faith and nationality. PMID:24972618

  20. Financing U.S. Graduate Medical Education: A Policy Position Paper of the Alliance for Academic Internal Medicine and the American College of Physicians.

    PubMed

    Butkus, Renee; Lane, Susan; Steinmann, Alwin F; Caverzagie, Kelly J; Tape, Thomas G; Hingle, Susan T; Moyer, Darilyn V

    2016-07-19

    In this position paper, the Alliance for Academic Internal Medicine and the American College of Physicians examine the state of graduate medical education (GME) financing in the United States and recent proposals to reform GME funding. They make a series of recommendations to reform the current funding system to better align GME with the needs of the nation's health care workforce. These recommendations include using Medicare GME funds to meet policy goals and to ensure an adequate supply of physicians, a proper specialty mix, and appropriate training sites; spreading the costs of financing GME across the health care system; evaluating the true cost of training a resident and establishing a single per-resident amount; increasing transparency and innovation; and ensuring that primary care residents receive training in well-functioning ambulatory settings that are financially supported for their training roles. PMID:27135592

  1. The development of academic family medicine in central and eastern Europe since 1990

    PubMed Central

    2013-01-01

    Background Since the early 1990s former communist countries have been reforming their health care systems, emphasizing the key role of primary care and recognizing family medicine as a specialty and an academic discipline. This study assesses the level of academic development of the discipline characterised by education and research in central and eastern European (CEE) countries. Methods A key informants study, using a questionnaire developed on the basis of a systematic literature review and panel discussions, conducted in 11 central and eastern European countries and Russia. Results Family medicine in CEE countries is now formally recognized as a medical specialty and successfully introduced into medical training at undergraduate and postgraduate levels. Almost all universities have FM/GP departments, but only a few of them are led by general practitioners. The specialist training programmes in all countries except Russia fulfil the recommendations of the European Parliament. Structured support for research in FM/GP is not always available. However specific scientific organisations function in almost all countries except Russia. Scientific conferences are regularly organised in all the countries, but peer-reviewed journals are published in only half of them. Conclusions Family medicine has a relatively strong position in medical education in central and eastern Europe, but research in family practice is less developed. Although the position of the discipline at the universities is not very strong, most of the CEE countries can serve as an example of successful academic development for countries southern Europe, where family medicine is still not fully recognised. PMID:23510461

  2. Great expectations: stress and the medical family. 1987 Committee on Issues, Association for Academic Surgery.

    PubMed

    Fabri, P J; McDaniel, M D; Gaskill, H V; Garrison, R N; Hanks, J B; Maier, R V; Telford, G L

    1989-11-01

    The high divorce rate and significant stress experienced by families of academic surgeons stimulated the Committee on Issues of the Association of Academic Surgery to choose medical family stress as the topic for the 1987 Committee presentation at the annual meeting. The Committee hoped to provide insight into the cause of this stress and new strategies for coping with this pervasive problem. Forty-three percent of the 505 surgeons who entered the Association from 1981 through 1984 and 38% of their spouses responded to a questionnaire covering issues of time management, response to stress, child rearing, financial security, and spouse career. A panel consisting of Shirley P. Levine, M.D., Hiram C. Polk, Jr., M.D., and Lane A. Gerber, Ph.D., after discussing the questionnaire results, recommended realistic goal setting, specific prioritization of activities, recognition of the considerable contributions of the spouse, and insight into personal limitations as mechanisms for improving family function. PMID:2811353

  3. A Novel Network for Mentoring Family Physicians on Mental Health Issues Using E-Mail

    ERIC Educational Resources Information Center

    Hunter, Jon J.; Rockman, Patricia; Gingrich, Nadine; Silveira, Jose; Salach, Lena

    2008-01-01

    Objective: Family practitioners are significant providers of mental health care and routinely report difficulty acquiring timely support in this area. The Collaborative Mental Health Care Network assembled groups of family practitioners and provided them with mental health practitioner mentors. This article addresses communication in the Network,…

  4. The family physician and health promotion: do-gooding or really doing well?

    PubMed

    Blum, A

    1982-09-01

    Conventional health promotion efforts, whether attempted by the individual physician or by community-wide health charities, suffer from a lack of creativity, timeliness, and an awareness of the principles of effective advertising. The difference between do-gooding and really doing well lies in carefully identifying the promoters of adverse health behavior (such as cigaret advertisers), studying their success, and-on an individual and community-wide basis-counteracting their influence by investing time and money in individualized, positive health strategies. PMID:21286523

  5. The Family Physician and Health Promotion: Do-Gooding or Really Doing Well?

    PubMed Central

    Blum, Alan

    1982-01-01

    Conventional health promotion efforts, whether attempted by the individual physician or by community-wide health charities, suffer from a lack of creativity, timeliness, and an awareness of the principles of effective advertising. The difference between do-gooding and really doing well lies in carefully identifying the promoters of adverse health behavior (such as cigaret advertisers), studying their success, and—on an individual and community-wide basis—counteracting their influence by investing time and money in individualized, positive health strategies. ImagesFigs. 1 & 2Fig. 3Fig. 4 PMID:21286523

  6. Differences between Groups of Family Physicians with Different Attitudes towards At-Risk Drinkers: A Post Hoc Study of the ODHIN Survey in Portugal

    PubMed Central

    Rosário, Frederico; Wojnar, Marcin; Ribeiro, Cristina

    2016-01-01

    Introduction. We have recently shown that family physicians can be classified into two groups based on their attitudes towards at-risk drinkers: one with better and the other with worse attitudes. Objective. To compare the two groups regarding demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Methods. A random sample of 234 Portuguese family physicians who answered the Optimizing Delivery of Health Care Interventions survey was included. The questionnaire asked questions on demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Results. Family physicians with better attitudes were younger (p = 0.005) and less experienced (p = 0.04) and with higher male proportion (p = 0.01). This group had more hours of postgraduate training (p < 0.001), felt more prepared to counsel risky drinkers (p < 0.001), and considered themselves to have better counselling efficacy (p < 0.001). More family physicians in the group with worse attitudes considered that doctors cannot identify risky drinkers without symptoms (p = 0.01) and believed counselling is difficult (p = 0.005). Conclusions. Family physicians with better attitudes had more education on alcohol and fewer barriers to work with at-risk drinkers. These differences should be taken into account when designing implementation programs seeking to increase alcohol screening and brief advice. PMID:26885392

  7. City mouse, country mouse: a mixed-methods evaluation of perceived communication barriers between rural family physicians and urban consultants in Newfoundland and Labrador, Canada

    PubMed Central

    Renouf, Tia; Alani, Sabrina; Whalen, Desmond; Harty, Chris; Pollard, Megan; Morrison, Megan; Coombs-Thorne, Heidi; Dubrowski, Adam

    2016-01-01

    Objectives To examine perceived communication barriers between urban consultants and rural family physicians practising routine and emergency care in remote subarctic Newfoundland and Labrador (NL). Design This study used a mixed-methods design. Quantitative and qualitative data were collected through exploratory surveys, comprised of closed and open-ended questions. The quantitative data was analysed using comparative statistical analyses, and a thematic analysis was applied to the qualitative data. Participants 52 self-identified rural family physicians and 23 urban consultants were recruited via email. Rural participants were also recruited at the Family Medicine Rural Preceptor meetings in St John's, NL. Setting Rural family physicians and urban consultants in NL completed a survey assessing perceived barriers to effective communication. Results Data confirmed that both groups perceived communication difficulties with one another; with 23.1% rural and 27.8% urban, rating the difficulties as frequent (p=0.935); 71.2% rural and 72.2% urban as sometimes (p=0.825); 5.8% rural and 0% urban acknowledged never perceiving difficulties (p=0.714). Overall, 87.1% of participants indicated that perceived communication difficulties impacted patient care. Primary trends that emerged as perceived barriers for rural physicians were time constraints and misunderstanding of site limitations. Urban consultants' perceived barriers were inadequate patient information and lack of native language skills. Conclusions Barriers to effective communication are perceived between rural family physicians and urban consultants in NL. PMID:27154475

  8. A Digital Health System to Assist Family Physicians to Safely Prescribe NOAC Medications.

    PubMed

    Abidi, Samina Raza; Cox, Jafna; Abusharekh, Ashraf; Hashemian, Nima; Abidi, Syed Sibte Raza

    2016-01-01

    Atrial Fibrillation (AF) is the most common cardiac arrhythmia. Generally, the therapeutic options for managing AF include the use of anticoagulant drugs that prevent the coagulation of blood. New Oral Anticoagulants (NOACs) are not optimally prescribed to patients, despite their efficacy. In Canada, NOAC medications are not directly available to patients who belong to provincial benefits programs, rather a NOAC special authorization process establishes the eligibility of a patient to receive a NOAC and be paid by the provincial Pharmacare program. This special authorization process is tedious and paper-based which inhibits physicians to prescribe NOAC leading to suboptimal AF care to patients. In this paper, we present a computerized NOAC Authorization Decision Support System (NOAC-ADSS), accessible to physicians to help them (a) determine a patient eligibility for NOAC based on Canadian AF clinical guidelines, and (b) complete the special authorization form. We present a semantic web based system to ontologically model the NOAC eligibility criteria and execute the knowledge to determine a patient NOAC eligibility and dosage. PMID:27577437

  9. Law, policy and the use of non-physicians in family planning service delivery.

    PubMed

    Paxman, J M

    1979-04-01

    A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist. PMID:12179400

  10. Fee code creep among general practitioners and family physicians in Ontario: Why does the ratio of intermediate to minor assessments keep climbing?

    PubMed Central

    Chan, B; Anderson, G M; Thériault, M E

    1998-01-01

    BACKGROUND: "Fee code creep" is the increasing tendency of primary care physicians in Ontario to bill for more intermediate than minor assessments over time. The authors examine the extent and nature of fee code creep and describe physician characteristics associated with the changes. METHODS: A cross-sectional and longitudinal analysis of Ontario Health Insurance Plan billing and physician characteristic data was conducted for fee-for-service general practitioners and family physicians (GP/FPs) in Ontario. The ratio of intermediate to minor assessments (I-M ratio) was determined for the period 1978-79 to 1994-95, and the relation of various physician characteristics to high ratios was tested with bivariate and multivariate analysis. RESULTS: The I-M ratio rose 10-fold, from 0.3 in 1978-79 to 2.9 in 1994-95. Although the I-M ratio was higher for older patients and young children, changes in population age profile over time did not account for any of the increase. The median ratio varied widely among groups of physicians: urban physicians had higher ratios than rural ones (3.9 v. 3.0, p < 0.05), and recent graduates had higher ratios than physicians 60 years of age or older (5.1 v. 2.9, p < 0.05). The I-M ratio was inversely related to number of visits; physicians billing for fewer than 5000 visits had a median ratio of 4.2, whereas those billing for 20,000 visits or more had a median ratio of 1.6. INTERPRETATION: Fee code creep has contributed to expenditure growth in Ontario. This phenomenon was related to both an increase in I-M ratio over time among physicians practising throughout the study period and an influx of new physicians billing at a higher ratio. Creep was not the result of aging of the population. PMID:9538853

  11. Correlates of Family Health History Discussions between College Students and Physicians: Does Family Cancer History Make a Difference?

    ERIC Educational Resources Information Center

    Smith, Matthew Lee; Sosa, Erica T.; Hochhalter, Angela K.; Covin, Julie; Ory, Marcia G.; McKyer, E. Lisako J.

    2011-01-01

    Effective communication between young adults and their healthcare providers can contribute to early detection of risk for developing cancer and establishment of lifelong habits for engagement in healthcare and health promotion behaviors. Our objectives were to examine factors influencing family health history discussions between college students…

  12. Revealing a cancer diagnosis to patients: attitudes of patients, families, friends, nurses, and physicians in Lebanon—results of a cross-sectional study

    PubMed Central

    Farhat, F.; Othman, A.; el Baba, G.; Kattan, J.

    2015-01-01

    Background Disclosure of a cancer diagnosis to patients is a major problem for physicians in Lebanon. Our survey aimed to identify the attitudes of patients, families and friends, nurses, and physicians regarding disclosure of a cancer diagnosis. Methods Study participants included 343 physicians, nurses, cancer patients, families, and friends from clinics in two major hospitals in Lebanon. All completed a 29-item questionnaire that assessed, by demographic group, the information provided about cancer, opinions about the disclosure of the diagnosis to cancer patients, perceived consequences to patients, and the roles of family, friends, and religion. Results Overall, 7.8% of the patients were convinced that cancer is incurable. Nearly 82% preferred to be informed about their diagnosis. Similarly, 83% of physicians were in favour of disclosing a cancer diagnosis to their patients. However, only 14% of the physicians said that they revealed the truth to the patients themselves, with only 9% doing so immediately after confirmation of the diagnosis. Disclosure of a cancer diagnosis was preferred before the start of the treatment by 59% of the patients and immediately after confirmation of the diagnosis by 72% of the physicians. Overall, 86% of physicians, 51% of nurses, and 69% of patients and their families believed that religion helped with the acceptance of a cancer diagnosis. A role for family in accepting the diagnosis was reported by 74% of the patients, 56% of the nurses, and 88% of the physicians. All participants considered that fear was the most difficult feeling (63%) experienced by cancer patients, followed by pain (29%), pity (8%), and death (1%), with no statistically significant difference between the answers given by the participant groups. Conclusions The social background in Lebanese society is the main obstacle to revealing the truth to cancer patients. Lebanese patients seem to prefer direct communication of the truth, but families take the opposite

  13. Managing Diabetes Mellitus in Children and Adolescents: Some Guidelines for Family Physicians

    PubMed Central

    Couch, Robert M.

    1990-01-01

    Insulin-dependent diabetes mellitus is a relatively common condition affecting children and adolescents. Successful management from the time of diagnosis can help prevent chronic complications of diabetes. This article reviews initial and follow-up management of diabetes in children. Guidelines for management during the remission phase, exercise, hypoglycemia, and illness, and the problems of recurrent ketoacidosis management in adolescence are discussed. The keys to successful management of diabetes mellitus in children and adolescents are patient and family education, continued support and encouragement, and early detection of and counselling for the dysfunctional family. PMID:21234001

  14. CSWP Panel Discussion: Women in Academic Science: Balancing Career and Family

    NASA Astrophysics Data System (ADS)

    Coppersmith, Susan; Drndic, Marija; Lee, Ka Yee; Mason, Nadya; Vollmayr-Lee, Katherina

    2007-03-01

    Many people who are considering pursuing academic careers in science worry about how to balance career with family. One challenge is the two-body problem, where partners are searching for jobs that are reasonably close together. Another challenge, particularly for women, is children: many women worry about whether they can have children as well as successful careers, and if so, when might be the best time to have them. This panel discussion will bring together five women who span a range of stages in their faculty careers and who all have children. Several of them have spouses who are also academic scientists. They will discuss practical strategies that they have adopted to address the challenges of career and family, as well as their views on what departments and institutions can/should do to help.

  15. Poor Child Health, Family Capital and Cumulative Inequality in Academic Achievement

    PubMed Central

    Jackson, Margot

    2015-01-01

    Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered; the duration and stability of poor health; and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N=9,252) to ask: 1) if child health is a source of cumulative inequality in academic achievement; 2) whether this relationship depends on the timing and duration of poor health; and 3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists, and that whether we observe shrinking or widening inequality as children age depends on when we measure their health, and whether children have access to compensatory resources. PMID:25926564

  16. Factors Associated with Behavior Change in Family Physicians After CME Presentation.

    ERIC Educational Resources Information Center

    Ferguson, Kristi J.; And Others

    1984-01-01

    Registrants of a four-day family practice refresher course responded to a survey assessing their reaction to a brief presentation recommending the use of penile anesthesia in newborn circumcision. The results suggest that evaluation of behavior change should consider attitudinal variables. (Author/MLW)

  17. Relations between early family risk, children’s behavioral regulation, and academic achievement

    PubMed Central

    Sektnan, Michaella; McClelland, Megan M.; Acock, Alan; Morrison, Frederick J.

    2010-01-01

    This study examined relations among early family risk, children’s behavioral regulation at 54 months and kindergarten, and academic achievement in first grade using data on 1,298 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Family risk was indexed by ethnic minority status, low maternal education, low average family income from 1 – 54 months, and high maternal depressive symptoms from 1 - 54 months. Results of structural equation modeling indicated that minority status, low maternal education, and low family income had significant negative effects on reading, math, and vocabulary achievement in first grade. Modest indirect effects were also found from ethnicity, maternal education, and maternal depressive symptoms, through 54-month and kindergarten behavioral regulation to first-grade achievement. Discussion focuses on the importance of behavioral regulation for school success especially for children facing early risk. PMID:20953343

  18. Psychiatric rehabilitation education for physicians.

    PubMed

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). PMID:23750768

  19. New conceptual model of EMR implementation in interprofessional academic family medicine clinics

    PubMed Central

    Halas, Gayle; Singer, Alexander; Styles, Carol; Katz, Alan

    2015-01-01

    Abstract Objective To capture users’ experiences with a newly implemented electronic medical record (EMR) in family medicine academic teaching clinics and to explore their perceptions of its use in clinical and teaching processes. Design Qualitative study using focus group discussions guided by semistructured questions. Setting Three family medicine academic teaching clinics in Winnipeg, Man. Participants Faculty, residents, and support staff. Methods Focus group discussions were audiorecorded and transcribed. Data were analyzed by open coding, followed by development of consensus on a final coding strategy. We used this to independently code the data and analyze them to identify salient events and emergent themes. Main findings We developed a conceptual model to reflect and summarize key themes that we identified from participant comments regarding EMR implementation and use in an academic setting. These included training and support, system design, information management, work flow, communication, and continuity. Conclusion This is the first specific analysis of user experience with a newly implemented EMR in urban family medicine teaching clinics in Canada. The experiences of our participants with EMR implementation were similar to those reported in earlier investigations, but highlight organizational influences and integration strategies. Learning how to use and transitioning to EMRs has implications for clinical learners. This points to the need for further research to gain a more in-depth understanding of the effects of EMRs on the learning environment. PMID:26167563

  20. How do family physicians communicate about cardiovascular risk? Frequencies and determinants of different communication formats

    PubMed Central

    2011-01-01

    Background Patients understand information about risk better if it is communicated in numerical or visual formats (e.g. graphs) compared to verbal qualifiers only. How frequently different communication formats are used in clinical primary care settings is unknown. Methods We collected socioeconomic and patient understanding data using questionnaires and audio-recorded consultations about cardiovascular disease risk. The frequencies of the communication formats were calculated and multivariate regression analysis of associations between communication formats, patient and general practitioner characteristics, and patient subjective understanding was performed. Results In 73% of 70 consultations, verbal qualifiers were used exclusively to communicate cardiovascular risk, compared to numerical (11%) and visual (16%) formats. Female GPs and female patient's gender were significantly associated with a higher use of verbal formats compared to visual formats (p = 0.001 and p = 0.039, respectively). Patient subjective understanding was significantly higher in visual counseling compared to verbal counseling (p = 0.001). Conclusions Verbal qualifiers are the most often used communication format, though recommendations favor numerical and visual formats, with visual formats resulting in better understanding than others. Also, gender is associated with the choice of communication format. Barriers against numerical and visual communication formats among GPs and patients should be studied, including gender aspects. Adequate risk communication should be integrated into physicians' education. PMID:21466686

  1. Educating physicians about women's health. Survey of Canadian family medicine residency programs.

    PubMed Central

    McCall, M. A.; Sorbie, J.

    1994-01-01

    OBJECTIVE: To identify which women's health issues are taught in the 2-year core curriculum of Canadian family medicine residency programs and whether educators think their current teaching of women's health is adequate. DESIGN: Mailed survey using a questionnaire. PARTICIPANTS: All program and unit directors of the 16 Canadian family medicine residency training programs were surveyed. Replies were received from 63% (10 of 16) of program directors and 79% (55 of 70) of unit directors. MAIN OUTCOME MEASURES: Percentage of programs teaching specific women's health topics from a list of 21 possible topics; percentage offering educational opportunities with sexual assault teams and women's shelters; participants' assessment of the adequacy of current teaching in each training program; plans to increase women's health education. RESULTS: Topics such as violence against women and medical conditions more common among women were taught in more than 80% of programs, but poverty and the health care concerns of Native and immigrant women were included in fewer than 40% of programs. Half of the program directors indicated that residents were given educational opportunities with sexual assault teams or women's shelters. Unit directors gave a lower estimate. Most (90%) program directors thought their current teaching of women's health issues was inadequate and had plans to increase it, as did 64% of unit directors. CONCLUSION: Violence against women and the traditional medical topics of osteoporosis, weight disorders, and reproductive and breast cancer are frequently taught in family medicine training programs. However, the social and cultural aspects of health are addressed less often. It is encouraging that many family medicine programs plan to increase their teaching of women's health. PMID:8038635

  2. Common psychiatric problems in homosexual men and women consulting family physicians.

    PubMed Central

    Myers, M F

    1980-01-01

    This paper describes the commoner psychiatric difficulties of homosexual patients seen in a family practice. It is written primarily to aid general practitioners in deciding who should be referred to a psychiatrist. Recent developments in the study of homosexuality indicate that homosexual persons are no more likely than heterosexuals to suffer psychiatric problems. Practical suggestions are made for management and counseling, and some of the misconceptions about the gay community are dispelled. PMID:7020902

  3. Navajo Culture and Family Influences on Academic Success: Traditionalism Is Not a Significant Predictor of Achievement among Navajo Youth.

    ERIC Educational Resources Information Center

    Willeto, Angela A. A.

    1999-01-01

    A study of 451 Navajo youths attending 11 high schools in the Navajo Nation found no relationship between their academic achievement and their cultural attachments and practices. Families modestly influenced educational outcomes, but being female was a stronger predictor of academic success. An appendix describes study variables. (Contains 42…

  4. The Effect of the Single-Parent Family on the Academic, Emotional, and Social Achievement of the Elementary School Child.

    ERIC Educational Resources Information Center

    DiSibio, Robert A.

