Sample records for doctors
-
Kenny, David A; Veldhuijzen, Wemke; Weijden, Trudy van der; Leblanc, Annie; Lockyer, Jocelyn; Légaré, France; Campbell, Craig
2010-03-01
Doctor-patient communication is an interpersonal process and essential to relationship-centered care. However, in many studies, doctors and patients are studied as if living in separate worlds. This study assessed whether: 1) doctors' perception of their communication skills is congruent with their patients' perception; and 2) patients of a specific doctor agree with each other about their doctor's communication skills. A cross-sectional study was conducted in three provinces in Canada with 91 doctors and their 1749 patients. Doctors and patients independently completed questions on the doctor's communication skills (content and process) after a consultation. Multilevel modeling provided an estimate of the patient and doctor variance components at both the dyad-level and the doctor-level. We computed correlations between patients' and doctors' perceptions at both levels to assess how congruent they were. Consensus among patients of a specific doctor was assessed using intraclass correlation coefficient (ICC). The mean score of the rating of doctor's skills according to patients was 4.58, and according to doctors was 4.37. The dyad-level variance for the patient was .38 and for the doctor was .06. The doctor-level variance for the patient ratings was .01 and for the doctor ratings, .18. The correlation between both the patients' and the doctors' skills' ratings scores at the dyad-level was weak. At the doctor-level, the correlation was not statistically significant. The ICC for patients' ratings was .03 and for the doctors' ratings .76. Overall, this study suggests that doctors and their patients have a very different perspective of the doctors' communication skills occurring during routine clinical encounters. 2009 Elsevier Ltd. All rights reserved.
-
[Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].
Xie, Zheng; Qiu, Ze-qi; Zhang, Tuo-hong
2009-04-18
To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.
-
Hagihara, Akihito; Tarumi, Kimio; Odamaki, Misato; Nobutomo, Koichi
2005-12-01
As one of the factors related to doctor-shopping behaviour (i.e. consulting multiple doctors with regard to the same illness episode), very little has been revealed about the role of doctor explanation. We examined therefore the association between doctor explanation and doctor-shopping behaviour. The subjects were internist-patient pairs in Japan. Signal detection analysis (SDA) was used for the data analysis. Of the 303 patients, 84 patients engaged in doctor shopping (27.7%). The following results were obtained: (1) of the 19 relevant variables, the 'level of doctor explanation: treatment' was the most significant predictor of doctor-shopping behaviour (P < 0.01), and (2) with regard to their subjective evaluations of the sufficiency of their explanations about treatment or testing, the evaluations of the doctors, rather than those of the patient, were significant predictors of doctor-shopping behaviour. These results imply the following: (1) a patient's inability to understand a doctor's explanation about treatment, which results from a large gap between the perceptions of the patient and those of the doctor, is the most significant predictor of doctor-shopping behaviour, and (2) in the context of favourable patient-doctor interactions, when doctors feel their explanations are insufficient, they may be able to prevent doctor-shopping behaviour by providing relatively thorough explanations about treatment.
-
University strategy for doctoral training: the Ghent University Doctoral Schools.
Bracke, N; Moens, L
2010-01-01
The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.
-
Lambert, Trevor; Surman, Geraldine; Goldacre, Michael
2014-10-01
To seek doctors' views about the NHS as an employer, our surveys about doctors' career intentions and progression, undertaken between 1999 and 2013, also asked whether the NHS was, in their view, a good 'equal opportunities' employer for women doctors, doctors from ethnic minority groups and doctors with disabilities. Surveys undertaken in the UK by mail and Internet. UK medical graduates in selected graduation years between 1993 and 2012. Respondents were asked to rate their level of agreement with three statements starting 'The NHS is a good equal opportunities employer for…' and ending 'women doctors', 'doctors from ethnic minorities' and 'doctors with disabilities'. Of first-year doctors surveyed in 2013, 3.6% (78/2158) disagreed that the NHS is a good equal opportunities employer for women doctors (1.7% of the men and 4.7% of the women); 2.2% (44/1968) disagreed for doctors from ethnic minorities (0.9% of white doctors and 5.8% of non-white doctors) and 12.6% (175/1387) disagreed for doctors with disabilities. Favourable perceptions of the NHS in these respects improved substantially between 1999 and 2013; among first-year doctors of 2000-2003, combined, the corresponding percentages of disagreement were 23.5% for women doctors, 23.1% for doctors from ethnic minorities and 50.6% for doctors with disabilities. Positive views about the NHS as an equal opportunities employer have increased in recent years, but the remaining gap in perception of this between women and men, and between ethnic minority and white doctors, is a concern. © The Royal Society of Medicine.
-
ERIC Educational Resources Information Center
Baylor Coll. of Medicine, Houston, TX.
This workshop, written in both English and Spanish, focuses on improving communication between physician and patient. In the workshop, the trainers will talk about "building bridges" between patient and doctor by understanding the doctor's role and his/her duty to the patient. According to the workshop, a person's doctor should…
-
Doctors and romance: not only of interest to Mills and Boon readers.
Callister, Paul; Badkar, Juthika; Didham, Robert
2009-06-01
Internationally there is a growing demand for health services. Skilled health workers, including doctors, have a high degree of international mobility and New Zealand (NZ) stands out internationally in terms of the significant flows of doctors in and out of the country. Through changes in training of doctors in NZ and migration flows, there have been major shifts in the composition of the medical workforce in NZ since the mid-1980s. Studies of the changing nature of the medical workforce often focus on gender and migration separately as well as only considering doctors as individuals. The aim of this exploratory study is to examine the living arrangements of doctors, the composition of migrant doctors who are coming to NZ, and to understand the educational and employment status of the partners of doctors. This study is a descriptive analysis primarily using census data from 1986 through to 2006 and immigration data collected by the Department of Labour. Half of the female medical doctors approved for residence through the Skilled/Business stream migrated independently, while for male doctors less than athird came to NZ independently. Male migrant doctors were more likely to be partnered. Census data showed that people with medical backgrounds tend to partner with each other. However, these relationships are changing, as more women become doctors. In 1986 about 14% of male doctors had a nurse or midwife as a partner and nearly 9% had a doctor partner. By 2006 the proportion of partners of male doctors who were also doctors had risen to 16%, higher than the 9% who were nurses. For female doctors the changes are more dramatic. In 1986, 42% of female doctors in relationships had a doctor as a partner. By 2006, female doctors had increased substantially, but the percentage with a doctor partner had dropped to under athird. Well-qualified couples where one or both are doctors, have a greater propensityto live in main urban areas. Through official reports and extensive media coverage, the NZ public is well aware of local and national doctor shortages. There is also awareness, often through personal visits to a GP or hospital, of the significant rise in number of female and of foreign-born doctors. The choices doctors are making in living arrangements need to be taken into account when considering both national and international recruitment of medical staff. Researchers and policy makers may need to consider family migration issues more than they have in the past for doctors as well as for other migrant groups.
-
Pfeiffer, M; Dimitriadis, K; Holzer, M; Reincke, M; Fischer, M R
2011-04-01
Weight and quality of medical doctoral theses have been discussed in Germany for years. Doctoral study programs in various graduate schools offer opportunities to improve quality of medical doctoral theses. The purpose of this study was to demonstrate distinctions and differences concerning motivation, choice of subject and the dissertation process between doctoral candidates completing the doctoral seminar for doctoral students in the Ludwig-Maximilians-University (LMU) Munich and doctoral candidates doing their doctorate individually. All 4000 medical students of the LMU obtained an online-questionnaire which was completed by 767 students (19 % response rate). The theoretical framework of this study was based upon the Self-Determination-Theory by Deci and Ryan. Doctoral candidates completing the doctoral study program were more intrinsically motivated than doctoral candidates doing their doctorate individually; no difference was found in their extrinsic motivation. In regard to choice of subject and dissertation process the doctoral students in the seminar were distinguished from the individual group by having chosen a more challenging project. They anticipated a demanding dissertation process including conference participation, publishing of papers, etc. Intrinsic motivation correlates positively with choosing a challenging project and a demanding dissertation process. High intrinsic motivation seems to be very important for autonomous scholarly practice. Our results suggest that doctoral study programs have a positive impact on intrinsic motivation and interest in research. © Georg Thieme Verlag KG Stuttgart · New York.
-
Lee, Soon-Ho; Chang, Dong-Seon; Kang, O-Seok; Kim, Hwa-Hyun; Kim, Hackjin; Lee, Hyejung; Park, Hi-Joon; Chae, Younbyoung
2012-12-01
The aim of this study was to investigate whether a patient's preference for a doctor's face is associated with better assessments of relational empathy in the patient-doctor relationship after the first clinical consultation. A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients' preference for doctors' faces was assessed by a two alternative forced choice (2AFC) task, with 60 different pairs of six different Asian male doctors' faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient-doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure. The data of all patients' simulated preferences for a doctor's face and their assessment values of a doctor's relational empathy was compared, and no significant correlation was found between both values (r=-0.024, p>0.809). These findings suggest that the perceived empathy in the patient-doctor relationship is not influenced by the patient's preference for a certain doctor's face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctor's face does not seem to matter in developing a good patient-doctor relationship.
-
The patient and the computer in the primary care consultation.
Pearce, Christopher; Arnold, Michael; Phillips, Christine; Trumble, Stephen; Dwan, Kathryn
2011-01-01
Studies of the doctor-patient relationship have focused on the elaboration of power and/or authority using a range of techniques to study the encounter between doctor and patient. The widespread adoption of computers by doctors brings a third party into the consultation. While there has been some research into the way doctors view and manage this new relationship, the behavior of patients in response to the computer is rarely studied. In this paper, the authors use Goffman's dramaturgy to explore patients' approaches to the doctor's computer in the consultation, and its influence on the patient-doctor relationship. Observational study of Australian general practice. 141 consultations from 20 general practitioners were videotaped and analyzed using a hermeneutic framework. Patients negotiated the relationship between themselves, the doctor, and the computer demonstrating two themes: dyadic (dealing primarily with the doctor) or triadic (dealing with both computer and doctor). Patients used three signaling behaviors in relation to the computer on the doctor's desk (screen watching, screen ignoring, and screen excluding) to influence the behavior of the doctor. Patients were able to draw the doctor to the computer, and used the computer to challenge doctor's statements. This study demonstrates that in consultations where doctors use computers, the computer can legitimately be regarded as part of a triadic relationship. Routine use of computers in the consultation changes the doctor-patient relationship, and is altering the distribution of power and authority between doctor and patient.
-
The feminisation of Canadian medicine and its impact upon doctor productivity.
Weizblit, Nataly; Noble, Jason; Baerlocher, Mark Otto
2009-05-01
We examined the differences in work patterns between female and male doctors in Canada to gain insight into the effect of an increased number of female doctors on overall doctor productivity. Data on the practice profiles of female and male doctors across Canada were extracted from the 2007 National Physician Survey. A doctor productivity measure, 'work hours per week per population' (WHPWPP), was created, based on the number of weekly doctor hours spent providing direct patient care per 100,000 citizens. The predicted WHPWPP was calculated for a hypothetical time-point when the female and male doctor populations reach equilibrium. The differences in current and predicted WHPWPP were then analysed. Female medical students currently (2007) outnumber male medical students (at 57.8% of the medical student population). The percentage of practising doctors who are women is highest in the fields of paediatrics, obstetrics and gynaecology, psychiatry and family practice. Female doctors work an average of 47.5 hours per week (giving 30.0 hours of direct patient care), compared with 53.8 hours worked by male doctors (35.0 hours of direct patient care) (P < 0.01, chi(2) test). Female doctors tend to work less on call hours per week and see fewer patients while on-call. Female doctors are also more likely to take parental leave or a leave of absence (P < 0.01, chi(2) test). The difference in current and predicted WHPWPP was found to be 2.6%, equivalent to 1853 fewer full-time female doctors or 1588 fewer full-time male doctors. Gender appears to have a significant influence on the practice patterns of doctors in Canada. If the gender-specific work patterns described in the present study persist, an overall decrease in doctor productivity is to be anticipated.
-
Surman, Geraldine; Goldacre, Michael
2014-01-01
Objectives To seek doctors’ views about the NHS as an employer, our surveys about doctors’ career intentions and progression, undertaken between 1999 and 2013, also asked whether the NHS was, in their view, a good ‘equal opportunities’ employer for women doctors, doctors from ethnic minority groups and doctors with disabilities. Design and Setting Surveys undertaken in the UK by mail and Internet. Participants UK medical graduates in selected graduation years between 1993 and 2012. Main outcome measures Respondents were asked to rate their level of agreement with three statements starting ‘The NHS is a good equal opportunities employer for…’ and ending ‘women doctors’, ‘doctors from ethnic minorities’ and ‘doctors with disabilities’. Results Of first-year doctors surveyed in 2013, 3.6% (78/2158) disagreed that the NHS is a good equal opportunities employer for women doctors (1.7% of the men and 4.7% of the women); 2.2% (44/1968) disagreed for doctors from ethnic minorities (0.9% of white doctors and 5.8% of non-white doctors) and 12.6% (175/1387) disagreed for doctors with disabilities. Favourable perceptions of the NHS in these respects improved substantially between 1999 and 2013; among first-year doctors of 2000–2003, combined, the corresponding percentages of disagreement were 23.5% for women doctors, 23.1% for doctors from ethnic minorities and 50.6% for doctors with disabilities. Conclusions Positive views about the NHS as an equal opportunities employer have increased in recent years, but the remaining gap in perception of this between women and men, and between ethnic minority and white doctors, is a concern. PMID:25271275
-
Introduction of a junior doctors' handbook: an essential guide for new doctors
Ross, Daniella; Petrie, Claire; Tully, Vicki
2016-01-01
The transition period for new junior doctors is a daunting and challenging time, as vast amounts of information specific to each hospital, ward, and job must be learnt while maintaining patient care standards.[1] In NHS Tayside, Scotland, tips and guidance for each job are informally handed over from previous junior doctors to the next, resulting in an unreliable and unsustainable handover of information. Time must then be spent by new doctors learning the intricacies and practicalities of their new job, rather than spending time focusing on patient care. Our aim was to improve this transition period for new junior doctors to NHS Tayside through the creation and implementation of a junior doctors' handbook, which would provide information and practical advice on day to day life as a junior doctor. We hoped to implement this project by August 2015 to coincide with the arrival of these new doctors to NHS Tayside. Through repeat PDSA cycles we created a sustainable and reliable junior doctors' handbook, containing a centralised hub of information for doctors that was accessible through our health board's website. The junior doctors' handbook has been a highly beneficial resource that has been praised for its detailed information on all aspects of day to day life for doctors in NHS Tayside. Feedback also demonstrated that doctors felt the junior doctors' handbook had improved their efficiency. Our hope is that this project can continue to be developed within our hospital, but also to be used as an idea outside our health board to improve the transition period for new doctors on a wider scale. PMID:26893891
-
Choosing a doctor and hospital for your cancer treatment
... the doctor accepts your plan. Your Cancer Care Team You may already have a primary care doctor. ... doctors. Often, these doctors work together as a team, so you will likely work with more than ...
-
Hao, Haijing
2015-06-01
Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers' attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95% CI 1.442-1.525) and an OR of 1.366 (95% CI 1.337-1.395), respectively. Quantitatively, traditional Chinese medicine doctors (P<.001) and gynecology-obstetrics-pediatrics doctors (P<.001) received more reviews than the combined small specialty areas. But internal medicine doctors received fewer reviews than the combined small specialty areas (P<.001). Also, the majority of quantitative reviews were positive-about 88% were positive for the doctors' treatment effect measure and 91% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors—internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries' online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor's real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China.
-
Mercer, Stewart W; Siu, Judy Y; Hillier, Sheila M; Lam, Cindy L K; Lo, Yvonne Y C; Lam, Tai Pong; Griffiths, Sian M
2010-06-04
Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong. The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method. Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs. Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed.
-
Smith, Fay; Goldacre, Michael J; Lambert, Trevor W
2017-05-01
Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.
-
Goldacre, Michael J; Lambert, Trevor W
2017-01-01
Summary Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question ‘Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?’, 44% of doctors answered ‘yes’. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered ‘yes’ cited ‘stress/work–life balance/workload’ as an adverse effect, and 45% mentioned illness. In response to the statement ‘The NHS of today is a good employer when doctors become ill themselves’, 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers. PMID:28504070
-
West, Thomas F.; Buckley, W. E.; Denegar, Craig R.
2001-01-01
Objective: The study had 3 objectives: (1) to assess the educational history of doctoral-educated certified athletic trainers (ATCs) who work at academic institutions, (2) to determine the current employment characteristics of doctoral-educated ATCs who work at academic institutions, and (3) to identify which competencies doctoral-educated ATCs feel are important for new doctoral graduates to possess upon graduation. Design and Setting: Multiple sources were used to identify doctoral-educated ATCs who work at academic institutions. These individuals were surveyed to assess their educational histories, current employment characteristics, and opinions on desired competencies for new doctoral graduates. Data were analyzed using descriptive and inferential statistics. Subjects: Surveys were sent to 130 individuals, and the response rate was 89.2% (n = 116). Measurements: Subjects answered questions regarding their educational history and employment characteristics. A 5-point Likert scale was used to assess the importance of 22 competencies for new doctoral graduates to possess upon graduation. Comparisons were made between program directors and non–program directors, respondents employed at doctoral-granting institutions and non–doctoral-granting institutions, and doctoral student advisors and non-advisors. Results: Subjects reported several different educational backgrounds, job titles, and job responsibilities. Significant differences in job responsibilities and assessment of desired competencies were found between program directors and non–program directors, employees of doctoral-granting institutions and non–doctoral-granting institutions, and doctoral student advisors and non-advisors. Conclusions: As new doctoral programs are established in athletic training, students should receive training as classroom instructors and program administrators, in addition to learning the skills necessary to perform independent research in athletic training. PMID:12937515
-
Colds and the flu - what to ask your doctor - adult
... to ask your doctor about colds and the flu - adult; Influenza - what to ask your doctor - adult; Upper respiratory ... what to ask your doctor - adult; H1N1 (Swine) flu - what to ask your doctor - adult
-
ERIC Educational Resources Information Center
Wildy, Helen; Peden, Sanna; Chan, Karyn
2015-01-01
Doctoral education is going through a period of transition. This transition is evident in the many varieties of doctoral degrees currently offered in higher education institutions worldwide, from the traditional research-based Doctor of Philosophy (PhD) to the Professional Doctorate and the New Route PhD. This article reports on a study which…
-
2015-01-01
Background Since the time of Web 2.0, more and more consumers have used online doctor reviews to rate their doctors or to look for a doctor. This phenomenon has received health care researchers’ attention worldwide, and many studies have been conducted on online doctor reviews in the United States and Europe. But no study has yet been done in China. Also, in China, without a mature primary care physician recommendation system, more and more Chinese consumers seek online doctor reviews to look for a good doctor for their health care concerns. Objective This study sought to examine the online doctor review practice in China, including addressing the following questions: (1) How many doctors and specialty areas are available for online review? (2) How many online reviews are there on those doctors? (3) What specialty area doctors are more likely to be reviewed or receive more reviews? (4) Are those reviews positive or negative? Methods This study explores an empirical dataset from Good Doctor website, haodf.com—the earliest and largest online doctor review and online health care community website in China—from 2006 to 2014, to examine the stated research questions by using descriptive statistics, binary logistic regression, and multivariate linear regression. Results The dataset from the Good Doctor website contained 314,624 doctors across China and among them, 112,873 doctors received 731,543 quantitative reviews and 772,979 qualitative reviews as of April 11, 2014. On average, 37% of the doctors had been reviewed on the Good Doctor website. Gynecology-obstetrics-pediatrics doctors were most likely to be reviewed, with an odds ratio (OR) of 1.497 (95% CI 1.461-1.535), and internal medicine doctors were less likely to be reviewed, with an OR of 0.94 (95% CI 0.921-0.960), relative to the combined small specialty areas. Both traditional Chinese medicine doctors and surgeons were more likely to be reviewed than the combined small specialty areas, with an OR of 1.483 (95% CI 1.442-1.525) and an OR of 1.366 (95% CI 1.337-1.395), respectively. Quantitatively, traditional Chinese medicine doctors (P<.001) and gynecology-obstetrics-pediatrics doctors (P<.001) received more reviews than the combined small specialty areas. But internal medicine doctors received fewer reviews than the combined small specialty areas (P<.001). Also, the majority of quantitative reviews were positive—about 88% were positive for the doctors' treatment effect measure and 91% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors—internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Conclusions Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries’ online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor’s real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China. PMID:26032933
-
Bismark, Marie M; Spittal, Matthew J; Gurrin, Lyle C; Ward, Michael; Studdert, David M
2013-01-01
Objectives (1) To determine the distribution of formal patient complaints across Australia's medical workforce and (2) to identify characteristics of doctors at high risk of incurring recurrent complaints. Methods We assembled a national sample of all 18 907 formal patient complaints filed against doctors with health service ombudsmen (‘Commissions’) in Australia over an 11-year period. We analysed the distribution of complaints among practicing doctors. We then used recurrent-event survival analysis to identify characteristics of doctors at high risk of recurrent complaints, and to estimate each individual doctor's risk of incurring future complaints. Results The distribution of complaints among doctors was highly skewed: 3% of Australia's medical workforce accounted for 49% of complaints and 1% accounted for a quarter of complaints. Short-term risks of recurrence varied significantly among doctors: there was a strong dose-response relationship with number of previous complaints and significant differences by doctor specialty and sex. At the practitioner level, risks varied widely, from doctors with <10% risk of further complaints within 2 years to doctors with >80% risk. Conclusions A small group of doctors accounts for half of all patient complaints lodged with Australian Commissions. It is feasible to predict which doctors are at high risk of incurring more complaints in the near future. Widespread use of this approach to identify high-risk doctors and target quality improvement efforts coupled with effective interventions, could help reduce adverse events and patient dissatisfaction in health systems. PMID:23576774
-
The patient and the computer in the primary care consultation
Arnold, Michael; Phillips, Christine; Trumble, Stephen; Dwan, Kathryn
2011-01-01
Objective Studies of the doctor–patient relationship have focused on the elaboration of power and/or authority using a range of techniques to study the encounter between doctor and patient. The widespread adoption of computers by doctors brings a third party into the consultation. While there has been some research into the way doctors view and manage this new relationship, the behavior of patients in response to the computer is rarely studied. In this paper, the authors use Goffman's dramaturgy to explore patients' approaches to the doctor's computer in the consultation, and its influence on the patient–doctor relationship. Design Observational study of Australian general practice. 141 consultations from 20 general practitioners were videotaped and analyzed using a hermeneutic framework. Results Patients negotiated the relationship between themselves, the doctor, and the computer demonstrating two themes: dyadic (dealing primarily with the doctor) or triadic (dealing with both computer and doctor). Patients used three signaling behaviors in relation to the computer on the doctor's desk (screen watching, screen ignoring, and screen excluding) to influence the behavior of the doctor. Patients were able to draw the doctor to the computer, and used the computer to challenge doctor's statements. Conclusion This study demonstrates that in consultations where doctors use computers, the computer can legitimately be regarded as part of a triadic relationship. Routine use of computers in the consultation changes the doctor–patient relationship, and is altering the distribution of power and authority between doctor and patient. PMID:21262923
-
EHR adoption among doctors who treat the elderly.