    Literature is reviewed to identify findings indicating the effects of the one-parent family on the elementary school child's academic achievement and social and emotional development. While findings are contradictory in the area of academic achievement, it is concluded that disruption in home life accompanying death, separation, or divorce is…

  5. Assessment of the impact of family physicians in the district health system of the Western Cape, South Africa

    PubMed Central

    Mash, Bob; Naledi, Tracey

    2014-01-01

    Background: In 2007, South Africa made family medicine a new speciality. Family physicians that have trained for this new speciality have been employed in the district health system since 2011. The aim of the present study was to explore the perceptions of district managers on the impact of family physicians on clinical processes, health system performance and health outcomes in the district health system (DHS) of the Western Cape. Methods: Nine in-depth interviews were performed: seven with district managers and two with the chief directors of the metropolitan and rural DHS. Interviews were recorded, transcribed and analysed using the ATLAS-ti and the framework method. Results: There was a positive impact on clinical processes for HIV/AIDS, TB, trauma, non-communicable chronic diseases, mental health, maternal and child health. Health system performance was positively impacted in terms of access, coordination, comprehensiveness and efficiency. An impact on health outcomes was anticipated. The impact was not uniform throughout the province due to different numbers of family physicians and different abilities to function optimally. There was also a perception that the positive impact attributed to family physicians was in the early stages of development. Unanticipated effects included concerns with their roles in management and training of students, as well as tensions with career medical officers. Conclusion: Early feedback from district managers suggests that where family physicians are employed and able to function optimally, they are making a significant impact on health system performance and the quality of clinical processes. In the longer term, this is likely to impact on health outcomes. Evaluation de l'impact des médecins de famille dans le système de santé du district du Western Cape, en Afrique du Sud. Contexte: En 2007, l'Afrique du Sud a institué une nouvelle spécialité, la médecine de famille. Les médecins de famille qui se sont sp

  6. Family physicians can play important role helping women overcome drinking problems.

    PubMed Central

    Lechky, O

    1995-01-01

    When alcoholic women seek medical assistance, it is more likely to be because of distress over interpersonal or family problems, and their complaints of anxiety, depression and insomnia will be treated with prescription drugs. The alcoholism, which presents differently in women than men, is often left undiagnosed and untreated. However, even when women seek help for a drinking problem, traditional and male-dominated support groups may not meet their unique needs. When it comes to alcoholism, men and women are certainly not created equal. PMID:7728702

  7. In-country and community-based postgraduate family practice training for Micronesian physicians--the Palau AHEC: a collaborative effort.

    PubMed

    Dever, Greg; Finau, Sitaleki A; McCormick, Ross; Kuartei, Stevenson; Withy, Kelley; Yano, Victor; Palafox, Neal; Ueda, Masao; Pierantozzi, Sandra; Pretrick, Eliuel; Ngaden, Victor; Durand, A Mark

    2002-03-01

    The U.S. Institute of Medicine in its 1998 review of the health care systems among the U.S.-Associated Pacific Islands (USAPI) identified promotion of primary health care (PHC) and training of the regional health workforce including postgraduate training for physicians as priorities. With the support of the health leadership of the USAPI and the Republic of Palau, the John A. Burns School of Medicine (JABSOM) of the University of Hawaii captured U.S. federal Area Health Education Center (AHEC) funds to implement a postgraduate program to train Family Practitioners - physician specialists in primary care for the region. The Palau AHEC has evolved into ajoint activity of JABSOM, the University of Auckland Faculty of Medicine and Health Sciences (UAFMHS), the School of Public Health & Primary Care--Fiji School of Medicine, and Palau Community College to provide Diploma-level training in Family Practice and Community Health for Micronesian physicians. PMID:12737433

  8. Examining reciprocal influences among family climate, school attachment, and academic self-regulation: Implications for school success.

    PubMed

    Xia, Mengya; Fosco, Gregory M; Feinberg, Mark E

    2016-06-01

    Guided by family systems and ecological theories, this study examined the multicontextual implications of family, school, and individual domains for adolescents' school success. The first goal of this study was to examine reciprocal influences among family climate, school attachment, and academic self-regulation (ASR) during the middle school years. The second goal was to test the relative impact of each of these domains on adolescents' school adjustment and academic achievement after the transition to high school. We applied a cross-lag structural equation modeling approach to longitudinal data from 979 students in the 6th grade and their families, followed over 5 measurement occasions, from 6th through 9th grade. Controlling for family income, parent education, and adolescent gender, the results revealed reciprocal relationships between the family climate and school attachment over time; both of these factors were related to increases in ASR over time. In turn, ASR was a robust predictor of academic success, with unique associations with school adjustment and academic achievement. Family climate and school adjustment had modest to marginal associations with school adjustment, and no association with academic achievement. Applications of these findings for family school interventions are discussed. (PsycINFO Database Record PMID:26376426

  9. A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.

    ERIC Educational Resources Information Center

    Taylor, Robert B; And Others

    1984-01-01

    A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

  10. Race, Class, and Family Intervention: Engaging Parents and Families for Academic Success

    ERIC Educational Resources Information Center

    Sampson, William Alfred

    2007-01-01

    In recent times, actor, comedian, and educator, Bill Cosby sparked a national debate over the role of poor black families in raising their children. Additionally, scholars including Reginald Clark, Annette Lareau, John Ogbu, Javier Tapia, James Comer, and William A. Sampson have done research that suggests that many poor black and Latino families…

  11. International challenges without borders: a descriptive study of family physicians' educational needs in the field of diabetes

    PubMed Central

    2011-01-01

    Background The optimal care of persons with diabetes by general practitioners and family physicians (GP/FP) is complex and requires multiple competencies. This is a fairly unrecognized key challenge in the healthcare systems. In some cases, local and national Continuous Professional Development (CPD) initiatives target these challenges; however there have been few international initiatives, possibly because challenges emerging from different studies have not been linked across national boundaries. In this context, the authors have compiled data about gaps and/or barriers inherent to GP/FP care of persons with type 2 diabetes from Austria, Canada, Germany and the United Kingdom. Methods Secondary analyzes of pre-existing studies were conducted to identify challenges in the care of patients with type 2 diabetes as faced by GPs/FPs. Two sources of data were reviewed: unpublished research data from collaborating organizations and articles from a literature search (in English and German). Articles retrieved were scanned by the research team for relevance to the study objectives and to extract existing gaps and barriers. The identified challenges were then categorized along three major axes: (1) phase of the continuum of care {from screening to management}; (2) learning domain {knowledge, skills, attitudes, behavior, context}; and (3) by country/region. Compilation and categorization were performed by qualitative researchers and discrepancies were resolved through discussion until concordance was achieved. Results and discussion Thirteen challenges faced by GPs/FPs in the care for patients with type 2 diabetes were common in at least 3 of the 4 targeted countries/regions. These issues were found across the entire continuum of care and included: pathophysiology of diabetes, diagnostic criteria, treatment targets assessment, drugs' modes of action, decision-making in therapies, treatment guidelines, insulin therapy, adherence, management of complications, lifestyle changes

  12. Test Scores, School Performance and Parenting Issues: Assuring Academic Achievement. The Connection between Family Life and School Achievement: Given a Supportive Family, Black Children Can Succeed.

    ERIC Educational Resources Information Center

    Williams, Wanda A.

    Two things in particular could change the status of students of color in our elementary and secondary education system and make improved academic achievement possible. One is providing role models that students can relate to in the classrooms, and the other is getting families involved in their children's education. A study on family life and…

  13. Family Policies and Academic Achievement by Young Children in Single-Parent Families: An International Comparison. Population Research Institute Working Paper.

    ERIC Educational Resources Information Center

    Pong, Suet-ling; Dronkers, Jaap; Hampden-Thompson, Gillian

    This study investigates the differences in the degree of low academic achievement of third and fourth graders living with single-parent families from 11 industrialized countries. The United States ranks first among the countries compared in terms of the achievement gap for children in single- and two-parent families. After controlling for…

  14. Maryland's Plan for Family, School, and Community Involvement: Recommendations for Reaching Academic Success for All Students through Family, School, and Community Partnerships

    ERIC Educational Resources Information Center

    Maryland State Department of Education, 2003

    2003-01-01

    The Maryland Plan for Family, School, and Community Involvement addresses the importance of families, schools, and communities working together to reach academic success for all students. To continuously improve public education in Maryland so that each learner from birth through the completion of high school acquires the skills and knowledge…

  15. Demography and early academic skills of students from immigrant families: The kindergarten class of 2011.

    PubMed

    Sullivan, Amanda L; Houri, Alaa; Sadeh, Shanna

    2016-06-01

    Children from immigrant families are one of the fastest growing and most diverse groups in America's schools. This study provides a demographic portrait of immigrant children who entered kindergarten in 2010 and describes patterns and predictors of early educational outcomes of students from immigrant families. A nationally representative sample of 13,530 students who participated in the Early Childhood Longitudinal Study-Kindergarten Class of 2010-11 was analyzed. Descriptive statistics were used to estimate the sociodemographic characteristics of this population. Regression was used to examine the relations between nativity, child characteristics, and family characteristics to reading and mathematics skills in kindergarten. Approximately 27% of kindergartners in the class of 2011 came from immigrant families. These students were more racially, linguistically, and socioeconomically diverse than students from U.S.-born parents. Educational outcomes varied by parents' region of origin. Children's early academic skills were significantly related to parent's region of origin, but these relations were attenuated when child health, language, family structure, and socioeconomic status were accounted for. These results indicate the importance of considering parent nativity when examining the outcomes and needs of students from immigrant families. Because of the diversity of characteristics and outcomes of children of immigrants, researchers should consider the implications of nativity for students' experiences and needs. (PsycINFO Database Record PMID:27243241

  16. Knowledge and Practice of People toward their Rights in Urban Family Physician Program: A Population-Based Study in Shiraz, Southern Iran

    PubMed Central

    Honarvar, Behnam; Lankarani, Kamran Bagheri; Rostami, Sara; Honarvar, Fatemeh; Akbarzadeh, Armin; Odoomi, Neda; Honarvar, Hossein; Malekmakan, Leila; Rabiye, Parisa; Arefi, Nafiseh

    2015-01-01

    Background: Urban family physician program has been launched as a pilot in Fars and Mazandaran provinces of Iran since 2012. Attitudes of policy makers and people toward urban family physician program have become challenging. This study shows what people know and practice toward this program. Methods: This cross-sectional population-based study was conducted by a multistage randomized sampling in Shiraz, Southern Iran. Knowledge and practice of adults toward urban family physician program were queried through filing the questionnaires. Single and multiple variable analyzes of data were performed. Results: Participation rate was 1257 of 1382 (90.9%), and the mean age of the respondents was 38.1 ± 13.2 years. Of 1257, 634 (50.4%) were men and 882 (70.2%) were married. Peoples’ total knowledge toward urban family physician program was 5 ± 2.7 of 19, showed that 1121 (89.2%) had a low level of knowledge. This was correlated positively and in order to being under coverage of this program (P < 0.001), being under coverage of one of the main insurance systems (P = 0.04) and being married (P = 0.002). The mean score of people's practice toward the program was 2.3 ± 0.9 of total score 7, showed that 942 (74%) had poor performance, and it was correlated positively and in order to being under coverage of this program (P < 0.001) and having higher than 1000$ monthly income (P = 0.004). Correlation of people's knowledge and practice toward the program was 24%. Conclusions: Current evidences show a low level of knowledge, poor practice and weak correlation of knowledge-practice of people toward urban family physician program. PMID:26124943

  17. Mother-Adolescent Language Proficiency and Adolescent Academic and Emotional Adjustment Among Chinese American Families

    PubMed Central

    Benner, Aprile D.; Lau, Anna S.; Kim, Su Yeong

    2009-01-01

    This study examined the role of adolescents’ and mothers’ self-reports of English and heritage language proficiency in youth’s academic and emotional adjustment among 444 Chinese American families. Adolescents who were proficient in English tended to exhibit higher reading achievement scores, math achievement scores, and overall GPA. Mothers who were English proficient tended to have children with higher academic achievement and fewer depressive symptoms. Results also indicated that adolescents’ heritage language maintenance was associated with positive adjustment, particularly amongst foreign-born youth and for youth whose parents were highly proficient in the heritage language. Mother-adolescent match in heritage language proficiency was related to higher math achievement scores and overall GPA. Additionally, higher heritage language proficiency was associated with fewer depressive symptoms for foreign-born but not U.S.-born youth. Overall, the findings suggest that proficiency in both the English and heritage language may confer advantages to Chinese American youth. PMID:19636729

  18. [Changing role of the family physician in British National Health Service].

    PubMed

    Goodwin, N

    2000-01-01

    Over the last ten years the traditional role of primary care in Great Britain has been undergoing major changes with the major impact being the introduction of what is termed "GP fundholding", a process by which GPs hold budgets to purchase care from hospitals on behalf of their patients. This paper addresses how the system of fundholding operates in practice and points out the difference between the new and the previous system in which the health authority would plan care for the whole of a district and costs by hospitals would be covered by an all-inclusive system. The paper studies the rationale of the introduction of the fundholding and examines the evidence on how successful the approach has been. With reference to a systematic literature review of the evidence on fundholding's outcomes undertaken by the author, the paper examines the evidence for and against fundholding under the following headings: efficiency, equity, quality, choice and responsiveness. The paper then addresses more recent changes to the British health care system and shows how these have changed the role of the family doctor irrevocablly. PMID:10748549

  19. Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial

    PubMed Central

    2011-01-01

    Background To explore ways to reduce the overuse of antibiotics for acute respiratory infections (ARIs), we conducted a pilot clustered randomized controlled trial (RCT) to evaluate DECISION+, a training program in shared decision making (SDM) for family physicians (FPs). This pilot project demonstrated the feasibility of conducting a large clustered RCT and showed that DECISION+ reduced the proportion of patients who decided to use antibiotics immediately after consulting their physician. Consequently, the objective of this study is to evaluate, in patients consulting for ARIs, if exposure of physicians to a modified version of DECISION+, DECISION+2, would reduce the proportion of patients who decide to use antibiotics immediately after consulting their physician. Methods/design The study is a multi-center, two-arm, parallel clustered RCT. The 12 family practice teaching units (FPTUs) in the network of the Department of Family Medicine and Emergency Medicine of Université Laval will be randomized to a DECISION+2 intervention group (experimental group) or to a no-intervention control group. These FPTUs will recruit patients consulting family physicians and residents in family medicine enrolled in the study. There will be two data collection periods: pre-intervention (baseline) including 175 patients with ARIs in each study arm, and post-intervention including 175 patients with ARIs in each study arm (total n = 700). The primary outcome will be the proportion of patients reporting a decision to use antibiotics immediately after consulting their physician. Secondary outcome measures include: 1) physicians and patients' decisional conflict; 2) the agreement between the parties' decisional conflict scores; and 3) perception of patients and physicians that SDM occurred. Also in patients, at 2 weeks follow-up, adherence to the decision, consultation for the same reason, decisional regret, and quality of life will be assessed. Finally, in both patients and physicians

  20. An evaluation of family physicians' educational needs and experiences in health promotion and disease prevention in Poland and Lithuania - a qualitative study

    PubMed Central

    2011-01-01

    Background The aim of this study is to explore the views of family physicians/general practitioners about the most important competences in health promotion and diseases prevention and areas where these competences might be below the desired level. Methods A qualitative, descriptive study, combining two data collection techniques, was conducted in two Eastern European countries in June and July 2009. Focus groups numbering 10 and 9 physicians, respectively, practising in various clinical settings, were held in Poland and Lithuania. Seven well-informed health care experts were recruited in both countries to provide information during the in-depth interviews. In both formats, questions were devoted to three main areas of health promotion and disease prevention competences: (1) educational, (2) clinical, (3) organisational. A qualitative content analysis was performed. Results Lithuanian and Polish family physicians/general practitioners view preventive care as one of their main responsibilities. Among 3 areas of competences, participants identified clinical competences as the most important in everyday practice. They also acknowledged that organisational and educational competences might be below the level required for effective preventive care. Only clinical competences were indicated as sufficiently developed during under- and post-graduate medical education. Conclusions In addressing current health promotion and disease prevention challenges, teachers of family medicine need to critically consider the training that currently exists for physicians. Development of a high-quality preventive service is not only a matter of proper education in the clinical field but also requires training in practice organisation and patient education. PMID:21435277

  1. Depressive symptoms, anxiety and academic motivation in youth: Do schools and families make a difference?

    PubMed

    Elmelid, Andrea; Stickley, Andrew; Lindblad, Frank; Schwab-Stone, Mary; Henrich, Christopher C; Ruchkin, Vladislav

    2015-12-01

    This longitudinal study aimed to examine the association between depressive and anxiety symptoms and academic motivation by gender, and whether positive school and family factors would be associated with academic motivation, in spite of the presence of such symptoms. Study participants were predominantly economically disadvantaged youths aged 13-15 years in a Northeastern US urban public school system. The Social and Health Assessment (SAHA) served as the basis for a survey undertaken in 2003 and 2004 with information being used from students who participated at both time points (N = 643). Multiple linear regression analyses showed that depressive symptoms were negatively associated with academic motivation, while anxiety was positively related to academic motivation in both genders. Teacher support, school attachment and parental control were positively related to academic motivation even in the presence of internalizing problems. The negative association of depressive symptoms with academic motivation may be potentially decreased by attachment to school. PMID:26476790

  2. First Generation College Students in Engineering: A Grounded Theory Study of Family Influence on Academic Decision Making

    ERIC Educational Resources Information Center

    Simmons, Denise Rutledge

    2012-01-01

    This work develops a constructivist grounded theory describing the influence of family and those that serve a role similar to family on the academic decision making of undergraduate first generation in college (FGC) students majoring in engineering. FGC students, in this study, are students with neither parent having attained a bachelor's…

  3. Effects of Family Functioning and Parenting Style on Early Entrants' Academic Performance and Program Completion

    ERIC Educational Resources Information Center

    Huey, Erron L.; Sayler, Michael F.; Rinn, Anne N.

    2013-01-01

    The purpose of the current study was to examine the predictive nature of parenting style and overall family environment on the academic performance and program completion of early college entrants. Furthermore, gender and family form were examined as possible moderators to these relationships. A total of 88 early college entrants participated in…

  4. Addressing Reciprocity between Families and Schools: Why These Bridges Are Instrumental for Students' Academic Success

    ERIC Educational Resources Information Center

    Tran, Yune

    2014-01-01

    One instrumental step in promoting overall children's academic success across the trajectory of early childhood, elementary, middle, and secondary grades is purposefully establishing positive linkages for families and schools through a shared partnership. By facilitating an ongoing collaborative approach to sustain family engagement practices…

  5. The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

    PubMed Central

    Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

    2009-01-01

    Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes

  6. Self-reported practices in opioid management of chronic noncancer pain: A survey of Canadian family physicians

    PubMed Central

    Allen, Michael JM; Asbridge, Mark M; MacDougall, Peter C; Furlan, Andrea D; Tugalev, Oleg

    2013-01-01

    BACKGROUND: In May 2010, a new Canadian guideline on prescribing opioids for chronic noncancer pain (CNCP) was released. To assess changes in family physicians’ (FPs) prescribing of opioids following the release of the guideline, it is necessary to know their practices before the guideline was widely disseminated. OBJECTIVES: To determine FPs’ practices and knowledge in prescribing opioids for CNCP in relation to the Canadian guideline, and to determine factors that hinder or enable FPs in prescribing opioids for CNCP. METHODS: An online survey was developed and FPs who manage CNCP were electronically contacted through the College of Family Physicians of Canada, university continuing medical education offices and provincial regulatory colleges. RESULTS: A total of 710 responses were received. FPs followed a precautionary approach to prescribing opioids and already practiced in accordance with Canadian guideline recommendations by discussing adverse effects, monitoring for aberrant drug-related behaviour and advising caution when driving. However, FPs seldom discontinued opioids even if they were ineffective and were unaware of the ‘watchful dose’ of opioids, the daily dose at which patients may need reassessment or closer monitoring. Only two of nine knowledge questions were answered correctly by more than 40% of FPs. The main enabler to optimal opioid prescribing was having access to a patient’s opioid history from a provincial prescription monitoring program. The main barriers to optimal prescribing were concerns about addiction and misuse. CONCLUSIONS: While FPs follow a precautionary approach to prescribing opioids for CNCP, there are substantial practice and knowledge gaps, with implications for patient safety and costs. PMID:23717824

  7. Perceptions of Family Physician Trainees and Trainers Regarding the Usefulness of a Virtual Community of Practice

    PubMed Central

    Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

    2013-01-01

    Background Training for Australian general practice, or family medicine, can be isolating, with registrars (residents or trainees) moving between rural and urban environments, and between hospital and community clinic posts. Virtual communities of practice (VCoPs), groups of people sharing knowledge about their domain of practice online and face-to-face, may have a role in overcoming the isolation associated with general practice training. Objective This study explored whether Australian general practice registrars and their supervisors (trainers) would be able to use, and would be interested in using, a VCoP in the form of a private online network for work and training purposes. It also sought to understand the facilitators and barriers to intention to use such a community, and considers whether any of these factors may be modifiable. Methods A survey was developed assessing computer, Internet, and social media access and usage, confidence, perceived usefulness, and barriers, facilitators, and intentions to use a private online network for training purposes. The survey was sent by email link to all 139 registrars and 224 supervisors in one of Australia’s 17 general practice training regions. Complete and usable responses were received from 131 participants (response rate=0.4). Results Most respondents had access to broadband at home (125/131, 95.4%) and at work (130/131, 99.2%). Registrars were more likely to spend more than 2 hours on the Internet (P=.03), and to use social media sites for nonwork purposes (P=.01). On a 5-point Likert scale, confidence was high (mean 3.93, SD 0.63) and was negatively associated with higher age (P=.04), but not associated with training stage. Social media confidence was lower, with registrars more confident than supervisors for almost all social media activities. On a 5-point Likert scale, overall usefulness was scored positively (n=123, mean 3.63, SD 0.74), and was not significantly associated with age or training level. The

  8. Knowledge and Perceptions of Family Leave Policies Among Female Faculty in Academic Medicine

    PubMed Central

    Freund, Karen M.; Kaplan, Samantha A.; Raj, Anita; Carr, Phyllis L.