Yeager, Valerie A; Menachemi, Nir; Brooks, Robert G
2010-12-01
The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilization of an important quality-enhancing health information technology application. This study is based on a primary survey of a large, statewide sample of doctors practising in outpatient settings in Florida. Logistic regression analysis was used to determine whether doctors who treat a high volume of elderly (HVE) patients were different with respect to EHR adoption. Our analyses included responses from 1724 doctors. In multivariate analyses controlling for doctor age, training, computer sophistication, practice size and practice setting, HVE doctors were significantly less likely to adopt EHR. Specifically, compared with their counterparts, HVE doctors were observed to be 26.7% less likely to be utilizing an EHR system (OR=0.733, 95% CI 0.547-0.982). We also found that doctor age is negatively related to EHR adoption, and practice size and doctor computer savvy-ness is positively associated. Despite the fact that EHR adoption has improved in recent years, doctors in Florida who serve the elderly are less likely to adopt EHRs. As long as HVE doctors are adopting EHR systems at slower rates, the elderly patients treated by these doctors will be at a disadvantage with respect to potential benefits offered by this technology. © 2010 Blackwell Publishing Ltd.
-
Colds and the flu - what to ask your doctor - child
... to ask your doctor about colds and the flu - child; Influenza - what to ask your doctor - child; Upper respiratory ... URI - what to ask your doctor - child; Swine flu (H1N1) - what to ask your doctor - child
-
Cheraghi, Mohammad-Ali; Jasper, Melanie; Vaismoradi, Mojtaba
2014-01-01
Nurses with doctorates are increasing in number throughout the world, yet the multitude of roles they play following graduation is unclear. The purpose of this study was to explore and describe clinical nurses' perceptions and expectations of the role of doctorally-prepared nurses in Iran. A qualitative study, using a content analysis approach was conducted with 43 clinical nurses chosen using a purposive sampling strategy. Oral, semi-structured and written interviews were used to generate data. During data analysis, three main themes emerged; "advantages of the doctoral degree", "clarification of doctorally-prepared nurses' role in clinical practice", and "unmet expectations of doctorally-prepared nurses". An understanding of the expectations of nurses on the role of doctorally-prepared nurses is needed to improve the collaboration between clinical nurses and doctorally-prepared nurses; remove misunderstandings on the abilities and skills of doctorally-prepared nurses; incorporate the expectations into doctoral education in order to facilitate their collaboration; and also remove the theory and practice gap through the utilisation of doctorally-prepared nurses' knowledge and skills in practice. Copyright © 2013 Elsevier Ltd. All rights reserved.
-
[Comparison of British and French expatriate doctors' characteristics and motivations].
Abbas, R; Carnet, D; D'Athis, P; Fiet, C; Le Breton, G; Romestaing, M; Quantin, C
2015-02-01
Migration of medical practitioners is rarely studied despite its importance in medical demography: the objective of this study was to analyze the characteristics and motivations of the French doctors settled in the United Kingdom and of the British doctors settled in France. This cross-sectional study was conducted using a self-completed questionnaire sent to all French doctors practicing in the United Kingdom (in 2005) and all British medicine doctors practicing in France (in 2009). The doctors were identified with official data from the National Medical Councils: 244 French doctors practicing in the United Kingdom and 86 British doctors practicing in France. The questionnaire was specifically developed to determine the reasons of moving to the other country, and the level of satisfaction after expatriation. A total of 98 French doctors (out of 244) and 40 British doctors (out of 86) returned the questionnaire. Respondents were mainly general practitioners with a professional experience of 8 to 9 years. The sex ratio was near 1 for both groups with a majority of women among physicians under 50 years. The motivations were different between groups: French doctors were attracted by the conditions offered at the National Health Service, whereas British doctors were more interested in opportunities for career advancement, joining husband or wife, or favourable environmental conditions. Overall, the respondents considered expatriation as satisfactory: 84% of French doctors, compared with only 58% of British doctors, were satisfied with their new professional situation. This study, the first in its kind, leads to a clearer understanding of the migration of doctors between France and the United Kingdom. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
-
Li, Xiaohong; Cochran, Christopher; Lu, Jun; Shen, Jay; Hao, Chao; Wang, Ying; Sun, Mei; Li, Chengyue; Chang, Fengshui; Hao, Mo
2015-01-01
As the most important public health service providers in rural China, village doctors are facing a new challenge of heavier workload resulting from the recent policy of public health service equalization. Studies on the shortage of village doctors, mainly based on the national statistics, have so far been very broad. This study conducted detailed field surveys to identify specific factors of and potential solutions to the shortage in village doctors. Eight hundred forty-four village doctors and 995 health decision makers and providers were surveyed through a questionnaire, and some of them were surveyed by in-depth face-to-face interviews and focus group interviews. Opinions on the shortage in village doctors and the potentially effective approaches to addressing the problem were sought. Some village doctors (51.3%) were at least 50 years old. Some village doctors (92.3%) did not want their children to become a village doctor, and the main reasons were "low salary" and "lack of social security". Village doctors felt that it was difficult to provide all the required public health services. Local residents indicated that they established good relationships with village doctors. Some health decision makers and providers (74.0%) thought that they needed more village doctors. The shortage in village doctors presents a major obstacle toward the realization of China's policy of public health service equalization. The aging of current village doctors exacerbates the problem. Policies and programs are needed to retain the current and attract new village doctors into the workforce. Separate measures are also needed to address disparities in socioeconomic circumstance from village to village. Copyright © 2014 John Wiley & Sons, Ltd.
-
Empathy and the wounded healer: a mixed-method study of patients and doctors views on empathy.
Brady, C; Bambury, R M; O'Reilly, S
2015-04-01
Empathy is increasingly being recognized as a crucial component for an effective doctor-patient relationship. Using a mixed method approach, we surveyed 125 patients and 361 medical practitioners (doctors and medical students) views of the doctor-patient relationship. We qualitatively assessed patients' views of what constituted a good doctor and qualitatively measured empathy using a validated scale in medical practitioners. Patients desire a doctor that is both clinically proficient 66 (55%) and caring 32 (27%). Doctors who have a personal experience of illness have a statistically higher empathy score. These doctors may be well placed to help develop and foster empathy in our profession.
-
Using Performance Measures to Motivate ‘Report-Averse’ and ‘Report-Loving’ Agents
Glazer, Jacob; McGuire, Thomas G.; Newhouse, Joseph P.
2013-01-01
In designing a quality report, a health plan needs to account for the report's effect on the doctor, hospital or other provider. This paper proposes a simple model of how quality reporting affects a health care provider, using the example of a doctor subject to reporting with a “cut point” that designates the doctor as above or below some standard. Choice of cut point affects the doctor's welfare through the doctor's preferences about income and by affecting market demand for the doctor's services. These factors lead doctors to be “report-averse” or “report-loving,” a determination that affects a health plan's cost to enlist a doctor in a contract with reporting and that guides choice of a cut point to maximize the doctors' effort to improve her quality. PMID:17996319
-
Li, Xiaohong; Shen, Jay J; Yao, Fang; Jiang, Chunxin; Chang, Fengshui; Hao, Fengfeng; Lu, Jun
2018-05-11
Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors' perceptions of whether that training helps them pass the exam and whether it improves their skills. Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire in July 2012. Chi-square test and Fisher exact test were used to identify differences of attitudes about the exam and training between the rural doctors and certified (assistant) doctors. Longitudinal annual statistics (1980-2014) of village doctors were further analyzed. Eight hundred and forty-four village doctors were asked to participate, and 837 (99.17%) responded. Only 14.93% of the respondents had received physician (assistant) certification. Only 49.45% of the village doctors thought that the areas tested by the certification exam were closely related to the healthcare needs of rural populations. The majority (86.19%) felt that the training program was "very helpful" or "helpful" for preparing for the exam. More than half the village doctors (61.46%) attended the "weekly school". The village doctors considered the most effective method of learning was "continuous training (40.36%)" . The majority of the rural doctors (89.91%) said they would be willing to participate in the training and 96.87% stated that they could afford to pay up to 2000 yuan for it. The majority of village doctors in Changzhou City perceived that neither the certification exam nor the training for it are closely related to the actual healthcare needs of rural residents. Policies and programs should focus on providing exam-preparation training for selected rural doctors, reducing training expenditures, and utilizing web-based methods. The training focused on rural practice should be provided to all village doctors, even certified physicians. The government should also adjust the local licensing requirements to attract and recruit new village doctors.
-
Trend in unequal geographical distribution of doctors by age and sex in Japan from 2004 to 2014.
Morita, T; Tanimoto, T; Morita, M; Tsubokura, M; Kami, M
2018-06-01
In Japan, the proportion of female doctors and elderly doctors is increasing as in other countries. We investigated the relationship between doctors' demographic changes and their geographical distribution. A national database study. We assessed trends in unequal geographical distribution of the number of doctors by sex and age from 2004 to 2014 in Japan. The Gini coefficient values for the number of female doctors (0.18) were larger than those for male doctors across all generations (0.13-0.14). The Gini coefficient values for the number of elderly doctors aged 60 years and older (male: 0.12, female: 0.18-0.23) were larger than those for majority age groups aged 40-59 years (male: 0.10, female: 0.16-0.17). The persisting geographical maldistribution of doctors may be associated with demographic changes, such as increase in the number of female doctors. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
-
Patient-doctor agreement on recall of clinical trial discussion across cultures.
Bernhard, J; Aldridge, J; Butow, P N; Zoller, P; Brown, R; Smith, A; Juraskova, I
2013-02-01
The purpose was to investigate patient-doctor agreement on clinical trial discussion cross-culturally. In the International Breast Cancer Study Group Trial 33-03 on shared decision-making for early breast cancer in Australian/New Zealand (ANZ) and Swiss/German/Austrian (SGA) centers, doctor and patient characteristics plus doctor stress and burnout were assessed. Within 2 weeks post-consultation about treatment options, the doctor and patient reported independently, whether a trial was discussed. Odds ratios of agreement for covariables were estimated by generalized estimating equations for each language cohort, with doctor as a random effect. In ANZ, 21 doctors and 339 patients were eligible; in SGA, 41 doctors and 427 patients. In cases where the doctor indicated 'no trial discussed', 82% of both ANZ and SGA patients agreed; if the doctor indicated 'trial discussed', 50% of ANZ and 38% of SGA patients agreed, respectively. Factors associated with higher agreement were: low tumor grade and fewer patients recruited into clinical trials in SGA; public institution, patient born in ANZ (versus other), higher doctor depersonalization and personal accomplishment in ANZ. There is discordance between oncologists and their patients regarding clinical trial discussion, particularly when the doctor indicates that a trial was discussed. Factors contributing to this agreement vary by culture.
-
Johnson, Anya; Nguyen, Helena; Parker, Sharon K; Groth, Markus; Coote, Steven; Perry, Lin; Way, Bruce
2017-06-19
Purpose The purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors' learning and improve patient management during the overtime shift. Design/methodology/approach A mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 "regular" shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews. Findings The intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors' engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors' total tasks. Interviews suggested the initiative reduced junior doctors' work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being. Originality/value Junior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors' learning and well-being.
-
Cao, Weidan; Qi, Xiaona; Yao, Ting; Han, Xuanye; Feng, Xujing
2017-05-01
The study is to examine the relationships between perceived initial cancer disclosure communication with doctors, levels of hope, and levels of trust in doctors among cancer patients in China. A total number of 192 cancer inpatients in a cancer hospital in China were surveyed. Perceived disclosure strategies, levels of hope, levels of trust in their doctors, as well as the demographic information were obtained from the participants. In addition to age, patients who had higher levels of perceived emotional support from doctors, or higher levels of perceived personalized disclosure from doctors, or higher levels of perceived discussion of multiple treatment plans with doctors were more likely to have higher levels of trust in doctors. In addition to perceived health status, perceived emotional support from doctors significantly predicted participants' levels of hope. That is, patients who had higher higher levels of perceived doctors' emotional support were more likely to have higher levels of hope. Key disclosure person was a marginally significant variable, that is, patients who were mainly disclosed by family members might have higher levels of hope compared with patients who were mainly disclosed by doctors. When communicating with a cancer patient, doctors might not ignore the importance of emotional support during cancer diagnosis communication. Doctors might want to involve family and collaborate with family to find out ways of personalized disclosure. During the communication process, doctors could provide their patients with multiple treatment options and discuss the benefits and side effects of each treatment. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
-
Some Thoughts on Doctoral Preparation in Mathematics Education
ERIC Educational Resources Information Center
Reys, Robert
2016-01-01
Arguments for significantly improving doctoral programs have long been made, both nationally and internationally. The nature and variety of doctoral programs makes it difficult to single out specific changes that would be equally applicable to every discipline-specific doctoral program. Therefore, this commentary will focus on doctoral programs…
-
Satisfaction among Current Doctoral Students in Special Education
ERIC Educational Resources Information Center
Wasburn-Moses, Leah
2008-01-01
Despite the growing demand for professionals with doctoral degrees in special education, doctoral programs are not producing enough graduates to fulfill this need. Although large attrition rates exist in doctoral study across discipline, very little is known about the attrition or satisfaction of doctoral students in special education. This…
-
Critical and Creative Thinking Nexus: Learning Experiences of Doctoral Students
ERIC Educational Resources Information Center
Brodin, Eva M.
2016-01-01
Critical and creative thinking constitute important learning outcomes at doctoral level across the world. While the literature on doctoral education illuminates this matter through the lens of experienced senior researchers, the doctoral students' own perspective is missing. Based upon interviews with 14 doctoral students from four disciplines at…
-
Supervising Doctoral Students: Variation in Purpose and Pedagogy
ERIC Educational Resources Information Center
Åkerlind, Gerlese; McAlpine, Lynn
2017-01-01
International policy changes that have prioritised increasing growth in the numbers of doctoral students have led to wide-ranging debate about the changing purpose of the doctorate. However, there has been little research aimed at investigating doctoral supervisors' views of the purpose of the doctorate, despite the significant role supervisors…
-
Understanding doctors' ethical challenges as role virtue conflicts.
McDougall, Rosalind
2013-01-01
This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis. © 2011 Blackwell Publishing Ltd.
-
Nurses' views on challenging doctors' practice in an acute hospital.
Churchman, J J; Doherty, C
To explore the extent to which nurses are willing to challenge doctors' practice in everyday situations in an acute NHS hospital. Qualitative data were collected using in-depth interviews with 12 nurses in an acute NHS hospital in England. Participants believed that they challenged doctors' practice and acted as patients' advocates. However, data revealed that nurses questioned doctors' practice only under specific circumstances. Nurses would not challenge doctors if they perceived that this would result in conflict or stress, if they were afraid of the doctor or feared reprisal. Nurses are discouraged from challenging doctors' practice by the structural inequality arising from the gender division of labour and doctors' expert knowledge and status (medical dominance) in the workplace.
-
200 junior doctors sacked in Zambia.
Ahmad, K
2000-07-29
Since December 1999 junior doctors in Zambia have been on strike, demanding from the government better working conditions, better pay, and improvements in hospital services. However, on June 20, 2000, around 200 junior doctors were dismissed by the Zambian government, who asserts that the action was taken in the public¿s interest. Nevertheless, the doctors argue that the move came at a time when the country is struggling with a critical shortage of doctors and with an HIV/AIDS crisis. In addition, health policy experts say that the dismissal could further undermine the alarming conditions of Zambia's health care system. It is noted that there are only 800 doctors registered with the Zambian Medical Council, but WHO estimates that the country needs 1500 clinicians. To meet such a shortage, the government has hired Cuban and Chinese doctors. They are paid more and given more benefits than the Zambian doctors, generating complaints from the president of the junior doctors' representative body.
-
The good doctor: the carer's perspective.
Levine, Carol
2004-01-01
Carers are family members, friends, and neighbours who perform medical tasks and personal care, manage housekeeping and financial affairs, and provide emotional support to people who are ill, disabled, or elderly. From a carer's perspective, the primary requisite for a good doctor is competence. Assuming equal technical skills and knowledge, the difference between 'good' and 'bad' doctors comes down to attitudes and behaviour-communication. An important aspect of communication is what doctors say to carers, and how they interpret what carers say to them. Body language-stances, gestures and expression-communicates as well. Good doctors are surrounded by courteous, helpful and efficient assistants. Doctors can make two types of errors in dealing with carers. Type 1 errors occur when doctors exclude the carer from decision making and information. Type 2 errors occur when doctors speak only to the carer and ignore the patient. Good doctors, patients and carers confront the existential meaning of illness together.
-
A comparison of Dutch family doctors' and patients' perspectives on nutrition communication.
van Dillen, S M E; Hiddink, G J
2008-12-01
In recent years, we have investigated both patients' and family doctors' communicative characteristics towards nutrition communication in general practice with several qualitative and quantitative studies. A sound comparison of the survey results between both conversation partners has not been made before. The aim of the present study was to put together data obtained by earlier studies for the first time in order to make comparisons of patients' and family doctors' communicative characteristics regarding nutrition communication. In The Netherlands, 603 patients completed a face-to-face interview-assisted questionnaire (65% response rate) and 267 family doctors completed a questionnaire (45% response rate). When comparing communicative characteristics, patients stronger believed that nutrition was an influence on health than family doctors. They also attributed a greater role to personal hygiene, stress and heredity, while family doctors were more convinced of the role of alcohol use and smoking on health. Patients more often rated their own nutrition knowledge as good than family doctors. In contrast, family doctors showed higher interest in nutrition and nutrition information than patients. As a result, a collinear model for family doctors and nutrition communication towards patients was provided. Significant differences between patients and family doctors were found for several communicative characteristics towards nutrition communication. It is important that family doctors become convinced that patients perceive them as a reliable and expert source of nutrition information. It is recommended that family doctors raise nutrition awareness among patients. Finally, we advise family doctors to pay attention to nutrition communication styles.
-
Itoh, Tsunetoshi
2009-01-01
In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.
-
Kerrien, Margaux; Pougnet, Richard; Garlantézec, Ronan; Pougnet, Laurence; Le Galudec, Mickaël; Loddé, Brice; Dewitte, Jean-Dominique
2015-04-01
The caregivers are exposed to several occupational hazards, including psychosocial risks. Among these occupational groups, junior doctors have been little studied. The aim of this study was to evaluate the prevalence of depression and anxiety among junior doctors and their links with their work. This is a prospective study using an anonymous online questionnaire between October 2011 and June 2012. Every junior doctor of Brest medical school was included without exclusion criteria. The questionnaire asked about demographic and health data. It included four validated scales: the Center for Epidemiologic Studies Depression Scale (CES-D), the Spielberger anxiety questionnaire, the Quality of Life Questionnaire of WHO (WHO-QOL) and the Job Content Questionnaire of Karasek. One hundred and ninety-two junior doctors were included; 68.2 % of them were women. They were 13.0 % suffering from depression; 28.7 % from anxiety; 32.8 % of junior doctors were in job strain and 29.7 % in iso strain. Depression was correlated with high psychological demands and anxiety. The lack of organizational support from senior doctors and competition between junior doctors increased the junior doctors' anxiety. A part of junior doctors is anxious and depressed, somehow due to the psychological demands of work and relationships with other junior doctors and with senior doctors. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
-
Moulin, Thierry
2013-01-01
Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived. Copyright © 2013 S. Karger AG, Basel.
-
The Role of Supervisors in Light of the Experience of Doctoral Students
ERIC Educational Resources Information Center
Begin, Christian; Gerard, Laetitia
2013-01-01
Doctoral supervision is one of the primary factors affecting doctoral degree completion and attrition rates. Basing their work on the concept of cognitive apprenticeship, the authors investigated the role that doctoral supervisors should adopt in supporting their students, in light of feedback from the latter. A total of 533 doctoral students…
-
An Initiative to Facilitate Practitioner Doctoral Students to Present at AERA
ERIC Educational Resources Information Center
Fenster, Mark J.
2009-01-01
The education doctorate is the most commonly awarded doctorate in academia. In preparation for developing and executing a piece of original research like a dissertation, doctoral students are required to take coursework in research and statistics. These courses can be considered part of a core set of competencies that doctoral students are…
-
Doctoral Student Learning Patterns: Learning about Active Knowledge Creation or Passive Production
ERIC Educational Resources Information Center
Vekkaila, Jenna; Pyhältö, Kirsi
2016-01-01
Doctoral studies are about learning to create new knowledge and to become a researcher. Yet surprisingly little is known about the individual learning patterns of doctoral students. The study aims to explore learning patterns among natural science doctoral students. The participants included 19 doctoral students from a top-level natural science…
-
Challenges to the Doctoral Journey: A Case of Female Doctoral Students from Ethiopia
ERIC Educational Resources Information Center
Bireda, Asamenew Demessie
2015-01-01
This study aimed to investigate some challenges female doctoral students experience in their doctoral journey. The study used a qualitative design and structured interviews. The theoretical framework that guided the study was that of Urie Bronfenbrenner's ecosystemic theory. A purposely selected sample of five female doctoral students from the…
-
Sensitising intern doctors to ethical issues in a doctor-patient relationship.
Shah, Nilima D; Mehta, Ritambhara Y; Dave, Kamlesh R
2017-01-01
There is a felt need in India to influence the ethical behaviour of doctors by giving students formal education in ethics in medical colleges. Since internship is the interface between learning and independent practice, it is important to sensitise intern doctors to ethical issues in a doctor-patient relationship at this stage.
-
ERIC Educational Resources Information Center
Nelson Russom, Lynn A.
2017-01-01
In many disciplines, the doctorate is the highest academic degree. Doctoral education is a complex process that includes transformation through knowledge acquisition and professional identity development (Gardner, 2009). Typically, the scope of the doctoral experience includes years of coursework, successfully passing a comprehensive or qualifying…
-
ERIC Educational Resources Information Center
Virtanen, V.; Taina, J.; Pyhältö, K.
2017-01-01
This study explored the causes of student disengagement from their doctoral studies in the biological and environmental sciences. The data came from interviews of 40 doctoral students (male = 15, female = 25) and underwent qualitative analysis for content. Our results showed that doctoral studies provide multiple contexts for disengagement, such…
-
Suicide In Doctors And Wives Of Doctors
Sakinofsky, Isaac
1980-01-01
This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them. PMID:21293651
-
Suicide in doctors and wives of doctors.
Sakinofsky, I
1980-06-01
This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them.
-
Jiang, Shaohai; Street, Richard L
2017-02-01
Based on Street's (2003) ecological framework of communication in medical encounters, this study examined personal, interpersonal, and media factors that could influence patients' use of the Internet to communicate with doctors. Results from data analysis of responses from the 2014 Health Information National Trends Survey showed that patient activation and ease of Internet access were two positive predictors of online doctor-patient communication. In addition, patients' trust in doctors positively moderated the relationships between patient activation and online doctor-patient communication, and between perceived health status and online doctor-patient communication. Finally, the quality of patients' past experiences communicating with doctors had a positive moderation effect on the association between health information seeking behavior and online doctor-patient communication. Implications and limitations are discussed.
-
The wealth of distinguished doctors: retrospective survey.
McManus, I C
2005-12-24
To assess changes in the wealth of distinguished doctors in the United Kingdom between 1860 and 2001. Retrospective survey. The UK. 980 doctors of sufficient distinction to be included in the Oxford Dictionary of National Biography and who died between 1860 and 2001. Wealth at death, based on probate records and adjusted relative to average earnings in 2002. The wealth of distinguished doctors declined substantially between 1860 and 2001, and paralleled a decline in the relative income of doctors in general. The wealth of distinguished doctors also declined relative to other groups of distinguished individuals. In the 19th century, distinction in doctors was accompanied by substantial wealth, whereas by the end of the 20th century, the most distinguished doctors were less wealthy than their contemporaries who had achieved national distinction in other areas.
-
Siu, Judy Yuen-Man
2014-02-06
Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients' illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants' social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients' unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants' sense of mismatch with these doctors, which induced them to shop for another doctor. Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their primary care providers. Primary care doctors' understanding on patients with overactive bladder with empathetic attitudes is important to reduce the motivations of doctor shopping behavior among these patients.
-
Wu, Tailai; Deng, Zhaohua; Zhang, Donglan; Buchanan, Paula R; Zha, Dongqing; Wang, Ruoxi
2018-07-01
The aim of this study is to investigate how doctor-consumer interaction in social media influences consumers' health information seeking and usage intention. Based on professional-client interaction theory and expectation confirmation theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interaction influence consumers' health information seeking and usage intention through consumer satisfaction and trust towards doctors. To validate our proposed research model, we employed the survey method. The measurement instruments for all constructs were developed based on previous literatures, and 352 valid answers were collected by using these instruments. Our results reveal that consumers' intention to seek health information significantly predicts their intention to use health information from social media. Meanwhile, both consumer satisfaction and trust towards doctors influences consumers' health information seeking and usage intention significantly. With regards to the impact of the interaction between doctors and consumers, the results show that both types of doctor-consumer interaction significantly affect consumer satisfaction and trust towards doctors. The mediation analysis confirms the mediation role of consumer satisfaction and trust towards doctors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as an effective intervention with low cost to promote consumers' health information seeking and usage. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. At last, consumer satisfaction and trust towards doctors could be considered as the important working mechanisms for the effect of doctor-consumer interaction. Copyright © 2018 Elsevier B.V. All rights reserved.
-
Himmelstein, Mary S; Sanchez, Diana T
2016-03-01
Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.
-
Smith, Fay; Goldacre, Michael J; Lambert, Trevor W
2016-07-01
To report a qualitative study of themes doctors raised spontaneously, in a large-scale prospective cohort study covering many aspects of their medical careers, when referring to their own chronic illness or disability. Questionnaire survey. UK. Questionnaires were sent one, five and 10 years after graduation to 44,539 doctors who qualified between 1993 and 2012 in the UK: 38,613 questionnaires were returned and 11,859 respondents provided comments made by doctors about their training or work. The comments of 123 doctors about their own chronic illness or disability. Main themes raised included poor support for doctors with chronic illness or disability, delays in and changes to careers (either planned ahead or imposed), the impact of pressure at work, difficulties returning to work after illness, limitations on career choices and inadequate careers advice for doctors with chronic illness or disabilities. More needs to be done to ensure that doctors with chronic illness or disability receive appropriate support. Occupational health guidance should be monitored closely, with more support for ill doctors including adjustments to the job, help if needed with morale and mental health, and advice on career options. Further studies should establish the prevalence of long-term health conditions among doctors.
-
Stewart, Grant D; Khadra, Mohamed H
2009-02-01
Currently, it is not clear which continuing medical education (CME) methods are being used by senior doctors and what their attitudes towards them are. The aims of this study were to investigate which modes of CME delivery senior Australian doctors utilise, to assess doctors' attitudes towards CME and to determine any differences in modes used and attitudes between clinical specialties and practice locations. A 52-statement questionnaire enquiring about doctors' current CME activities and their attitudes towards CME was distributed to 1336 senior Australian doctors. 494 doctors responded to the questionnaire. Traditional forms of CME (eg, meetings, conferences, journals and lectures) were most commonly used. Doctors thought CME involving face-to-face interaction was superior to electronic forms of CME. All doctors, especially those in hospital practice, had a positive attitude towards CME but found lack of time a barrier to learning. Rural doctors found CME sessions more difficult to attend than did their metropolitan colleagues. Traditional forms of CME were more popular than modern CME approaches, such as e-learning. Australian doctors had a positive attitude towards undertaking CME despite struggling to find time to perform CME. The differences in attitudes towards CME demonstrated between specialties and different practice location will aid future CME planning.
-
Bianchi, Eleonora F; Bhattacharyya, Mimi R; Meakin, Richard
2016-09-16
To explore the views of senior doctors on mental illness within the medical profession. There has been increasing interest on the issue of doctors' mental health. However, there have been few qualitative studies on senior doctors' general attitude towards mental illness within the medical profession. Large North London teaching hospital. 13 hospital consultants and senior academic general practitioners. A qualitative study involving semi-structured interviews and reflective work. The outcome measures were the themes derived from the thematic framework approach to analysis. Four main themes were identified. (1) 'Doctors' attitudes to mental illness'-doctors felt that there remained a significant stigma attached to suffering from a mental illness within the profession. (2) 'Barriers to seeking help'-doctors felt that there were numerous barriers to seeking help such as negative career implications, being perceived as weak, denial and fear of prejudice. (3) 'Support'-doctors felt that the use of support depended on certainty concerning confidentiality, which for occupational health was not thought to be guaranteed. Confiding in colleagues was rare except among close friends. Supervision for all doctors was raised. (4) 'General Medical Council (GMC) involvement'-doctors felt that uneasy referring colleagues to the GMC and the appraisal and revalidation process was thought not to be thorough enough in picking up doctors with a mental illness. Owing to the small size of this study, the conclusions are limited; however, if the findings are confirmed by larger studies, they suggest that greater efforts are needed to destigmatise mental illness in the profession and improve support for doctors. Additional research should be carried out into doctors' views on occupational health services in managing doctors with mental illness, the provision of supervision for all doctors and the effectiveness of the current appraisal and revalidation process at identifying doctors with a mental illness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
-
Wu, Dan; Wang, Yun; Lam, Kwok Fai; Hesketh, Therese
2014-12-31
To explore the factors influencing doctors' job satisfaction and morale in China, in the context of the ongoing health system reforms and the deteriorating doctor-patient relationship. Cross-sectional survey using self-completion questionnaires. The survey was conducted from March to May 2012 among doctors at the provincial, county and primary care levels in Zhejiang Province, China. The questionnaire was completed by 202 doctors. Factors which contributed most to low job satisfaction were low income and long working hours. Provincial level doctors were most dissatisfied while primary care doctors were the least dissatisfied. Three per cent of doctors at high-level hospitals and 27% of those in primary care were satisfied with the salary. Only 7% at high-level hospitals were satisfied with the work hours, compared to 43% in primary care. Less than 10% at high levels were satisfied with the amount of paid vacation time (3%) and paid sick leave (5%), compared with 38% and 41%, respectively, in primary care. Overall, 87% reported that patients were more likely to sue and that patient violence against doctors was increasing. Only 4.5% wanted their children to be doctors. Of those 125 who provided a reason, 34% said poor pay, 17% said it was a high-risk profession, and 9% expressed concerns about personal insecurity or patient violence. Doctors have low job satisfaction overall. Recruitment and retention of doctors have become major challenges for the Chinese health system. Measures must be taken to address this, in order to ensure recruitment and retention of doctors in the future. These measures must first include reduction of doctors' workload, especially at provincial hospitals, partly through incentivisation of appropriate utilisation of primary care, increase in doctors' salary and more effective measures to tackle patient violence against doctors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
-
ERIC Educational Resources Information Center
Hwang, Eunjin; Smith, Rachel N.; Byers, Valerie Tharp; Dickerson, Shirley; McAlister-Shields, Leah; Onwuegbuzie, Anthony J.; Benge, Cindy
2015-01-01
The non-completion of doctoral degrees has been a concern due to its economic, social, and personal consequences. In the current study, the researchers investigated perceived barriers of select doctoral students in completing their doctoral degrees by utilizing a fully mixed sequential mixed research design. The quantitative and qualitative data…
-
A Qualitative Examination of Challenges Influencing Doctoral Students in an Online Doctoral Program
ERIC Educational Resources Information Center
Deshpande, Anant
2016-01-01
The main purpose of the study was to investigate the challenges faced by students in completion of an online doctoral program at the University of Liverpool, Online Doctoral Business Administration program. We analyse the responses of 91 doctoral students in an online DBA program. Based on the exploratory qualitative study themes were developed…
-
Doctoral Studies in Romania: Admission Procedures, Social, and Legal Aspects of Doctoral Training
ERIC Educational Resources Information Center
Miclea, Mircea
2008-01-01
This contribution presents a concise and up-to-date report of doctoral studies in Romania, with a special emphasis on legal and social aspects. The author also argues that in order to be sustainable, the reform of doctoral studies should be substantiated by the differentiation of universities, reliable post-doctoral programmes, and a substantive…
-
Lovdal, L T; Pearson, R
1989-03-01
A study was conducted to determine what consumers value in doctors' behavior. Results indicate that consumers in the sample population studied prefer doctors who are friendly and caring as well as those who are technically competent. However, these respondents reported less favorable opinions about doctors' friendliness (i.e., affective behavior) than they did about doctors' competence (i.e., instrumental behavior).
-
A Project Perspective on Doctoral Studies--A Student Point of View
ERIC Educational Resources Information Center
Backlund, Fredrik
2017-01-01
Purpose: Many doctoral students never obtain a doctoral degree, and many do not finish their studies in time. To promote aspects of effectiveness and efficiency in doctoral studies, the purpose of this paper is to explore a project perspective, more specifically how doctoral students experience their studies in terms of key dimensions of projects.…
-
ERIC Educational Resources Information Center
Barnes, Benita J.
2010-01-01
The high attrition rate from doctoral programs has been called a "hidden crisis" in graduate education (Lovitts & Nelson, 2000). Previous research has identified a constellation of factors that may contribute to doctoral attrition. However, the literature suggests that one of the most powerful influences on doctoral persistence is the relationship…
-
The Experiences of Blacks Who Obtained Doctorates from Predominantly White Institutions
ERIC Educational Resources Information Center
Nickelberry, Tressie A.
2012-01-01
Being in a doctoral program requires a substantial amount of one's time, energy, and commitment. Doctoral students face many challenges while pursuing their degrees. For example, some may be on financial aid, work full-time, and/or have a family. While doctoral students face many hurdles, Black doctoral students face additional barriers. The…
-
ERIC Educational Resources Information Center
Philpott, Carey
2015-01-01
Timely completion has recently been an important focus of academic literature on supervising Doctoral students. This paper is a reflection on the academic literature on timely doctoral completion by a former Doctoral student who has been a serial non-completer. This reflection explores whether academics' constructions, reported in the research…
-
Talking to Your Child's Doctor
... doctor is unrealistic expectations or an unwillingness to trust a doctor's diagnosis or treatment of a minor ... communication by letting the doctor know that you trust him or her to care for your child. ...
-
Perspectives of Nurses Pursuing Doctoral Degrees in Georgia: Implications for Recruitment.
Wheeler, Rebecca McCombs; Eichelberger, Lisa Wright
2017-08-01
Increasing the number of nurses with doctorates is a goal of the nursing profession. The Georgia Nursing Leadership Coalition developed a survey to understand the perspectives of nurses pursuing doctoral degrees in Georgia to improve recruitment and retention strategies. A 26-item online survey was distributed to all students enrolled in Georgia-based doctoral programs in nursing in spring 2014. One hundred fifty responses were received (54% response rate). Most students first seriously considered doctoral education during their master's programs or more than 5 years into practice. For most, obtaining a doctoral degree was a personal life goal. Work-life balance was the most significant barrier. Recruitment of nurses to doctoral programs should focus on messaging, timing, and highlighting the unique aspects of programs. Schools should work to reduce barriers. Understanding students' perspectives of doctoral education in nursing can improve recruitment strategies and increase the number of nurses graduating with doctorates in Georgia. [J Nurs Educ. 2017;56(8):466-470.]. Copyright 2017, SLACK Incorporated.
-
Kim, Geun Bae
2014-12-01
This paper traces how Koreans of north area became medical doctors in colonial Korea. Most of the past research have focused only on the well-known medical doctors, or even when they discussed a great number of doctors, many research tended to only pay attention to the explicit final results of those doctors. This research, on the other hand, includes ordinary medical doctors as well as the renowed ones, and adjusts the focus to the lifetime period of their growth and activities. As a result, the misunderstanding and obscurity about the Korean medical doctors of north area during this period have been cleared. The new characteristics of the Korean medical doctors of this period have been found, along with their embodiment of historical significance. At the time, Koreans had to get through a number of qualifications in order to become doctors. First is the unique background of origin in which the family held interest in the modern education and was capable of supporting it financially. Second is the long-term status of education that the education from elementary to high school was completed without interruption. Third is the academic qualification that among various institutions of higher education, medical science was chosen as a major. Fourth is the condition of career in which as the career as a doctor had consistently continued. Thus, in oder to become a modern medical doctor, Koreans had to properly complete these multiple steps of process. The group of Korean medical doctors in north area, which was formed after getting through these series of process, possessed a number of characteristics. Firstly, as the upper-middle classes constituted the majority of medical doctors in Korea, the societal status of doctors rose and the foundation for the career as a doctor to be persisted as the family occupation settled. Secondly, the research career and academic degree became the principal method to escape from the discrimination and hierarchy existed between doctors. A PhD degree, especially, was the significant mark for clearly displaying the abilities and outcomes of the doctors. Lastly, the research career, education experience, clinical training and such that the Korean doctors of the period had built up were weak at the time, however, they were important sources for the future medical science development. Indeed, after Liberation, the rapid settlement and growth of Korea's medical science field were largely beholden to thus. Therefore, the growth of the Koreans as doctors did not cease in colonial Korea, but instead continued onto the history of future generations. In spite of the fact that the Korean doctors's growth and activities were greatly limited under the forceful policy of colonial domination of the era, the efforts the Korean doctors had put were not in vain. Likewise, if we do not fix our attention at the dominating policy and system, but rather put together the actors' correspondence and struggles of the period, then the Korean doctors will be a part of the living history. Hereby, the clue to the paradox between the suppression of medical science in colonial Korea and its leap after Liberation can be untied.
-
Heartburn - what to ask your doctor
... your doctor; GERD - what to ask your doctor; Gastroesophageal reflux disease - what to ask your doctor ... MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol . 2013;108(3):308- ...
-
Cao, Xuebing
2014-01-01
The article evaluates submerged discontent among Chinese public hospital doctors (Note1) regarding their pay and patterns of accommodation, including doctors' responses through formal and informal actions in the context of health service marketization. On the basis of a case study of two public hospitals, the article illustrates the dynamical impact of marketization on Chinese doctors' pay-related dissatisfaction and health service employment relationship. Because of the authoritarian management and compliant trade unions, the conflict between doctors and hospitals is unable to be accommodated through collective methods. Instead, doctors' discontent is often channelled through informal, individual and subtle activities. Meanwhile, doctors' professional society is gradually influential, showing its potential of developing doctors' group identity and protecting members' interests in future. Copyright © 2013 John Wiley & Sons, Ltd.
-
"What do you know?"--knowledge among village doctors of lead poisoning in children in rural China.
Huang, Ruixue; Ning, Huacheng; Baum, Carl R; Chen, Lei; Hsiao, Allen
2017-11-23
This study evaluates the extent of village doctors' knowledge of lead poisoning in children in rural China and assesses the characteristics associated with possessing accurate knowledge. A cross-sectional, questionnaire-based survey of 297 village doctors in Fenghuang County, Hunan Province, China was conducted. All village doctors were interviewed face-to-face using a "What do you know" test questionnaire focusing on prevention strategies and lead sources in rural children. A total of 287 (96.6%) village doctors completed the survey in full. Most village doctors had an appropriate degree of general knowledge of lead poisoning; however, they had relatively poor knowledge of lead sources and prevention measures. Village doctors with an undergraduate level education scored an average of 2.7 points higher than those who had a junior college level education (p = 0.033). Village doctors with an annual income ≤ 10,000 RMB yuan scored 1.03 points lower than those whose income was >10,001 RMB yuan. Ethnic Han village doctors scored 1.12 points higher, on average, than ethnic Tujia village doctors (p = 0.027). This study identified important gaps in knowledge concerning lead poisoning in children among a rural population of village doctors. There is a clear need for multifaceted interventions that target village doctors to improve their knowledge regarding lead poisoning in children. The "What do you know" questionnaire is a new tool to evaluate lead poisoning knowledge and education projects.
-
ERIC Educational Resources Information Center
Sterie, Anca Cristina
2015-01-01
At the hospital, nurses' telephone calls to doctors mostly revolve around obtaining doctors' intervention in a medical case. To achieve this, nurses need to make the doctor's intervention relevant, by explicitly requesting it or, more indirectly, by reporting a medical problem. Two recorded telephone conversations have been selected for analysis…
-
Doctoral Writing in the Visual and Performing Arts: Two Ends of a Continuum
ERIC Educational Resources Information Center
Paltridge, Brian; Starfield, Sue; Ravelli, Louise; Nicholson, Sarah
2012-01-01
Doctoral degrees in the visual and performing arts are a fairly recent entrant in the research higher degree landscape in Australian universities. At the same time, a new kind of doctorate is evolving, a doctorate in which significant aspects of the claim for the doctoral characteristics of originality, mastery and contribution to the field are…
-
ERIC Educational Resources Information Center
Gopaul, Bryan
2015-01-01
While studies have examined a myriad of issues in doctoral study, much of this research has not employed the tools of major social and cultural thinkers to the dynamics of doctoral education. This paper explores the use of Bourdieu's notion of field to render visible the practices and contexts of doctoral education that produce inequalities across…
-
[Job satisfaction among Norwegian doctors].
Nylenna, Magne; Aasland, Olaf Gjerløw
2010-05-20
Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.
-
Kay, Margaret; Mitchell, Geoffrey; Clavarino, Alexandra; Frank, Erica
2012-01-01
Health access behaviours of doctors need to be understood if the profession is to adequately respond to concerns raised about doctors' health. There has been limited investigation of these issues and most qualitative studies have focussed on doctors who have been seriously unwell. This research project was designed to explore doctors' attitudes to health access and the barriers they experience using six independently facilitated focus groups (37 general practitioners) in Brisbane, Australia. Themes that emerged using inductive thematic analysis were grouped into three key categories. The findings challenge current representations of doctors' health within the medical literature. Doctors in this study reported positive attitudes towards their own health care. Health access, however, was difficult because of the barriers they encountered. These barriers are described in detail revealing the rationale used by doctors seeking care. A framework of patient, provider and profession barrier domains is developed to enable a comparison between the health access barriers of the doctor and those experienced by the general community. The complexity is highlighted as the socio-cultural factors woven through these barrier domains are recognised. The potential for this framework to provide a structure for future interventions to enhance doctors' health access is discussed.
-
Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.
Umefjord, Göran; Petersson, Göran; Hamberg, Katarina
2003-10-22
In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. To study why individuals choose to consult previously-unknown doctors on the Internet. Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.
-
[Working style among regular general practitioners and other doctors in the out-of-hours services].
Sandvik, Hogne; Hunskår, Steinar
2010-01-28
RGPs (regular general practitioners) are obliged to take on duties in the out-of-hours services in Norway, but they actually perform less than half of this work. We wished to compare remuneration claims for out-of-hours work from RGPs with those from other doctors. The Norwegian Labour and Welfare administration provided information about all doctors working in the out-of-hours services in Norway in 2006 (4 729 of whom 2 220 were RGPs) and coupled this with the remuneration they had claimed in this period. RGPs had 46.6 % of all patient contacts in the out-of-hours services, but more telephone contacts (57.4 %) and simple/short contacts (50.7 %) than other doctors. Other doctors had most contacts in the largest (59.8 %) and most central (56.7 %) municipalities and used general and unspecific diagnoses more often than the RGPs (12.6 % of all consultations vs. 11.0 %). Older doctors used fewer fees than younger doctors, but otherwise the total number of fees only differed slightly between various groups of doctors. Newly qualified doctors serving their compulsory practice period claimed extra remuneration for long consultations in 41.2 % of the cases, RGPs who are also general practice specialists in 20.2 % of cases, and other doctors in 35.7 % of the consultations. RGPs wrote sick notes more often (7.1 % of consultations) than newly qualified doctors (5.7 %) and other doctors (6.6 %). General practice specialists wrote sick notes most often (7.4 %). Experienced RGPs and general practice specialists spend less time per patient than other doctors in the out-of-hours services.
-
Haboubi, Hasan N; Morgan, Holly; Aldalati, Omar
2015-12-14
To evaluate the opinions of practicing clinicians on medical television dramas and the effects these series have on society as well as their own practice. Observational study using a structured questionnaire disseminated among doctors of all grades and specialties at one tertiary centre and two large secondary care district general hospitals in Wales, United Kingdom. Three hundred and seventy-two questionnaires were distributed over a 3-month period, with 200 completed questionnaires received (response rate, 54%). Frequency and reasons for watching these programs, and opinions regarding realism, educational value and public perception, evaluated by doctors' grades and specialties. Identification of work practice with any observed traits in fictional doctors was also analysed. 65% of doctors surveyed admitted to watching these programs on more than one occasion. Junior doctors (interns and resident medical officers) were more regular viewers. Most doctors who admitted to watching medical dramas did so for entertainment purposes (69%); 8% watched for educational purposes and, of these, 100% watched House MD, 82% felt that these dramas were unrepresentative of daily practice, and 10% thought that they accurately portrayed reality. Most of the positive responses were from junior doctors. 61% of doctors identified some aspect of their clinical practice with another doctor (fictional or non-fictional; most junior doctors identified with a fictional doctor, compared with non-fictional role models for more senior practicing clinicians. This survey shows that a large body of the medical workforce watches medical television dramas and that such programs exercise a growing influence on the practice of junior doctors, particularly those in physicianly specialties. The reasons for certain role model selections remain unknown and may require further evaluation.
-
Predictors of Maternal Trust in Doctors About Advice on Infant Care Practices: The SAFE Study.