    2014-01-01

    Objective The purpose of this research was to examine the knowledge and perceptions of family leave policies and practices among senior leaders including American Association of Medical College members of the Group on Women in Medicine and Science (GWIMS) to identify perceived barriers to career success and satisfaction among female faculty. Methods In 2011–2012 GWIMS representatives and senior leaders at 24 medical schools were invited to participate in an interview about faculty perceptions of gender equity and overall institutional climate. An inductive thematic analysis of the qualitative data was conducted to identify themes represented in participant responses. The research team read and reviewed institutional family leave policies for concordance with key informant descriptions. Findings 22 GWIMS representatives and senior leaders comprised the final sample. Participants were female, 18 (82%) were full professors with the remainder being associate professors. Compared with publicly available policies at each institution, the knowledge of nine participants was consistent with policies, was discrepant for six, with the remaining seven acknowledging a lack of knowledge of policies. Four major themes were identified from the interview data: 1) Framing family leave as a personal issue undermines its effect on female faculty success; 2) Poor communication of policies impairs access and affects organizational climate; 3) Discrepancies in leave implementation disadvantage certain faculty in terms of time and pay; 4) Leave policies are valued and directly related to academic productivity. Conclusions Family leave policies are an important aspect of faculty satisfaction and academic success, yet policy awareness by senior leaders is lacking. Further organizational support is needed to promote equitable policy creation and implementation to support women in medical academia. PMID:24533979

  9. Female physicians: trends and likely impacts on healthcare in Israel

    PubMed Central

    2013-01-01

    Background Female physicians have become an increasing proportion of the medical workforce in Israel. This study investigates this trend and discusses its likely impact on the quantity and quality of medical care available. Method Data on licensed physicians and new licenses issued to physicians were taken from a Ministry of Health database, and analyzed by gender, age, academic origin (Israeli graduates, immigrants, Israeli-born who studied abroad), and specialty for the years 1999–2011. Data on employed physicians, their population group, and work hours were taken from the Central Bureau of Statistics (CBS) annual Labour Force Survey for the years 2009–2011. Results The proportion of women amongst physicians aged under 65 rose from 38% in 1999 to 42% in 2011, and was even higher for younger physicians. The highest proportion of females is found amongst new immigrant physicians who studied abroad. The corresponding proportion has been rising steadily amongst Israeli-educated physicians, and is lowest amongst Israeli-born physicians who studied abroad. Similarly, among newly licensed physicians, the proportion of females has traditionally been highest among immigrants who studied abroad and lowest among Israeli-born graduates who studied abroad. Among newly-licensed physicians who studied in Israel, the proportion of females has historically been intermediate between the other two groups, but it has recently risen to 54% and now parallels the proportion of females among immigrants who studied abroad. In recent years, the mix of academic origins among newly licensed physicians has changed dramatically, with important implications for the proportion of women among newly licensed physicians. The highest percentage of females was found in family medicine followed by oncology, pediatrics and psychiatry. The greatest increase over the years in this percentage was for gynecology and internal medicine. Female physicians worked shorter hours than males, particularly at

  10. Teacher-child relationship quality and academic achievement of Chinese American children in immigrant families.

    PubMed

    Ly, Jennifer; Zhou, Qing; Chu, Keira; Chen, Stephen H

    2012-08-01

    This study examined the cross-sectional relations between teacher-child relationship quality (TCRQ) and math and reading achievement in a socio-economically diverse sample of Chinese American first- and second-grade children in immigrant families (N=207). Teachers completed a questionnaire measuring TCRQ dimensions including closeness, conflict, and intimacy, and children completed a questionnaire measuring overall TCRQ. Standardized tests were used to assess children's math and reading skills. Analyses were conducted to (a) test the factor structure of measures assessing TCRQ among Chinese American children, (b) examine the associations between teacher- and child-rated TCRQ and children's academic achievement, controlling for demographic characteristics, and (c) examine the potential role of child gender as a moderator in the relations between TCRQ and achievement. Results indicated that teacher-rated TCRQ Warmth was positively associated with Chinese American children's reading achievement. Two child gender-by-TCRQ interactions were found: (a) teacher-rated TCRQ Conflict was negatively associated with girls' (but not boys') math achievement, and (b) child-rated Overall TCRQ was positively associated with boys' (but not girls') reading achievement. These findings highlight the valuable role of TCRQ in the academic success of school-aged children in immigrant families. PMID:22710020

  11. Shaping the Future of Academic Health Centers: The Potential Contributions of Departments of Family Medicine

    PubMed Central

    Newton, Warren P.; DuBard, C. Annette

    2006-01-01

    Academic health centers (AHCs) must change dramatically to meet the changing needs of patients and society, but how to do this remains unclear. The purpose of this supplement is to describe ways in which departments of family medicine can play leadership roles in helping AHCs evolve. This overview provides background for case studies and commentaries about the contribution of departments of family medicine in 5 areas: (1) ambulatory and primary care, (2) indigent care, (3) education in community and international settings, (4) workforce policy and practice, and (5) translational research. The common theme is a revitalization of the relationship between AHCs and the communities they serve across all missions. Family medicine leadership can provide dramatic organizational improvement in primary and ambulatory care networks and foster opportunities for leadership by AHCs in improving the health of the population. Departments of family medicine can also play a leading role in developing new partnerships with community-based organizations, managing the care of the indigent, and developing new curricula in community and international settings. Finally, family medicine departments and their faculty have a central role in helping AHCs respond to workforce needs and in developing translational research that emphasizes the health of the population and effectiveness of care. AHCs are a public good that must now evolve substantially to meet the needs of patients and society. By pushing for substantial change, by helping to reinvigorate the relationship between AHCs and the communities they serve, and by emphasizing fundamental innovation in clinical care, teaching, and research, family medicine can help lead the renewal of the AHC. PMID:17003157

  12. Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease

    PubMed Central

    Rocker, Graeme; Young, Joanne; Donahue, Margaret; Farquhar, Morag; Simpson, Catherine

    2012-01-01

    Background: A recent national practice guideline recommends the use of opioids for the treatment of refractory dyspnea in patients with advanced chronic obstructive pulmonary disease (COPD). We conducted two qualitative studies to explore the experiences of patients and family caregivers with opioids for refractory COPD-related dyspnea and the perspectives and attitudes of physicians toward opioids in this context. Methods: Patients (n = 8; 5 men, 3 women), their caregivers (n = 12; 5 men, 7 women) and physicians (n = 28, 17 men, 11 women) in Nova Scotia participated in the studies. Semistructured interviews were recorded, transcribed verbatim, coded conceptually and analyzed for emergent themes using interpretive description methodology. Results: Patients reported that opioids provided a sense of calm and relief from severe dyspnea. Family caregivers felt that opioids helped patients to breathe more “normally,” observed improvements in patients’ symptoms of anxiety and depression, and experienced reductions in their own stress. Patients reported substantial improvements in their quality of life. All patients and family caregivers wanted opioid therapy to continue. Most physicians were reluctant to prescribe opioids for refractory dyspnea, describing a lack of related knowledge and experience, and fears related to the potential adverse effects and legal censure. Interpretation: Discrepancies between the positive experiences of patients and family caregivers with opioids and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care. Bridging this gap will require initiatives to improve the uptake of practice guidelines and to increase confidence in prescribing opioids for dyspnea refractory to conventional treatment. PMID:22529167

  13. Childhood bullying: implications for physicians.

    PubMed

    Lyznicki, James M; McCaffree, Mary Anne; Robinowitz, Carolyn B

    2004-11-01

    Childhood bullying has potentially serious implications for bullies and their targets. Bullying involves a pattern of repeated aggression, a deliberate intent to harm or disturb a victim despite the victim's apparent distress, and a real or perceived imbalance of power. Bullying can lead to serious academic, social, emotional, and legal problems. Studies of successful antibullying programs suggest that a comprehensive approach in schools can change student behaviors and attitudes, and increase adults' willingness to intervene. Efforts to prevent bullying must address individual, familial, and community risk factors, as well as promote an understanding of the severity of the problem. Parents, teachers, and health care professionals must become more adept at identifying possible victims and bullies. Physicians have important roles in identifying at-risk patients, screening for psychiatric comorbidities, counseling families about the problem, and advocating for bullying prevention in their communities. PMID:15554490

  14. Marital Transitions, Parenting, and Schooling: Exploring the Link Between Family-Structure History and Adolescents' Academic Status

    PubMed Central

    Cavanagh, Shannon E.; Schiller, Kathryn S.; Riegle-Crumb, Catherine

    2010-01-01

    The linkage between family structure and adolescents’ academic experiences is part of a larger, dynamic process unfolding over time. To investigate this phenomenon, this study drew on the National Longitudinal Study of Adolescent Health and the Adolescent Health and Academic Achievement Study. Logistic regressions revealed that family structure at birth predicted students’ academic status in math in the ninth grade, and multinomial regressions revealed that family instability, along with curricular location in the ninth grade, parenting behaviors, and adolescents’ adjustment and aspirations, distinguished those who completed higher-level math by the end of high school from those who did not but still graduated from high school and from those who dropped out of high school. PMID:20352021

  15. Reproductive Health of Women in Rural Areas of East Azerbaijan – Iran, before and after Implementation of rural Family Physician Program: an Ecologic Study

    PubMed Central

    Alizadeh, Mahasti; Jabbari Birami, Hossein; Moradi, Siavash

    2015-01-01

    Introduction: Implementation of rural family physician program in Iran in 2005 has been evaluated and shown that this program has been led to some improvements in health indicators. In this study, some reproductive health (RH) indicators were compared before and after implementation of this program in rural areas of East Azerbaijan, Iran. Methods: In this ecologic- time trend study, the data of 191075 births of rural women of East Azerbaijan from 2001 to 2010 was extracted from vital horoscope (ZIJ) and used for calculation of 20 important RH indicators. The paired t-test and correlation analysis wear used for data analysis. Results: Some indicators such as adolescent marriage rate, adolescent birth and over 35 year olds birth rate were increased after rural family physician program implementation in 2005. Also stillbirth rate and unsafe delivery were decreased during this period. There was a significant correlation between increasing adolescent birth rate and increasing low birth weight deliveries (r= 0.911, P= 0.031) and also between increasing over 35 year olds birth rate and increasing neonatal mortality rate in term of prematurity and congenital malformations (r= 0.912, P= 0.031) after program implementation. Conclusion: Perinatal care and safe delivery even for pregnancies outside the typical child-bearing ages are promoting after implementation of rural family physician program in East Azerbaijan. Also decreasing unsafe delivery and stillbirth rate can be considered as achievements of running this program in this province. PMID:26744731

  16. Behavioral and emotional adjustment, family functioning, academic performance, and social relationships in children with selective mutism.

    PubMed

    Cunningham, Charles E; McHolm, Angela; Boyle, Michael H; Patel, Sejal

    2004-11-01

    This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of 52 community controls, 52 children with SM were more anxious, obsessive, and prone to somatic complaints. In contrast, children with SM were less oppositional and evidenced fewer attentional difficulties at school. We found no group differences in family structure, economic resources, family functioning, maternal mood difficulties, recreational activities, or social networks. While parents reported no differences in parenting strategies, children with SM were described as less cooperative in disciplinary situations. The academic (e.g., reading and math) and classroom cooperative skills of children with SM did not differ from controls. Parents and teachers reported that children with SM had significant deficits in social skills. Though teachers and parents rated children with SM as less socially assertive, neither teachers nor parents reported that children with SM were victimized more frequently by peers. PMID:15482497

  17. Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan

    PubMed Central

    Hajizadeh, Shayesteh; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    Background The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density. Methods In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline. Results After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03–0.25) in women’s awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women’s preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22–0.85); P>0.001). Conclusions The results of this study

  18. Providing Support to Families with Specific Regard to the Removal of Barriers that Exist for Families Trying to Provide Academic Support at Home

    ERIC Educational Resources Information Center

    Martin, Christine

    2011-01-01

    The purpose of this study was to provide resources for families such that they would be well equipped to provide academic support at home; hence examining the impact of providing said resources and the subsequent impact on a first grade child's reading development. In this study, the researcher took a group of twenty students and divided them into…

  19. Family Background, School-Age Trajectories of Activity Participation, and Academic Achievement at the Start of High School

    PubMed Central

    Crosnoe, Robert; Smith, Chelsea; Leventhal, Tama

    2014-01-01

    Applying latent class and regression techniques to data from the NICHD Study of Early Child Care and Youth Development (n = 997), this study explored the potential academic advantages of time spent in out-of-school activities. Of particular interest was how these potential advantages played out in relation to the timing and duration of activity participation and the family contexts in which it occurred. Participation closer to the start of high school—including consistent participants and latecomers—was associated with higher grades at the transition into high school, especially for youth from low-income families. Sensitivity analyses indicated that this link between school-age activity participation and adolescent academic progress was unlikely to be solely a function of selection. It also tended to be more pronounced among youth from lower-income families, although without varying by other aspects of family status or process. PMID:26279615

  20. Effortful Control, Behavior Problems and Peer Relations: What Predicts Academic Adjustment in Kindergarteners from Low-income Families?

    PubMed Central

    Morris, Amanda Sheffield; John, Aesha; Halliburton, Amy L.; Morris, Michael D. S.; Robinson, Lara R.; Myers, Sonya S.; Aucoin, Katherine J.; Keyes, Angela W.; Terranova, Andrew

    2013-01-01

    This study examined the role of effortful control, behavior problems, and peer relations in the academic adjustment of 74 kindergarten children from primarily low-income families using a short-term longitudinal design. Teachers completed standardized measures of children’s effortful control, internalizing and externalizing problems, school readiness, and academic skills. Children participated in a sociometric interview to assess peer relations. Research Findings: Correlational analyses indicate that children’s effortful control, behavior problems in school, and peer relations are associated with academic adjustment variables at the end of the school year, including school readiness, reading skills, and math skills. Results of regression analyses indicate that household income and children’s effortful control primarily account for variation in children’s academic adjustment. The associations between children’s effortful control and academic adjustment did not vary across sex of the child or ethnicity. Mediational analyses indicate an indirect effect of effortful control on school readiness, through children’s internalizing problems. Practice or Policy: Effortful control emerged as a strong predictor of academic adjustment among kindergarten children from low-income families. Strategies for enhancing effortful control and school readiness among low-income children are discussed. PMID:24163572

  1. Effect of the Implementation of the Family Physician Program 2015 on Fair Accessibility for People to Health Care Services in the Sistan Region.

    PubMed

    Sarani, Mohammad; Arbabisarjou, Azizollah; Saravani, Soleyman; Miri, Ali; Shahrakivahed, Aziz

    2016-01-01

    Equitable access to primary health care is an indispensable right and a basic need of all human beings. Currently, the development of any society is judged based on the level of public access to primary health care services. This comparative study attempted to examine the fairness accessibility of people in Sistan to health care services through Family Physician Program 2015.This was a descriptive, analytical research focusing on the level of equitable public access to primary health care in Sistan. Samples were taken from all the service-providing centers. Data were collected through HNIS software, network management center to analyze the gathered data. The results showed that prior to the implementation of the family doctor plan (before 2005), there was a doctor for every 9545 people, a midwife for every 10,000 people and one paramedic for 1,111 people. After beginning the family doctor plan, the figures showed that there was one doctor or MD for every 3387 people and one midwife for every 2916 people, and one health worker for every 549 rural residents. The implementation of the family physician program was an opportunity for the health system in Sistan region, where the appropriate resources management and equitable distribution of health care services throughout the region could facilitate accessibility to identical services. PMID:27357871

  2. Patients’ Ratings of Family Physician Practices on the Internet: Usage and Associations With Conventional Measures of Quality in the English National Health Service

    PubMed Central

    Pape, Utz J; Lee, Henry; Smith, Dianna M; Darzi, Ara; Majeed, Azeem; Millett, Christopher

    2012-01-01

    Background Patients are increasingly rating their family physicians on the Internet in the same way as they might rate a hotel on TripAdvisor or a seller on eBay, despite physicians’ concerns about this process. Objective This study aims to examine the usage of NHS Choices, a government website that encourages patients to rate the quality of family practices in England, and associations between web-based patient ratings and conventional measures of patient experience and clinical quality in primary care. Methods We obtained all (16,952) ratings of family practices posted on NHS Choices between October 2009 and December 2010. We examined associations between patient ratings and family practice and population characteristics. Associations between ratings and survey measures of patient experience and clinical outcomes were examined. Results 61% of the 8089 family practices in England were rated, and 69% of ratings would recommend their family practice. Practices serving younger, less deprived, and more densely populated areas were more likely to be rated. There were moderate associations with survey measures of patient experience (Spearman ρ 0.37−0.48, P<.001 for all 5 variables), but only weak associations with measures of clinical process and outcome (Spearman ρ less than ±0.18, P<.001 for 6 of 7 variables). Conclusion The frequency of patients rating their family physicians on the Internet is variable in England, but the ratings are generally positive and are moderately associated with other measures of patient experience and weakly associated with clinical quality. Although potentially flawed, patient ratings on the Internet may provide an opportunity for organizational learning and, as it becomes more common, another lens to look at the quality of primary care. PMID:23076301

  3. Do Babies Matter? The Effect of Family Formation on the Lifelong Careers of Academic Men and Women.

    ERIC Educational Resources Information Center

    Mason, Mary Ann; Goulden, Marc

    2002-01-01

    Examines family formation and its effects on the career lives of both women and men academics from the time they receive their doctorates until 20 years later. Finds that there is a consistent and large gap in achieving tenure between women who have early babies and men who have early babies. Discusses policy implications. (EV)

  4. The Effects of Financial Stress on the Academic Achievement of Young Adolescents from Farm and Nonfarm Families.

    ERIC Educational Resources Information Center

    Clark-Lempers, Dania S.; Netusil, Anton

    Financial stress brought about by economic changes in farm communities affects the academic achievement of young adolescents. This effect is mediated by the social support of parents and degree of dissonance in young adolescents relationships with parents. Young adolescents, mothers, and fathers from 105 farm and nonfarm families participated in…

  5. An Examination of the Interrelationships between Self-Esteem, Others' Expectations, Family Support, Learning Approaches and Academic Achievement

    ERIC Educational Resources Information Center

    Roman, Sergio; Cuestas, Pedro J.; Fenollar, Pedro

    2008-01-01

    The current research represents an initial step into the analysis of the effect of self-esteem, others' (peers and teachers) expectations and family support on academic achievement through learning approaches (deep processing, surface processing and effort). Data were gathered from 553 university students from different faculties of a Spanish…

  6. Family Background, Students' Academic Self-Efficacy, and Students' Career and Life Success Expectations

    ERIC Educational Resources Information Center

    Kim, Mihyeon

    2014-01-01

    This study examined the relationship of family background on students' academic self-efficacy and the impact of students' self-efficacy on their career and life success expectations. The study used the national dataset of the Educational Longitudinal Study of 2002 (ELS: 2002), funded by the U.S. Department of Education. Based on a path…

  7. Experiences of Latina First Generation College Students: Exploring Resources Supporting the Balancing of Academic Pursuits and Family Life

    ERIC Educational Resources Information Center

    Corona-Ordonez, Hercilia B.

    2013-01-01

    This study used a qualitative interview approach and thematic analysis (Braune and Clark, 2006) to interview first generation college student Latinas, exploring their experiences with higher education, their navigation/negotiation of resources for academic success and for wellness of self and family, and barriers they face as they attempt to both…

  8. Adding Academics to the Work/Family Puzzle: Graduate Student Parents in Higher Education and Student Affairs

    ERIC Educational Resources Information Center

    Sallee, Margaret W.

    2015-01-01

    Based on interviews with 18 parents who were enrolled in higher education and student affairs master's programs and also employed on college and university campuses, this article explores the ways that student parents navigate their academic, familial, and professional responsibilities. Using role conflict theory as a theoretical guide, this study…

  9. An Analytical Comparison of the Opinions of Physicians Working in Emergency and Trauma Surgery Departments at Tabriz and Vienna Medical Universities Regarding Family Presence during Resuscitation

    PubMed Central

    Soleimanpour, Hassan; Behringer, Wilhelm; Tabrizi, Jafar Sadegh; Sarahrudi, Kambiz; Golzari, Samad E J; Hajdu, Stefan; Rasouli, Maryam; Nikakhtar, Mehdi; Mehdizadeh Esfanjani, Robab

    2015-01-01

    The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients’ relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants’ demographic data, the participants’ opinions regarding their support for the family’s presence during resuscitation, and the multiple potential factors affecting the participants’ attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of family presence. Each question could be answered using a Likert-type scale. The results showed that the mean scores for Question 16 were 4.31 ± 0.64 and 3.57 ± 1.31 for participants at Vienna and Tabriz universities, respectively. Moreover, physicians at Vienna University disapproved of the presence of patients’ families during resuscitation to a higher extent than did those at Tabriz University (P = 0.018). Of the studied prognostic factors affecting the perspectives of Vienna Medical University’s physicians, health beliefs (P = 0.000; B = 1.146), triggers (P = 0.000; B = 1.050), and norms (P = 0.000; B = 0.714) were found to be significant. Moreover, of the studied prognostic factors affecting the perspectives of Tabriz Medical University’s physicians, health beliefs (P = 0.000; B = 0.875), triggers (P = 0.000; B = 1.11), self-efficacy (P = 0.001; B = 0.5), and perceived behavioral control (P = 0.03; B = 0.713) were significant. Most physicians at Vienna and Tabriz Medical universities

  10. [Preschool familial environment and academic difficulties: A 10-year follow-up from kindergarten to middle school].

    PubMed

    Câmara-Costa, H; Pulgar, S; Cusin, F; Dellatolas, G

    2016-02-01

    The persistence of academic difficulties from childhood through adulthood has led researchers to focus on the identification of the early factors influencing children's subsequent achievement in order to improve the efficient screening of children who might be at risk of school failure. The foundations of academic achievement can be accurately traced back to the preschool years prior to children's entry in formal schooling and are largely influenced by environmental determinants. Importantly, some environmental conditions act as early risk factors undermining children's later academic achievement due to the well-established relation between underachievement and exposure to moderate to high levels of environmental risk. In the present study, we aimed to investigate the longitudinal effects of environment-level factors (sociodemographic and family characteristics) and early risk exposure at kindergarten on children's subsequent academic achievement at the end of middle school (grade 9). The sample of analysis comprised 654 kindergarteners aged 5-6 years (2001-2002 school year) followed through the end of middle school when they were aged 14-15 years (2010-2011 school year). At kindergarten, assessment included questionnaire-based measures of sociodemographic and family background characteristics. These included an original set of information pertaining to family background including parental nationality, education level, history of reading difficulties, type of early childcare, family situation, family size, and language-based bedtime routines, as well as individual-level factors such as children's first language, medical history, language delay, birth weight, age of walking onset, and gestation period. At grade 9, outcome measures were composed of children's results in the national evaluations performed at the end of middle school ("Diplôme National du Brevet"), or history of repetition for a second year of the same class. The results indicated that all family

  11. Effects of Recruiting Midwives into a Family Physician Program on the Indices of Maternal Health Program in the Rural Areas of Kurdistan.