Hwang, Sunah S; Rybin, Denis V; Kerr, Stephen M; Heeren, Timothy C; Colson, Eve R; Corwin, Michael J
To determine predictors of maternal trust in doctors about advice on infant care practices. Using probability sampling methods, we recruited mothers from 32 US maternity hospitals. Mothers completed a survey 2 to 6 months postpartum that included questions about maternal trust in doctors regarding 6 infant care practices and physician characteristics (doctor asked mother's opinion, doctor is qualified, infant sees 1 main doctor who is/is not of the same ethnicity/race). Prevalence estimates and 95% confidence intervals were calculated for maternal trust in physician advice for each infant care practice. Multivariate logistic regression was used to calculate the independent association of maternal and physician characteristics and trust for each infant care practice, controlling for sociodemographic characteristics. Of the 3983 mothers enrolled from January 2011 to March 2014, 3297 (83%) completed the follow-up survey. Maternal trust in the doctor varied according to infant care practice with highest trust for vaccination (89%) and lowest trust for pacifier use (56%). In the adjusted analyses, for all infant care practices, mothers were more likely to trust their doctors if they reported that the doctors were qualified (adjusted odds ratio [AOR], >3.0 for all practices) or if the doctor had asked their opinion (AOR, 1.76-2.43). For mothers who reported seeing 1 main doctor, white mothers were more likely to trust physicians for almost all infant care practices if they reported the doctor was the same race (AOR, 1.54-2.19). Physician characteristics and ways of communication were significantly associated with maternal trust in doctors about advice on infant care practices. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
-
Adhikari, Samaj; Paudel, Kumar; Aro, Arja R; Adhikari, Tara Ballav; Adhikari, Bipin; Mishra, Shiva Raj
2016-11-08
Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer's V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05. Our study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p < 0.05) in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying. Significant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics.
-
Jolley, Jeremy
2007-02-01
The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking 'could this possibly be for me'? This paper will try to help the reader decide which if any option to take. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities' advertising material. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and academic support and is more practice orientated. It is suggested that the move towards doctoral programmes for nurses will present one of the most important evolutionary changes in the practice of nursing. It is suggested that doctoral education for nurses will increase in prevalence and that this process of change is already underway. Doctoral education will provide practitioners with the experience and skills required to conduct research and further develop practice. For individual practitioners, doctoral education will enhance self-confidence in an increasingly technical and complex arena and in a practice discipline that is becoming ever more politically charged. The professional doctorate appears to be particularly suited to senior nurse practitioners. What remains is for us to accept this new challenge and to shape its development for the benefit of the practice of nursing.
-
2014-01-01
Background Although having a regular primary care provider is noted to be beneficial to health, doctor shopping has been documented as a common treatment seeking behavior among chronically ill patients in different countries. However, little research has been conducted into the reasons behind doctor shopping behavior among patients with overactive bladder, and even less into how this behavior relates to these patients’ illness and social experiences, perceptions, and cultural practices. Therefore, this study examines overactive bladder patients to investigate the reasons behind doctor shopping behavior. Methods My study takes a qualitative approach, conducting 30 semi-structured individual interviews, with 30 overactive bladder patients in Hong Kong. Results My study found six primary themes that influenced doctor shopping behavior: lack of perceived need, convenience, work-provided medical insurance, unpleasant experiences with doctors, searching for a match doctor, and switching between biomedicine and traditional Chinese medicine. Besides the perceptual factors, participants’ social environment, illness experiences, personal cultural preference, and cultural beliefs also intertwined to generate their doctor shopping behavior. Due to the low perceived need for a regular personal primary care physician, environmental factors such as time, locational convenience, and work-provided medical insurance became decisive in doctor shopping behavior. Patients’ unpleasant illness experiences, stemming from a lack of understanding among many primary care doctors about overactive bladder, contributed to participants’ sense of mismatch with these doctors, which induced them to shop for another doctor. Conclusions Overactive bladder is a chronic bladder condition with very limited treatment outcome. Although patients with overactive bladder often require specialty urology treatment, it is usually beneficial for the patients to receive continuous, coordinated, comprehensive, and patient-centered support from their primary care providers. Primary care doctors’ understanding on patients with overactive bladder with empathetic attitudes is important to reduce the motivations of doctor shopping behavior among these patients. PMID:24502367
-
Hao, Junhui; Wang, Jiana; Liu, Li; Wu, Wei; Wu, Hui
2016-03-16
As a common mental disorder, depressive symptoms had been studied extensively all over the world. However, positive resources for combating depressive symptoms among Chinese doctors were rarely studied. Our study aimed to investigate the relationships between work-family conflict (WFC) and family-work conflict (FWC) with depressive symptoms among Chinese doctors. Meanwhile, the role of perceived organizational support (POS) in this association was explored at an organizational level. The investigation was conducted between March and April 2014. Questionnaires that measured WFC, FWC, depressive symptoms and POS were distributed to 1200 doctors in Shenyang, China. The final study subjects were 931 doctors (effective response rate: 77.6%). In all analyses, male and female doctors were analyzed separately because of possible gender differences. Hierarchical linear regression analyses were used to examine the moderating role of POS. Baron and Kenny's technique and asymptotic and resampling strategies were used to explore the mediating role of POS on the associations of WFC or FWC with depressive symptoms. WFC and FWC had positive relations with depressive symptoms among doctors. POS played a partial mediating role on the correlation of FWC with depressive symptoms among male doctors, and POS played a partial mediating role on the correlation of WFC with depressive symptoms among female doctors. POS had a positive moderating effect on the relationship between WFC and depressive symptoms among doctors. WFC and FWC could aggravate doctors' depressive symptoms, and POS, as an organizational resource, could fight against doctors' depressive symptoms. When POS functioned as a mediator, FWC had a negative effect on POS, which could increase male doctors' depressive symptoms, and WFC had a negative effect on POS, which could increase female doctors' depressive symptoms. In the meantime, POS, as a moderator, could enhance the effects of WFC on depressive symptoms.
-
A systematic review of burnout among doctors in China: a cultural perspective.
Lo, Dana; Wu, Florence; Chan, Mark; Chu, Rodney; Li, Donald
2018-01-01
Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor. Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including "burnout", "doctors" and "China" in 3 electronic databases has been undergone. Traditional understanding of "work attitude" and "doctors' humanity" from ancient Chinese literature has also been retrieved. Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors' level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life. The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China.
-
Patient-doctor relationship: the practice orientation of doctors in Kano.
Abiola, T; Udofia, O; Abdullahi, A T
2014-01-01
Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.
-
The national and international implications of a decade of doctor migration in the Irish context.
Bidwell, Posy; Humphries, Niamh; Dicker, Patrick; Thomas, Steve; Normand, Charles; Brugha, Ruairí
2013-04-01
Between 2000 and 2010, Ireland became increasingly dependent on foreign-trained doctors to staff its health system. An inability to train and retain sufficient doctors to meet demand is the primary reason for the dependence on foreign-trained doctors. By 2008 the proportion of foreign-trained doctors was the second highest in the OECD. This increased dependence on international medical migration has both national and international policy implications. Registration data were obtained from the Medical Council of Ireland (MCI) for a 10-year period: 2000-2010. Data indicate country of qualification but not nationality. The total number of registrants and entrants (n) was determined for each year. Immigration data were also obtained on the number of work visas issued to doctors. Registration and visa data were then compared in order to estimate doctor migration to Ireland 2000-2010. The proportion of foreign-trained doctors rose from 13.4% of all registered doctors in 2000 to 33.4% by 2010. The largest increase was in foreign-trained doctors from outside the EU, rising from 972 (7.4%) in 2000 to 4740 (25.3%) of registered doctors in 2010. The biggest source country in 2000 was Pakistan. By 2010, South Africa had become the biggest source country. The number of foreign-trained doctors from other EU countries doubled from 780 in 2000 to 1521 in 2010. Registration data are likely to over-estimate and visa data under-estimate the numbers of doctors actively working in Ireland. However, they serve to illustrate Ireland's rapidly increasing and potentially unsustainable reliance on foreign-trained doctors; and to highlight the need for better data to measure migratory flows. Improved measurement of health worker migration is necessary both for national workforce planning and to fulfil the requirements of the WHO Global Code on the International Recruitment of Health Personnel. Copyright © 2012. Published by Elsevier Ireland Ltd.
-
Doctors and pharmaceutical industry.
Beran, Roy G
2009-09-01
The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.
-
Kidney stones - what to ask your doctor
Nephrolithiasis - what to ask your doctor; Renal calculi - what to ask your doctor; What to ask your doctor about kidney stones ... Strategies for nonmedical management of upper urinary tract calculi. In: Wein AJ, Kavoussi LR, Partin AW, Peters ...
-
Epilepsy - what to ask your doctor - adult
What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...
-
The wealth of distinguished doctors: retrospective survey
McManus, I C
2005-01-01
Objective To assess changes in the wealth of distinguished doctors in the United Kingdom between 1860 and 2001. Design Retrospective survey. Setting The UK. Participants 980 doctors of sufficient distinction to be included in the Oxford Dictionary of National Biography and who died between 1860 and 2001. Main outcome measures Wealth at death, based on probate records and adjusted relative to average earnings in 2002. Results The wealth of distinguished doctors declined substantially between 1860 and 2001, and paralleled a decline in the relative income of doctors in general. The wealth of distinguished doctors also declined relative to other groups of distinguished individuals. Conclusions In the 19th century, distinction in doctors was accompanied by substantial wealth, whereas by the end of the 20th century, the most distinguished doctors were less wealthy than their contemporaries who had achieved national distinction in other areas. PMID:16373738
-
Chen, Minxing; Lu, Jun; Hao, Chao; Hao, Mo; Yao, Fang; Sun, Mei
2015-03-25
To reveal the challenges of village doctors' survival and training in economically developed areas in eastern China. A field survey was used to assess the challenges of village doctors. The study was conducted in Changzhou, Jiangsu province, which is an economically developed region in eastern China. The participants included 844 village doctors, 15 township hospital staff members and 6 health bureau leaders. The main challenges in Changzhou include an insufficient amount of village doctors, difficulties in obtaining professional qualification for village doctors, low salaries and benefits, and difficulties in recruitment. With increasing urbanisation in China, the gap between actual and expected income and social security has been increasing. Changes to training have influenced the stability of village doctor teams. Declining attachment of young people to their hometown village has contributed to recruitment difficulties. © 2015 National Rural Health Alliance Inc.
-
ERIC Educational Resources Information Center
Pilbeam, Colin; Denyer, David
2009-01-01
Doctoral education in the UK embraces both independent self-directed study and collective shared learning. The extent to which individual doctoral students remain isolated, or become integrated into a network of doctoral students, is a function of the attributes of the individual and the nature of the doctorate and its mode of delivery. Using the…
-
Translations on Eastern Europe, Scientific Affairs, Number 567
1977-12-16
becomes effective on the day of its promulgation. [signed by] Ferenc Marta general secretary 2542 CSO: 2502 11 HUNGARY ACADEMY ESTABLISHES...doctor of medical sciences, Dezso Schüler, doctor of medical sciences, Gabor Szabo , academician, Jozsef Szegi, doctor of agricultural sciences, Pal...were: Marta Dery, doctor of technical sciences, L. Gyprgy Nagy and Sandor Rohrsetzer, doctors of chemical sciences. II. The Committee of
-
ERIC Educational Resources Information Center
Godskesen, Mirjam; Kobayashi, Sofie
2016-01-01
In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students' sense of progress in doctoral education. The study used a mixed-methods approach in that we draw on quantitative and qualitative data from the evaluation of a project on coaching doctoral students. We…
-
ERIC Educational Resources Information Center
National Science Foundation, 2009
2009-01-01
"Doctorate Recipients from U.S. Universities: Summary Report 2007-08" is the 41st in a series of reports on research doctorates awarded by universities in the United States. Data presented in this report were collected by the Survey of Earned Doctorates (SED). The SED, which has been conducted annually since 1957, is a census of all…
-
Solberg, Ingunn Bjarnadóttir; Tómasson, Kristinn; Aasland, Olaf; Tyssen, Reidar
2013-12-18
Globalization has facilitated the employability of doctors almost anywhere in the world. In recent years, the migration of doctors seems to have increased. However, we lack studies on doctors' migration from developed countries. Because the economic recession experienced by many countries might have affected the migration of doctors, research on this topic is important for the retention of doctors. Iceland was hit hard by the economic recession in 2008. Therefore, we want to explore how many specialist doctors in Iceland have considered migrating and whether economic factors at work and in private life, such as extensive cost-containment initiatives at work and worries about personal finances, are related to doctors' migration considerations. In 2010, all doctors in Iceland registered with the Icelandic Medical Association were sent an electronic cross-sectional survey by email. The 467 specialists who participated in this study represent 55% of all specialist doctors working in Iceland. Information on doctors' contemplation of migration was available from responses to the question: "Have you considered moving and working abroad?" The predictor variables in our logistic regression model are perceived cost-containment initiatives at work, stress related to personal finances, experience of working abroad during vacations, job dissatisfaction, job position, age, and gender. Sixty-three per cent of Iceland's specialist doctors had considered relocation abroad, 4% were moving in the next year or two, and 33% had not considered relocating. Logistic regression analysis shows that, controlling for age, gender, job position, job satisfaction, and experience of working abroad during vacations, doctors' migration considerations were significantly affected by their experiences of cost-containment initiatives at work (odds ratio (OR) = 2.0, p < 0.01) and being stressed about personal finances (OR = 1.6, p < 0.001). Age, job satisfaction, and working abroad during vacations also had an effect, whereas job position did not. Economic factors affect whether specialist doctors in Iceland consider migration. More studies on the effect of economic recession on migration by doctors are needed.
-
[The Image of Doctors in Europe: A Comparison of Countries].
Heinz, Andreas; Décieux, Jean Philippe
2018-04-01
Patients expect a lot from doctors. They expect doctors to be trustworthy and competent, to discuss all treatment options with them, to inform them about mistakes made during the treatment and to put their interests before their own interests. This paper examines how the population of Europe assesses doctors in this respect and whether there are countries where the assessments are similar. In the "International Social Survey Programme - ISSP" the population in 32 countries was asked to assess the doctors in their respective countries. For this paper, data of 27,772 respondents from 18 European countries were analysed. The respondents were asked to rate 5 statements about doctors on a 5-point scale, with 1 indicating a positive assessment and 5 indicating a negative assessment. For each country, the mean values for the statements were calculated and grouped using cluster analysis to identify countries with similar assessments. "Doctors can be trusted" is the statement with the highest approval across all countries, with means ranging from 2.0 in Denmark to 2.7 in Russia. In most countries, the means of the following statements were close to each other: "Doctors discuss all treatment options with their patients", "The medical skills of doctors are as good as they should be", and "Doctors do not care more about their earnings than about their patients." In almost all countries, respondents were particularly skeptical about the statement "Doctors would tell their patients if they had made a mistake during treatment". Four clusters were identified, but there was no cluster that rated among the best for all five statements. With regard to trust, the discussion of treatment options and the pursuit of self-serving interests, doctors in Germany were not rated particularly well or particularly badly. In Germany, the population was more likely to think that doctors would not inform their patients about mistakes during the treatment. Trust in doctors seems to reflect the general level of trust in a country. The question arises why trust in doctors is high across countries if the respondents are much more skeptical regarding the other statements. © Georg Thieme Verlag KG Stuttgart · New York.
-
Protest of doctors: a basic human right or an ethical dilemma.
Abbasi, Imran Naeem
2014-03-10
Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial action. The author calls for the debate and discussion to revitalize the understanding of the ethical predicaments of doctors' strikes with patient care as the priority.
-
[Physicians' tasks in the Occupational Health Services].
von Bülow, B A
1995-03-06
The aim of this study was to describe the kind of present and future tasks doctors employed in the Occupational Health Service (OHS) in Denmark carried out and to shed light on the reasons why only a moderate number of doctors are employed in the OHS. Additional aims were to map out the number of engaged part-time and full-time doctors in the OHS in Denmark compared with the number of other professionals engaged in the OHS. The study was based on questionnaires sent out to all 109 OHS units in Denmark and to all the doctors employed in the OHS. Ten persons in the OHS were strategically selected for an open interview. There were still only a very few doctors (9%) employed in the OHS in comparison to the other professionals employed in OHS, (nurses, various therapists and technicians) and the doctors were mostly engaged part-time; most of them for less than 10 hours a week. The moderate number of doctors was amongst other things explained by the relatively high cost of the doctors' salaries and the doctors having a reputation for being arrogant and dominating. The doctors were in general very experienced in occupational health matters and solved many problems which required a doctors education. A great deal of the problems they solved were in finding the causality between the workers' symptoms and the working-place conditions. The doctors suggested several future tasks for OHS, e.g. to evaluate its preventive results and to participate in a higher degree when planning working environments.
-
NASA Astrophysics Data System (ADS)
Barry, Deborah S.
As the realities of the academic job market have forced some PhD recipients to accept less-preferable position types, there has been increasing concerns that these students are not prepared for their careers, especially in STEM fields. However, aside from the labor market, few studies have explored the influences on career aspiration and attainment among doctoral degree holders. This study utilized the socialization theory framework to identify aspects of the doctoral education process that are predictive of the likelihood of certain career aspirations among science and engineering doctoral candidates and career attainment among STEM doctoral recipients by utilizing nationally representative datasets: The National Research Council's Assessment of Research Doctorate Programs student questionnaire and the National Science Foundation's Survey of Earned Doctorates. This study identified field of study, research productivity rank of doctoral programs, primary type of finding doctoral students received, level of satisfaction with research experiences, and their sense of belonging within their doctoral program as factors that predict the likelihood of certain career aspirations compared with a career in education. Doctoral candidates' background characteristics that were significant predictors of career aspirations were gender, marital status, dependent status, race, age, and citizenship status. Further, this study identified participant's field of study, the Carnegie Rank of institutions attended, primary type of funding received, length of time to PhD, gender, marital status, dependent status, race, citizenship stats, and age as factors that predict the likelihood of the career outcomes investigated in this study, including doctoral recipients' employment field and primary work activity.
-
Farrington, Conor; Burt, Jenni; Boiko, Olga; Campbell, John; Roland, Martin
2017-06-01
Patient experience surveys are increasingly important in the measurement of, and attempts to improve, health-care quality. To date, little research has focused upon doctors' attitudes to surveys which give them personalized feedback. This paper explores doctors' perceptions of patient experience surveys in primary and secondary care settings in order to deepen understandings of how doctors view the plausibility of such surveys. We conducted a qualitative study with doctors in two regions of England, involving in-depth semi-structured interviews with doctors working in primary care (n = 21) and secondary care (n = 20) settings. The doctors in both settings had recently received individualized feedback from patient experience surveys. Doctors in both settings express strong personal commitments to incorporating patient feedback in quality improvement efforts. However, they also concurrently express strong negative views about the credibility of survey findings and patients' motivations and competence in providing feedback. Thus, individual doctors demonstrate contradictory views regarding the plausibility of patient surveys, leading to complex, varied and on balance negative engagements with patient feedback. Doctors' contradictory views towards patient experience surveys are likely to limit the impact of such surveys in quality improvement initiatives in primary and secondary care. We highlight the need for 'sensegiving' initiatives (i.e. attempts to influence perceptions by communicating particular ideas, narratives and visions) to engage with doctors regarding the plausibility of patient experience surveys. This study highlights the importance of engaging with doctors' views about patient experience surveys when developing quality improvement initiatives. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
-
Luo, Jing; Fu, Chang-geng; Xu, Hao
2015-04-01
The inheritance of famous old traditional Chinese medicine (TCM) doctors plays an essential role in the fields of TCM research. Qualitative interviews allow for subjectivity and individuality within clinical experience as well as academic ideas of doctors, making it a potential appropriate research method for inheritance of famous old TCM doctors. We summarized current situations of inheritance research on famous old TCM doctors, and then discussed the feasibility of applying qualitative interviews in inheritance of famous old TCM doctors. By combining our experience in research on inheritance of famous old TCM doctors, we gave some advice on study design, interview implementation, data transcription and analyses , and report writing, providing a reference for further relevant research.
-
Ear tube surgery - what to ask your doctor
What to ask your doctor about ear tube surgery; Tympanostomy - what to ask your doctor; Myringotomy - what to ask your doctor ... need ear tubes? Can we try other treatments? What are the risks of the surgery? Is it ...
-
Skjeggestad, Erik; Gerwing, Jennifer; Gulbrandsen, Pål
2017-08-01
To explore how language barriers influence communication and collaboration between newly-employed international medical doctors and Norwegian health personnel. Interviews were conducted with 16 doctors who had recently started working in Norway and 12 Norwegian born health personnel who had extensive experience working with international medical doctors. Analyses were consistent with principles of systematic text condensation. All participants experienced that language barriers caused difficulties in their everyday collaboration. Furthermore, the participants' descriptions of "language barriers" encompassed a wide range of topics, including semantics (e.g., specialized professional vocabulary, system knowledge), pragmatics (e.g., using language in doctor-patient and interprofessional interactions), and specific culturally sensitive topics. All participants described that language barriers provoked uncertainty about a doctor's competence. Newly employed international medical doctors and their colleagues are concerned by ineffective communication due to language barriers. Experiences of language barriers threaten professional identity as a competent and effective doctor. Newly employed doctors who are non-native speakers could benefit from support in understanding and handling the array of barriers related to language. Copyright © 2017 Elsevier B.V. All rights reserved.
-
A marketing clinical doctorate programs.
Montoya, Isaac D; Kimball, Olive M
2007-01-01
Over the past decade, clinical doctorate programs in health disciplines have proliferated amid both support and controversy among educators, professional organizations, practitioners, administrators, and third-party payers. Supporters argue that the explosion of new knowledge and increasing sophistication of technology have created a need for advanced practice models to enhance patient care and safety and to reduce costs. Critics argue that necessary technological advances can be incorporated into existing programs and believe that clinical doctorates will increase health care costs, not reduce them. Despite the controversy, many health disciplines have advanced the clinical doctorate (the most recent is the doctor of nursing practice in 2004), with some professions mandating the doctorate as the entry-level degree (i.e., psychology, pharmacy, audiology, and so on). One aspect of the introduction of clinical doctoral degrees has been largely overlooked, and that is the marketing aspect. Because of marketing considerations, some clinical doctorates have been more successfully implemented and accepted than others. Marketing is composed of variables commonly known as "the four P's of marketing": product, price, promotion, and place. This report explores these four P's within the context of clinical doctorates in the health disciplines.
-
The doctor(s) in house: an analysis of the evolution of the television doctor-hero.
Strauman, Elena C; Goodier, Bethany C
2011-03-01
The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the "television doctor" by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the "doctor-hero" as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House's character as the central figure who is personally and interpersonally problematic but biomedically effective.
-
ERIC Educational Resources Information Center
Syverson, Peter D.
1990-01-01
An analysis of data on Black doctoral recipients was done to clarify the actual trends in Black higher education. Examination of data collected by the National Research Council on new doctorate recipients found that certain disciplinary trends skew the overall picture. This analysis found that Black American doctorate recipients are highly…
-
Young, Bridget; Ward, Jo; Forsey, Mary; Gravenhorst, Katja; Salmon, Peter
2011-10-01
We explored parent-doctor relationships in the care of children with leukaemia from three perspectives simultaneously: parents', doctors' and observers'. Our aim was to investigate convergence and divergence between these perspectives and thereby examine the validity of unitary theory of emotionality and authority in clinical relationships. 33 audiorecorded parent-doctor consultations and separate interviews with parents and doctors, which we analysed qualitatively and from which we selected three prototype cases. Across the whole sample doctors' sense of relationship generally converged with our observations of consultation, but parents' sense of relationship diverged strongly from each. Contrary to current assumptions, parents' sense of emotional connection with doctors did not depend on doctors' emotional behaviour, and parents did not feel disempowered by doctors' authority. Moreover, authority and emotionality were not conceptually distinct for parents, who gained emotional support from doctors' exercise of authority. The relationships looked very different from the three perspectives. These divergences indicate weaknesses in current ideas of emotionality and authority in clinical relationships and the necessity of multisource datasets to develop these ideas in a way that characterises clinical relationships from all perspectives. Methodological development will be needed to address the challenges posed by multisource datasets. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
-
Pas, B R; Lagro-Janssen, A L M; Doorewaard, J A C M; Eisinga, R N; Peters, C P
2008-10-04
To determine gender differences in career motivation and the effect of a family friendly work environment. Cross-sectional pilot investigation. A web survey among male and female doctors (n = 107; 72 women and 35 men) in different specialties, including surgical, internal medicine and general practitioners, was used to gather information on different dimensions of career motivation and perceptions of the family friendliness of the work environment. Differences were analysed by means of t-tests and regression analyses. Male doctors had higher scores on career identity and on career planning than female doctors. However, male and female doctors did not differ in their willingness to achieve top positions. Female doctors were more determined concerning their career goals than their male counterparts. The family friendliness of the work environment had an overall positive effect on career motivation for both male and female doctors. However, a family friendly work environment had a negative effect on the career identity of male doctors. For male and female doctors alike, support to achieve career goals and elimination of career barriers lead to increased career identity. Male and female doctors differed in certain dimensions of career motivation. Offering support for career goals and taking away career barriers leads to a higher career motivation than offering a family friendly work environment.
-
Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar
2015-01-01
Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.
-
Waddington, I; Roderick, M; Naik, R
2001-01-01
Objective—To examine the methods of appointment, experience, and qualifications of club doctors and physiotherapists in professional football. Methods—Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned. Results—In almost all clubs, methods of appointment of doctors are informal and reflect poor employment practice: posts are rarely advertised and many doctors are appointed on the basis of personal contacts and without interview. Few club doctors had prior experience or qualifications in sports medicine and very few have a written job description. The club doctor is often not consulted about the appointment of the physiotherapist; physiotherapists are usually appointed informally, often without interview, and often by the manager without involving anyone who is qualified in medicine or physiotherapy. Half of all clubs do not have a qualified (chartered) physiotherapist; such unqualified physiotherapists are in a weak position to resist threats to their clinical autonomy, particularly those arising from managers' attempts to influence clinical decisions. Conclusions—Almost all aspects of the appointment of club doctors and physiotherapists need careful re-examination. Key Words: football clubs; doctors; physiotherapists; qualifications PMID:11157462
-
[The importance of master's degree and doctorate degree in general surgery].
Montalvo-Javé, Eduardo Esteban; Mendoza-Barrera, Germán Eduardo; Valderrama-Treviño, Alan Isaac; Alcántara-Medina, Stefany; Macías-Huerta, Nain Abraham; Tapia-Jurado, Jesús
2016-01-01
The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Program in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral program, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.
-
Yemm, Rowan; Bhattacharya, Debi; Wright, David; Poland, Fiona
2014-07-05
This study aimed to identify any differences in opinion between UK hospital junior doctors and community General Practitioners (GPs) with respect to the ideal content and characteristics of discharge summaries, and to explore junior doctors' training for and awareness of post-discharge requirements of GPs. A piloted anonymous survey was posted to 74 junior doctors at a UK general hospital and 153 local GPs. Doctors were asked to rank discharge summary key content and characteristics in order of importance. GP discharge summary preferences and junior doctor training were also investigated. Non-respondents, identified by non-receipt of a separate participation card, were followed up once. Thirty-six (49%) junior doctors and 42 (28%) GPs returned completed questionnaires. Accuracy was a priority with 24 (72%) GPs and 28 (88%) junior doctors ranking it most important. Details of medication changes were considered most important by 13 (39%) GPs and 4 (12%) junior doctors. Inadequate training in discharge summary writing was reported by 13 (36%) junior doctors. Although based on small sample sizes from one location, the level and range of differences in perceived importance of reporting medication changes suggests that many discharge summaries may not currently fulfil GP requirements for managing continuity of care. Results indicate that over a third of junior doctors felt inadequately prepared for writing discharge summaries. There may therefore be both a need and professional support for further training in discharge summary writing, requiring confirmatory research.
-
Algra, Annemijn M; Cleyndert, Lisette; Drenth, Joost P H
2011-01-01
To investigate the role of art and culture in the recreational activities of doctors, accountants and lawyers. Descriptive questionnaire study. In this study, doctors, accountants and lawyers were asked to respond to an online questionnaire. They were presented with 13 questions or statements concerning their recreational activities and their active or passive involvement with art and culture. To gain an impression in which respect doctors, accountants and lawyers could be distinguished from each other, predictive models based on logistic regression with possible results 'doctor', 'accountant' or 'lawyer' were generated. On the basis of these models, a miniquiz was created, which could distinguish the typical doctor, accountant or lawyer after answering of dichotomous questions. Among all respondents, museum and cinema visits were popular, sports or gardening were favourite activities, and apart from newspapers, the Internet was frequently consulted for news. It was remarkable that doctors and lawyers resembled each other in most of the areas investigated, whereas the accountants differed significantly. Doctors and lawyers particularly visited museums and dance, opera or theatre performances, and two-thirds themselves played music. The majority of these 2 groups also had an above average interest in art and culture, this being a significant part of the recreational activity. Therefore, we were able to differentiate between a doctor or lawyer and an accountant, but the difference between doctors and lawyers was less clear. Doctors and lawyers seemed to have comparable interests in art and culture, but accountants differed in important respects.
-
Code of Federal Regulations, 2014 CFR
2014-10-01
... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...
-
Code of Federal Regulations, 2013 CFR
2013-10-01
... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...
-
Code of Federal Regulations, 2011 CFR
2011-10-01
... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...
-
Code of Federal Regulations, 2012 CFR
2012-10-01
... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...
-
Code of Federal Regulations, 2010 CFR
2010-10-01
... AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements... professionals: (1) A doctor of medicine or osteopathy. (2) A doctor of dental surgery or medicine. (3) A doctor of podiatric medicine. (4) A doctor of optometry. (5) A chiropractor. Geographic health professional...
-
White-Coat Hypertension: When Blood Pressure Rises at the Doctor's Office
... blood pressure rises at the doctor's office My blood pressure is always higher in the doctor's office than it is at home. ... coat hypertension. White coat hypertension occurs when the blood pressure readings at your doctor's office are higher than ...
-
McQuoid-Mason, David Jan
2015-11-09
Doctors should be cautious about suing their patients, because it may generate bad publicity. Where a criminal or civil case or complaint to the Health Professions Council of South Africa by a patient about a doctor's professional conduct is withdrawn or dismissed, a doctor may only sue the patient for defamation if it can be proved that the patient acted from malice, spite or an improper motive. Doctors may only sue patients for malicious prosecution or abuse of civil proceedings if such patients acted with 'malice' and 'without reasonable and probable cause'. If a doctor successfully defends a case against a patient, the court will usually order the patient to pay the doctor's costs.
-
Opportunities outside private practice before 1860.
Deacon, Harriet; van Heyningen, Elizabeth
2004-01-01
This chapter discusses the restrictions and opportunities which salaried employment offered Cape doctors in the pay of government and charitable organisations during the first two thirds of the nineteenth century. Although Cape doctors often acted as agents of the colonial state there were many nuances within this relationship. While military doctors played an important role in the profession during the first few decades of the century, by the 1840s civilian doctors were beginning to assert greater influence in Cape Town, if not yet in the Eastern Cape. Hospital posts and an expanding network of charitable organisations and government-funded district surgeoncies provided part-time employment for some doctors throughout the colony. This helped urban-based doctors to sustain practices and encouraged more doctors to practice in the smaller country towns serving large farming areas.
-
Declercq, Eugene; Caldwell, Karen; Hobbs, Suzanne Havala; Guyer, Bernard
2008-01-01
We examined trends in doctoral education in public health and the challenges facing practice-oriented doctor of public health (DrPH) programs. We found a rapid rise in the numbers of doctoral programs and students. Most of the increase was in PhD students who in 2006 composed 73% of the total 5247 current public health doctoral students, compared with 53% in 1985. There has also been a substantial increase (40%) in students in DrPH programs since 2002. Challenges raised by the increased demand for DrPH practice-oriented education relate to admissions, curriculum, assessment processes, and faculty hiring and promotion. We describe approaches to practice-based doctoral education taken by three schools of public health. PMID:18633094
-
Xu, Sanchun; Hu, Danian
2017-09-01
Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable. Copyright © 2017 Elsevier Ltd. All rights reserved.
-
The master degree: A critical transition in STEM doctoral education
NASA Astrophysics Data System (ADS)
Lange, Sheila Edwards
The need to broaden participation in the nation's science, technology, engineering, and mathematics (STEM) undergraduate and graduate programs is currently a matter of national urgency. The small number of women and underrepresented minorities (URM) earning doctoral degrees in STEM is particularly troubling given significant increases in the number of students earning master's degrees since 1990. In the decade between 1990 and 2000, the total number of master's recipients increased by 42%. During this same time period, the number of women earning master's degrees increased by 56%, African Americans increased by 132%, American Indians by 101%, Hispanics by 146%, and Asian Americans by 117% (Syverson, 2003). Growth in underrepresented group education at the master's level raises questions about the relationship between master's and doctoral education. Secondary data analysis of the Survey of Earned Doctorates (SED) was used to examine institutional pathways to the doctorate in STEM disciplines and transitions from master's to doctoral programs by race and gender. While the study revealed no significant gender differences in pathways, compared to White and Asian American students, URM students take significantly different pathways to the doctorate. URM students are significantly more likely to earn the bachelor's, master's, and doctoral degrees at three different institutions. Their path is significantly more likely to include earning a master's degree en route to the doctorate. Further, URM students are more likely to experience transition between the master's and doctoral degrees, and the transitions are not limited to those who earn master's degrees at master's-only institutions. These findings suggest that earning a master's degree is more often a stepping stone to the doctorate for URM students. Master's degree programs, therefore, have the potential to be a valuable resource for policymakers and graduate programs seeking to increase the diversity of URM students earning doctorates in STEM.
-
Ortega, Elena; Walsh, Margaret M
2014-02-01
Because dental hygiene education has had a similar trajectory as nursing education, this critical review addressed the question "What can the dental hygiene discipline learn from the nursing experience in their development of doctoral education?" Information on admission and degree requirements, modes of instruction, and program length and cost was collected from the websites associated with 112 of 125 PhD nursing programs nationally, and 174 of 184 Doctor of Nursing Practice (DNP) programs. In addition, searches of PubMed, Cumulative Index Nursing Allied Health Literature (CINAHL) and the Web of Science were utilized to identify key articles and books. The following 4 insights relevant to future dental hygiene doctoral education emerged from a review of nursing doctoral education: First, nursing doctoral education offers 2 main doctoral degrees, the research-focused PhD degree and the practice-focused DNP degree. Second, there is a well-documented need for doctoral prepared nurses to teach in nursing programs at all levels in managing client-care settings. Third, curricula quality and consistency is a priority in nursing education. Fourth, there are numerous templates on nursing doctoral education available. The historical background of nursing doctoral education was also reviewed, with the assumption that it can be used to inform the dental hygiene discipline when establishing doctoral dental hygiene education. The authors recommend that with the current changes toward medically and socially compromised patient populations, impending changes in health care policies and the available critical mass of master degree-prepared dental hygiene scholars ready to advance the discipline, now is the time for the dental hygiene discipline to establish doctoral education.
-
Who benefit from school doctors' health checks: a prospective study of a screening method.
Nikander, Kirsi; Kosola, Silja; Kaila, Minna; Hermanson, Elina
2018-06-27
School health services provide an excellent opportunity for the detection and treatment of children at risk of later health problems. However, the optimal use of school doctors' skills and expertise remains unknown. Furthermore, no validated method for screening children for school doctors' assessments exists. The aims of the study are 1) to evaluate the benefits or harm of school doctors' routine health checks in primary school grades 1 and 5 (at ages 7 and 11) and 2) to explore whether some of the school doctors' routine health checks can be omitted using study questionnaires. This is a prospective, multicenter observational study conducted in four urban municipalities in Southern Finland by comparing the need for a school doctor's assessment to the benefit gained from it. We will recruit a random sample of 1050 children from 21 schools from primary school grades 1 and 5. Before the school doctor's health check, parents, nurses and teachers fill a study questionnaire to identify any potential concerns about each child. Doctors, blinded to the questionnaire responses, complete an electronic report after the appointment, including given instructions and follow-up plans. The child, parent, doctor and researchers assess the benefit of the health check. The researchers compare the need for a doctor's appointment to the benefit gained from it. At one year after the health check, we will analyze the implementation of the doctors' interventions and follow-up plans. The study will increase our knowledge of the benefits of school doctors' routine health checks and assess the developed screening method. We hypothesize that targeting the health checks to the children in greatest need would increase the quality of school health services. ClinicalTrials.gov Identifier: NCT03178331 , date of registration June 6 th 2017.
-
Whittal, Amanda; Rosenberg, Ellen
2015-10-29
In many countries doctors are seeing an increasing amount of immigrant patients. The communication and relationship between such groups often needs to be improved, with the crucial factor potentially being the basic attitudes (acculturation orientations) of the doctors and patients. This study therefore explores how acculturation orientations of Canadian doctors and immigrant patients impact the doctor-patient relationship. N = 10 participants (five doctors, five patients) participated in acculturation orientation surveys, video recordings of a regular clinic visit, and semi structured interviews with each person. Acculturation orientations were calculated using the Euclidean distance method, video recordings were analyzed according to the Verona Coding System, and thematic analysis was used to analyze the interviews. Interviews were used to explain and interpret the behaviours observed in the video recordings. The combined acculturation orientations of each the doctor and immigrant patient played a role in the doctor-patient relationship, although different combinations than expected produced working relationships. Video recordings and interviews revealed that these particular immigrant patients were open to adapting to their new society, and that the doctors were generally accepting of the immigrants' previous culture. This produced a common level of understanding from which the relationship could work effectively. A good relationship and level of communication between doctors and immigrant patients may have its foundation in acculturation orientations, which may affect the quality of care, health behaviours and quality of life of the immigrant. The implications of these findings are more significant when considering effective interventions to improve the quality of doctor-patient relationships, which should have a solid foundational framework. Our research suggests that interventions based on understanding the influence of acculturation orientations could help create a basic level of understanding, and therefore improved interaction between doctors and immigrant patients.
-
Nylenna, Magne; Gulbrandsen, Pål; Førde, Reidun; Aasland, Olaf G
2005-01-01
Background General opinion is that doctors are increasingly dissatisfied with their job, but few longitudinal studies exist. This study has been conducted to investigate a possible decline in professional and personal satisfaction among doctors by the turn of the century. Methods We have done a survey among a representative sample of 1 174 Norwegian doctors in 2002 (response rate 73 %) and compared the findings with answers to the same questions by (most of) the same doctors in 1994 and 2000. The main outcome measures were self reported levels of life satisfaction and job satisfaction according to the Job Satisfaction Scale (JSS). Results Most Norwegian doctors are happy. They reported an average life satisfaction of 5.21 in 1994 and 5.32 in 2002 on a scale from 1 (extremely dissatisfied) to 7 (extremely satisfied). Half of the respondents reported a very high level of general life satisfaction (a score of 6 or 7) while only one third said they would have reported this high level of satisfaction five years ago. The doctors thought that they had a higher level of job satisfaction than other comparable professional groups. The job satisfaction scale among the same doctors showed a significant increase from 1994 to 2002. Anaesthesiologists and internists reported a lower and psychiatrists and primary care doctors reported a higher level of job satisfaction than the average. Conclusion Norwegian doctors seem to have enjoyed an increasing level of life and job satisfaction rather than a decline over the last decade. This challenges the general impression of unhappy doctors as a general and worldwide phenomenon. PMID:15943859
-
Involving junior doctors in medical article publishing: is it an effective method of teaching?
Oyibo, Samson O
2017-01-01
Having peer-reviewed articles published in medical journals is important for career progression in many medical specialties. Despite this, only a minority of junior doctors have the skills in the area of medical article publishing. The aim of this study was to assess junior doctors' views concerning being involved in medical article publishing and whether they perceive involvement as an effective method of teaching. A cross-sectional survey was administered to a convenience sample of doctors who had been involved in medical article publishing. Questions concerned training and involvement in publishing as junior doctors, effects on education and training, is it an effective method of teaching and should publishing be part of their education and training program. Questions used the 5-point Likert scale. Of the 39 doctors, 37 (94.9%) doctors responded. Only one-third of respondents agreed that they had adequate training or involvement in medical article publishing during their undergraduate medical training. Many (78.4%) agreed that it was difficult to get published as a junior doctor. Publishing as a junior doctor improved knowledge about publishing, understanding of the topic and interest in the field of study for 92, 92 and 73% of respondents, respectively. Many (89%) agreed that publishing made them eager to publish more. Most (76%) agreed that it was likely to encourage interest in a postgraduate career in that field of study. A majority (92%) felt that involvement in medical article publishing is an effective method of teaching and it should be a part of the junior doctors' education and training program. Junior doctors feel that involvement in medical article publishing contributes to learning and education and is an effective method of teaching. This supports the need to incorporate such training into the junior doctors' education and training program.
-
The use of specialty training to retain doctors in Malawi: A discrete choice experiment.
Mandeville, Kate L; Ulaya, Godwin; Lagarde, Mylène; Muula, Adamson S; Dzowela, Titha; Hanson, Kara
2016-11-01
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not yet in specialty training. Over August 2012 to March 2013, 148 doctors took part out of 153 eligible in Malawi. Despite evidence that specialty training is highly sought after, Malawian junior doctors would not accept all types of training. Doctors preferred timely training outside of Malawi in core specialties (internal medicine, general surgery, paediatrics, obstetrics & gynaecology). Specialty preferences are particularly strong, with most junior doctors requiring nearly double their monthly salary to accept training all in Malawi and over six-fold to accept training in ophthalmology (representing a bundle of unpopular but priority specialties). In contrast, the location of work before training did not significantly influence most doctors' choices when guaranteed specialty training. Using a latent class model, we identified four subgroups of junior doctors with distinct preferences. Policy simulations showed that these preferences could be leveraged by policymakers to improve retention in exchange for guaranteed specialty training, however incentivising the uptake of training in priority specialties will only be effective in those with more flexible preferences. These results indicate that indiscriminate expansion of postgraduate training to slow emigration of doctors from sub-Saharan African countries may not be effective unless doctors' preferences are taken into account. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
-
Gopichandran, Vijayaprasad; Chetlapalli, Satish Kumar
2013-01-01
Background Trust is a forward-looking covenant between the patient and the doctor where the patient optimistically accepts his/her vulnerability. Trust is known to improve the clinical outcomes. Objectives To explore the factors that determine patients’ trust in doctors and to segment the community based on factors which drive their trust. Setting Resource-poor urban and rural settings in Tamil Nadu, a state in southern India. Participants A questionnaire was administered to a sample of 625 adult community-dwelling respondents from four districts of Tamil Nadu, India, chosen by multistage sampling strategy. Outcome measures The outcomes were to understand the main domains of factors influencing trust in doctors and to segment the community based on which of these domains predominantly influenced their trust. Results Factor analysis revealed five main categories, namely, comfort with the doctor, doctor with personal involvement with the patient, behaviourally competent doctor, doctor with a simple appearance and culturally competent doctor, which explained 49.3% of the total variance. Using k-means cluster analysis the respondents were segmented into four groups, namely, those who have ‘comfort-based trust’, ‘emotionally assessed trust’, who were predominantly older and belonging to lower socioeconomic status, those who had ‘personal trust’, who were younger people from higher socioeconomic strata of the community and the group who had ‘objectively assessed trust’, who were younger women. Conclusions Trust in doctors seems to be influenced by the doctor's behaviuor, perceived comfort levels, personal involvement with the patient, and to a lesser extent by cultural competence and doctor's physical appearance. On the basis of these dimensions, the community can be segmented into distinct groups, and trust building can happen in a strategic manner which may lead to improvement in perceived quality of care. PMID:24302512
-
Reasons for Consulting a Doctor on the Internet: Web Survey of Users of an Ask the Doctor Service
Petersson, Göran; Hamberg, Katarina
2003-01-01
Background In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. Objective To study why individuals choose to consult previously-unknown doctors on the Internet. Methods Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" Results 1223 surveys were completed (response rate 34%). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. Conclusions We found that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet. PMID:14713654
-
Kadam, Shridhar; Nallala, Srinivas; Zodpey, Sanjay; Pati, Sanghamitra; Hussain, Mohammad Akhtar; Chauhan, Abhimanyu Singh; Das, Sovesh; Martineau, Tim
2016-02-24
An effective health workforce is essential for achieving health-related new Sustainable Development Goals. Odisha, one of the states in India with low health indicators, faces challenges in recruiting and retaining health staff in the public sector, especially doctors. Recruitment, deployment and career progression play an important role in attracting and retaining doctors. We examined the policies on recruitment, deployment and promotion for doctors in the state and how these policies were perceived to be implemented. We undertook document review and four key informant interviews with senior state-level officials to delineate the policies for recruitment, deployment and promotion. We conducted 90 in-depth interviews, 86 with doctors from six districts and four at the state level to explore the perceptions of doctors about these policies. Despite the efforts by the Government of Odisha through regular recruitments, a quarter of the posts of doctors was vacant across all institutional levels in the state. The majority of doctors interviewed were unaware of existing government rules for placement, transfer and promotion. In addition, there were no explicit rules followed in placement and transfer. More than half (57%) of the doctors interviewed from well-accessible areas had never worked in the identified hard-to-reach areas in spite of having regulatory and incentive mechanisms. The average length of service before the first promotion was 26 (±3.5) years. The doctors expressed satisfaction with the recruitment process. They stated concerns over delayed first promotion, non-transparent deployment policies and ineffective incentive system. Almost all doctors suggested having time-bound and transparent policies. Adequate and appropriate deployment of doctors is a challenge for the government as it has to align the individual aspirations of employees with organizational needs. Explicit rules for human resource management coupled with transparency in implementation can improve governance and build trust among doctors which would encourage them to work in the public sector.