    PubMed

    Hajizadeh, Shayesteh; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    A family physician program has been implemented in rural areas of the country since the early 2005.Therefore, due to the increase in the density of midwives in this project, it is expected that more services would be provided to pregnant women. This cross-sectional study used the difference-in-differences model and Matchit statistical model to compare the indices of maternal health program before and after the implementation of a family physician program. It compared health centres that had increase in their density of midwives in the course of the study with those that did not. The study sample consisted of 668 mothers of 2-month-old children in 2013. Data were collected using a questionnaire that was administered in structured interviews. In this study, in 2013, 38.8% of the women received preconception care, 66.5% received prenatal care and 41.6% received postpartum care, as defined by the standards. Based on the results of statistical models of difference-in-differences analyses and Matchit, there was no significant change in indices of maternal health program between 2005 and 2013. The results of this study showed that an increase in the density of midwives in a family physician program did not have an impact on the indices of maternal health program; it indicated that the increase in the density of midwives alone was not efficient. In other words, the quality of primary health care is strongly dependent on the use of trained health workers. In addition, manpower planning and management can have an important role in improvement of prenatal care. PMID:27241401

  12. Educational needs of family physicians in the domains of health and conformity with continuing education in Fasa University of Medical Sciences

    PubMed Central

    ZARIF SANAIEY, NAHID; KARAMNEJAD, SAHAR; REZAEE, RITA

    2015-01-01

    Introduction Assessment and prioritization are the first steps of planning. According to the family physician's idea, evaluating programs in order to improve them is one of the necessities of promoting quality and increases the efficiency and effectiveness of continuing education. This study aimed to determine family physicians’ educational needs regarding health and its applicability in continuous medical education in Fasa University of Medical Sciences. Methods In this cross-sectional study, viewpoints of 45 general physicians working at Fasa University of Medical Sciences in 2013 were studied. Samples were selected through census. Data collection was done using a researcher-made questionnaire using 10-point Likert scale and a checklist with Delphi technique.  Content validity of the questionnaire and its reliability were confirmed by the experts’ opinion and Cronbach's alpha of 80%.  The data were analyzed through SPSS software version 16, using both descriptive and inferential statistics (mean and standard deviation, standard score (SQ), t-test, ANOVAs). A significance level of <0.05 was considered. Results The highest educational priority was in the field of mental health (SQ= 0.38), and environmental and professional health was the lowest priority (SQ= _0.24). Additionally, within each of the areas above specific priorities were determined. Based on the results of this study, gender, graduation date, cooperation time, and university they were educated in did not affect expressing educational needs (p>0.05). The most educational conformity with continuing education was in the diseases area (topic 27%, content 37%). In the areas of environmental and professional health and health education, compliance was zero. Conclusions The physicians stated that mental health was the first educational need and environmental and professional health was the last one. According to the results, proper continuing medical programs should be coordinated with educational

  13. Family, peer, and neighborhood influences on academic achievement among African-American adolescents: one-year prospective effects.

    PubMed

    Gonzales, N A; Cauce, A M; Friedman, R J; Mason, C A

    1996-06-01

    Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American Community. PMID:8864209

  14. The Physician-Scientist: An Endangered Species.

    ERIC Educational Resources Information Center

    Legato, Marianne, J.

    1983-01-01

    The number of physician-scientists in training decreased below the recommended level in 1976. Reasons young doctors are not attracted to research training and why these academic physicians are needed are discussed. The demise of the academic medical community will begin an ice age in American medicine. (SR)

  15. Helping physicians in distress. Developing a physician assessment and referral service.

    PubMed Central

    Fish, J. S.; Steinert, Y.

    1995-01-01

    In 1987, a Physician Assessment and Referral Service was created in the Department of Family Medicine of a large urban hospital to help physicians and their families. This article describes the rationale, development, accomplishments, and limitations of the service in light of 5 years' experience. Although this program was developed for family physicians in particular, it has value for all medical specialties. PMID:7734998

  16. Continuous sedation until death: the everyday moral reasoning of physicians, nurses and family caregivers in the UK, The Netherlands and Belgium

    PubMed Central

    2014-01-01

    Background Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. Methods This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. Results The participants’ responses can be captured as different dimensions of ‘closeness’, i.e. the degree to which one feels connected or ‘close’ to a certain decision or event. We distinguished four types of ‘closeness’, namely emotional, physical, decisional, and causal. Using these four dimensions of ‘closeness’ it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Conclusion Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these

  17. Academic Outcomes of an Elementary School-Based Family Support Programme

    ERIC Educational Resources Information Center

    Pullmann, Michael D.; Weathers, Ericka S.; Hensley, Spencer; Bruns, Eric J.

    2013-01-01

    School-based family support programmes (FSPs) work within schools to build partnerships with families, promote family engagement, address family needs, provide mentorship to students and increase access to community resources. Very few programme evaluation studies of FSPs have been conducted. We report on findings from a participatory evaluation…

  18. Physician strikes.

    PubMed

    Thompson, Stephen L; Salmon, J Warren

    2014-11-01

    Throughout medical history, physicians have rarely formed unions and/or carried out strikes. In a profession faced with the turmoil of health reform and increasing pressure to change their practices and lifestyles, will physicians resort to unionization for collective bargaining, and will a strike weapon be used to fight back against the array of corporate and government powers involved in the transformation of the American health-care system? This article examines the question of whether there could be such a thing as an ethical physician strike. Although physicians have not historically used collective bargaining or the strike weapon, the rapidly changing practice environment in the United States might push physicians and other health-care professionals toward unionization. This article considers the ethical questions that would arise if physicians started taking advantage of labor laws, and it lays out criteria for an ethical strike. PMID:25367473

  19. The views of key leaders in South Africa on implementation of family medicine: critical role in the district health system

    PubMed Central

    2014-01-01

    Background Integrated team-based primary care is an international imperative. This is required more so in Africa, where fragmented verticalised care dominates. South Africa is trying to address this with health reforms, including Primary Health Care Re-engineering. Family physicians are already contributing to primary care despite family medicine being only fully registered as a full specialty in South Africa in 2008. However the views of leaders on family medicine and the role of family physicians is not clear, especially with recent health reforms. The aim of this study was to understand the views of key government and academic leaders in South Africa on family medicine, roles of family physicians and human resource issues. Methods This was a qualitative study with academic and government leaders across South Africa. In-depth interviews were conducted with sixteen purposively selected leaders using an interview guide. Thematic content analysis was based on the framework method. Results Whilst family physicians were seen as critical to the district health system there was ambivalence on their leadership role and ‘specialist’ status. National health reforms were creating both threats and opportunities for family medicine. Three key roles for family physicians emerged: supporting referrals; clinical governance/quality improvement; and providing support to community-oriented care. Respondents’ urged family physicians to consolidate the development and training of family physicians, and shape human resource policy to include family physicians. Conclusions Family physicians were seen as critical to the district health system in South Africa despite difficulties around their precise role. Whilst their role was dominated by filling gaps at district hospitals to reduce referrals it extended to clinical governance and developing community-oriented primary care - a tall order, requiring strong teamwork. Innovative team-based service delivery is possible despite human

  20. “Maternal Health and Family Planning Distance Education” experience among physicians: a three-phase study to determine the educational needs, develop education program, and evaluate efficacy of the education administered

    PubMed Central

    Ciftci, Bestami; Uzel, Nesibe; Ozel, M Onur; Zergeroglu, Sema; Deger, Cetin; Turasan, S Sare; Karakoc, Ayse Gul; Ozbalci, Semra

    2016-01-01

    Aim This study aims to assess the educational needs of family practitioners and evaluate the efficacy of the ongoing “Maternal Health and Family Planning Distance Education” program conducted by the General Directorate of Health Research (SAGEM) of the Turkish Ministry of Health. Methods This study consisted of three phases. In the first phase, an online survey on maternal health and family planning educational needs was sent to 20,611 physicians via e-mail. Of the 20,611 physicians, 4,729 completed the survey. In the second phase, of the 1,061 physicians registered to the education program, 632 physicians with active participation were included. In the third phase, the preeducation expectations of 287 physicians and posteducation satisfaction of 54 physicians were analyzed with a questionnaire. Results The majority of the physicians were employed in a family health center (97.4%) and practicing for 16–20 years (23.2%) without any prior in-service training (60.9%). High-to-very high educational need was expressed by 56.4% of physicians for pregnancy, delivery, and puerperality. Topics that the physicians, including both those with ≥16 years in practice and without prior in-service training, expressed need for more detailed content were pregnancy, delivery, and puerperality (37.5%); emergency obstetric approach in the primary care setting (33.1%); and gynecological infectious diseases and treatment approach (32.4%). Following the education program, the participants’ expectations were fulfilled in terms of refreshing their knowledge, particularly in the field of Maternal Health and Family Planning (87.1% and 75.9%) and the percentage of participants who expressed that they had sufficient high level knowledge increased from 55% to 68.5%. Conclusion The education on Maternal Health and Family Planning refreshed the knowledge of participants and highly met the preeducation expectations. Determining the educational needs and expectations of the target

  1. Why does teaching research skills to family medicine trainees make sense?

    PubMed

    Kersnik, Janko; Ungan, Mehmet; Klemenc-Ketis, Zalika

    2015-01-01

    There are only a few countries in Europe that have incorporated research skills training in specialty training programmes. In the eyes of most practising family physicians, research traditionally is a field reserved for colleagues with academic ambitions; an activity that often is not associated with the clinical practice of family medicine. However, residents became aware that research is essential to improving healthcare provision. Research in family medicine has a long tradition. Performing or taking part in research projects opens new horizons to present and future family physicians and provides support to increase their self-esteem. Consequently, this could foster future family medicine development. The authors urge the whole family physician community to raise the awareness every single family physician towards teaching and learning research skills in specialty training and basic medical education as a generic subject. PMID:26414382

  2. Associations between Early Family Risk, Children's Behavioral Regulation, and Academic Achievement in Portugal

    ERIC Educational Resources Information Center

    Cadima, Joana; Gamelas, Ana M.; McClelland, Megan; Peixoto, Carla

    2015-01-01

    Research Findings: This study examined concurrent associations between family sociodemographic risk, self-regulation, and early literacy and mathematics in young children from Azores, Portugal (N = 186). Family sociodemographic risk was indexed by low maternal education, low family income, and low occupational status. Behavioral aspects of…

  3. Solving Family and Work Role Problems: An Academic Department Case Study.

    ERIC Educational Resources Information Center

    Coffey, Kitty R.

    1985-01-01

    Describes a project at Carson-Newman College (Tennessee) in which the home economics department utilizes problem confrontation, practical reasoning, and creative alternatives to foster positive interaction between work and family for 10 faculty members. Examines the costs and benefits of two-career families and attempts to reduce family/work role…

  4. When Academics Become Parents: An Overview of Family Leave Policies at Canadian Universities.

    ERIC Educational Resources Information Center

    Prentice, Susan; Pankratz, Curtis J.

    2003-01-01

    Reviews family leave policies in Canadian universities through March 2002. Analysis of pregnancy, adoption, and partner (paternity) leave policies reveal that most Canadian university policies produce income loss and disruption and are characterized by gender regulation and familialism. The paper proposes that improving faculty family leave…

  5. Indirect Effects of the Family Check-up on School-Age Academic Achievement through Improvements in Parenting in Early Childhood

    ERIC Educational Resources Information Center

    Brennan, Lauretta M.; Shelleby, Elizabeth C.; Shaw, Daniel S.; Gardner, Frances; Dishion, Thomas J.; Wilson, Melvin

    2013-01-01

    This project examined the hypothesis that the impact of the Family Check-Up on parent use of positive behavior support would indirectly improve academic achievement scores at school age. The study included a sample of 731 high-risk families recruited from Women, Infant, and Children Supplemental Nutrition Program settings in 3 geographically…

  6. Two-Year Impacts of a Comprehensive Family Financial Rewards Program on Children's Academic Outcomes: Moderation by Likelihood of Earning Rewards

    ERIC Educational Resources Information Center

    Berg, Juliette; Morris, Pamela; Aber, Larry

    2013-01-01

    This article examines the extent to which impacts of a conditional cash transfer (CCT) program on children's academic outcomes vary by key characteristics associated with families' propensity to earn the rewards offered by the program. We utilize an experimental study of Opportunity NYC-Family Rewards, a comprehensive CCT program in New…

  7. Female and Underrepresented Minority Faculty in Academic Departments of Family Medicine: Are Women and Minorities Better Off in Family Medicine?

    ERIC Educational Resources Information Center

    Lewis-Stevenson, Sherri; Hueston, William J.; Mainous, Arch G., III; Bazell, Carol; Ye, Xiaobu

    2001-01-01

    Surveyed departments of family medicine to determine workforce composition and rank of women and minority faculty. Found that while faculty were more likely to be female or minority than in other medical disciplines, women and minorities were less likely to be associate or full professors. Found no institutional or departmental characteristics…

  8. The Academic Adaptation of Children of Immigrants in New and Established Settlement States: The Role of Family, Schools, and Neighborhoods

    PubMed Central

    Potochnick, Stephanie

    2016-01-01

    The dispersion of immigrants has challenged educators in new immigrant destinations to adapt to the needs of their first cohorts of children of immigrants. This paper evaluates how families, schools, and neighborhoods shape the academic adaptation of immigrants’ children in new and established immigrant states. Using the Educational Longitudinal Study (ELS) from 2002, the paper examines how 10th grade math and reading test scores differ across three settlement locations: established, new, and other immigrant states. Results indicate that achievement in math and reading is highest in new immigrant states. While demographic differences between settlement locations largely explained differences in achievement, families and schools in new immigrant states also strongly influenced achievement. PMID:26900193

  9. Personal and family perfectionism of Taiwanese college students: relationships with depression, self-esteem, achievement motivation, and academic grades.

    PubMed

    Wang, Kenneth T

    2012-01-01

    An increasing number of perfectionism studies have been conducted across different countries outside of the Western framework. Using an international egalitarian approach that adopts indigenous frameworks and concepts from the cultural context of the population studied is imperative. This study examines different groups of perfectionists with a sample of 348 Taiwanese college students, emphasizing the collectivistic culture. In particular, this is a follow-up study to further explore characteristics of a group with low standards/high discrepancy--a feeling that they are not good enough despite having low standards--found in a previous study with Taiwanese students. More specifically, this study investigates whether the source of the high discrepancy scores among this group is related to having higher perfectionistic standards from their family. Perfectionism was examined not only from a personal/individualistic perspective, but also from a familistic dimension to reflect Taiwanese collectivistic cultural values. Results partially supported the hypotheses--this group reported having higher family discrepancy, but not family standards, than nonperfectionists. However, this group of participants reported lower academic grades, which implies the possibility of their discrepancy being associated with poorer performance. Four cluster groups--adaptive perfectionists, maladaptive perfectionists, nonperfectionists, and those with low standards/high discrepancy--were compared on their levels of depression, self-esteem, achievement motivation, and academic grades. Maladaptive perfectionists reported the highest depression level, while adaptive perfectionists reported the highest self-esteem. Results also show that aspects of personal perfectionism and family perfectionism related to self-esteem differently among this sample. Findings and implications are discussed with consideration of the collectivistic cultural context in Taiwan. PMID:22150292

  10. Continuity or Change? Gender, Family, and Academic Work for Junior Faculty in Ontario Universities

    ERIC Educational Resources Information Center

    Acker, Sandra; Webber, Michelle; Smyth, Elizabeth

    2016-01-01

    Over the past 40 or so years, women's share of faculty positions in Canada and elsewhere has increased considerably, if not yet reaching parity. Yet working in the gendered university remains problematic. This article uses data from a qualitative research project in which 38 junior academics were interviewed about their responses to being on the…

  11. Single-Parent Families: The Role of Parent's and Child's Gender on Academic Achievement

    ERIC Educational Resources Information Center

    Lee, Sang Min; Kushner, Jason

    2008-01-01

    Using national survey data, the present study investigated whether adolescents living with parents of their same gender fare better on academic achievement than their peers living with opposite-gender parents. Multiple analyses of covariance (MANCOVA) procedures were employed to examine the effects of the children's gender in single-father and…

  12. Stay in the Game: Gender, Family Formation and Alternative Trajectories in the Academic Life Course

    ERIC Educational Resources Information Center

    Wolfinger, Nicholas H.; Mason, Mary Ann; Goulden, Marc

    2009-01-01

    Academic careers have traditionally been conceptualized as pipelines, through which young scholars move seamlessly from graduate school to tenure-track positions. This model often fails to capture the experiences of female Ph.D. recipients, who become tenure-track assistant professors at lower rates than do their male counterparts. What do these…

  13. Individual, Family, Peer, and Academic Characteristics of Male Juvenile Sexual Offenders

    ERIC Educational Resources Information Center

    Ronis, Scott T.; Borduin, Charles M.

    2007-01-01

    This study examined the individual functioning, interpersonal relations, and academic performance of 115 male juveniles who were divided into 5 demographically matched groups (sexual offenders with peer/adult victims, sexual offenders with child victims, violent nonsexual offenders, nonviolent nonsexual offenders, and nondelinquent youths).…

  14. Warning: Children in the Library! Welcoming Children and Families into the Academic Library

    ERIC Educational Resources Information Center

    Tvaruzka, Kathryn

    2009-01-01

    While library programming for children is a staple in most public libraries, it is quite rare in the academic setting. In 2006 the education librarian at the University of Wisconsin-Eau Claire began offering literacy programs in a library that traditionally discouraged children and community members from using its resources. Successful programs…

  15. School Climate, Family Structure, and Academic Achievement: A Study of Moderation Effects

    ERIC Educational Resources Information Center

    O'Malley, Meagan; Voight, Adam; Renshaw, Tyler L.; Eklund, Katie

    2015-01-01

    School climate has been lauded for its relationship to a host of desirable academic, behavioral, and social-emotional outcomes for youth. The present study tested the hypothesis that school climate counteracts youths' home-school risk by examining the moderating effects of students' school climate perceptions on the relationship between family…

  16. Families' Goals, School Involvement, and Children's Academic Achievement: A Follow-Up Study Thirteen Years Later

    ERIC Educational Resources Information Center

    Kyle, Diane W.

    2011-01-01

    A study conducted from 1996-2000 focused on the academic development of children within a statewide educational reform effort, including changing the organizational structure of the early years of schooling into nongraded primary programs (formerly age-based classrooms for kindergarteners through third grade). The multisite study involved children…

  17. Demography and Early Academic Skills of Students from Immigrant Families: The Kindergarten Class of 2011

    ERIC Educational Resources Information Center

    Sullivan, Amanda L.; Houri, Alaa; Sadeh, Shanna

    2016-01-01

    Children from immigrant families are one of the fastest growing and most diverse groups in America's schools. This study provides a demographic portrait of immigrant children who entered kindergarten in 2010 and describes patterns and predictors of early educational outcomes of students from immigrant families. A nationally representative sample…

  18. Academic Promises and Family (Dis)Enchantments: Clues for Guidance and Counselling in Higher Education

    ERIC Educational Resources Information Center

    Dias, Diana; Sá, Maria José

    2016-01-01

    Family has an undeniable influence upon the career construction of higher education (HE) students, since it is a primary source of their socialisation. This article presents a qualitative analysis of 30 interviews conducted with first-year students, aimed at understanding the relationship between family sociocultural status and career choice and…

  19. Differential Influences of Family Processes for Scientifically Talented Individuals' Academic Achievement along Developmental Stages

    ERIC Educational Resources Information Center

    Cho, Seokhee; Campbell, James Reed

    2011-01-01

    Differential influences of various family processes for students of science talent and students in general education from Grades 4 to 12 and Science Olympians in Korea were examined by administering Korean Inventory of Parental Influence. Korean Science Olympians were additionally interviewed about their family and school experiences. Family…

  20. Influence of Family and Socio-Demographic Variables on Students with Low Academic Achievement

    ERIC Educational Resources Information Center

    Casanova, Pedro F.; Garcia-Linares, M. Cruz; de la Torre, Manuel J.; Carpio, M. de la Villa

    2005-01-01

    In this study we compare the distribution of parental educational styles and the scores reported both by parents and students for various family characteristics (acceptance, control, involvement, and expectations) and socio-demographic factors (socio-economic status, family structure, number of children, and order of birth of the children) in a…

  1. Seamless health care for chronic diseases in a dual health care system: managed care and the role of family physicians.

    PubMed

    Lee, A

    1998-01-01

    Neither private nor state run health care systems are perfect. Although there is increasing evidence that Health Maintenance Organizations (HMOs) provide comparable care at lower cost, HMOs tend to select healthy patients. The dual health care system in Hong Kong spends about 3.9 per cent of GDP, with health indices among the best in the world. Hong Kong still faces the problem of escalating health care expenditure. One should take advantage of the dual health care system to evolve a new paradigm for a primary-led seamless health care service. The Diabetes Centre of a university teaching hospital together with the University of Community and Family Medicine has started a structured shared care programme in diabetes mellitus, involving general practitioners in both the private and public sectors integrating the primary and secondary care, and the private and public sectors. This programme starts to develop an infrastructure for providing quality care at an affordable cost for a large pool of patients with chronic disease. Unlike other "managed care schemes", this one is not run by profit-oriented companies, but by health professionals with an interest in providing best possible care at an affordable cost. The "disease management" approach needs a care delivery system without traditional boundaries; and a continuous improvement process which develops and refines the knowledge base, guidelines and delivery system. PMID:10351265

  2. Specific issues related to developing, disseminating, and implementing pediatric practice guidelines for physicians, patients, families, and other stakeholders.

    PubMed Central

    Bauchner, H; Simpson, L

    1998-01-01

    OBJECTIVE: To describe ways in which medical information should be developed and disseminated, focusing on pediatric practice guidelines as an example of one type of information. PRINCIPAL FINDINGS: The methodology of guideline development is well known and has been previously reviewed. Guideline development poses problems for many medical specialties, but particularly for pediatrics, because (1) few diseases are prevalent, (2) only limited randomized controlled trials have been conducted with respect to specific diagnostic and therapeutic options, and (3) clinicians often are dealing with patient surrogates--parents--rather than with the actual patient. Patient and family involvement in guideline development and dissemination has been limited and may affect the likelihood that guidelines will be adopted and subsequently improve child health outcomes. The science of dissemination, including guidelines and other information, is poorly developed. Little is known about the most effective ways to ensure that guidelines reach clinicians and are adopted. Finally, the effect of guidelines on child health outcomes is itself uncertain. RECOMMENDATIONS: (1) Research efforts should focus on guideline dissemination and adoption. (2) The effect of guideline implementation on health outcomes needs to be better understood. (3) Parents should be more involved in guideline dissemination and adoption. PMID:9776953

  3. Career, Family, and Institutional Variables in the Work Lives of Academic Women in the Chemical Sciences

    NASA Astrophysics Data System (ADS)

    Fassinger, Ruth E.; Scantlebury, Kathryn; Richmond, Geraldine

    This article presents quantitative results of a study of 139 academic women in the chemical sciences who participated in a professional development program sponsored by the Committee on the Advancement of Women Chemists. The study investigated variables frequently examined in the vocational psychology of women: approaches to achievement, coping strategies, career advancement, the home-work interface, workplace climate, and mentoring. The article presents and discusses results in the context of unique issues faced by women in scientific careers.

  4. Is a management degree worth the investment for physicians? A survey of members of the American College of Physician Executives.