-
Diagnosis of Irritable Bowel Syndrome
... doctors may order tests to rule out other health problems. Review of your symptoms Your doctor will ask about your symptoms and look for ... Doctors may perform other tests to rule out health problems that cause ... IBS symptoms. Your doctor will decide whether you need other tests based ...
-
Retheorizing Doctoral Supervision as Professional Work
ERIC Educational Resources Information Center
Halse, Christine; Malfroy, Janne
2010-01-01
A competitive higher education environment marked by increased accountability and quality assurance measures for doctoral study, including the structured training of doctoral supervisors, has highlighted the need to clearly articulate and delineate the work of supervising doctoral students. This article responds to this imperative by examining the…
-
Smeltzer, Suzanne C; Sharts-Hopko, Nancy C; Cantrell, Mary Ann; Heverly, Mary Ann; Wise, Nancy; Jenkinson, Amanda
Support for research strongly predicts doctoral program faculty members' research productivity. Although academic administrators affect such support, their views of faculty members' use of support are unknown. We examined academic administrators' perceptions of institutional support and their perceptions of the effects of teaching doctoral students on faculty members' scholarship productivity and work-life balance. An online survey was completed by a random sample of 180 deans/directors of schools of nursing and doctoral programs directors. Data were analyzed with descriptive statistics, chi-square analysis, and analysis of variance. Deans and doctoral program directors viewed the level of productivity of program faculty as high to moderately high and unchanged since faculty started teaching doctoral students. Deans perceived better administrative research supports, productivity, and work-life balance of doctoral program faculty than did program directors. Findings indicate the need for greater administrative support for scholarship and mentoring given the changes in the composition of doctoral program faculty. Copyright © 2017 Elsevier Inc. All rights reserved.
-
Dean, Jessica; Mahar, Patrick; Loh, Erwin; Ludlow, Karinne
2013-10-01
Medical practitioners may have their particular skills called upon outside a direct professional context. The responsibilities of medical practitioners outside their defined scope of clinical practice may not be clear to all clinicians. To consider the possible legal consequences of a doctor refusing to assist a person in need of urgent medical attention both in terms of medical negligence and professional misconduct. Where an established clinical relationship does not exist, and a doctor does not wish to render aid, three particular scenarios may arise. A doctor may actively deny being a doctor, passively avoid identifying themselves as a doctor or acknowledge being a doctor, but refuse to render assistance. Aside from any ethical issues, how a doctor chooses to act and represent themselves may lead to different legal ramifications. There exists significant variation in state provisions relating to legal obligations to render aid, which may benefit from review and revision at a national level.
-
The path of patient loyalty and the role of doctor reputation.
Torres, Eduardo; Vasquez-Parraga, Arturo Z; Barra, Cristobal
2009-01-01
Patient loyalty to doctors is relevant to medical services in which doctor-patient relationships are central and for which competition has increased in recent years. This study aims at understanding the process whereby patients develop loyalty to their doctor and doctor reputation has a moderating role. Based on a randomization of subjects, the study offers and tests an explanation chain representing key variables determining patient loyalty: patient commitment, trust and satisfaction, and doctor reputation. Primary data was collected using a structured questionnaire from a quota sample of regular patients in a large city in South America. The patients most committed to their doctor are more loyal to them. In turn, commitment is determined by patient trust, which is determined by patient satisfaction. Doctor reputation positively influences both patient trust and satisfaction. The explanation chain not only gives an account of how patient loyalty is formed; it also identifies a path health professionals can follow to secure patient loyalty.
-
The experience of international nursing students studying for a PhD in the U.K: A qualitative study.
Evans, Catrin; Stevenson, Keith
2011-06-13
Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students.
-
Doctor-patient relationship. Islamic perspective.
Chamsi-Pasha, Hassan; Albar, Mohammed A
2016-02-01
The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor's instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients.
-
Effective doctor-patient communication: an updated examination.
Matusitz, Jonathan; Spear, Jennifer
2014-01-01
This article examines, in detail, the quality of doctor-patient interaction. Doctor-patient communication is such a powerful indicator of health care quality that it can determine patients' self-management behavior and health outcomes. The medical visit (i.e., the medical encounter) plays a pivotal role in the health care process. In fact, doctor-patient communication is one of the most essential dynamics in health care, affecting the course of patient care and patient compliance with recommendations for care. Unlike many other analyses (that often look at only one or two specific aspects of doctor-patient relationships), this analysis is more encompassing; it looks at doctor-patient communication from multiple perspectives.
-
Exploring the Pursuit of Doctoral Education by Nurses Seeking or Intending to Stay in Faculty Roles.
Dreifuerst, Kristina Thomas; McNelis, Angela M; Weaver, Michael T; Broome, Marion E; Draucker, Claire Burke; Fedko, Andrea S
2016-01-01
The purpose of this study was to describe the factors influencing the pursuit and completion of doctoral education by nurses intending to seek or retain faculty roles. Traditionally, doctoral education evolved to focus on the preparation of nurses to conduct scientific research, primarily through the doctor of philosophy programs. Most recently, the doctor of nursing practice degree emerged and was designed for advanced practice nurses to be clinical leaders who translate research into practice and policy. Nurses who pursue doctoral education in order to assume or maintain faculty roles must choose between these degrees if they desire a doctorate within the discipline; however, factors influencing their decisions and the intended outcomes of their choice are not clear. During this study, 548 nurses (current students or recent graduates of doctoral programs) completed a comprehensive survey to generate critical evidence about the factors influencing the choices made. Principal findings are related to the issues of time, money, and program selection. These findings can be used to develop strategies to increase enrollment and, therefore, the number of doctorally prepared faculty who are specifically prepared to excel as nursing faculty. Copyright © 2016 Elsevier Inc. All rights reserved.
-
How many doctors should we train for Sri Lanka? System dynamics modelling for training needs
De Silva, D
2017-12-26
Over the years, Sri Lanka has achieved remarkable health gains for the money spent on health. Currently about 1450 doctors enter the health system annually. While some advocate opening up of new medical schools to address an apparent shortage of doctors in the country, others argue against it. To identify the number of doctors Sri Lanka need. System dynamics, an analytical modelling approach and a methodology for studying complex feedback systems was used. Two sub models of “need” and “supply” were developed and simulated for a period of 15 years from 2017 to 2032 At present the doctor to population ratio is 1:671 and 91% of the need has been met. This study shows that currently there is a shortage of doctors in the country. However, the supply will match the need by 2025/26. Increasing the number of doctors, will result in oversupply of doctors towards the latter part of the next decade. There is no acute necessity to open up new Medical Schools. However comprehensive health workforce analysis needs to be done once in 5 years and the number of doctors to be trained, decided accordingly.
-
'Half the fun is getting there': a beginner's guide to doctoral study.
Green, Elyce
2016-07-01
There is a significant need for more nurses to enrol in doctoral studies and to improve attrition rates in these courses. It is therefore important that those who consider undertaking doctoral studies are prepared for the many challenges associated with pursuing a higher degree by research. To present a personal reflection of the first year of doctoral study to inform others about the challenges and joys associated with beginning a doctorate, as well as to demystify some of the challenges of studying a PhD, and to encourage nurses and other healthcare professionals to pursue a doctorate. Issues discussed include the changing identity of a doctoral student, how to select and manage the supervisory team, and some of the barriers that will be faced in the first year of candidature and ways to overcome them. 'Imposter syndrome' and threshold concepts are also discussed. Embarking on a PhD is a challenging and transformative journey. Those who wish to undertake doctoral studies must plan carefully and pursue a topic they are passionate about. Research is essential in contemporary nursing practice. Greater numbers of nurses enrolled in doctoral studies would increase generation of new nursing knowledge and translation of research to practice.
-
The doctor as businessman: the changing politics of a cultural icon.
Stone, D A
1997-04-01
From just after the Civil War, when medicine began to professionalize, until the late 1970s, doctors and policy makers believed that clinical judgment should not be influenced by the financial interests of doctors. Physicians were highly entrepreneurial, and organized medicine fought to preserve their entrepreneurial interests, but the moral norm that justified their autonomy from state regulation was a strict separation of clinical judgment and pecuniary interests. Under managed care, the old norm is reversed. A good doctor takes financial considerations into account in making clinical decisions. Theoretically, doctors should consider measures of cost to society, but in practice, the payment systems of managed care plans induce doctors to consider the impact of each clinical decision on their own income. Because doctors share the risks of insuring patients with managed care plans, they have the same incentives as insurers to avoid patients who are expensively sick. The new cultural image of doctors as entrepreneurs masks their considerable loss of clinical autonomy under managed care. It also serves to persuade doctors to accept managed care arrangements and to persuade insurance consumers and patients to accept reduced benefits from employers and the government.
-
Cunningham, Wayne; Crump, Raewyn; Tomlin, Andrew
2003-10-10
To analyse the incidence and characteristics of medical complaints received by doctors in New Zealand. A cross-sectional survey of New Zealand doctors randomly selected from each of three groups from the New Zealand medical register: vocationally registered general practitioners; vocationally registered hospital-based specialists; and general registrants. Nine hundred and seventy one doctors (11% of registered New Zealand doctors) indicated that 34% had ever received a medical complaint, and 66% had never received one. The rate of complaint in New Zealand is rising. The annual rate of complaint in 2000 was 5.7%, with doctors in the 40-60 age group receiving 68% of complaints. Doctors who were male, vocationally registered general practitioners, and holding higher postgraduate qualifications were more likely to receive a complaint. Time to resolution of a complaint is long, with 74% of dismissed and 59% of upheld complaints being resolved within 12 months. This study finds a high incidence of complaint in New Zealand. It finds differences between doctors based on gender, qualification, and field of practice, and suggests that responsibility for patient care may be an important determinant of the risk of receiving a complaint.
-
Waddington, I; Roderick, M; Naik, R
2001-02-01
To examine the methods of appointment, experience, and qualifications of club doctors and physiotherapists in professional football. Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned. In almost all clubs, methods of appointment of doctors are informal and reflect poor employment practice: posts are rarely advertised and many doctors are appointed on the basis of personal contacts and without interview. Few club doctors had prior experience or qualifications in sports medicine and very few have a written job description. The club doctor is often not consulted about the appointment of the physiotherapist; physiotherapists are usually appointed informally, often without interview, and often by the manager without involving anyone who is qualified in medicine or physiotherapy. Half of all clubs do not have a qualified (chartered) physiotherapist; such unqualified physiotherapists are in a weak position to resist threats to their clinical autonomy, particularly those arising from managers' attempts to influence clinical decisions. Almost all aspects of the appointment of club doctors and physiotherapists need careful re-examination.
-
Doctors' voices in patients' narratives: coping with emotions in storytelling.
Lucius-Hoene, Gabriele; Thiele, Ulrike; Breuning, Martina; Haug, Stephanie
2012-09-01
To understand doctors' impacts on the emotional coping of patients, their stories about encounters with doctors are used. These accounts reflect meaning-making processes and biographically contextualized experiences. We investigate how patients characterize their doctors by voicing them in their stories, thus assigning them functions in their coping process. 394 narrated scenes with reported speech of doctors were extracted from interviews with 26 patients with type 2 diabetes and 30 with chronic pain. Constructed speech acts were investigated by means of positioning and narrative analysis, and assigned into thematic categories by a bottom-up coding procedure. Patients use narratives as coping strategies when confronted with illness and their encounters with doctors by constructing them in a supportive and face-saving way. In correspondence with the variance of illness conditions, differing moral problems in dealing with doctors arise. Different evaluative stances towards the same events within interviews show that positionings are not fixed, but vary according to contexts and purposes. Our narrative approach deepens the standardized and predominantly cognitive statements of questionnaires in research on doctor-patient relations by individualized emotional and biographical aspects of patients' perspective. Doctors should be trained to become aware of their impact in patients' coping processes.
-
NASA Astrophysics Data System (ADS)
Soporan, V. F.; Samoilă, V.; Lehene, T. R.; Pădureţu, S.; Crişan, M. D.; Vescan, M. M.
2018-06-01
The paper presents a method of analysis of doctoral theses in castings production, elaborated in Romania, the analysis period ranging from 1918 to 2016. The procedure, based on the evolution of the analyzed problem, consists of the following steps: establishment of a coding system for the domains and subdomains established in the thematic characterization of doctoral theses; the establishment of the doctoral organizing institutions, the doctoral specialties, the doctoral supervisors and the time frame for the analysis; selecting the doctoral thesis that will be included in the analysis; establishing the key words for characterization of doctoral theses, based on their title; the assignment of theses to the domains and subdomains according to the meaning of the keywords, to the existing groups of the coding system; statistical processing of results and determination of shares for each domain and subdomain; conclusions on the results obtained and their interpretation in the context of economic and social developments. The proposed method being considered as general, the case study is carried out at the level of the specific field of castings production, the territory of the analysis refers to the institutions organizing doctoral studies.
-
Tyrrell, Ella; Keegan, Conor; Humphries, Niamh; McAleese, Sara; Thomas, Steve; Normand, Charles; Brugha, Ruairí
2016-06-30
The World Health Organization's Global Code on the International Recruitment of Health Personnel urges Member States to observe fair recruitment practices and ensure equality of treatment of migrant and domestically-trained health personnel. However, international medical graduates (IMGs) have experienced difficulties in accessing postgraduate training and in progressing their careers in several destination countries. Ireland is highly dependent on IMGs, but also employs non-European Union (EU) doctors who qualified as doctors in Ireland. However, little is known regarding the career progression of these doctors. In this context, the present study assesses the determinants of career progression of non-EU doctors with particular focus on whether barriers to progression exist for those graduating outside Ireland compared to those who have graduated within. The study utilises quantitative data from an online survey of non-EU doctors registered with the Medical Council of Ireland undertaken as part of the Doctor Migration Project (2011-2013). Non-EU doctors registered with the Medical Council of Ireland were asked to complete an online survey about their recruitment, training and career experiences in Ireland. Analysis was conducted on the responses of 231 non-EU hospital doctors whose first post in Ireland was not permanent. Career progression was analysed by means of binary logistic regression analysis. While some of the IMGs had succeeded in accessing specialist training, many experienced slow or stagnant career progression when compared with Irish-trained non-EU doctors. Key predictors of career progression for non-EU doctors working in Ireland showed that doctors who qualified outside of Ireland were less likely than Irish-trained non-EU doctors to experience career progression. Length of stay as a qualified doctor in Ireland was strongly associated with career progression. Those working in anaesthesia were significantly more likely to experience career progression than those in other specialities. The present study highlights differences in terms of achieving career progression and training for Irish-trained non-EU doctors, compared to those trained elsewhere. However, the findings herein warrant further attention from a workforce planning and policy development perspective regarding Ireland's obligations under the Global Code of hiring, promoting and remunerating migrant health personnel on the basis of equality of treatment with the domestically-trained health workforce.
-
Unequal Socialization: Interrogating the Chicano/Latino(a) Doctoral Education Experience
ERIC Educational Resources Information Center
Ramirez, Elvia
2017-01-01
This article examines the experiences of Chicano/Latino(a) doctoral students at a research-intensive doctorate-granting institution. Based on in-depth qualitative interviews with 24 Chicano/Latino(a) doctoral students across social science, humanities, education, and science disciplines, this qualitative investigation analyzed how disciplinary…
-
Purist or Pragmatist? UK Doctoral Scientists' Moral Positions on the Knowledge Economy
ERIC Educational Resources Information Center
Hancock, Sally; Hughes, Gwyneth; Walsh, Elaine
2017-01-01
Doctoral scientists increasingly forge non-academic careers after completing the doctorate. Governments and industry in advanced economies welcome this trend, since it complements the "knowledge economy" vision that has come to dominate higher education globally. Knowledge economy stakeholders consider doctoral scientists to constitute…
-
Doctoral Scientists in Oceanography.
ERIC Educational Resources Information Center
National Academy of Sciences-National Research Council, Washington, DC. Assembly of Mathematical and Physical Sciences.
The purpose of this report was to classify and count doctoral scientists in the United States trained in oceanography and/or working in oceanography. Existing data from three sources (National Research Council's "Survey of Earned Doctorates," and "Survey of Doctorate Recipients," and the Ocean Sciences Board's "U.S. Directory of Marine…
-
Understanding Physical Education Doctoral Students' Perspectives of Socialization
ERIC Educational Resources Information Center
Richards, K. Andrew R.; McLoughlin, Gabriella M.; Ivy, Victoria Nicole; Gaudreault, Karen Lux
2017-01-01
Purpose: Despite an abundance of research on doctoral student socialization in higher education, little attention has been paid to physical education doctoral students. This study sought to understand physical education doctoral students' perceptions of their socialization as preparation for faculty roles. Method: Participants included 32 physical…
-
Identifying, Characterising and Assessing New Practices in Doctoral Education
ERIC Educational Resources Information Center
Baschung, Lukas
2016-01-01
Traditionally, European doctoral education has principally taken place within the binary relationship of professors and their doctoral students according to the "apprenticeship model." However, in the last one to two decades, this model has been questioned. Governments and higher education institutions (HEIs) reform doctoral education by…
-
Perceptions of Mattering in the Doctoral Student and Advisor Relationship
ERIC Educational Resources Information Center
Schneider, Holly Anne
2015-01-01
The advising relationship has been acknowledged as one of the most important factors in doctoral student persistence and attrition. Less researched are psychosocial factors that contribute to doctoral student persistence and completion. Preliminary research including measures of psychosocial factors on doctoral student success found…
-
The Professional Doctorate in Nursing: A Position Paper
ERIC Educational Resources Information Center
Newman, Margaret A.
1975-01-01
The need for family-centered health care could be met by nurses now if they had a professional doctorate and the recognition and authority that go with it. The author distinguishes between an academic doctorate (Preparation for scholars) and a professional doctorate (a practice degree). (Author/BP)
-
Developing Online Doctoral Programmes
ERIC Educational Resources Information Center
Chipere, Ngoni
2015-01-01
The objectives of the study were to identify best practices in online doctoral programming and to synthesise these practices into a framework for developing online doctoral programmes. The field of online doctoral studies is nascent and presents challenges for conventional forms of literature review. The literature was therefore reviewed using a…
-
Matsumoto, Yuuki; Hoshiko, Michiko; Morimatsu, Yoshitaka; Mori, Mihoko; Kushino, Nanae; Ishitake, Tatsuya
2015-01-01
Fatigue caused by high workload is often responsible for the high attrition among doctors, and has contributed to a disruption in community medicine. In order to address this problem, institutional mechanisms at the hospital level are required. Previous studies have shown that systemic measures at the hospital level and a change in the mindset of patients can help manage the problem. "Convenient visits" refer to emergency visits for non-emergency problems. It is an avoidable cause of high workload on doctors. Convenient visits also refer to emergency consultation for non-emergency symptoms. As this is a new phenomenon, its relationship with doctors' fatigue needs further research. We investigated the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales. We selected 44 hospitals, with >200 beds each, in provincial cities of prefectures with a doctor-population ratio lower than the national average. These cities were considered likely to manifest the phenomenon of 24-hour society and include overworked doctors. Ordinance-designated cities were excluded from this study owing to wide population variability. Three doctors from each hospital were randomly selected from among physicians, surgeons, and pediatricians. We distributed questionnaires (a questionnaire concerning convenient visits, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale) to 132 doctors. Forty-two doctors responded to the survey. The median proportion of convenient visits among emergency visits was 50%. Sixty percent of the doctors surveyed were annoyed by convenient visits. Other doctors indicated good collaboration between the hospitals and communities or that they were not currently annoyed by convenient visits, although they had been annoyed previously. The emotional exhaustion in doctors, who worked in hospitals that did not restrict convenient visits, was significantly higher than in those who worked in hospitals that restricted these visits. A significant risk of serious burnout was found via crude and multiple logistic regression analysis (adjusted for age and gender, or adjusted for age, gender, clinical department, frequency of work shifts, and sleep duration during work shifts). Doctors working in hospitals that do not protect them against convenient visits are more prone to burnout. Although the number of convenient visitors is increasing, many hospitals lack systemic measures to manage them. This contributes to doctors' burnout. We suggest that hospitals control convenient visits for preventing doctors' burnout. Collaboration between hospitals and communities is required to help alleviate this problem.
-
1984-05-01
moral charac- ter. In August 1976, the New Jersey Board of Medical Examiners issued an order suspending the doctor for gross malpractice . The Board...GAO obtained information for the period Janu- ary 1977 through December 1982 on six types of practitioners-- medical doctors , osteopathic doctors ...See p. 4.) GAO iden- tified 328 practitioners in these categories-- 144 medical doctors , 37 osteopathic doctors , 33 dentists, 10 chiropractors, 5
-
Misaki, Yuko
2015-06-01
This research is based on materials of the Bureau of Hygiene (see text) and the minutes of the Central Board of Health (see text) contained in Hosokawa Junjiro's (see text) monograph Goen Sosho (see text). It showed that the movement toward allowing the qualification of modern female doctors in Japan was going on in various parts of Japan from 1881 or earlier. This history shows the presence of many female doctors in the Edo Period. At an extraordinary meeting of the Central Board of Health, an advisory body of the Bureau of Hygiene, the qualification of female doctors was approved of in 1881. This was based on an article in the yororyo law (see text) about female doctors contained in the ancient laws of Japan. As a result, the Department of the Interior allowed female doctors in June, 1884. At this time, five females took the national examination for medical practitioners. The following year, Ogino Ginko (see text) became the first modern female doctor in Japan. Owing to the yororyou law about female doctors, and the efforts of many other females who wanted to become doctors, the first modern female doctors in Japan came into being.
-
[Effect of doctor-patient communication education on oral clinical practice].
Wang, Yi; Tang, Yu; He, Yan; Zhu, Ya-qin
2012-08-01
To evaluate the effect of doctor-patient communication education on dental clinical practice. The process of 61 dental interns' clinical practice was divided into two stages. The dental interns were taught with traditional teaching method in the first stage. Doctor-patient communication and communication skill training were added to the second stage. Scale of medical student's doctor-patient communication behavior was used to evaluate the dental interns' behavior by themselves after two stages. The SEGUE frame work was used to evaluate the dental interns' behavior by teachers after two stages. All statistical analysis was performed using SPSS 13.0 software package. The result of scale of medical student's doctor-patient communication behavior was analyzed using Fisher exact test or Chi-square test. The score of the SEGUE frame work was analyzed using Student's t test. The result of Scale of medical student's doctor-patient communication behavior showed only 37.71% of dental interns could establish good doctor-patient relationship in the first stage. After doctor-patient communication and communication skill training, the percentage became 75.4%. The result of the SEGUE frame work showed the score was raised from 16.066±3.308 to 21.867±2.456, and a significant difference was found between the two stages. Doctor-Patient communication education can improve dental interns' communication skills and help to establish a good doctor-patient relationship.
-
Doctors and the state: lessons from the Biko case.
Silove, D
1990-01-01
The death of the well-known black leader, Steve Biko, in detention in South Africa in 1977 has continued to generate debate in the international medical literature. The three doctors who examined him during his terminal illness made a diagnosis of malingering in spite of overwhelming evidence suggesting that he had suffered extensive traumatic brain injury while in detention. The inquest into his death provided a rare insight into the manner in which state doctors function in relation to the police of a repressive regime. This article documents the relevant testimony from the inquest and explores the reasons for the doctor's mismanagement of Biko. It is suggested that failures in the doctors' judgement were a result of complex influences including the effects of their own social conditioning, the risk of habituation by state doctors to degrading prison conditions, the inroads that Apartheid has made into medical practice, the possibility of reprisal if state doctors oppose the wishes of the police, and, more speculatively, the possibility that the doctors' obedience and passivity were exploited by the Security Police who wished to absolve themselves from responsibility of Biko's injuries. Most importantly, it is argued that the repeated failure of the major medical organizations in South Africa to provide clear guidance and leadership to state-employed doctors increases the risk that individual doctors will continue to succumb to hierarchical pressures to condone acts of state-sanctioned violence against detainees.
-
Medical humanities play an important role in improving the doctor-patient relationship.
Wang, Fan; Song, Zhenzhen; Zhang, Wen; Xiao, Yawen
2017-05-23
Doctors in China have been wounded or even killed in frequent violence as conflict between doctors and patients has intensified. China has had a massive dearth of medical students over the past decade and doctors are dissatisfied with conditions in their profession. Conditions in medicine are not conducive to medical reform. This paper notes that the main factors affecting the doctor-patient relationship are a lack of humanity in medicine, the predominance of techniques and technologies, and inappropriate administration of hospitals. These factors are related to a lack of medical humanities. This paper describes several steps to make medicine more humane and to help establish a harmonious doctor-patient relationship, including improved humanities education for doctors and medical students, ending the predominance of techniques and technologies, bringing back "humanity" in medicine, and improving the administration of hospitals.
-
Development of village doctors in China: financial compensation and health system support.
Hu, Dan; Zhu, Weiming; Fu, Yaqun; Zhang, Minmin; Zhao, Yang; Hanson, Kara; Martinez-Alvarez, Melisa; Liu, Xiaoyun
2017-07-01
Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot doctors. But After 1985, the formal health system played a more dominant role in the CHW system including both selection and training of village doctors. China applied various mechanisms to compensate village doctors in different stages. During 1960s and 1970s, the main income source of barefoot doctors was from their villages' collective economy. After 1985 when the rural collective economy collapsed and barefoot doctors were transformed to village doctors, they depended on user fees, especially from drug sale revenues. In the new century, especially after the new round of health system reform in 2009, government subsidy has become an increasing source of village doctors' income. The barefoot doctor policy has played a significant role in providing basic human resources for health and basic health services to rural populations when rural area had great shortages of health resources. The key experiences for this great achievement are the intersection between the community and the formal health system, and sustained and stable financial compensation to the community health workers.
-
Importance and benefits of the doctoral thesis for medical graduates.
Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke
2016-01-01
The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.
-
Maisonneuve, Jenny J; Lambert, Trevor W; Goldacre, Michael J
2014-02-06
To report on doctors' views, from all specialty backgrounds, about the European Working Time Directive (EWTD) and its impact on the National Health Service (NHS), senior doctors and junior doctors. All medical school graduates from 1999 to 2000 were surveyed by post and email in 2012. The UK. Among other questions, in a multipurpose survey on medical careers and career intentions, doctors were asked to respond to three statements about the EWTD on a five-point scale (from strongly agree to strongly disagree): 'The implementation of the EWTD has benefited the NHS', 'The implementation of the EWTD has benefited senior doctors' and 'The implementation of the EWTD has benefited junior doctors'. The response rate was 54.4% overall (4486/8252), 55.8% (2256/4042) of the 1999 cohort and 53% (2230/4210) of the 2000 cohort. 54.1% (2427) of all respondents were women. Only 12% (498/4136 doctors) agreed that the EWTD has benefited the NHS, 9% (377) that it has benefited senior doctors and 31% (1289) that it has benefited junior doctors. Doctors' views on EWTD differed significantly by specialty groups: 'craft' specialties such as surgery, requiring extensive experience in performing operations, were particularly critical. These cohorts have experience of working in the NHS before and after the implementation of EWTD. Their lack of support for the EWTD 4 years after its implementation should be a concern. However, it is unclear whether problems rest with the current ceiling on hours worked or with the ways in which EWTD has been implemented.
-
Khan, Nazib Uz Zaman; Rasheed, Sabrina; Sharmin, Tamanna; Ahmed, Tanvir; Mahmood, Shehrin Shaila; Khatun, Fatema; Hanifi, Sma; Hoque, Shahidul; Iqbal, Mohammad; Bhuiya, Abbas
2015-08-05
Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. Our study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention. The study was conducted in Chakaria, a remote rural area in south-eastern Bangladesh during April-May 2013. Twelve village doctors were selected purposively from a pool of 55 village doctors who participated in the mobile health (mHealth) intervention. In depth interviews were conducted to collect data. The data were manually analysed using themes that emerged. The village doctors talked about both business benefits (access to formal doctors, getting support for decision making, and being entitled to call trained doctors) and personal benefits (both financial and non-financial). Some of the major barriers mentioned were technical problems related to accessing the call centre, charging consultation fees, and unfamiliarity with the call centre physicians. Village doctors saw many benefits to having a business relationship with the trained doctors that the mHealth intervention provided. mHealth through call centres has the potential to ensure consultation services to populations through existing informal healthcare providers in settings with a shortage of qualified healthcare providers.
-
Rutberg, Pooja C; King, Brandy; Gaufberg, Elizabeth; Brett-MacLean, Pamela; Dinardo, Perry; Frankel, Richard M
2017-04-01
To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession. The authors noted a highly similar distribution of primary and secondary relational themes for essays from 1999 and 2013. The majority of the essays emphasized the centrality of the doctor-patient relationship. Student essays focused little on teamwork, systems innovation, or technology use-all important developments in contemporary medicine. Medical students' narrative reflections are increasingly used as rich sources of information about the lived experience of medical education. The findings reported here suggest that medical students understand the "good doctor" as a relational being, with an enduring emphasis on the doctor-patient relationship. Medical education would benefit from including an emphasis on the relational aspects of medicine. Future research should focus on relational learning as a pedagogical approach that may support the formation of caring, effective physicians embedded in a complex array of relationships within clinical, community, and larger societal contexts.
-
Liang, Ying; Wang, Hanwei; Tao, Xiaojun
2015-09-24
In contemporary Chinese society, obstacles such as frequent violence against medical workers and tense doctor-patient relationships affect the health of Chinese doctors. This study attempted to explore the quality of life (QOL) of young clinical doctors in public hospitals in China's developed cities to study the psychometric properties of QOL and related risk factors of doctors' health. This study sampled young doctors aged 15-45 in 18 public hospitals of three cities in East China (Shanghai, Nanjing, and Hangzhou, N = 762). The Nottingham Health Profile was used to measure QOL, the dependent variable of this study. Methodologies such as reliability analysis, mean comparison, and exploratory factor analysis were used to study related psychometric properties. Almost 90 % of young Chinese clinical doctors have a bachelor's degree or above. Approximately 70.4 % of the doctors have relatively low job titles. Among the sample, 76.1 % have a monthly income ranging from USD 326 to USD 1139, and 91.3 % work over eight hours daily. These respondents have poor sleeping habits and mental functions, but have relatively good physical functions. Being female, low education, low job title, low salary, and long work hours are factors associated with doctors' poor QOL. Regression analysis results emphasize the great effect of high education on the improvement of QOL. Young clinical doctors in public hospitals in Chinese developed cities have poor QOL. Reforms on the current medical health system, improving the working environment of doctors and relieve their occupational stress should be required.
-
Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009.
Goldacre, Michael J; Fazel, Seena; Smith, Fay; Lambert, Trevor
2013-03-01
Recruitment of adequate numbers of doctors to psychiatry is difficult. To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). One, three and five years after graduation, 4-5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists' choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave 'job content' as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Junior doctors' views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation.
-
Science and Engineering Doctorate Awards: 1998.
ERIC Educational Resources Information Center
Hill, Susan T.
The data presented in this report shows trends in doctorate awards by science and engineering (S&E) field and recipient characteristics, institutions awarding doctorates, and postgraduation plans of recipients. The source of the data is the Survey of Earned Doctorates (SED). The SED has been conducted annually for the National Science Foundation…
-
Science and Engineering Doctorate Awards: 1999.
ERIC Educational Resources Information Center
Hill, Susan T.
The data in this report show trends in doctorate awards by science and engineering (S&E) field and recipient characteristics, institutions awarding doctorates, and postgraduation plans of recipients. The source of the data is the Survey of Earned Doctorates (SED). The SED is conducted annually for the National Science Foundation (NSF) and four…
-
Doctoral Assistants = Critical Friends: A Simple yet Complex Equation
ERIC Educational Resources Information Center
Hay, John; Laguerre, Fabrice; Moore, Eric; Reedy, Katherine; Rose, Scott; Vickers, Jerome
2015-01-01
The Carnegie Project on the Education Doctorate (CPED) encourages doctoral candidates volunteering in order to give back and continue their relationship with the university after completing their dissertation. Volunteering can take on many forms, from acting as doctoral assistants to performing the role of critical friends on future doctoral…
-
Invisible Roles of Doctoral Program Specialists
ERIC Educational Resources Information Center
Bachman, Eva Burns; Grady, Marilyn L.
2016-01-01
The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…
-
ERIC Educational Resources Information Center
Ryan, Margaret Vail
2011-01-01
Prominent challenges facing contemporary community colleges are enhancing leadership capacity and serving their diverse student populations. While doctoral education constitutes a mainstay strategy for developing community college leaders, community college professionals face constraints accessing doctoral programs. The innovation of an…
-
Re-Imagining Doctoral Education: Professional Doctorates and beyond
ERIC Educational Resources Information Center
Lee, Alison; Brennan, Marie; Green, Bill
2009-01-01
Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…
-
ERIC Educational Resources Information Center
van der Merwe, Mathilde
2015-01-01
Writing-for-publication is a practice that doctoral students should acquire for integration into international research culture. Publication rates and forms of pedagogy supporting the development of publication skills for doctoral students, however, remain inadequate worldwide. Limited data of doctoral student publication from African universities…
-
From Dissertation to Publication: Converting Doctoral Research into a Peer-Reviewed Journal Article
ERIC Educational Resources Information Center
Rodriquez-Kiino, Diane
2012-01-01
"The Journal of Applied Research in the Community College" (JARCC) actively seeks scholarly submissions on community colleges that originate from doctoral dissertations. Understanding the scope and complexity of community and junior colleges nationally requires multiple vantage points. Newly minted doctorates and doctoral candidates can provide a…
-
Shaping Graduate Education's Future: Improving the Doctoral Experience.
ERIC Educational Resources Information Center
Beeler, Karl J.
A discussion of graduate higher education suggests that shifts in demography of graduate school students and changes in traditional doctoral programs will lead to increased participation in doctoral study by the nation's best and brightest students. Declines in doctoral program participation due to demographic shifts, decreasing financial support,…
-
42 CFR 476.98 - Reviewer qualifications and participation.
Code of Federal Regulations, 2010 CFR
2010-10-01
... services furnished or proposed to be furnished by a licensed doctor of medicine or osteopathy or by a doctor of dentistry must be respectively another licensed doctor of medicine or osteopathy or of... that peers are not available to make initial denial determinations, a doctor of medicine or osteopathy...
-
State Level Review of Doctoral Programs in Texas.
ERIC Educational Resources Information Center
Whittington, Nil
Review of doctoral degree programs in Texas public colleges and universities is discussed. Attention is directed to review procedures and strengths and weaknesses in the state's doctoral programs in educational psychology, counseling and guidance, and student personnel services. Doctoral programs were reviewed because of their high cost and a…
-
#Hermandad: Twitter as a Counter-Space for Latina Doctoral Students
ERIC Educational Resources Information Center
Hernández, Estee
2015-01-01
Latinas are significantly underrepresented in doctoral programs in U.S. higher education institutions. While pursuing doctoral studies is a challenging experience for anyone, Latina doctoral students are particularly burdened with additional stressors in an academic environment that does not support Latina/o cultural values, such as…
-
Peer Mentoring among Doctoral Students of Science and Engineering in Taiwan
ERIC Educational Resources Information Center
Lin, Yii-nii; Hsu, Angela Yi-ping
2012-01-01
This study describes the peer mentoring experience from doctoral student mentors' point of view. Twelve science and engineering doctoral students participated in this phenomenology study. The findings suggest doctoral peer mentors served instrumental, psychosocial, buffering, and liaison roles; they passed on their social, professional, and…
-
Advising Doctoral Students in Education Programs
ERIC Educational Resources Information Center
Craft, Christy Moran; Augustine-Shaw, Donna; Fairbanks, Amanda; Adams-Wright, Gayla
2016-01-01
Because almost one half of students enrolled in American doctoral programs do not complete their degrees, the factors that lead to doctoral student attrition need to be identified. Research suggests that the nature of the advisor-advisee relationship contributes to the persistence levels of doctoral students. In this study, we conducted a content…
-
Doctoral Women: Managing Emotions, Managing Doctoral Studies
ERIC Educational Resources Information Center
Aitchison, Claire; Mowbray, Susan
2013-01-01
This paper explores the experiences of women doctoral students and the role of emotion during doctoral candidature. The paper draws on the concept of emotional labour to examine the two sites of emotional investment students experienced and managed during their studies: writing and family relationships. Emotion is perceived by many dominant…
-
34 CFR 662.1 - What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program?
Code of Federal Regulations, 2014 CFR
2014-07-01
... Research Abroad Fellowship Program? 662.1 Section 662.1 Education Regulations of the Offices of the... DOCTORAL DISSERTATION RESEARCH ABROAD FELLOWSHIP PROGRAM General § 662.1 What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program? (a) The Fulbright-Hays Doctoral Dissertation...
-
34 CFR 662.1 - What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program?
Code of Federal Regulations, 2011 CFR
2011-07-01
... Research Abroad Fellowship Program? 662.1 Section 662.1 Education Regulations of the Offices of the... DOCTORAL DISSERTATION RESEARCH ABROAD FELLOWSHIP PROGRAM General § 662.1 What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program? (a) The Fulbright-Hays Doctoral Dissertation...
-
34 CFR 662.1 - What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program?
Code of Federal Regulations, 2012 CFR
2012-07-01
... Research Abroad Fellowship Program? 662.1 Section 662.1 Education Regulations of the Offices of the... DOCTORAL DISSERTATION RESEARCH ABROAD FELLOWSHIP PROGRAM General § 662.1 What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program? (a) The Fulbright-Hays Doctoral Dissertation...
-
34 CFR 662.1 - What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program?
Code of Federal Regulations, 2010 CFR
2010-07-01
... Research Abroad Fellowship Program? 662.1 Section 662.1 Education Regulations of the Offices of the... DOCTORAL DISSERTATION RESEARCH ABROAD FELLOWSHIP PROGRAM General § 662.1 What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program? (a) The Fulbright-Hays Doctoral Dissertation...
-
34 CFR 662.1 - What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program?
Code of Federal Regulations, 2013 CFR
2013-07-01
... Research Abroad Fellowship Program? 662.1 Section 662.1 Education Regulations of the Offices of the... DOCTORAL DISSERTATION RESEARCH ABROAD FELLOWSHIP PROGRAM General § 662.1 What is the Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program? (a) The Fulbright-Hays Doctoral Dissertation...
-
Changing Doctoral Degrees: An International Perspective.
ERIC Educational Resources Information Center
Noble, Keith Allan
This book examines the origin and development of doctoral degrees and offers recommendations for the improvement of doctoral programs and degrees. It discusses the birth of universities and doctoral degrees in medieval Europe and reviews the spread of the degree to the United States, Britain, Canada, and Australia. Contemporary concerns about…
-
Arab doctors, evolving society and corruption: a medical student's perspective.
Alamri, Yassar
2015-01-01
Doctors, especially junior doctors, face immense pressure in their day-to-day work. As a result, the rates of depression and anxiety are particularly high in this demanding profession. The pressure, which is compounded by constantly being under societal scrutiny, can unfortunately drive the doctor to breaking point. However, we can help doctors deal with these pressures in a more meaningful way if we make them aware of their wider environment (within a social paradigm) and the implications of their actions.
-
Fogel, Joshua; Teichman, Chaim
2014-01-01
This study examines variables associated with seeking information from doctors, the Internet, and a combination of both doctors and Internet after exposure to direct-to-consumer advertisements. Data were analyzed from 462 college students. Younger age, women, and health insurance were associated with greater odds for doctor; women, subjective norms, intentions, and greater time since seen doctor were associated with greater odds for Internet; and African American, Hispanic, subjective norms, intentions, and health insurance were associated with greater odds for both doctor and Internet. Marketers of direct-to-consumer advertisements can use these findings for tailoring and targeting direct-to-consumer advertisements.
-
Parfenov, Iu A
2012-01-01
The article presents the actual in modern medicine problem of professional burnout of polyclinic doctors of middle and elderly age. It is shown that the specificity of the polyclinic doctors' activity provokes the formation of professional burnout syndrome, paired with maladaptive neuro-psychic conditions. We studied the prevalence of this syndrome in polyclinic doctors of middle age and older; its specific versions among the middle-aged doctors were defined, where the level of burnout is associated with aggressive tendencies, and the elderly doctors, where professional burnout is associated with the instability of affective response. Pathogenic markers of compensatory redistribution of information saturation of indicators of electroencephalography to the occipital cortex at professional burnout in polyclinic doctors of the elderly age, reflecting the involution processes in prefrontal areas of the cerebral cortex of the brain were identified.
-
Women who doctor shop for prescription drugs.
Worley, Julie; Thomas, Sandra P
2014-04-01
Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.
-
[The cult of Asklepios and the doctors in Greek epigraphical evidence].
Nissen, Cécile
2007-01-01
Greek inscriptions afford several examples of the relationship between Asklepios, the god of medicine, and human doctors in Graeco-Roman Antiquity. Many dedications of steles, statues, altars and even sanctuaries were consecrated to Asklepios by physicians. Other physicians have undertaken the offices of zacorate or priesthood in the worship of Asklepios. In some cities, notably at Athens and Ephesos, the doctors sacrificed collectively to the physician-god. The aim of this paper is to explain these cult relations between Asklepios and the doctors. After the Asklepiads, doctors at Kos and Knidos, who were believed to be the descendants of Asklepios, all the ancient doctors were connected with Asklepios by their techne; the physician-god was the divine patron of the physicians. Furthermore although the doctors rejected the divine origin of the diseases, they acknowledged the healing power of the gods, especially Asklepios, and could seek his help.
-
Content and Process in a Teaching Workshop for Faculty and Doctoral Students
ERIC Educational Resources Information Center
Rinfrette, Elaine S.; Maccio, Elaine M.; Coyle, James P.; Jackson, Kelly F.; Hartinger-Saunders, Robin M.; Rine, Christine M.; Shulman, Lawrence
2015-01-01
Teaching in higher education is often not addressed in doctoral education, even though many doctoral graduates will eventually teach. This article describes a biweekly teaching workshop, presents pitfalls and challenges that beginning instructors face, and advocates pedagogical training for doctoral students. Led by a well-known social work…
-
ERIC Educational Resources Information Center
Carter, Susan; Fazey, John; Gonzalez Geraldo, Jose Luis; Trevitt, Chris
2010-01-01
The European Union Bologna Process is a significant agent for internationalization of education. Acknowledging fiscal and political drivers, this article shows that Bologna inclusion of the doctoral degree offers potential for enhanced doctoral experience. Interest in transferability of doctoral education across national borders, standardization…
-
ERIC Educational Resources Information Center
Richards, Constance V. S.
2012-01-01
Few studies have explored the positive characteristics that motivate doctoral students to pursue and complete their degree; research has historically focused on doctoral student attrition. To fully understand doctoral student success, research must focus on factors that contribute to completion. Based on Seligman's theory of explanatory style,…
-
Researching Doctoral Pedagogy Close up: Design and Action in Two Doctoral Programmes
ERIC Educational Resources Information Center
Danby, Susan; Lee, Alison
2012-01-01
With growing international interest in diversifying sites for pedagogical work within the doctorate, doctoral programmes of different kinds are being developed in different disciplinary, institutional and national settings. However, little is known about how the pedagogical work of these programmes is designed and enacted, and with what effects.…
-
Experiencing Doctoral Liminality as a Conceptual Threshold and How Supervisors Can Use It
ERIC Educational Resources Information Center
Keefer, Jeffrey M.
2015-01-01
Doctoral students face numerous challenges along the path toward achieving a doctorate. With the experience likened to a rite of passage, many face periods of confusion and disorientation, liminal periods of being betwixt and between. Threshold concept theory, reconceived as conceptual thresholds when experienced on the doctoral level, can inform…
-
Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors
ERIC Educational Resources Information Center
Rogers, Mary E.; Creed, Peter A.; Searle, Judy
2014-01-01
Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1-4, who completed a web-based survey assessing…
-
ERIC Educational Resources Information Center
Calabrese, Raymond L.; Zepeda, Sally J.; Peters, April L.; Hummel, Crystal; Kruskamp, William H.; San Martin, Teresa; Wynne, Stefanie C.
2007-01-01
A case study using appreciate inquiry identified and described the experiences of five educational administration doctoral students representing three universities regarding their doctoral program studies and dissertation process. Data were collected using reflective narratives and the Left Hand Right Hand Column Case Method. Data revealed (a) the…
-
Doctoral Students as Journal Editors: Non-Formal Learning through Academic Work
ERIC Educational Resources Information Center
Hopwood, Nick
2010-01-01
Much attention has been paid to formal pedagogic elements of the doctorate--supervision and other structured institutional provisions--but we know less about the role played by non-formal practices in doctoral students' learning. This paper explores the experiences of eight doctoral students involved in editing student-run journals. Editorship and…
-
ERIC Educational Resources Information Center
Horber, Dot; Langenau, Erik E.; Kachur, Elizabeth
2014-01-01
Teaching and assessing doctor-patient communication has become a priority in medical education. This pilot study evaluated resident physicians' perceptions of teaching and assessing doctor-patient communication skills related to pain management using a web-based format. Fifty-nine resident physicians completed four doctor-patient clinical…
-
ERIC Educational Resources Information Center
Roberts, Martin J.; Campbell, John L.; Richards, Suzanne H.; Wright, Christine
2013-01-01
Introduction: Multisource feedback (MSF) ratings provided by patients and colleagues are often poorly correlated with doctors' self-assessments. Doctors' reactions to feedback depend on its agreement with their own perceptions, but factors influencing self-other agreement in doctors' MSF ratings have received little attention. We aimed to identify…
-
ERIC Educational Resources Information Center
Aittola, Helena
2017-01-01
In Europe, doctoral education systems have been systematically reformed. These reforms are aimed at improving the quality of research and the competitiveness of European countries. In Finland, the reform project of doctoral education started vigorously in the mid-1990s which has contributed significantly to the emergence of more structured…
-
Exploring the Nexus between Research and Doctoral Education
ERIC Educational Resources Information Center
Pearson, Margot; Evans, Terry; Macauley, Peter
2012-01-01
Exploring the nexus between doctoral education and research, and developments in how research is organised and funded is of significance as doctoral education is both part of the higher education system for teaching and learning, and part of the research enterprise. Doctoral candidates are both students and effectively early career researchers.…
-
Doctoral Success as Ongoing Quality Business: A Possible Conceptual Framework
ERIC Educational Resources Information Center
Bitzer, E. M.