    PubMed

    Weeks, William B; Lazarus, Arthur; Wallace, Amy E

    2008-01-01

    In a survey of 568 physician members of the American College of Physician Executives (ACPE), most of whom had advanced management degrees (MBA, MMM, MPH), approximately 90% of respondents reported that their investment in the education was "worth it." The return on investment was independent of the quality of the academic institution, although primary care physicians stood to gain more relative to specialists. Salary comparisons showed that female physicians had approximately 20% lower incomes than male physicians, confirming the presence of a "glass ceiling" for female physician executives as seen in other medical specialties. These findings have implications for early and mid-career physicians and physician recruiters. PMID:18309736

  5. Revealing a Child's Pathology: Physicians' Experiences

    ERIC Educational Resources Information Center

    Scelles, Regine; Aubert-Godard, Anne; Gargiulo, Marcela; Avant, Monique; Gortais, Jean

    2010-01-01

    In this study, 12 physicians and 12 care-givers were interviewed using semi-structured interviews. We explored physicians' experiences when they revealed a diagnosis. We also tried to understand which family members the physician was thinking of, with whom they identified themselves, and their first choice of the person to whom they prefer to…

  6. Indirect Effects of the Family Check-Up on School-Age Academic Achievement Through Improvements in Parenting in Early Childhood

    PubMed Central

    Brennan, Lauretta M.; Shelleby, Elizabeth C.; Shaw, Daniel S.; Gardner, Frances; Dishion, Thomas J.; Wilson, Melvin

    2013-01-01

    This project examined the hypothesis that the impact of the Family Check-Up on parent use of positive behavior support would indirectly improve academic achievement scores at school age. The study included a sample of 731 high-risk families recruited from Women, Infant, and Children Supplemental Nutrition Program settings in 3 geographically distinct areas. The results demonstrated that changes in positive parenting between the child ages of 2 and 3 were associated with higher scores on children’s school-age academic achievement, as measured by the Woodcock–Johnson III (W-J) Academic Skills composite. Moreover, structural equation modeling revealed that random assignment to the intervention was associated with higher levels of children’s academic achievement at age 5 and age 7.5 indirectly, through greater increases in parents’ use of positive behavior support in intervention families than in control families. Results are discussed with respect to the potential of a brief parenting intervention for improving parenting practices that promote academic achievement up to 5 years later. The results have promising implications for efforts to promote child adaptation in the school environment. PMID:24319295

  7. Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

    PubMed

    Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

    2015-05-01

    The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. PMID:25903144

  8. Physician, heal thyself

    PubMed Central

    Blais, Régis; Safianyk, Catherine; Magnan, Anne; Lapierre, André

    2010-01-01

    ABSTRACT OBJECTIVE To document the opinions of the users of the Quebec Physicians Health Program (QPHP) about the services they received. DESIGN Mailed questionnaire. SETTING Quebec. PARTICIPANTS A total of 126 physicians who used QPHP services between 1999 and 2004. MAIN OUTCOME MEASURES Users’ overall rating of the QPHP services, their opinions about the program, and whether their situations improved as a result of accessing QPHP services. RESULTS Ninety-two of the 126 physicians surveyed returned their completed questionnaires, providing a response rate of 73%. Most respondents thought that the QPHP services were good or excellent (90%), most would use the program again (86%) or recommend it (96%), and most thought the Quebec physician associations and the Collège des médecins du Québec should continue funding the QPHP (97%). Most respondents thought the service confidentiality was excellent (84%), as was staff professionalism (82%), and 62% thought the quality of the services they were referred to was excellent. However, only 57% believed their situations had improved with the help of the QPHP. CONCLUSION The QPHP received good marks from its users. Given the effects of physician burnout on patients and on the health care system, it is not only a personal problem, but also a collective problem. Thus, actions are needed not only to set up programs like the QPHP for those suffering from burnout, but also to prevent these types of problems. Because family physicians are likely to be the first ones consulted by their physician patients in distress, they play a key role in acknowledging these problems and referring those colleagues to the appropriate help programs when needed. PMID:20944027

  9. Why Family Medicine is a Good Career Choice for Indian Medical Graduates?

    PubMed

    Kumar, Raman

    2014-01-01

    Internationally family medicine has evolved as an independent academic discipline of medical science and speciality vocational training for community based primary care physicians. India has a long tradition of family practice however due to various regulatory barriers family medicine did not optimally develop in mainstream medical education system for many decades. Recently, there is growing interest in this concept in India and family medicine is emerging as a viable career option for medical graduates in India. PMID:24791226

  10. Collaborative Care for Older Adults with low back pain by family medicine physicians and doctors of chiropractic (COCOA): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Low back pain is a prevalent and debilitating condition that affects the health and quality of life of older adults. Older people often consult primary care physicians about back pain, with many also receiving concurrent care from complementary and alternative medicine providers, most commonly doctors of chiropractic. However, a collaborative model of treatment coordination between these two provider groups has yet to be tested. The primary aim of the Collaborative Care for Older Adults Clinical Trial is to develop and evaluate the clinical effectiveness and feasibility of a patient-centered, collaborative care model with family medicine physicians and doctors of chiropractic for the treatment of low back pain in older adults. Methods/design This pragmatic, pilot randomized controlled trial will enroll 120 participants, age 65 years or older with subacute or chronic low back pain lasting at least one month, from a community-based sample in the Quad-Cities, Iowa/Illinois, USA. Eligible participants are allocated in a 1:1:1 ratio to receive 12 weeks of medical care, concurrent medical and chiropractic care, or collaborative medical and chiropractic care. Primary outcomes are self-rated back pain and disability. Secondary outcomes include general and functional health status, symptom bothersomeness, expectations for treatment effectiveness and improvement, fear avoidance behaviors, depression, anxiety, satisfaction, medication use and health care utilization. Treatment safety and adverse events also are monitored. Participant-rated outcome measures are collected via self-reported questionnaires and computer-assisted telephone interviews at baseline, and at 4, 8, 12, 24, 36 and 52 weeks post-randomization. Provider-rated expectations for treatment effectiveness and participant improvement also are evaluated. Process outcomes are assessed through qualitative interviews with study participants and research clinicians, chart audits of progress notes and content

  11. Academic success across the transition from primary to secondary schooling among lower-income adolescents: understanding the effects of family resources and gender.

    PubMed

    Serbin, Lisa A; Stack, Dale M; Kingdon, Danielle

    2013-09-01

    Successful academic performance during adolescence is a key predictor of lifetime achievement, including occupational and social success. The present study investigated the important transition from primary to secondary schooling during early adolescence, when academic performance among youth often declines. The goal of the study was to understand how risk factors, specifically lower family resources and male gender, threaten academic success following this "critical transition" in schooling. The study involved a longitudinal examination of the predictors of academic performance in grades 7-8 among 127 (56 % girls) French-speaking Quebec (Canada) adolescents from lower-income backgrounds. As hypothesized based on transition theory, hierarchical regression analyses showed that supportive parenting and specific academic, social and behavioral competencies (including spelling ability, social skills, and lower levels of attention problems) predicted success across this transition among at-risk youth. Multiple-mediation procedures demonstrated that the set of compensatory factors fully mediated the negative impact of lower family resources on academic success in grades 7-8. Unique mediators (social skills, spelling ability, supportive parenting) also were identified. In addition, the "gender gap" in performance across the transition could be attributed statistically to differences between boys and girls in specific competencies observed prior to the transition, as well as differential parenting (i.e., support from mother) towards girls and boys. The present results contribute to our understanding of the processes by which established risk factors, such as low family income and gender impact development and academic performance during early adolescence. These "transitional" processes and subsequent academic performance may have consequences across adolescence and beyond, with an impact on lifetime patterns of achievement and occupational success. PMID:23904002

  12. Academic Promotion and Tenure in U.S. Family Medicine Units.

    ERIC Educational Resources Information Center

    Holloway, Richard L.; And Others

    1989-01-01

    A national survey of representatives of medical college family practice units concerning their perceptions of the unit's and the institution's values on research, teaching, patient care, and administrative duties found consistent disparity between the units' and institutions' value structures, but also a trend toward faculty promotion and tenure…

  13. Helping Academics Have Families and Tenure Too: Universities Discover Their Self-Interest

    ERIC Educational Resources Information Center

    Marcus, Jon

    2007-01-01

    "Did you have a kid and, if so, how?" is one of the hottest questions everywhere in higher education. Even as women overtake men among Americans receiving doctorates, a substantial body of new research shows that they are being discouraged from careers in academia because the timing and requirements of tenure make it so hard to raise families. In…

  14. Students' Perceptions of Family Influences on their Academic Motivation: A Qualitative Analysis

    ERIC Educational Resources Information Center

    Urdan, Tim; Solek, Monica; Schoenfelder, Erin

    2007-01-01

    Research examining family influences on student motivation and achievement in school has generally focused on parental influences and has often been limited to one or two variables (e.g., parental expectations or aspirations, parental involvement in schoolwork). In the present study we interviewed high school seniors to examine whether and how…

  15. Gender, Family Negotiations and Academic Success of Young Moroccan Women in Spain

    ERIC Educational Resources Information Center

    Tarrés, Marta Bertran; Ponferrada-Arteaga, Maribel; Rovira, Jordi Pàmies

    2016-01-01

    This article examines the lives of pioneering young women from Morocco, the first to enjoy educational and social success in Catalonia, by analyzing the family negotiations entered into during this process. The study is based on the life stories of these young Moroccan women and on ideas that emerge from discussion groups involving the women…

  16. Predictors of Suicide Ideation and Depression in Hong Kong Adolescents: Perceptions of Academic and Family Climates

    ERIC Educational Resources Information Center

    Lee, Margaret T. Y.; Wong, Betty P.; Chow, Bonnie W.-Y.; McBride-Chang, Catherine

    2006-01-01

    The unique dimensions of perceptions of school and family contributing to depression and suicide ideation in Hong Kong adolescents were examined in two studies. In Study 1, among 327 Hong Kong Chinese female students ages 13-18, 47% reported some suicide ideation. Suicide ideation was significantly associated with depression, test anxiety,…

  17. Behavioral and Emotional Adjustment, Family Functioning, Academic Performance, and Social Relationships in Children with Selective Mutism

    ERIC Educational Resources Information Center

    Cunningham, Charles E.; McHolm, Angela; Boyle, Michael H.; Patel, Sejal

    2004-01-01

    This study addressed four questions which parents of children with selective mutism (SM) frequently ask: (1) Is SM associated with anxiety or oppositional behavior? (2) Is SM associated with parenting and family dysfunction? (3) Will my child fail at school? and (4) Will my child make friends or be teased and bullied? In comparison to a sample of…

  18. Ahiska Refugee Families' Configuration of Resettlement and Academic Success in U.S. Schools

    ERIC Educational Resources Information Center

    Bal, Aydin; Arzubiaga, Angela E.

    2014-01-01

    In this article, we report on an ethnographic study of figured worlds of resettlement and identities that Muslim refugee youth from the Russian Federation coconstructed in an urban school at the Southwestern U.S. border. In the school, multiple cultural-historical discourses came together within a global context: refugee families, a global Islamic…

  19. Teacher-Child Relationship Quality and Academic Achievement of Chinese American Children in Immigrant Families

    ERIC Educational Resources Information Center

    Ly, Jennifer; Zhou, Qing; Chu, Keira; Chen, Stephen H.

    2012-01-01

    This study examined the cross-sectional relations between teacher-child relationship quality (TCRQ) and math and reading achievement in a socio-economically diverse sample of Chinese American first- and second-grade children in immigrant families (N=207). Teachers completed a questionnaire measuring TCRQ dimensions including closeness, conflict,…

  20. The effect of family violence on children's academic performance and behavior.

    PubMed Central

    Dyson, J. L.

    1990-01-01

    Homicide perpetrated by an acquaintance or a close family member is the leading cause of death among blacks. Black children adversely affected by these violent occurrences suffer posttraumatic stress disorder. The purpose of this study is to illustrate how damage caused to black children from exposure to violence is reflected in behavior problems and poor school performance. PMID:2304094

  1. Family Practice—What's The Difference?

    PubMed Central

    Brown, D. C.

    1979-01-01

    Twelve significant differences of family practice are presented with supporting information from the literature. Seven differences between family physicians and other primary care physicians are presented. PMID:20469306

  2. The Role of Institutional, Family and Peer-Based Discourses and Practices in the Construction of Students' Socio-Academic Trajectories

    ERIC Educational Resources Information Center

    Poveda, David; Jociles, Maria Isabel; Franze, Adela; Moscoso, Maria Fernanda; Calvo, Albano

    2012-01-01

    In this article, we discuss findings from multi-level ethnography conducted in a secondary school located in Madrid (Spain). The study focuses on the variety of institutional, family and peer-based factors that contribute to the construction of students' socio-academic trajectories. In particular, we attempt to understand the role these social…

  3. An Analysis of the Impact of Parent Education Level and Family Income on the Academic Achievement of Students of Hispanic and White Ethnicities

    ERIC Educational Resources Information Center

    Siegel, Scott M.

    2011-01-01

    The purpose of this study was to analyze the impact of the socioeconomic factors of parent education level and family income on the academic achievement of students of Hispanic and white ethnicities. Scaled scores from the 2009 administration of the California Standards Tests in English language arts and mathematics and matched demographic…

  4. Assessing differential effects: Applying regression mixture models to identify variations in the influence of family resources on academic achievement

    PubMed Central

    Van Horn, M. Lee; Jaki, Thomas; Masyn, Katherine; Ramey, Sharon Landesman; Smith, Jessalyn A.; Antaramian, Susan

    2015-01-01

    Developmental scientists frequently seek to understand effects of environmental contexts on development. Traditional analytic strategies assume similar environmental effects on all children, sometimes exploring possible moderating influences or exceptions (e.g. outliers) as a secondary step. These strategies are poorly matched to ecological models of human development which posit complex individual by environment interactions. An alternative conceptual framework is proposed that tests the hypothesis that the environment has differential (non-uniform) effects on children. A demonstration of the utility of this framework is provided by examining the effects of family resources on children’s academic outcomes in a multisite study (N=6305). Three distinctive groups of children were identified, including one group particularly resilient to influence of low levels of family resources. Predictors of group differences including parenting and child demographics are tested, the replicability of the results are examined, and findings are contrasted with those using traditional regression interaction effects. This approach is proposed as a partial solution to advance theories of the environment, social ecological systems research, and behavioral genetics in order to create well-tailored environments for children. PMID:19702393

  5. Assessing differential effects: applying regression mixture models to identify variations in the influence of family resources on academic achievement.

    PubMed

    Van Horn, M Lee; Jaki, Thomas; Masyn, Katherine; Ramey, Sharon Landesman; Smith, Jessalyn A; Antaramian, Susan

    2009-09-01

    Developmental scientists frequently seek to understand effects of environmental contexts on development. Traditional analytic strategies assume similar environmental effects for all children, sometimes exploring possible moderating influences or exceptions (e.g., outliers) as a secondary step. These strategies are poorly matched to ecological models of human development that posit complex individual by environment interactions. An alternative conceptual framework is proposed that tests the hypothesis that the environment has differential (nonuniform) effects on children. A demonstration of the utility of this framework is provided by examining the effects of family resources on children's academic outcomes in a multisite study (N = 6,305). Three distinctive groups of children were identified, including 1 group particularly resilient to influence of low levels of family resources. Predictors of group differences including parenting and child demographics are tested, the replicability of the results are examined, and findings are contrasted with those obtained with traditional regression interaction effects. This approach is proposed as a partial solution to advance theories of the environment, social ecological systems research, and behavioral genetics to create well-tailored environments for children. PMID:19702393

  6. Early Academic Achievement Among American Low-Income Black Students from Immigrant and Non-Immigrant Families.

    PubMed

    Calzada, Esther; Barajas-Gonzalez, R Gabriela; Dawson-McClure, Spring; Huang, Keng-Yen; Palamar, Joseph; Kamboukos, Dimitra; Brotman, Laurie Miller

    2015-11-01

    At least half of the well-documented achievement gap for low-income Black children is already present in kindergarten, due in part to limited opportunities for acquiring foundational skills necessary for school success. There is some evidence that low-income minority children from immigrant families have more positive outcomes than their non-immigrant counterparts, although little is known about how the immigrant paradox may manifest in young children. This study examines foundational school readiness skills (academic and social-emotional learning) at entry into pre-kindergarten (pre-k) and achievement in kindergarten and second grade among Black children from low-income immigrant and non-immigrant families (N = 299). Immigrant and non-immigrant children entered pre-k with comparable readiness scores; in both groups, reading scores decreased significantly from kindergarten to second grade and math scores decreased significantly for non-immigrant children and marginally for immigrant children. Regardless of immigrant status, pre-k school readiness and pre-k classroom quality were associated with elementary school achievement. However, declines in achievement scores were not as steep for immigrant children and several predictive associations were moderated by immigrant status, such that among those with lower pre-k school readiness or in lower quality classrooms, immigrant children had higher achievement test scores than children from non-immigrant families. Findings suggest that immigrant status provides young Black students with some protection against individual- and classroom-level risk factors for early underachievement in elementary school. PMID:26048254

  7. Investigating Patient and Physician Delays in the Diagnosis of Head and Neck Cancers: a Canadian Perspective.

    PubMed

    Lee, Jonghun John; Dhepnorrarat, Chris; Nyhof-Young, Joyce; Witterick, Ian

    2016-03-01

    Diagnostic delays for head and neck cancer (HNC) patients are common. Patients often disregard symptoms for long periods before seeking help, and some family physicians may not be alert to the warning symptoms and signs of HNCs. This study evaluated the factors associated with length of delays in the diagnosis of HNCs in a Canadian population. This was a mixed-method study consisting of patient interviews and surveys in an academic health center. A questionnaire requesting demographic and disease information was completed by HNC patients followed by a 30 min semi-structured interview in a private setting. Interviews were audio recorded, transcribed, anonymized, and descriptively coded for emergent themes. Twenty-eight head and neck cancer patients participated in the study. More patients experienced physician delay (71 %) than patient delay (36 %). The median physician delay and patient delay were 108 and 31 days, respectively. Two main themes regarding these delays were (1) physician lack of knowledge and (2) lack of patient awareness. Results indicate that physician delay needs to be focused on compared to patient delay, as it is more common and has longer delays. More comprehensive training in head and neck clinical examination skills during undergraduate and residency training is recommended to reduce physician delay. Patient delay could be targeted by public education programs via both physicians and dentists. PMID:25566764

  8. The Development of Perceived Scholastic Competence and Global Self-Worth in African American Adolescents from Low-Income Families: The Roles of Family Factors, Early Educational Intervention, and Academic Experience.

    ERIC Educational Resources Information Center

    Campbell, Frances A.; Pungello, Elizabeth P.; Miller-Johnson, Shari

    2002-01-01

    Examined early childhood and concurrent factors associated with adolescents' self-perceptions of scholastic competence and global self-worth. Found that family conflict in adolescence, early childhood educational intervention (Abecedarian Project), and academic achievement predicted perceived scholastic competence. Perceptions of scholastic,…

  9. Woman physician stalked

    PubMed Central

    Manca, Donna P.

    2005-01-01

    OBJECTIVE To increase awareness of the stalking and harassing behaviour physicians sometimes encounter from patients and to explore how best to approach and address this behaviour. SOURCES OF INFORMATION A physician’s personal reflection of a stalking incident is combined with a review of the literature. Few studies have addressed this subject. MAIN MESSAGE Any family physician could be the victim of stalking. Physicians’ routines and schedules are often public knowledge because of their availability to their practices; thus they are particularly vulnerable to stalkers. We rarely think of women stalking female family physicians; however, it is likely more common than we realize. Increased awareness of this phenomenon and appropriate interventions could reduce escalation of harassing behaviour. Helpful strategies could include recognizing and addressing the behaviour early, seeking assistance, and documenting all incidents in a separate file that includes tape recordings or other material. CONCLUSION We should explore stalking and harassing behaviour openly and become aware of the risks so that we can identify appropriate strategies to avert problems and deal with stalkers. PMID:16805082

  10. Longevity of Thai physicians.

    PubMed

    Sithisarankul, Pornchai; Piyasing, Veera; Boontheaim, Benjaporn; Ratanamongkolgul, Suthee; Wattanasirichaigoon, Somkiat

    2004-10-01

    The objectives of this study were to explore characteristics of the long-lived Thai physicians. We sent 983 posted questionnaires to 840 male and 143 female physicians. We obtained 327 of them back after 2 rounds of mailing, yielding a response rate of 33.3 percents. The response rate of male physicians was 32.4 percents and that of female physicians was 38.5 percents. Their ages were between 68-93 years (75.1 +/- 4.86 years on average). The majority were married, implying that their spouses were also long-lived. Around half of them still did some clinical work, one-fourth did some charity work, one-fourth did various voluntary works, one-fifth did some business, one-fifth did some academic work, and some did more than one type of work. Most long-lived physicians were not obese, with BMI of 16.53-34.16 (average 23.97 +/- 2.80). Only 8 had BMI higher than 30. BMIs were not different between male and female physicians. However, four-fifths of them had diseases that required treatment, and some of them had more than one disease. The five most frequent diseases were hypertension, diabetes, ischemic heart disease, dyslipidemia, and benign prostate hypertrophy, respectively. Most long-lived physicians did exercise (87.8%), and some did more than one method. The most frequent one was walking (52.3%). Most did not drink alcohol or drank occasionally, only 9.0% drank regularly. Most of them slept 3-9 hours per night (average 6.75 +/- 1.06). Most (78.3%) took some medication regularly; of most were medicine for their diseases. Most did not eat macrobiotic food, vegetarian food, or fast food regularly. Most long-lived physicians practiced some religious activities by praying, paying respect to Buddha, giving food to monks, practicing meditation, and listening to monks' teaching. They also used Buddhist practice and guidelines for their daily living and work, and also recommended these to their younger colleagues. Their recreational activities were playing musical instruments

  11. Physician, Practice, and Patient Characteristics Related to Primary Care Physician Physical and Mental Health: Results from the Physician Worklife Study

    PubMed Central

    Williams, Eric S; Konrad, Thomas R; Linzer, Mark; McMurray, Julia; Pathman, Donald E; Gerrity, Martha; Schwartz, Mark D; Scheckler, William E; Douglas, Jeff

    2002-01-01

    Objective To study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, and physical health. Data Sources Based on a survey of over 5,000 physicians nationwide. Four waves of surveys resulted in 2,325 complete responses. Elimination of ineligibles yielded a 52 percent response rate; 1,411 responses from primary care physicians were used. Study Design A conceptual model was tested by structural equation modeling. Physician job satisfaction and stress mediated the relationship between physician, practice, and patient characteristics as independent variables and physician physical and mental health as dependent variables. Principle Findings The conceptual model was generally supported. Practice and, to a lesser extent, physician characteristics influenced job satisfaction, whereas only practice characteristics influenced job stress. Patient characteristics exerted little influence. Job stress powerfully influenced job satisfaction and physical and mental health among physicians. Conclusions These findings support the notion that workplace conditions are a major determinant of physician well-being. Poor practice conditions can result in poor outcomes, which can erode quality of care and prove costly to the physician and health care organization. Fortunately, these conditions are manageable. Organizational settings that are both “physician friendly” and “family friendly” seem to result in greater well-being. These findings are particularly important as physicians are more tightly integrated into the health care system that may be less clearly under their exclusive control.

  12. The Relationship between Parenting, Acculturation, and Adolescent Academics in Mexican-Origin Immigrant Families in Los Angeles.

    ERIC Educational Resources Information Center

    Plunkett, Scott W.; Bamaca-Gomez, Mayra Y.

    2003-01-01

    A study examining Mexican-born parents' influence on their children's academic outcomes surveyed 273 Mexican American students attending three Los Angeles high schools. Girls reported higher academic motivation and educational aspirations than boys. Parent behaviors of helping, monitoring, and supporting positively affected academic motivation.…

  13. Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study

    PubMed Central

    2013-01-01

    Background Following the completion of treatment and as they enter the follow-up phase, breast cancer patients (BCPs) often recount feeling ‘lost in transition’, and are left with many questions concerning how their ongoing care and monitoring for recurrence will be managed. Family physicians (FPs) also frequently report feeling ill-equipped to provide follow-up care to BCPs. In this three-phase qualitative pilot study we designed, implemented and evaluated a multi-faceted survivorship care plan (SCP) to address the information needs of BCPs at our facility and of their FPs. Methods In Phase 1 focus groups and individual interviews were conducted with 35 participants from three stakeholder groups (BCPs, FPs and oncology specialist health care providers (OHCPs)), to identify specific information needs. An SCP was then designed based on these findings, consisting of both web-based and paper-based tools (Phase 2). For Phase 3, both sets of tools were subsequently evaluated via focus groups and interviews with 26 participants. Interviews and focus groups were audio taped, transcribed and content analysed for emergent themes and patterns. Results In Phase 1 patients commented that web-based, paper-based and human resources components were desirable in any SCP. Patients did not focus exclusively on the post-treatment period, but instead spoke of evolving needs throughout their cancer journey. FPs indicated that any tools to support them must distill important information in a user-friendly format. In Phase 2, a pilot SCP was subsequently designed, consisting of both web-based and paper-based materials tailored specifically to the needs of BCPs as well as FPs. During Phase 3 (evaluation) BCPs indicated that the SCP was effective at addressing many of their needs, and offered suggestions for future improvements. Both patients and FPs found the pilot SCP to be an improvement from the previous standard of care. Patients perceived the quality of the BCP-FP relationship as

  14. Do physician-payment mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario.

    PubMed Central

    Hutchison, B; Birch, S; Hurley, J; Lomas, J; Stratford-Devai, F

    1996-01-01

    OBJECTIVES: To determine whether payment of primary care physicians based on capitation, with an additional incentive payment for low hospital-utilization rates, resulted in lower hospital-utilization rates among patients of these physicians than among patients of physicians still paid on a fee-for-service basis. DESIGN: Retrospective cohort study. SETTING: Capitation-based and fee-for-service primary care practices in Ontario. SUBJECTS: Thirty-nine physicians whose method of payment was converted from fee-for-service to capitation during the period from June 1985 to January 1989 and 7 physicians who remained in fee-for-service practice, two of whom were matched with one physician in capitation-based practice on the basis of practice location, type of practice (academic v. community), hours of practice (part-time v. full-time), years since graduation, physician group size, practice size (number of patients), type of group (primary care v. multispecialty), sex, certification in family medicine, country of graduation (Canada v. other) and age. One physician in capitation-based practice was matched with only one physician in fee-for-service practice. OUTCOME MEASURES: Annual hospital-utilization rates (hospital separations or hospital days per 1000 patients in each practice) for the physicians paid on a capitation basis 3 years before, 1 year before and 3 years after they converted from fee-for-service payment and at corresponding periods for the matched physicians still paid on a fee-for-service basis. RESULTS: The mean annual rate of hospital days used, adjusted for the age and sex of patients as well as for their social-program-recipient status, fell from 1085 per 1000 patients (3 years before the conversion date) to 1030 (1 year before conversion) and to 954 (3 years after conversion) in capitation-based practices. For the matched physicians in fee-for-service practice, the rates during the corresponding periods were 1085, 1035 and 956 hospital days per 1000

  15. Difficulties facing physician mothers in Japan.

    PubMed

    Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

    2011-01-01

    Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. PMID:22027270

  16. Gender in medicine – an issue for women only? A survey of physician teachers' gender attitudes

    PubMed Central

    Risberg, Gunilla; Johansson, Eva E; Westman, Göran; Hamberg, Katarina

    2003-01-01

    Background During the last decades research has disclosed gender differences and gender bias in different fields of academic and clinical medicine. Consequently, a gender perspective has been asked for in medical curricula and medical education. However, in reports about implementation attempts, difficulties and reluctance have been described. Since teachers are key persons when introducing new issues we surveyed physician teachers' attitudes towards the importance of gender in professional relations. We also analyzed if gender of the physician is related to these attitudes. Method Questionnaires were sent to all 468 senior physicians (29 % women), at the clinical departments and in family medicine, engaged in educating medical students at a Swedish university. They were asked to rate, on five visual analogue scales, the importance of physician and patient gender in consultation, of physician and student gender in clinical tutoring, and of physician gender in other professional encounters. Differences between women and men were estimated by chi-2 tests and multivariate logistic regression analyses. Results The response rate was 65 %. The physicians rated gender more important in consultation than in clinical tutoring. There were significant differences between women and men in all investigated areas also when adjusting for speciality, age, academic degree and years in the profession. A higher proportion of women than men assessed gender as important in professional relationships. Those who assessed very low were all men while both men and women were represented among those with high ratings. Conclusions To implement a gender perspective in medical education it is necessary that both male and female teachers participate and embrace gender aspects as important. To facilitate implementation and to convince those who are indifferent, this study indicates that special efforts are needed to motivate men. We suggest that men with an interest in gender issues should be

  17. Family Medicine Education in Canada, 1983

    PubMed Central

    Hennen, Brian K. E.

    1983-01-01

    We now have good information about family medicine in terms of content, principles, and practice load. Undergraduate, residency and continuing education are improving, but some family medicine programs still have limited support from their university's faculty and governments. Residency in-training assessment and the certification process are better developed than is evaluation of new family doctors' practice performance. Research in the family medicine base is expanding, and residents are increasingly involved in projects. Family medicine teachers are now on a par with other clinical faculty, because they must meet tougher criteria for appointment and promotion. The political leadership of family medicine education, shared by the College of Family Physicians of Canada and academic departments, requires strong consensus and persistent activity. PMID:20469408

  18. The Mindful Physician and Pooh

    ERIC Educational Resources Information Center

    Winter, Robin O.

    2013-01-01

    Resident physicians are particularly susceptible to burnout due to the stresses of residency training. They also experience the added pressures of multitasking because of the increased use of computers and mobile devices while delivering patient care. Our Family Medicine residency program addresses these problems by teaching residents about the…

  19. The Physician as a Marriage Counselor

    ERIC Educational Resources Information Center

    Trainer, Joseph B.

    1973-01-01

    The author describes the emergence of a new style of family physician whose education is incorporating more behavioral science and whose practice moves increasingly into the field of marital and sexual problems. Closer cooperation between physicians and clinical psychologists and marriage counselors is advocated. (Editor)

  20. A Study of the Educationally Influential Physician.

    ERIC Educational Resources Information Center

    Kaufman, David M.; Ryan, Kurt; Hodder, Ian

    1999-01-01

    A survey of 172 family doctors found that they approached educationally influential (EI) physicians they knew through their hospitals; only 20% used e-mail and 40% the Internet for medical information; EI physicians helped extend their knowledge and validate innovations found in the literature; and health care reform was negatively affecting…

  1. Qualitative study of employment of physician assistants by physicians

    PubMed Central

    Taylor, Maureen T.; Wayne Taylor, D.; Burrows, Kristen; Cunnington, John; Lombardi, Andrea; Liou, Michelle

    2013-01-01

    Abstract Objective To explore the experiences and perceptions of Ontario physician assistant (PA) employers about the barriers to and benefits of hiring PAs. Design A qualitative design using semistructured interviews. Setting Rural and urban eastern and southwestern Ontario. Participants Seven family physicians and 7 other specialists. Methods The 14 physicians participated in semistructured interviews, which were audiorecorded and transcribed verbatim. An iterative approach using immersion and crystallization was employed for analysis. Main findings Physician-specific benefits to hiring PAs included increased flexibility, the opportunity to expand practice, the ability to focus more time on complex patients, overall reduction in work hours and stress, and an opportunity for professional fellowship. Physicians who hired PAs without government financial support said PAs were affordable as long as they were able to retain them. Barriers to hiring PAs included uncertainty about funding, the initial need for intensive supervision and training, and a lack of clarity around delegation of acts. Conclusion Physicians are motivated to hire PAs to help deal with long wait times and long hours, but few are expecting to increase their income by taking on PAs. Governments, medical colleges, educators, and regulators must address the perceived barriers to PA hiring in order to expand and optimize this profession. PMID:24235209

  2. Academic Support by Significant Others and Educational Resilience in Mexican-Origin Ninth Grade Students from Intact Families

    ERIC Educational Resources Information Center

    Plunkett, Scott W.; Henry, Carolyn S.; Houltberg, Benjamin J.; Sands, Tovah; Abarca-Mortensen, Sandra

    2008-01-01

    This study used dominance analysis to examine the relative importance of ninth grade, Mexican-origin adolescents' perceptions of academic support from significant others (i.e., mothers, fathers, teachers, and friends) in relation to aspects of academic success. Self-report and school record data were collected from 216 Mexican-origin adolescents…

  3. Coping as Part of Motivational Resilience in School: A Multidimensional Measure of Families, Allocations, and Profiles of Academic Coping

    ERIC Educational Resources Information Center

    Skinner, Ellen; Pitzer, Jennifer; Steele, Joel

    2013-01-01

    A study was designed to examine a multidimensional measure of children's coping in the academic domain as part of a larger model of motivational resilience. Using items tapping multiple ways of dealing with academic problems, including five adaptive ways (strategizing, help-seeking, comfort-seeking, self-encouragement, and commitment) and six…

  4. High-billing general practitioners and family physicians in Ontario: how do they do it? An analysis of practice patterns of GP/FPs with annual billings over $400,000.

    PubMed Central

    Chan, B; Anderson, G M; Thériault, M E

    1998-01-01

    BACKGROUND: To better understand the reasons why some fee-for-service physicians have high billing levels, the authors compared the practice and demographic characteristics of general practitioners and family physicians (GP/FPs) who submitted over $400,000 in annual Ontario Health Insurance Plan (OHIP) fee-for-service claims in 1994-95 with those of GP/FPs who billed between $35,000 and $400,000. METHODS: The authors describe the OHIP billing and physician characteristic data for fiscal year 1994-95. They used multivariate logistic regression to determine factors independently associated with high billing status. RESULTS: A total of 219 GP/FPs (2.5% of the GP/FPs in Ontario) billed over $400,000 in 1994-95. Of these, 14 had billing patterns similar to those of specialists, and 27 billed predominantly for diagnostic and therapeutic procedures (particularly physiotherapy). The remaining 178 (81.3%) billed for a mix of services similar to that of other GP/FPs but on average had 2.6 times the volume of patient assessments and a greater share of their total billings derived from diagnostic and therapeutic procedures (9.1% v. 5.6%). Multivariate analysis indicated that these high-volume GP/FPs were less likely than GP/FPs who billed between $35,000 and $400,000 to be 60 years of age or older (odds ratio [OR] 0.09, p < 0.05) and female (OR 0.21) and were more likely to be foreign graduates (OR 1.85) and practising in a region with low physician supply (OR 0.45 for each increase of 1 physician per 1000 population). Metropolitan Toronto was an outlier to the latter relation and was more likely to have high-volume GP/FPs (OR 16.89). INTERPRETATION: High-billing GP/FPs attained their high billing levels by maintaining large numbers of patient visits and by performing procedures. Further research is needed to determine the time spent per patient and the quality of care delivered by these physicians as well as the appropriateness of the procedures that they perform. PMID

  5. Educational outreach and collaborative care enhances physician's perceived knowledge about Developmental Coordination Disorder

    PubMed Central

    Gaines, Robin; Missiuna, Cheryl; Egan, Mary; McLean, Jennifer

    2008-01-01

    Background Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental condition that affects 5–6% of children. When not recognized and properly managed during the child's development, DCD can lead to academic failure, mental health problems and poor physical fitness. Physicians, working in collaboration with rehabilitation professionals, are in an excellent position to recognize and manage DCD. This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with DCD. Methods The intervention included educational outreach and collaborative care for children with suspected DCD. Physicians were educated by and worked with rehabilitation professionals from February 2005 to April 2006. Mixed methods evaluation approach documented the process and impact of the intervention. Results Physicians: 750 primary care physicians from one major urban area and outlying regions were invited to participate; 147 physicians enrolled in the project. Children: 125 children were identified and referred with suspected DCD. The main outcome was improvement in knowledge and perceived skill of physicians concerning their ability to screen, diagnose and manage DCD. At baseline 91.1% of physicians were unaware of the diagnosis of DCD, and only 1.6% could diagnose condition. Post-intervention, 91% of participating physicians reported greater knowledge about DCD and 29.2% were able to diagnose DCD compared to 0.5% of non-participating physicians. 100% of physicians who participated in collaborative care indicated they would continue to use the project materials and resources and 59.4% reported they would recommend or share the materials with medical colleagues. In addition, 17.6% of physicians not formally enrolled in the project reported an increase in knowledge of DCD. Conclusion Physicians receiving educational outreach visits significantly improved their knowledge about

  6. Sex role ideology among physicians.

    PubMed Central

    Leichner, P.; Harper, D.

    1982-01-01

    Physicians have been accused by some feminist writers of having traditional views on sex roles that make them part of society's oppressive power structure and therefore responsible in part for the high incidence of psychologic problems and drug dependency among women. To assess whether physicians' attitudes towards women are indeed polarized in a traditional fashion, a sex role ideology questionnaire was given to all practising physicians belonging to the Manitoba Medical Association. Overall the physicians were found to be more feminist than male college students and a group of women with traditional beliefs. Psychiatrists, who had the highest adjusted group mean score on a sex role ideology scale (high indicating feminist beliefs), were found to be significantly more feminist than family practitioners, surgeons, and obstetricians and gynecologists, although not more so than internists, radiologists, pediatricians and anesthesiologists. These findings do not support the assumption that physicians have traditional views that reflect those of society. However, the significant differences between specialties emphasize the need for educating physicians and medical students in the behaviour of women. PMID:7104916

  7. Family Advocates' Perspectives on the Early Academic Success of Children Born to Low-Income Adolescent Mothers

    ERIC Educational Resources Information Center

    Luster, Tom; Bates, Laura; Vandenbelt, Marcia; Nievar, M. Angela

    2004-01-01

    Qualitative analyses were conducted to examine family factors related to individual differences in the early school success of children born to low-income adolescent mothers from the perspective of paraprofessional family advocates. These families were participants in a 5-year family support program. Achievement test scores and teacher ratings…

  8. Pharmaceutical marketing research and the prescribing physician.

    PubMed

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue. PMID:17502635

  9. Physician buy-in for EMRs.

    PubMed

    Yackanicz, Lori; Kerr, Richard; Levick, Donald

    2010-01-01

    Implementing an EMR in an ambulatory practice requires intense workflow analysis, introduction of new technologies and significant cultural change for the physicians and physician champion. This paper will relate the experience at Lehigh Valley Health Network in the implementation of an ambulatory EMR and with the physician champions that were selected to assist the effort. The choice of a physician champion involves political considerations, variation in leadership and communication styles, and a cornucopia of personalities. Physician leadership has been shown to be a critical success factor for any successful technology implementation. An effective physician champion can help develop and promote a clear vision of an improved future, enlist the support of the physicians and staff, drive the process changes needs and manage the cultural change required. The experience with various types of physician champions will be discussed, including, the "reluctant leader", the "techie leader", the "whiny leader", and the "mature leader". Experiences with each type have resulted in a valuable, "lessons learned" summary. LVHN is a tertiary academic community medical center consisting of 950 beds and over 450 employed physicians. LVHN has been named to the Health and Hospital Network's 100 Top Wired and 25 Most Wireless Hospitals. PMID:20397333

  10. Patient Relationships and the Personal Physician in Tomorrow's Health System: A Perspective from the Keystone IV Conference.

    PubMed

    Colwill, Jack M; Frey, John J; Baird, Macaran A; Kirk, John W; Rosser, Walter W

    2016-01-01

    A group of senior leaders from the early generation of academic family medicine reflect on the meaning of being a personal physician, based on their own clinical experiences and as teachers of residents and students in academic health centers. Recognizing that changes in clinical care and education at national and local systems levels have added extraordinary demands to the role of the personal physician, the senior group offers examples of how the discipline might go forward in changing times. Differently organized care such as the Family Health Team model in Ontario, Canada; value-based payment for populations in large health systems; and federal changes in reimbursement for populations can have positive effects on physician satisfaction. These changes and examples of changes in medical student and residency education also have the potential to positively affect the primary care workforce. The authors conclude that, without substantive educational and health system reform, the ability to truly serve as a personal physician and adhere to the values of continuity, responsibility, and accountability will continue to be threatened. PMID:27387166

  11. Hospital demand for physicians.

    PubMed

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  12. Academic detailing.

    PubMed

    Shankar, P R; Jha, N; Piryani, R M; Bajracharya, O; Shrestha, R; Thapa, H S

    2010-01-01

    There are a number of sources available to prescribers to stay up to date about medicines. Prescribers in rural areas in developing countries however, may not able to access some of them. Interventions to improve prescribing can be educational, managerial, and regulatory or use a mix of strategies. Detailing by the pharmaceutical industry is widespread. Academic detailing (AD) has been classically seen as a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits physicians in their offices to provide evidence-based information. Face-to-face sessions, preferably on an individual basis, clear educational and behavioural objectives, establishing credibility with respect to objectivity, stimulating physician interaction, use of concise graphic educational materials, highlighting key messages, and when possible, providing positive reinforcement of improved practices in follow-up visits can increase success of AD initiatives. AD is common in developed countries and certain examples have been cited in this review. In developing countries the authors have come across reports of AD in Pakistan, Sudan, Argentina and Uruguay, Bihar state in India, Zambia, Cuba, Indonesia and Mexico. AD had a consistent, small but potentially significant impact on prescribing practices. AD has much less resources at its command compared to the efforts by the industry. Steps have to be taken to formally start AD in Nepal and there may be specific hindering factors similar to those in other developing nations. PMID:21209521

  13. Navigating Government Service as a Physician

    ERIC Educational Resources Information Center

    Koh, Howard K.

    2016-01-01

    Working in government can be a remarkable life experience for anyone but particularly for those who have trained in the worlds of medicine and public health. This article describes some lessons learned from a physician initially based in academic medicine and public health who has since spent more than a decade serving in leadership positions at…

  14. Leadership Attributes of Physician Assistant Program Directors

    ERIC Educational Resources Information Center

    Eifel, Raymond Leo

    2014-01-01

    Physician assistant (PA) program directors perform an essential role in the initiation, continuation, and development of PA education programs in the rapidly changing environments of both health care and higher education. However, only limited research exists on this academic leader. This study examined the leadership roles of PA program directors…

  15. 22 CFR 62.27 - Alien physicians.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... or academic medical center which has been designated an exchange visitor program by the Secretary of... Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program Provisions § 62.27 Alien physicians. (a) Purpose. Pursuant to the Mutual Educational and Cultural...

  16. 22 CFR 62.27 - Alien physicians.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or academic medical center which has been designated an exchange visitor program by the Secretary of... Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES EXCHANGE VISITOR PROGRAM Specific Program Provisions § 62.27 Alien physicians. (a) Purpose. Pursuant to the Mutual Educational and Cultural...

  17. Predicting Academic Entitlement in Undergraduates

    ERIC Educational Resources Information Center

    Sohr-Preston, Sara; Boswell, Stefanie S.

    2015-01-01

    Academic entitlement (AE) is a common source of frustration for college personnel. This investigation examined predictors (self-concept, academic dishonesty, locus of control, and family functioning) of AE in male and female college students. Academic dishonesty and the interaction between locus of control and family functioning significantly…

  18. Determinants of physicians' prescribing behaviour of methylphenidate for cognitive enhancement.

    PubMed

    Ponnet, Koen; Wouters, Edwin; Van Hal, Guido; Heirman, Wannes; Walrave, Michel

    2014-01-01

    The non-medical use of methylphenidate for cognitive enhancement becomes a more and more common practice among college and university students. Although physicians are a source of access, little is known about the underlying mechanisms that might lead to physicians' intention and behaviour of prescribing methylphenidate to improve students' academic performance. Applying Ajzen's theory of planned behaviour (TPB), we tested whether attitudes, subjective norms (controllability and self-efficacy) and perceived behavioural control predicted the intention and the prescribing behaviour of physicians. Participants were 130 physicians (62.3% males). Structural equation modelling was used to test the ability of TPB to predict physicians' behaviour. Overall, the present study provides support for the TPB in predicting physicians' prescribing behaviour of methylphenidate for cognitive enhancement. Subjective norms, followed by attitudes, are the strongest predictors of physicians' intention to prescribe methylphenidate. To a lesser extent, controllability predicts the intention of physicians, and self-efficacy predicts the self-reported behaviour. Compared to their male colleagues, female physicians seem to have more negative attitudes towards prescribing methylphenidate for cognitive enhancement, feel less social pressure and perceive more control over their behaviour. Intervention programmes that want to decrease physicians' intention to prescribe methylphenidate for improving academic performance should primarily focus on alleviating the perceived social pressure to prescribe methylphenidate and on converting physician neutral or positive attitudes towards prescribing methylphenidate into negative attitudes. PMID:23713799

  19. Mothers' Academic Gender Stereotypes and Education-Related Beliefs about Sons and Daughters in African American Families

    ERIC Educational Resources Information Center

    Wood, Dana; Kurtz-Costes, Beth; Rowley, Stephanie J.; Okeke-Adeyanju, Ndidi

    2010-01-01

    The role of African American mothers' academic gender stereotype endorsement in shaping achievement-related expectations for and perceptions of their own children was examined. Mothers (N = 334) of 7th and 8th graders completed measures of expectations for their children's future educational attainment, perceptions of their children's academic…

  20. Teacher Ratings of Academic Achievement of Children between 6 and 12 Years Old from Intact and Non-Intact Families

    ERIC Educational Resources Information Center

    Molepo, Lephodisa S.; Maunganidze, Levison; Mudhovozi, Pilot; Sodi, Tholene

    2010-01-01

    We investigated teacher ratings of the impact of parental divorce on academic achievement of children between 6 and 12 years old up to 12 months after their parents divorced. A purposive sample of 120 children attending four different primary schools in a small South African town took part in the study. One third (n = 40) of the children had…

  1. Survey reveals physicians' experiences with cults.

    PubMed

    Lottick, E A

    1993-02-01

    In late June 1992, a stratified random sample of Pennsylvania physicians (5,400) were mailed a two-page questionnaire asking about experiences with destructive cults, either personal, professional, or both. Professional experience was defined as "with patients or their families," and personal experience was defined as "with self, family, or friends." The survey sample group was drawn from primary care physicians (family practice, general practice, internal medicine, and pediatrics) and psychiatrists. Surveys were returned by 1,396 participants, a 26 percent rate of return. A number of the returned surveys (173) included personal observations and comments. PMID:8327257

  2. Ethnic Retention as a Predictor of Academic Success: Lessons from the Children of Immigrant Families and Black Children

    ERIC Educational Resources Information Center

    Akiba, Daisuke

    2007-01-01

    Educators and policymakers often believe that immigrant children perform better in school if they and their families culturally assimilate and assume the characteristics prevalent in the dominant mainstream society. Therefore, ethnic retention (i.e., immigrant families and people of color embracing their own ethnic values, artifacts, and…

  3. Preparing family physicians for the care of patients with severe and persistent mental illness: Examples from two U.S. residency programs.

    PubMed

    Romain, Amy M; Muench, John; Phillips, Julie P

    2015-01-01

    Individuals with severe and persistent mental illness have increased morbidity and mortality and significant barriers to accessing health care. Although primary care providers deliver most health care for this population, residency training programs generally lack specialized training in this area. This article describes the approaches of two family medicine residency programs in addressing this educational gap. Each program collaborated with external organizations to create service models that would enhance patient access, while immersing residents in the care of patients with severe and persistent mental illness. Residents educated in these programs gain experience with an underserved population, practice advanced skills in managing complex medical and psychiatric illness, and increase knowledge from collaborative work in unique care settings. Further implementation of programs like these, and rigorous study of such programs, could have significant benefits for family medicine education and the care of patients with severe and persistent mental illness. PMID:26142287

  4. Physician career satisfaction within specialties

    PubMed Central

    Leigh, J Paul; Tancredi, Daniel J; Kravitz, Richard L

    2009-01-01

    Background Specialty-specific data on career satisfaction may be useful for understanding physician workforce trends and for counseling medical students about career options. Methods We analyzed cross-sectional data from 6,590 physicians (response rate, 53%) in Round 4 (2004-2005) of the Community Tracking Study Physician Survey. The dependent variable ranged from +1 to -1 and measured satisfaction and dissatisfaction with career. Forty-two specialties were analyzed with survey-adjusted linear regressions Results After adjusting for physician, practice, and community characteristics, the following specialties had significantly higher satisfaction levels than family medicine: pediatric emergency medicine (regression coefficient = 0.349); geriatric medicine (0.323); other pediatric subspecialties (0.270); neonatal/prenatal medicine (0.266); internal medicine and pediatrics (combined practice) (0.250); pediatrics (0.250); dermatology (0.249);and child and adolescent psychiatry (0.203). The following specialties had significantly lower satisfaction levels than family medicine: neurological surgery (-0.707); pulmonary critical care medicine (-0.273); nephrology (-0.206); and obstetrics and gynecology (-0.188). We also found satisfaction was significantly and positively related to income and employment in a medical school but negatively associated with more than 50 work-hours per-week, being a full-owner of the practice, greater reliance on managed care revenue, and uncontrollable lifestyle. We observed no statistically significant gender differences and no differences between African-Americans and whites. Conclusion Career satisfaction varied across specialties. A number of stakeholders will likely be interested in these findings including physicians in specialties that rank high and low and students contemplating specialty. Our findings regarding "less satisfied" specialties should elicit concern from residency directors and policy makers since they appear to be in

  5. Academic achievement among immigrant and U.S.-born Latino adolescents: Associations with cultural, family, and acculturation factors

    PubMed Central

    Santiago, Catherine DeCarlo; Gudiño, Omar G.; Baweja, Shilpa; Nadeem, Erum

    2015-01-01

    This study examined proximal risk and protective factors that contribute to academic achievement among 130 Latino students. Participating students were 56.2% female and 35.3% foreign-born (mean age = 11.38, SD = .59). Acculturative stress, immigrant status, child gender, parental monitoring, traditional cultural values, mainstream values, and English language proficiency were explored in relation to academic achievement. Higher levels of parental monitoring, English language proficiency, and female gender were associated with higher grades, while mainstream values were associated with lower grades. In addition, a significant interaction between acculturative stress and immigrant status was found, such that higher acculturative stress was related to poorer grades for U.S.-born students in particular. Thus, parental monitoring and female gender are potential protective factors, while identification with mainstream values and low English language proficiency are risk factors for poor grades. U.S.-born students may be particularly vulnerable to the effects of acculturative stress. PMID:25983352

  6. Prepaid entitlements. A new challenge for physician-patient relationships.

    PubMed

    Schroeder, J L; Clarke, J T; Webster, J R

    1985-12-01

    The transition from a fee-for-service model to a prepaid health care system creates new challenges for both physicians and patients. Occasionally both can feel trapped in the new setting and must rely on new or different strategies to reach sometimes divergent objectives. This may alter the physician-patient relationship in ways that neither likes. Based on our experience in a large multispecialty academic group practice, we have developed management strategies to mitigate such stresses on both parties. These include review of marketing efforts; education of new patients to foster realistic expectations; a physician-generated, prospective internal policy for dealing with dissatisfied patients and physicians; a strong central administrative physician to serve as a "lightning rod" and counselor; and continuing physician orientation and education to improve judgment and attitudes. These strategies promote the physician's role as expert consultant-educator with the best interests of the patient as the first priority. PMID:4057530

  7. [The pharmacist-physician collaboration for IPW: from physician's perspective].

    PubMed

    Son, Daisuke; Kawamura, Kazumi; Nakashima, Mitsuko; Utsumi, Miho

    2015-01-01

    Interprofessional work (IPW) is increasingly important in various settings including primary care, in which the role of pharmacists is particularly important. Many studies have shown that in cases of hypertension, diabetes, dyslipidemia, and metabolic syndrome, physician-pharmacist collaboration can improve medication adherence and help to identify drug-related problems. Some surveys and qualitative studies revealed barriers and key factors for effective physician-pharmacist collaboration, including trustworthiness and role clarification. In Japan, some cases of good collaborative work between pharmacists and physicians in hospitals and primary care settings have been reported. Still, community pharmacists in particular have difficulties collaborating with primary care doctors because they have insufficient medical information about patients, they feel hesitant about contacting physicians, and they usually communicate by phone or fax rather than face to face. Essential competencies for good interprofessional collaboration have been proposed by the Canadian Interprofessional Health Collaborative (CIHC): interprofessional communication; patient/client/family/community-centered care; role clarification; team functioning; collaborative leadership; and interprofessional conflict resolution. Our interprofessional education (IPE) team regularly offers educational programs to help health professionals learn interprofessional collaboration skills. We expect many pharmacists to learn those skills and actively to facilitate interprofessional collaboration. PMID:25743907

  8. In defense of industry-physician relationships.

    PubMed

    Nakayama, Don K

    2010-09-01

    The objective was to examine the economic, ethical, and legal foundations for conflict of interest restrictions between physicians and pharmaceutical and medical device industries ("industry"). Recently academic medical centers and professional organizations have adopted policies that restrict permissible interactions between industry and physicians. The motive is to avoid financial conflicts of interest that compromise core values of altruism and fiduciary relationships. Productive relationships between industry and physicians provide novel drugs and devices of immense benefit to society. The issues are opposing views of medical economics, profit motives, medical professionalism, and extent to which interactions should be lawfully restricted. Industry goals are congruent with those of physicians: patient welfare, safety, and running a profitable business. Profits are necessary to develop drugs and devices. Physician collaborators invent products, refine them, and provide feedback and so are appropriately paid. Marketing is necessary to bring approved products to patients. Economic realities limit the extent to which physicians treat their patients altruistically and as fiduciaries. Providing excellent service to patients may be a more realistic standard. Statements from industry and the American College of Surgeons appropriately guide professional behavior. Preservation of industry-physician relationships is vital to maintain medical innovation and progress. PMID:20836349

  9. Patient–physician mistrust and violence against physicians in Guangdong Province, China: a qualitative study

    PubMed Central

    Tucker, Joseph D; Cheng, Yu; Wong, Bonnie; Gong, Ni; Nie, Jing-Bao; Zhu, Wei; McLaughlin, Megan M; Xie, Ruishi; Deng, Yinghui; Huang, Meijin; Wong, William C W; Lan, Ping; Liu, Huanliang; Miao, Wei; Kleinman, Arthur

    2015-01-01

    Objective To better understand the origins, manifestations and current policy responses to patient–physician mistrust in China. Design Qualitative study using in-depth interviews focused on personal experiences of patient–physician mistrust and trust. Setting Guangdong Province, China. Participants One hundred and sixty patients, patient family members, physicians, nurses and hospital administrators at seven hospitals varying in type, geography and stages of achieving goals of health reform. These interviews included purposive selection of individuals who had experienced both trustful and mistrustful patient–physician relationships. Results One of the most prominent forces driving patient–physician mistrust was a patient perception of injustice within the medical sphere, related to profit mongering, knowledge imbalances and physician conflicts of interest. Individual physicians, departments and hospitals were explicitly incentivised to generate revenue without evaluation of caregiving. Physicians did not receive training in negotiating medical disputes or humanistic principles that underpin caregiving. Patient–physician mistrust precipitated medical disputes leading to the following outcomes: non-resolution with patient resentment towards physicians; violent resolution such as physical and verbal attacks against physicians; and non-violent resolution such as hospital-mediated dispute resolution. Policy responses to violence included increased hospital security forces, which inadvertently fuelled mistrust. Instead of encouraging communication that facilitated resolution, medical disputes sometimes ignited a vicious cycle leading to mob violence. However, patient–physician interactions at one hospital that has implemented a primary care model embodying health reform goals showed improved patient–physician trust. Conclusions The blind pursuit of financial profits at a systems level has eroded patient–physician trust in China. Restructuring incentives

  10. PERFORMANCE MEASURES OF PHYSICIANS.

    ERIC Educational Resources Information Center

    PRICE, PHILIP B.; AND OTHERS

    CRITERION MEASURES DEVELOPED FOR ON-THE-JOB PERFORMANCE OF PHYSICIANS WILL BE USED IN A SUBSEQUENT STUDY TO DETERMINE HOW MUCH THE PERFORMANCE OF PHYSICIANS CAN BE PREDICTED BY THEIR INDIVIDUAL ACHIEVEMENTS IN MEDICAL AND PREMEDICAL SCHOOL. APPROXIMATELY 29 MEASURES OF THE UNIVERSITY OF UTAH COLLEGE OF MEDICINE AND OTHER PHYSICIANS IN THE UTAH…

  11. Physicians: Requirements for Becoming a Physician

    MedlinePlus

    ... Us Contact Us A | A Text size Email Requirements for Becoming a Physician Note: We are not ... the doctor's knowledge and skills remain current. CME requirements vary by state, by professional organizations, and by ...

  12. The relation of dialogic, control, and racial socialization practices to early academic and social competence: effects of gender, ethnicity, and family socioeconomic status.

    PubMed

    Barbarin, Oscar; Jean-Baptiste, Esther

    2013-01-01

    This research tests the relations of parental practices to child competence and assertions that practices differ by gender of the child. Home-based interviews and structured observations of parent-child interactions were conducted with an ethnically and socioeconomically diverse sample of families (N = 501) whose 4-year-old children were served in public prekindergarten. Study data confirmed the importance of parental practices for children's academic and social competence but did not support claims that use of any of the practices was related to the child's gender. Significant differences were found for economic status on dialogic practices and for ethnicity on control and ethnic socialization. Poor parents employed dialogic practices less than nonpoor parents' and African American parents employed dialogic practices less often and control and ethnic socialization more often than European Americans. Dialogic practices were related to competence, but parental control and ethnic socialization were not. PMID:23889013

  13. Relationships of physician characteristics to performance quality and improvement.

    PubMed Central

    Payne, B C; Lyons, T F; Neuhaus, E

    1984-01-01

    The quality of ambulatory medical care provided by 1,135 physicians in five separate practice settings in the Midwest was measured using predetermined process criteria. Specialists performed better in their own areas of specialized training than did family/general practitioners or specialists performing outside their specialty areas. Physicians with fewer years of practice performed somewhat better than physicians with more years since medical school graduation. Board certification was not consistently related to performance. Performances of the physicians improved following quality assurance interventions in these sites. Differences in the rates of change in performance quality were not consistently related to any of the physician characteristics studied. PMID:6746295

  14. The Role of Family Involvement in Predicting Student-Teacher Relationships and Academic and Behavioral Outcomes for Children of Immigrants

    ERIC Educational Resources Information Center

    Ryce, Patrice

    2012-01-01

    Using a multi-ethnic, socioeconomically varied sample of children of immigrants attending Islamic and public schools from first through third grade, this dissertation examined the degree to which school-based family involvement predicted teacher perceptions of value differences with parents, teacher expectations, child externalizing behavioral…

  15. Parenting and Academic Socialization as They Relate to School Readiness: The Roles of Ethnicity and Family Income.

    ERIC Educational Resources Information Center

    Hill, Nancy E.

    2001-01-01

    Relationships between parenting and children's school readiness were examined within socioeconomically comparable samples of African American and Euro-American kindergarten children, mothers, and teachers. Although similarities existed across ethnic groups in the relationships between parenting and school performance, family income moderated…

  16. How Academic Psychiatry Can Better Prepare Students for Their Future Patients: Part II--A Course in Ultra-Brief Initial Diagnostic Screening Suitable for Future Primary Care Physicians

    ERIC Educational Resources Information Center

    Lake, C. Raymond

    2008-01-01

    Depression is inadequately treated in primary care (PC), primarily because of a failure to recognize symptoms of depression. The results can be catastrophic and include death by suicide. The prevention of suicide is a critical function of physicians. The recognition of depression is the first step to preventing suicide because suicide…

  17. Reconceptualizing Academic Support

    ERIC Educational Resources Information Center

    Vantine, Laura

    2016-01-01

    Over the past 30 years, more and more independent schools have established academic support programs and learning centers to address their students' individual learning needs. Perhaps not surprisingly, as the number of students being evaluated has increased, even more families have requested academic accommodations and services for their children.…

  18. Criteria for selection of future physicians.

    PubMed Central

    Sade, R M; Stroud, M R; Levine, J H; Fleming, G A

    1985-01-01

    Academic achievement correlates poorly with clinical performance of physicians, so it is probably more important to select college students for medical school admission who will be superior physicians than to select those who will be excellent medical students. Before such selection criteria can be developed, a valid description of a superior physician must be determined. The relative importance of 87 characteristics of a superior physician, based on a previously published list, was determined by asking medical school faculty members to rate them. The resulting description of a superior physician is valid, because it correlated very highly (r = 0.87, p less than 0.001) with the published ratings of the same characteristics from decades earlier in another part of the country, and because it was constant across many subgroups. The faculty was also asked to rate how easily each characteristic could be taught, and those ratings were validated by high correlations across several subgroups. The importance and the teachability ratings were combined into a nonteachable-important index (NTII) that provides a rank order of traits that are important but cannot be taught easily. These are the characteristics that should be used in selecting future physicians. PMID:3970604

  19. Attitudes of patients and physicians regarding physician dress and demeanor in the emergency department.

    PubMed

    Colt, H G; Solot, J A

    1989-02-01

    To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED. PMID:2783838

  20. Legalizing physician-assisted suicide: some thoughts and concerns.

    PubMed

    Koenig, H G

    1993-08-01

    Surveys show that most Americans favor the decriminalization of physician-assisted suicide in certain circumstances. Several states are now considering legislation to bring this about and make the United States the first place in the civilized world where physician aid in dying is sanctioned. In the Netherlands, where physician-assisted suicide is practiced but officially remains illegal, 85% of assisted suicides occur in the elderly, and most involve the help of general practitioners. In the United States, family physicians provide health care to many older adults with chronic or terminal illness whose numbers will increase as the elderly population expands. The legalization of physician-assisted suicide would affect the way American physicians practice medicine in unpredictable ways, yet physicians are participating relatively little in deliberations concerning this issue. The problem of suffering in persons with chronic and terminal illness cannot be ignored. Compassionate, effective, and ethical solutions must be found. As a former family physician and now geriatric psychiatrist, I review the pros and cons of physician-assisted suicide (emphasizing arguments against legalization) and encourage family physicians to debate this matter. PMID:8336099

  1. Where should family medicine papers be published - following the impact factor?

    PubMed

    Peleg, Roni; Shvartzman, Pesach

    2006-01-01

    Academic institutions weigh the research contribution of family physicians and take this factor into account when determining eligibility for the candidates' promotion. Among other parameters, these institutions consider the journals in which family physicians publish. In this respect, the impact factor (IF) has gained a foothold as one of the most accepted means to measure this contribution. The IF may be a measure of the main importance of a scientific journal. IF has a huge, but controversial, influence on the perception and evaluation of published scientific research. It is important for family physicians to understand and be aware of the importance of the IF and the way it is calculated. The IF is one consideration in the decision-making process of a researcher as to where to publish because the IF of most family medicine journals is less than 2.0. Thus publication in these journals might not yield the proper "score" for academic promotion in many institutions. On the other hand, publication in journals with higher IF that are not necessarily widely read by primary care physicians could result in a small impact of their findings on direct patient care. PMID:17090797

  2. The Development of Cognitive Skills and Gains in Academic School Readiness for Children from Low-Income Families

    PubMed Central

    Welsh, Janet A.; Nix, Robert L.; Blair, Clancy; Bierman, Karen L.; Nelson, Keith E.

    2010-01-01

    This study examined developmental associations between growth in domain-general cognitive processes (working memory and attention control) and growth in domain-specific skills (emergent literacy and numeracy) across the pre-kindergarten year, and their relative contributions to kindergarten reading and math achievement. One hundred sixty-four Head Start children (44% African American or Latino; 57% female) were followed longitudinally. Path analyses revealed that working memory and attention control predicted growth in emergent literacy and numeracy skills during the pre-kindergarten year, and furthermore, that growth in these domain-general cognitive skills made unique contributions to the prediction of kindergarten math and reading achievement, controlling for growth in domain-specific skills. These findings extend research highlighting the importance of working memory and attention control for academic learning, demonstrating the effects in early childhood, prior to school entry. We discuss the implications of these findings for pre-kindergarten programs, particularly those designed to reduce the school readiness gaps associated with socio-economic disadvantage. PMID:20411025

  3. African leaders’ views on critical human resource issues for the implementation of family medicine in Africa

    PubMed Central

    2014-01-01

    Background The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. Method In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. Results There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Conclusions Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team

  4. Autism Speaks Toolkits: Resources for Busy Physicians.

    PubMed

    Bellando, Jayne; Fussell, Jill J; Lopez, Maya

    2016-02-01

    Given the increased prevalence of autism spectrum disorders (ASD), it is likely that busy primary care providers (PCP) are providing care to individuals with ASD in their practice. Autism Speaks provides a wealth of educational, medical, and treatment/intervention information resources for PCPs and families, including at least 32 toolkits. This article serves to familiarize PCPs and families on the different toolkits that are available on the Autism Speaks website. This article is intended to increase physicians' knowledge on the issues that families with children with ASD frequently encounter, to increase their ability to share evidence-based information to guide treatment and care for affected families in their practice. PMID:26149848

  5. Physician-Assisted Suicide

    Cancer.gov

    Module fourteen of the EPEC-O Self-Study Original Version focuses on the skills that the physician can use to respond both compassionately and confidently to a request, not on the merits of arguments for or against legalizing physician-assisted suicide (PAS) or euthanasia.

  6. Negotiation for physicians.

    PubMed

    Hill, Micah J; DeCherney, Alan H

    2013-05-01

    Physicians are involved in negotiations on a daily basis. Interactions with patients, support staff, nurses, fellow physicians, administrators, lawyers, and third parties all can occur within the context of negotiation. This article reviews the basic principles of negotiation and negotiation styles, models, and practical tools. PMID:23609153

  7. Physician drug dispensing.

    PubMed

    Lober, C W; Behlmer, S D; Penneys, N S; Shupack, J L; Thiers, B H

    1988-11-01

    We have reviewed the issue of physician drug dispensing by focusing upon quality of care, economic considerations, drug availability, patient compliance, safety, and increased governmental regulation. From a quality of care perspective, the increased use of pharmacist assistants, the tendency toward generic and therapeutic drug substitution, and the less specialized clinical education of pharmacists all pose hazards rather than safety checks upon physician prescribing. There is no evidence that pharmacists charge less than physicians. If they did, there would be no need to protect their incomes legislatively by restricting physician dispensing. Economic motivation per se is less important to a physician than providing a true convenience for his patients and thus encouraging a closer doctor-patient relationship. Physician dispensing adds to the availability of medication and may minimize the number of patients shuttling between pharmacies to obtain complex multi-ingredient preparations. Compliance is enhanced as availability increases. Prepackaged pharmaceuticals prepared under the auspices of pharmacists and dispensed by physicians are at least as safe as those prepared by the ungloved hands of a pharmacist hidden behind store counters. Thus, restricting the physician's right to dispense can negatively affect the quality of medical care, the cost of medications, safety, the availability of pharmaceuticals, and patient compliance. Such limitation is certainly not in the best interest of our patients. PMID:3056999

  8. Liabilities of a physician confronted with child abuse.

    PubMed

    Vansweevelt, Thierry

    2013-06-01

    Several research questions raises when physicians are confronted with a possible case of child abuse. First, there is a problem of professional secrecy. In most European countries, physicians have the right to speak when confronted with a state of emergency. In other countries, physicians have a duty to speak and alert the police when the life or physical integrity of a person is at stake. A second topic to be discussed involves the possible liability of physicians who do not report child abuse. By not reporting a case of possible child abuse, the physician is respecting the family life of the parents, even though the child might continue to suffer damages. Third and essentially, I analyse the possible liability of physicians who do inform the prosecutor ofa suspected child abuse. Specific criteria are elaborated to establish negligence when physicians report child abuse to the prosecutor. PMID:23984493

  9. Palestinian physicians' misconceptions about and approval of wife abuse.

    PubMed

    Haj-Yahia, Muhammad M

    2010-03-01

    The article presents the results of a study that examined Palestinian physicians' misconceptions about abused wives and abusive husbands and the extent to which Palestinian physicians approve of wife abuse. Self-administered questionnaires were completed by 396 physicians. The results revealed that between 10% and 49% of the Palestinian physicians held misconceptions about abused wives and between 15% and 63% held misconceptions about abusive husbands. The findings also revealed that substantial percentages of physicians tended to approve of moderate and severe violence against wives. Significant amounts of the variance in the physicians' approval of moderate and severe wife abuse can be attributed to their exposure to family violence and to their patriarchal ideology-variance over and above that which can be explained by the physicians' sociodemographic characteristics. The limitations of the study are discussed, as are the implications of the results for future research and theory development on the approaches of professionals toward wife abuse. PMID:19531634

  10. Effects of the Family Bereavement Program on Academic Outcomes, Educational Expectations and Job Aspirations 6 Years Later: The Mediating Role of Parenting and Youth Mental Health Problems

    PubMed Central

    Schoenfelder, Erin N.; Tein, Jenn-Yun; Wolchik, Sharlene; Sandler, Irwin N.

    2014-01-01

    Experiencing the death of a parent during childhood is associated with a variety of difficulties, including lower academic achievement, that have implications for functioning in childhood and adulthood. This study examines effects of the Family Bereavement Program (FBP), a preventive intervention for parentally-bereaved youth and their caregivers, on grade point averages (GPA), educational expectations and job aspirations of youths 6 years after the intervention. A total of 244 bereaved youths ages 8-16 and their caregivers were randomized to either the FBP or a comparison group that received books about bereavement. Assessments occurred at pretest, post-test, and 11-month and 6-year follow-ups. Direct program effects on educational outcomes and job aspirations 6 years later were non-significant, although the program improved educational expectations for children with fewer behavior problems at program entry, and GPA for younger children. Mediational pathways for program effects on educational outcomes were also tested. Program-induced improvements in effective parenting at 11-month follow-up were associated with higher GPAs at 6-year follow-up for youth who were younger or for whom more time had passed since the loss. Program-induced improvements in parenting and teacher-rated youth mental health problems at the 6-year follow-up mediated program effects on youths’ educational expectations for those with fewer behavior problems at program entry. The implications of these findings for understanding processes related to academic and educational outcomes following the death of a parent and for prevention efforts to help bereaved and other high-risk children succeed in school are discussed. PMID:25052624

  11. Effects of the Family Bereavement Program on academic outcomes, educational expectations and job aspirations 6 years later: the mediating role of parenting and youth mental health problems.

    PubMed

    Schoenfelder, Erin N; Tein, Jenn-Yun; Wolchik, Sharlene; Sandler, Irwin N

    2015-02-01

    Experiencing the death of a parent during childhood is associated with a variety of difficulties, including lower academic achievement, that have implications for functioning in childhood and adulthood. This study examines effects of the Family Bereavement Program (FBP), a preventive intervention for parentally-bereaved youth and their caregivers, on grade point averages (GPA), educational expectations and job aspirations of youths 6 years after the intervention. A total of 244 bereaved youths ages 8-16 and their caregivers were randomized to either the FBP or a comparison group that received books about bereavement. Assessments occurred at pretest, post-test, and 11-month and 6-year follow-ups. Direct program effects on educational outcomes and job aspirations 6 years later were non-significant, although the program improved educational expectations for children with fewer behavior problems at program entry, and GPA for younger children. Mediational pathways for program effects on educational outcomes were also tested. Program-induced improvements in effective parenting at 11-month follow-up were associated with higher GPAs at 6-year follow-up for youth who were younger or for whom more time had passed since the loss. Program-induced improvements in parenting and teacher-rated youth mental health problems at the 6-year follow-up mediated program effects on youths' educational expectations for those with fewer behavior problems at program entry. The implications of these findings for understanding processes related to academic and educational outcomes following the death of a parent and for prevention efforts to help bereaved and other high-risk children succeed in school are discussed. PMID:25052624

  12. Are Physicians Discussing Prostate Cancer Screening with Their Patients and Why or Why Not? A Pilot Study

    PubMed Central

    Jacobs, Samantha E.; Holmes, John H.; Shea, Judy A.

    2007-01-01

    BACKGROUND Prostate cancer screening (PCS) is controversial. Ideally, patients should understand the risks and benefits of screening before undergoing PSA testing. This study assessed whether primary care physicians routinely discuss PCS and explored the barriers to and facilitators of these discussions. METHODS Qualitative pilot study involving in-depth, semistructured interviews with 18 purposively sampled, academic and community-based primary care physicians. Barriers and facilitators of PCS discussions were ascertained using both interviews and chart-stimulated recall—a technique utilizing patient charts to probe recall and provide context to physician decision-making during clinic encounters. Analysis was performed using consensus conferences based on grounded theory techniques. RESULTS All 18 participating physicians reported that they generally discussed PCS with patients, though 6 reported sometimes ordering PSA tests without discussion. A PCS discussion occurred in only 16 (36%) of the 44 patient–physician encounters when patients were due for PCS that also met criteria for chart-stimulated recall. Barriers to PCS discussion were patient comorbidity, limited education/health literacy, prior refusal of care, physician forgetfulness, acute-care visits, and lack of time. Facilitators of PCS discussion included patient-requested screening, highly educated patients, family history of prostate cancer, African-American race, visits for routine physicals, review of previous PSA results, extra time during encounters, and reminder systems. CONCLUSIONS PCS discussions sometimes do not occur. Important barriers to discussion are inadequate time for health maintenance, physician forgetfulness, and patient characteristics. Future research should explore using educational and decision support interventions to involve more patients in PCS decisions. PMID:17549576

  13. Hospitals focus on physician relations.

    PubMed

    Rubright, R

    1987-09-01

    Many hospital administrators are shifting their marketing focus from consumers and referral agents to the hospital's attending physicians. These new comprehensive physician relations or retention programs are much broader than those implemented in the past and are used to build mutual exchanges between hospitals and physicians, sharpen the physicians' awareness of the hospital's most appealing attributes, compete with nearby hospitals that develop their own aggressive physician relations programs, and ensure a more promising financial picture for both parties. "Cutting-edge" physician relations plans in Catholic hospitals include the following: Marketing plans for the medical staff alone or with key medical staff sections; A strong physician data base; A physician referral system; A director of medical affairs; Practice enhancement and business assistance services; A young physicians section; Continuing marketing auditing and research into physicians' opinions, attitudes, and behavior patterns; Physician inclusion in all major programs, services, policies, and events; Programs for physician office staff; Marketing committees consisting of physicians. PMID:10283486

  14. Academic medicine in Russia.

    PubMed

    Burger, Edward J; Ziganshina, Lilia; Ziganshin, Airat U

    2004-12-01

    Academic medicine, along with professionalism of the medical community in Russia underwent a remarkable evolution from the Revolution through the decline of the Soviet Union. The Soviet period brought about an enormous expansion of numbers of admissions to medical schools and a corresponding increase in the number of new physicians. Academic medical institutions were separated from institutions of higher learning in general and medical science was separated from the mainstream of science. Many of these features have been reversed in the past 14 years and re-professionalization of medicine has resumed. PMID:15578798

  15. Revising the Definition of the Generalist Physician.

    ERIC Educational Resources Information Center

    Altman, David F.

    1995-01-01

    Although generalist physicians have traditionally been defined by their specialties (family, internal, pediatric medicine), this approach may not recognize specific competencies and training needed. A new definition based on functional requirements of generalist practice and the central role of the generalist in comprehensive care is proposed.…

  16. How Physicians Integrate Advances into Clinical Practices.

    ERIC Educational Resources Information Center

    Lockyer, Jocelyn M.; And Others

    1985-01-01

    Family physicians and specialists were asked to identify the sources of information they used in the process of making changes in their clinical practices. An average of 3.08 sources of information were utilized for each change and over 50 percent of the changes were complete in less than one year. (CT)

  17. The Changing Distribution of Physicians in Regionville.

    ERIC Educational Resources Information Center

    Sorensen, Andrew A.; Kunitz, Stephen J.

    1978-01-01

    The consequences of medical reform, the myth of the family doctor, the importance of foreign medical graduates in providing medical care, the importance of facilities and innovative practice settings for the attraction of physicians, and the significance of suburbanization in influencing the growth of the local service sector are addressed in this…

  18. Autism Spectrum Disorder Early Screening Practices: A Survey of Physicians

    ERIC Educational Resources Information Center

    Self, Trisha L.; Parham, Douglas F.; Rajagopalan, Jagadeesh

    2015-01-01

    The American Academy of Pediatrics (AAP) released a policy statement in 2007 urging physicians to screen for autism spectrum disorder (ASD) at 18 and 24 months. This study sought to identify the screening practices of pediatricians and family physicians (FPs) in following the AAP guidelines for ASD. A survey was mailed to 1,500 pediatricians and…

  19. Improving Physician-Patient Communication through Coaching of Simulated Encounters

    ERIC Educational Resources Information Center

    Ravitz, Paula; Lancee, William J.; Lawson, Andrea; Maunder, Robert; Hunter, Jonathan J.; Leszcz, Molyn; McNaughton, Nancy; Pain, Clare

    2013-01-01

    Objective: Effective communication between physicians and their patients is important in optimizing patient care. This project tested a brief, intensive, interactive medical education intervention using coaching and standardized psychiatric patients to teach physician-patient communication to family medicine trainees. Methods: Twenty-six family…

  20. Physicians' Knowledge of Alcohol, Tobacco and Folic Acid in Pregnancy

    ERIC Educational Resources Information Center

    Lefebvre, L. G.; Ordean, A.; Midmer, D.; Kahan, M.; Tolomiczenko, G.

    2007-01-01

    Objective: To assess: (1) physicians' knowledge and clinical confidence regarding problematic substance use in pregnancy compared to folic acid, and (2) physicians' desire for education in this area and their preferred learning modalities tools. Design: Self-administered survey. Setting: "Family Medicine Forum 2004" in Toronto, Canada.…

  1. The physician's response to climate change.

    PubMed

    Sarfaty, Mona; Abouzaid, Safiya

    2009-05-01

    Climate change will have an effect on the health and well-being of the populations cared for by practicing physicians. The anticipated medical effects include heat- and cold-related deaths, cardiovascular illnesses, injuries and mental harms from extreme weather events, respiratory illnesses caused by poor air quality, infectious diseases that emanate from contaminated food, water, or spread of disease vectors, the injuries caused by natural disasters, and the mental harm associated with social disruption. Within several years, such medical problems are likely to reach the doorsteps of many physicians. In the face of this reality, physicians should assume their traditional roles as medical professionals, health educators, and community leaders. Clinicians provide individual health services to patients, some of whom will be especially vulnerable to the emerging health consequences of global warming. Physicians also work in academic medical institutions and hospitals that educate and provide continuing medical education to students, residents, and practitioners. The institutions also produce a measurable carbon footprint. Societies of physicians at national, state, and local levels can choose to use their well-developed avenues of communication to raise awareness of the key issues that are raised by climate change as well as other environmental concerns that have profound implications for human health and well-being. PMID:19418286

  2. The Growth of a Family

    PubMed Central

    Carroll, June C.; Biringer, Anne

    1991-01-01

    Caring for a family during pregnancy and birth is an ideal opportunity for family physicians to assess family functioning and help the family adjust to the birth of a new child. Stress and support systems can influence the course of pregnancy, including obstetric and perinatal outcomes. A family-centered approach can help patients during this critical stage of family development. PMID:21229107

  3. Physician collective bargaining.

    PubMed

    Schiff, Anthony Hunter

    2009-11-01

    Current antitrust enforcement policy unduly restricts physician collaboration, especially among small physician practices. Among other matters, current enforcement policy has hindered the ability of physicians to implement efficient healthcare delivery innovations, such as the acquisition and implementation of health information technology (HIT). Furthermore, the Federal Trade Commission and Department of Justice have unevenly enforced the antitrust laws, thereby fostering an increasingly severe imbalance in the healthcare market in which dominant health insurers enjoy the benefit of largely unfettered consolidation at the cost of both consumers and providers. This article traces the history of antitrust enforcement in healthcare, describe the current marketplace, and suggest the problems that must be addressed to restore balance to the healthcare market and help to ensure an innovative and efficient healthcare system capable of meeting the demands of the 21st century. Specifically, the writer explains how innovative physician collaborations have been improperly stifled by the policies of the federal antitrust enforcement agencies, and recommend that these policies be relaxed to permit physicians more latitude to bargain collectively with health insurers in conjunction with procompetitive clinical integration efforts. The article also explains how the unbridled consolidation of the health insurance industry has resulted in higher premiums to consumers and lower compensation to physicians, and recommends that further consolidation be prohibited. Finally, the writer discusses how health insurers with market power are improperly undermining the physician-patient relationship, and recommend federal antitrust enforcement agencies take appropriate steps to protect patients and their physicians from this anticompetitive conduct. The article also suggests such steps will require changes in three areas: (1) health insurers must be prohibited from engaging in anticompetitive

  4. Remembering More Jewish Physicians.

    PubMed

    Weisz, George M; Grzybowski, Andrzej

    2016-01-01

    The history of medicine has been an intriguing topic for both authors. The modern relevance of past discoveries led both authors to take a closer look at the lives and contributions of persecuted physicians. The Jewish physicians who died in the Holocaust stand out as a stark example of those who merit being remembered. Many made important contributions to medicine which remain relevant to this day. Hence, this paper reviews the lives and important contributions of two persecuted Jewish physicians: Arthur Kessler (1903-2000) and Bronislawa Fejgin (1883-1943). PMID:27487308

  5. A Family Physician's Approach to Acne

    PubMed Central

    Turgeon, Eugene

    1981-01-01

    Because of the potential for permanent physical and psychological sequelae, acne vulgaris should be regarded as a true disease—not the “normal” physiologic response one might infer from its near universal prevalence in adolescence. Effective therapy reduces pilosebaceous unit obstruction, minimizes secondary inflammation, and lessens the chance of significant scarring. This article reviews current therapeutic modalities, and suggests a sequence for implementation of specific agents. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5 PMID:21289790

  6. Marriage and Medicine: The Physician as Partner, Parent, and Person

    PubMed Central

    Christie-Seely, J.

    1986-01-01

    Physicians are beginning to see the need to heal themselves, and to change the statistics on their morbidity, mortality, and marital distress. Stress for physicians comes from five sources: the nature of the work, their training, their public image, their families, and themselves. Medical school stress as an ‘initiation rite’ is discussed. Three theoretical frameworks are described which will enable family physicians to take a closer look at their own marriages and families as well as those of patients. A systems orientation will help avoid blame of self or partner or parents; object relations theory clarifies the human tendency to repeat history; a theory connecting self-esteem and communication styles will allow physicians to be more open at work and with their families. The importance of developing priorities and meaningful interests outside medicine is also discussed. PMID:21267270

  7. Find an ACFAS Physician

    MedlinePlus

    ... Search Text Size Print Bookmark Find an ACFAS Physician Acceptance Policy By clicking on the "I Accept" ... Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Dem People's Rep Korea, Rebublic Of Kuwait Kyrgyzstan ...

  8. Physician Assistant profession (PA)

    MedlinePlus

    ... provide health care services under the direction and supervision of a doctor of medicine (MD) or a ... location as the PA. Most states allow physician supervision by telephone communication with periodic site visits. Supervising ...

  9. American College of Physicians

    MedlinePlus

    ... Health Policy Advocacy in Action Current Public Policy Papers ACP Policies & Recommendations Store Membership Benefits for Physicians ... Health Policy Advocacy in Action Current Public Policy Papers ACP Policies & Recommendations Store Search Google Appliance Enter ...

  10. Work Satisfaction and Performance of Physicians in Pediatric Outpatient Clinics

    PubMed Central

    Nathanson, Constance A.; Becker, Marshall H.

    1973-01-01

    The sources and consequences of variations in work satisfaction are investigated in a study of approximately 100 physicians in six pediatric outpatient clinics, half of them associated with teaching hospitals and half with community hospitals. Measures of work satisfaction, role conflict, and performance are related to physicians' perceived internal and external reward values, controlling for clinic attributes and physicians' background characteristics, and differences between the two clinic types are documented. Implications of the study results for potential conflict between outpatient care and academic aims in teaching hospitals are discussed and avenues of possible further research are suggested. PMID:4705214

  11. The Medical Home: Locus of Physician Formation

    PubMed Central

    Daaleman, Timothy P.

    2013-01-01

    Family medicine is currently undergoing a transformation and, amid such change, the medical home has emerged as the new polestar. This article examines the medical home through the lens of philosopher Alasdair MacIntyre and offers a perspective, informed by Hubert Dreyfus and Peter Senge, about medical homes as practical sites of formation for family physicians. The intellectual past of family medicine points to contextually sensitive patient care as a practice that is particular to the discipline, with the virtue of “placing patients within contexts over time” as a commonly held virtue. Dreyfus provides a model of knowledge and skill acquisition that is relevant to the training of family physicians in practical wisdom. In this model, there is a continuum from novice to more advanced stages of professional formation that is aided by rules that not only must be learned, but must be applied in greater contextually informed situations. Senge’s emphasis on learning organizations— organizations where people are continually learning how to learn together—presents a framework for evaluating the extent to which future medical homes facilitate or retard the formation of family physicians. PMID:18772299

  12. Complementary therapy use by cancer patients. Physicians' perceptions, attitudes, and ideas.

    PubMed Central

    O'Beirne, Maeve; Verhoef, Marja; Paluck, Elan; Herbert, Carol

    2004-01-01

    OBJECTIVE: To explore family physicians' perceptions of their cancer patients' use of complementary therapy. DESIGN: Qualitative pilot study. SETTING: British Columbia and Alberta. PARTICIPANTS: Rural and urban family physicians. METHOD: Five focus groups were conducted with a total of 28 participants. Content analysis of focus group transcripts. MAIN FINDINGS: Eight themes were identified: definition of complementary therapies, importance of holistic health, role of evidence, attitudes toward complementary therapies, perceptions of cancer patients' use of complementary therapies, patient-physician communication, perceptions of family physicians' role with respect to complementary therapies, and concerns about complementary therapies. Family physicians believed that many of their patients were using complementary therapies and that patients and physicians needed to communicate about this practice. CONCLUSION: The study increased understanding of physicians'perspectives on communication about complementary therapies and exposed issues that need to be addressed through education and research. PMID:15233371

  13. Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

    PubMed

    Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

    2016-01-01

    State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health. PMID:26813489

  14. General Grant: his physicians and his cancer.

    PubMed

    Steckler, R M; Shedd, D P

    1976-10-01

    In early June 1884, seven years after leaving office as President of the United States, General Ulysses S. Grant was found to have carcinoma of the right tonsillar pillar. The General's physicians kept a detailed record of the course of their patient's disease. Speaking was quite painful for the patient, and his words and thoughts have been preserved on the scraps of paper on which he communicated to family, physicians, and friends. The diagnosis, symptomatic treatment, and inexorably progressive course of General Grant's mouth cancer taking place in an atmosphere of personal financial ruin are discussed in detail. PMID:797264

  15. [The physician-patient relationship in glaucoma].

    PubMed

    Hamelin, N

    2008-07-01

    Healthcare of chronic pathologies, especially in glaucoma, which is asymptomatic for a long period of time, is based on a good, confident relationship between physicians and patients. This relationship has to be created, maintained, and reinforced throughout follow-up. The patient's information source is to a large extent the physician, who must provide all the necessary information concerning the disease, including the definition, prognosis, follow-up, and treatment. How the information is transmitted should be personally adapted to patients, taking into account their own and their family's psychological reactions. It is also important to keep in mind the factors influencing poor compliance when talking to our patients. PMID:18957912

  16. A Qualitative Study of Work-Life Choices in Academic Internal Medicine

    PubMed Central

    Isaac, Carol; Byars-Winston, Angela; McSorley, Rebecca; Schultz, Alexandra; Kaatz, Anna; Carnes, Mary L.

    2013-01-01

    The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career advancement. Semi-structured interviews were conducted with a purposeful sample of 18 residents and 34 faculty members representing male and female physicians at different career stages. Using thematic analysis, three themes emerged: 1) the love of being a physician (“Raison d’être”), 2) family obligations (“2nd Shift”), and 3) balancing work demands with non-work life (“Negotiating Academic Medicine”). Female researchers and educators reported more strategies for multiple role planning and management than female practitioners. Interventions aimed at enhancing academic internists’ planning and self-efficacy for multiple role management should be investigated as a potential means for increasing participation and facilitate advancement. PMID:23605099

  17. Cigaret Smoking and Lifestyle Modification: Patients' Views on Physicians' Roles

    PubMed Central

    Pederson, Linda; Vanderheyden, Debbie

    1986-01-01

    Six hundred and twenty-eight patients completed a Health Habits Questionnaire in family practice waiting rooms. The questions covered lifestyle and health habits, how to improve health, and what the family physician could do to help. Current smokers believed they should quit smoking, and some thought the physician could help by providing advice and encouragement. Physicians should continue to educate their patients about the health risks of smoking, to advise patients repeatedly, if necessary, to quit and to reinforce abstinence on a continuing basis. More research is needed, however, to assess the effectiveness of these recommendations in relation to long-term abstinence from cigarets. PMID:21267206

  18. Returns to physician human capital: evidence from patients randomized to physician teams.

    PubMed

    Doyle, Joseph J; Ewer, Steven M; Wagner, Todd H

    2010-12-01

    Physicians play a major role in determining the cost and quality of healthcare, yet estimates of these effects can be confounded by patient sorting. This paper considers a natural experiment where nearly 30,000 patients were randomly assigned to clinical teams from one of two academic institutions. One institution is among the top medical schools in the U.S., while the other institution is ranked lower in the distribution. Patients treated by the two programs have similar observable characteristics and have access to a single set of facilities and ancillary staff. Those treated by physicians from the higher ranked institution have 10-25% less expensive stays than patients assigned to the lower ranked institution. Health outcomes are not related to the physician team assignment. Cost differences are most pronounced for serious conditions, and they largely stem from diagnostic-testing rates: the lower ranked program tends to order more tests and takes longer to order them. PMID:20869783

  19. Being community-responsive physicians. Doing the right thing.

    PubMed Central

    Oandasan, Ivy; Malik, Rebecca; Waters, Ian; Lambert-Lanning, Anita

    2004-01-01

    OBJECTIVE: To explore how primary care physicians respond to a community's needs and challenges. DESIGN: Qualitative study using focus groups. SETTING: Fee-for-service practices or community health centres in downtown Toronto, Ont. PARTICIPANTS: Purposive sample of 21 community family physicians (10 women and 11 men). METHOD: Participants were invited to join focus groups of four to six physicians. Themes were derived from qualitative analysis of the data using grounded theory. MAIN FINDINGS: Three major themes were identified by these community-responsive physicians: they carry out specific roles (collaborator, health educator, advocate, resource, and tailor of care); they face several challenges, including lack of funding and a dysfunctional health care system; and they share common beliefs about practising medicine. Whether current health care structures support physicians to actually carry out these roles in practice, however, is unclear. CONCLUSION: This study increased understanding of how primary care physicians respond to community needs and what they experience in the process. PMID:15317233

  20. [Is gender of significance for specialization of physicians? An analysis of specialization degree among female and male physicians].

    PubMed

    Gjerberg, E; Hofoss, D

    1995-04-20

    Although there has been a substantial increase in the number of women in medicine, we still find strong gender differences in career patterns. Female physicians specialize to a lower degree than their male colleagues do, although the percentage who do so has increased in recent years. The gender difference in frequency of specialization is not an effect of female physicians' spending a longer time on specialist training. Our results indicate that female physicians, to a greater extent than their male colleagues have to choose between family and career. A larger percentage of female than of male physicians live alone, perhaps indicating that career demands a higher price for the former. However, the percentage of singles is, larger among older than among younger female physicians. We interpret this as indicating that the necessity to choose between career and family is not as strong as it used to be. PMID:7754497