2011-01-01
The challenges involving doctoral non-completion and a lack of academic or scholarly quality are not restricted to putting the blame on doctoral candidates themselves, their supervisors or the institutions where they enrol. As candidates carry huge responsibilities when entering doctoral studies, success can be associated with an array of factors…
-
Barefoot-Doctors. Occasional Paper No. 77-4.
ERIC Educational Resources Information Center
Perez, Joel
A description of "barefoot doctors" in the People's Republic of China is presented. These peasant doctors are commune workers who have taken basic courses in medical treatment. Because 80% of the population lives in a rural agricultural setting, and because most doctors and medical services are located in cities, there is a serious need…
-
Agency, Socialization, and Support: A Critical Review of Doctoral Student Attrition
ERIC Educational Resources Information Center
Rigler, Kenneth L., Jr.; Bowlin, Linda K.; Sweat, Karen; Watts, Stephen; Throne, Robin
2017-01-01
Almost universally, residential doctoral programs have reported attrition rates of up to 50% for face-to-face programs and 50-70% for online doctoral programs. The purpose of this critical review was to explore current literature for doctoral attrition and persistence to explore reasons and attributes for improved persistence to completion. We…
-
Promoting the UK Doctorate: Opportunities and Challenges. Research Report
ERIC Educational Resources Information Center
Emery, Faye; Metcalfe, Janet
2009-01-01
The last decade has seen increased interest in various aspects of the UK doctorate. This report brings together issues arising from national policy developments, the doctoral researcher cohort, the diversification of doctoral level provision in the UK and the development of the third cycle in the Bologna process. Through discussions with key…
-
ERIC Educational Resources Information Center
Kanyi, Titus Kamau
2009-01-01
Doctoral studies are at the apex of the education system. Attracting, recruiting, enrolling, and graduating the best suited students in doctoral education is, therefore, critical in ensuring the highest academic standards and service to society. Focusing on Rowan University's Doctor of Education (Ed.D.) in Educational Leadership program, this…
-
Looking Back at Doctoral Education in South Africa
ERIC Educational Resources Information Center
Herman, Chaya
2017-01-01
This article provides a quantitative picture of doctoral education in South Africa up to 2010, from the time the first doctorate was awarded in 1899. It identifies the different institutional profiles and emphases of doctoral graduation in South African universities at various periods of time in the context of economic, political and social…
-
The Trouble with Doctoral Aspiration Now
ERIC Educational Resources Information Center
Burford, James
2018-01-01
This article attends to the affective-political dimensions of doctoral aspiration. It considers why doctoral students continue to hope for an 'academic good life' in spite of the depressed and precarious features of the academic present. The article emerges from 2013 research with ten doctoral students in the Arts and Social Sciences, at a…
-
ERIC Educational Resources Information Center
Chaney, Bradford; And Others
A survey instrument was sent to all doctorate-granting institutions and all institutions identified as offering doctorates in plant biology. Doctorate-granting institutions were identified using the U.S. Department of Education's Higher Education General Information Surveys (HEGIS) listings. Responses were received from plant biology program…
-
Career Implications of Doctoral Social Work Student Debt Load
ERIC Educational Resources Information Center
Begun, Audrey L.; Carter, James R.
2017-01-01
Although research has been conducted in other professional disciplines, social work has yet to explore how doctoral student debt load influences career development. This exploratory study surveyed 281 social work doctoral students and recent graduates, 75 BSW and MSW program leaders, and 24 doctoral program leaders about debt load, career choices,…
-
Obstacles to Success--Doctoral Student Attrition in South Africa
ERIC Educational Resources Information Center
Herman, Chaya
2011-01-01
The article explores doctoral attrition in South Africa, investigating and comparing the attributions of attrition of doctoral students and PhD programme leaders. The article is based on secondary data analysis of two large studies on doctoral education in South Africa. The main point of the article is that the different understandings of the…
-
ERIC Educational Resources Information Center
Westerband, Yamissette Milagros
2016-01-01
Latinas are underrepresented within the professorate and within doctoral programs, particularly within Research Intensive Institutions. This dissertation explores how the doctoral socialization process impacts the pipeline from the Ph.D. to scholarly careers for Latinas in Research universities. Given the low numbers of representation and…
-
Sharing the Stories of Racism in Doctoral Education: The Anti-Racism Project
ERIC Educational Resources Information Center
Davis, Ashley; Livingstone, Allyson
2016-01-01
Across-racial group of social work doctoral students engaged in an Anti-Racism Project. Through shared journaling and group discussions, participants explored and interrogated experiences of racism related to doctoral education. A thematic analysis of qualitative data surfaced several themes: experiences with racism as a doctoral student, noticing…
-
ERIC Educational Resources Information Center
Doyle, Stephanie; Manathunga, Catherine; Prinsen, Gerard; Tallon, Rachel; Cornforth, Sue
2018-01-01
While the experiences of international doctoral students, especially those from Asian countries, have been well researched, fewer studies have explored the experiences of African students in Southern countries like Australia and Aotearoa/New Zealand. This article reports on doctoral writing and student and supervisor perspectives on English…
-
Doctoral Advising: A Grounded Theory Exploration of Female Mainland Chinese International Students
ERIC Educational Resources Information Center
Kuttig, Miao Yan
2012-01-01
The quality of the doctoral advising relationship is paramount in the success of doctoral education. This study explores female Mainland Chinese student's advising experience in their respective doctoral programs, including the factors that influence their experience, the challenges they encounter, and concerns they have in their programs.…
-
A Shared Experience: An Interdisciplinary Professional Doctorate in Health and Social Care
ERIC Educational Resources Information Center
Mcvicar, Andrew; Caan, Woody; Hillier, Dawn; Munn-Giddings, Carol; Ramon, Shulamit; Winter, Richard
2006-01-01
This paper describes the development of an innovative interprofessional doctorate in health and social care, within an academic framework designed explicitly to ensure that candidates must demonstrate qualities of cognitive application commensurate with doctoral study, yet must also meet the practice-focused outcomes of a professional doctorate.…
-
Characteristics of Doctoral Scientists and Engineers in the United States, 1973.
ERIC Educational Resources Information Center
Scopino, John A.; And Others
This publication presents data on the supply, utilization, and characteristics of U.S. doctoral scientists and engineers. The population surveyed consisted of individuals in the United States who held science or engineering doctorates, or who had received doctorates in nonscience and nonengineering areas but were employed in science or engineering…
-
Rhetorical Analysis of the Doctoral Abstracts on English Language Teaching in Turkey
ERIC Educational Resources Information Center
Özmen, Kemal Sinan
2016-01-01
Doctoral dissertation has an important role to embark on an academic career confidently. The case is much more challenging for the early career doctorate who strives to contribute to the wider academic community. Using Swale's IMRD model, this study analyzed the rhetorical organization of English abstracts of 147 doctoral dissertations written…
-
ERIC Educational Resources Information Center
von Zur-Muehlen, Max
A profile of the socio-economic characteristics of the permanent residents of Canada holding an earned doctorate is presented. In 1973, there were 27,410 Canadian residents who had obtained an earned doctorate. (Holders of such professional doctoral degrees as Doctor of Medicine are excluded from this study.) Only 9 percent of the Ph.Ds were…
-
Completing the Three Stages of Doctoral Education: An Event History Analysis
ERIC Educational Resources Information Center
Ampaw, Frim D.; Jaeger, Audrey J.
2012-01-01
Doctoral programs have high dropout rates of 43% representing the highest among all post-baccalaureate programs. Cross sectional studies of doctoral students' retention have showed the importance of financial aid in predicting degree completion. These studies however, do not estimate the labor market's effect on doctoral student retention and…
-
Giannakakis, Ioannis A; Ioannidis, John P A
2000-01-01
Objective To describe how pharmaceutical companies cater to the material needs of doctors. Design Case report of memoirs. Setting Facilities that have nothing to do with medicine, somewhere in the Arabian peninsula. Patient population Random sample of doctors. Interventions Promotion by the pharmaceutical industry. Main outcome measures Short term outcomes were travel, pleasure, amusement, and gifts, and long term outcomes were the market share of specific companies. Results Short term outcomes were heterogeneous, underlying the diversity of the means employed by the pharmaceutical industry to subvert, divert, and influence medical practice. Overall, 200 doctors were dressed in white gowns, a doctor in preventive medicine quoted Hippocrates in favour of smoking, a senior doctor became a poet, a doctor trying to understand the Methods section of a poster paper wondered whether he should have been sunbathing at the beach instead, and two women doctors were kidnapped by Bedouin warriors. Long term outcomes on the sales of the company drugs are pending but are likely to be most favourable. Conclusions Eat, drink, be merry, and boost prescriptions. PMID:11124175
-
Sari, Merry Indah; Prabandari, Yayi Suryo; Claramita, Mora
2016-01-01
Professionalism is the core duty of a doctor to be responsible to the society. Doctors' professionalism depicts an internalization of values and mastery of professionals' standards as an important part in shaping the trust between doctors and patients. Professionalism consists of various attributes in which current literature focused more on the perspective of the health professionals. Doctors' professionalism may influence patients' satisfaction, and therefore, it is important to know from the patients' perspectives what was expected of medical doctors' professionalism. This study was conducted to determine the attributes of physician professionalism from the patient's perspective. This was a qualitative research using a phenomenology study design. In-depth interviews were conducted with 18 patients with hypertension and diabetes who had been treated for at least 1 year in primary care facilities in the city of Yogyakarta, Indonesia. The results of the interview were transcribed, encoded, and then classified into categories. Communication skills were considered as the top priority of medical doctors' attributes of professionalism in the perspectives of the patients. This study revealed that communication skill is the most important aspects of professionalism which greatly affected in the process of health care provided by the primary care doctors. Doctor-patient communication skills should be intensively trained during both basic and postgraduate medical education.
-
Duke, Dawn C; Denicolo, Pam M
2017-05-01
Over the past two decades, there has been a flurry of government papers and policy reports worldwide calling for increased number and diversity of doctoral researchers and a broadening of the curriculum to meet the developing needs of respective national 'knowledge-driven' economies. This has been followed by position papers and best practice examples of employability skills development in boundary-crossing doctoral programmes, especially in response to these initiatives. However, there is a disassociation between this ample literature expounding the new doctorate with its broader remit, inclusivity and production of 'industry-ready' graduates and the comparatively sparse literature on the doctoral candidates' experiences of their programmes and career readiness. Within this review, we briefly outline international government initiatives and examples of the responses by Life Science and Biomedical doctoral programmes to address these various challenges. Furthermore, we explore the recent literature on the lived experience of doctoral researchers by examining their perception of the recent changes to the research context to make recommendations for universities and supervisors on how to better support an ever more diverse doctoral population for a wide range of career opportunities. Examples of how doctoral researchers themselves can make the best of currently available opportunities are also provided. © FEMS 2017.
-
Empathy and the application of the 'unbearable suffering' criterion in Dutch euthanasia practice.
van Tol, Donald G; Rietjens, Judith A C; van der Heide, Agnes
2012-05-01
A pivotal due care criterion for lawful euthanasia in the Netherlands is that doctors must be convinced that a patient requesting for euthanasia, suffers unbearably. Our study aims to find out how doctors judge if a patient suffers unbearably. How do doctors bridge the gap from 3rd person assessment to 1st person experience? We performed a qualitative interview study among 15 physicians, mainly general practitioners, who participated earlier in a related quantitative survey on the way doctors apply the suffering criterion. Results show that doctors follow different 'cognitive routes' when assessing a patients suffering in the context of a euthanasia request. Sometimes doctors do this imagining how she herself would experience the situation of the patient ('imagine self'). Doctors may also try to adopt the perspective of the patient and imagine what the situation is like for this particular patient ('imagine other'). Besides this we found that the (outcome of the) assessment is influenced by a doctor's private norms, values and emotions considering (the performance of) euthanasia. We conclude by arguing why doctors should be aware of both the 'cognitive route' followed as well as the influence of their own personal norms on the assessment of suffering in the context of euthanasia requests. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
-
Denicolo, Pam M.
2017-01-01
Abstract Over the past two decades, there has been a flurry of government papers and policy reports worldwide calling for increased number and diversity of doctoral researchers and a broadening of the curriculum to meet the developing needs of respective national ‘knowledge-driven’ economies. This has been followed by position papers and best practice examples of employability skills development in boundary-crossing doctoral programmes, especially in response to these initiatives. However, there is a disassociation between this ample literature expounding the new doctorate with its broader remit, inclusivity and production of ‘industry-ready’ graduates and the comparatively sparse literature on the doctoral candidates’ experiences of their programmes and career readiness. Within this review, we briefly outline international government initiatives and examples of the responses by Life Science and Biomedical doctoral programmes to address these various challenges. Furthermore, we explore the recent literature on the lived experience of doctoral researchers by examining their perception of the recent changes to the research context to make recommendations for universities and supervisors on how to better support an ever more diverse doctoral population for a wide range of career opportunities. Examples of how doctoral researchers themselves can make the best of currently available opportunities are also provided. PMID:28472431
-
Improving diet and exercise in pregnancy with Video Doctor counseling: a randomized trial.
Jackson, Rebecca A; Stotland, Naomi E; Caughey, Aaron B; Gerbert, Barbara
2011-05-01
To determine if an interactive, computerized Video Doctor counseling tool improves self-reported diet and exercise in pregnant women. A randomized trial comparing a Video Doctor intervention to usual care in ethnically diverse, low-income, English-speaking pregnant women was conducted. Brief messages about diet, exercise, and weight gain were delivered by an actor-portrayed Video Doctor twice during pregnancy. In the Video Doctor group (n=158), there were statistically significant increases from baseline in exercise (+28 min), intake of fruits and vegetables, whole grains, fish, avocado and nuts, and significant decreases in intake of sugary foods, refined grains, high fat meats, fried foods, solid fats, and fast food. In contrast, there were no changes from baseline for any of these outcomes in the usual care group (n=163). Nutrition knowledge improved significantly over time in both groups but more so in the Video Doctor group. Clinician-patient discussions about these topics occurred significantly more frequently in the Video Doctor group. There was no difference in weight gain between groups. A brief Video Doctor intervention can improve exercise and dietary behaviors in pregnant women. The Video Doctor can be integrated into prenatal care to assist clinicians with effective diet and exercise counseling. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
-
Shaw, Joanne; Brown, Rhonda; Dunn, Stewart
2015-10-01
The purpose of this study was to investigate the relationship between doctors' bad news delivery style and their experience of physiological stress during simulated bad news consultations. 31 doctors participated in two simulated breaking bad news (BBN) consultations. Delivery style was categorized as either blunt, forecasting or stalling (i.e. avoidant), based on the time to deliver the bad news and qualitative analysis of the interaction content and doctor's language style. Doctors' heart rate (HR) and skin conductance (SC) were recorded in consecutive 30s epochs. Doctors experienced a significant decrease in HR (F(1,36)=44.9, p<.0001) and SC (F(1,48)=5.6, p<.001) between the pre- and post-news delivery phases of the consultation. Between-group comparisons for the three delivery styles did not identify any significant differences in HR (F(2,36)=2.2, p>.05) or SC (F(2,48)=.66, p>.05). Doctors experience heightened stress in the pre-news delivery phase of breaking bad news interactions. Delaying the delivery of bad news exposes doctors to a longer period of increased stress.This suggests that medical students and doctors should be taught to deliver bad news without delay, to help mitigate their response to this stressful encounter. Copyright © 2015. Published by Elsevier Ireland Ltd.
-
Work hours and sleep/wake behavior of Australian hospital doctors.
Ferguson, Sally A; Thomas, Matthew J W; Dorrian, Jillian; Jay, Sarah M; Weissenfeld, Adrian; Dawson, Drew
2010-07-01
The objective of the study was to describe the work and sleep patterns of doctors working in Australian hospitals. Specifically, the aim was to examine the influence of work-related factors, such as hospital type, seniority, and specialty on work hours and their impact on sleep. A total of 635 work periods from 78 doctors were analyzed together with associated sleep history. Work and sleep diary information was validated against an objective measure of sleep/wake activity to provide the first comprehensive database linking work and sleep for individual hospital doctors in Australia. Doctors in large and small facilities had fewer days without work than those doctors working in medium-sized facilities. There were no significant differences in the total hours worked across these three categories of seniority; however, mid-career and senior doctors worked more overnight and weekend on-call periods than junior doctors. With respect to sleep, although higher work hours were related to less sleep, short sleeps (< 5 h in the 24 h prior to starting work) were observed at all levels of prior work history (including no work). In this population of Australian hospital doctors, total hours worked do impact sleep, but the pattern of work, together with other nonwork factors are also important mediators.
-
Impact of Doctors' Resistance on Success of Drug Utilization Review System
Choi, Jong Soo; Yun, Seong Hyeon; Kim, Dongsoo
2014-01-01
Objectives The drug utilization review (DUR) system, which checks any conflict event of medications, contributes to improve patient safety. One of the important barriers in its adoption is doctors' resistance. This study aimed to analyze the impacts of doctors' resistance on the success of the DUR system. Methods This study adopted an augmented the DeLone and McLean Information System (D&M IS) Success Model (2003), which used doctors' resistance as a socio-technological measure. This study framework is the same as that of the D&M IS Success Model in that it is based on qualities, such as system, information, and services. The major difference is that this study excluded the variable 'use' because it was not statistically significant for mandatory systems. A survey of doctors who used computers to enter prescriptions was conducted at a Korean tertiary hospital in February 2012. Results This study is very meaningful in that it is the first study to explore the success factors of the DUR system associated with doctors' resistance. Doctors' resistance to the DUR system was not statistically associated with user usefulness, whereas it affected user satisfaction. Conclusions The results indicate that doctors still complain of discomfort in using the DUR system in the outpatient clinical setting, even though they admit that it contributes to patient safety. To mitigate doctors' resistance and raise user satisfaction, more opinions from doctors regarding the DUR system have to be considered and have to be reflected in the system. PMID:24872908
-
Psychiatric Prescribers' Experiences With Doctor Shoppers.
Worley, Julie; Johnson, Mary; Karnik, Niranjan
2015-01-01
Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.
-
Taşdemir, Zekeriya; Alkan, Banu Arzu
2015-01-01
Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice.
-
A study of the relationship between resilience, burnout and coping strategies in doctors.
McCain, R Scott; McKinley, Nicola; Dempster, Martin; Campbell, W Jeffrey; Kirk, Stephen J
2017-08-09
The aim of this study was to measure resilience, coping and professional quality of life in doctors. A cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors. 283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors. Despite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
-
Video study of physician selection: preferences in the face of diversity.
Gerbert, Barbara; Berg-Smith, Steven; Mancuso, Michelle; Caspers, Nona; Danley, Dale; Herzig, Karen; Brand, Richard
2003-07-01
To determine whether a diverse group of people would predominantly choose a white male physician regardless of group member's sex and ethnicity when given a choice among 6 actor-portrayed video doctors (males and females of Latino, European, and African descent) and whether further exposure would alter initial selections. Participants selected a video doctor after viewing a brief introduction and again after viewing the delivery of a prevention message. Three hundred ninety-five participants recruited at a shopping mall in the San Francisco Bay Area (61% female, 39% male; 30% Asian American, 29% European American, 26% Latino, 8% African American, and 7% other). Initial and final video doctor selections; ratings of video doctors on interpersonal qualities. Most participants (85% of females and 63% of males) initially chose a female video doctor (P<.001) and even more did so at final selection. Approximately half initially chose a same-race video doctor (66% of European Americans, 51% of Latinos, and 50% of African Americans), but fewer did so at final selection (56% of European Americans, 44% of Latinos, and 52% of African Americans). In addition, at final selection 57% of Asian Americans and other-ethnicity participants chose a non-European American video doctor. Many healthcare consumers will accept physicians of both sexes and of different races. After observing the video doctors demonstrate a professional and warm affect, participants became even more receptive to choosing a video doctor of a different race. Video doctor technology holds promise for increasing our understanding of patients' preferences.
-
Patient opinion of the doctor-patient relationship in a public hospital in Qatar.
Weber, Alan S; Verjee, Mohamud A; Musson, David; Iqbal, Navid A; Mosleh, Tayseer M; Zainel, Abdulwahed A; Al-Salamy, Yassir
2011-03-01
To analyze the factors associated with the level of satisfaction of outpatients in their relationship with their doctor at the largest public hospital in Qatar. This study was a cross-sectional survey of attitudes. Researchers surveyed 626 outpatients at Hamad General Hospital in Doha, Qatar from September 2009 to January 2010 using a novel questionnaire assessing satisfaction with patients' interaction(s) with their doctor (spent time with patient, took case seriously, maintained confidentiality, and the overall quality of visit). Mean responses on 4 Likert scale items (one to 5) were as follows: "spent enough time with patient" = 4.39; "doctor took case seriously" = 4.57; "satisfaction with doctor-patient confidentiality" = 4.71; "overall quality of visit" = 4.46. Age, gender, citizenship, level of education, and number of visits did not significantly impact the level of satisfaction. For 73.1% of patients, the physician's qualification was the most important factor in choosing a doctor. Of those surveyed, 40.7% of men and 28.1% of women preferred to see a doctor of their own gender. A positive correlation between perceived communication and satisfaction with the doctor-patient encounter was established. This study found that patients in the Out-Patient Department at Hamad Hospital were highly satisfied with their relationships with their doctors, and physician qualification was the most significant factor in choosing a doctor. A significant number of males and females preferred a physician of their own gender. Communication difficulty correlated with lower satisfaction.
-
Who is more likely to use doctor-rating websites, and why? A cross-sectional study in London
Galizzi, Matteo Maria; Miraldo, Marisa; Stavropoulou, Charitini; Desai, Mihir; Jayatunga, Wikum; Joshi, Mitesh; Parikh, Sunny
2012-01-01
Objectives To explore the extent to which doctor-rating websites are known and used among a sample of respondents from London. To understand the main predictors of what makes people willing to use doctor-rating websites. Design A cross-sectional study. Setting The Borough of Hammersmith and Fulham, London, England. Participants 200 individuals from the borough. Main outcome measures The likelihood of being aware of doctor-rating websites and the intention to use doctor-rating websites. Results The use and awareness of doctor-rating websites are still quite limited. White British subjects, as well as respondents with higher income are less likely to use doctor-rating websites. Aspects of the doctor–patient relationship also play a key role in explaining intention to use the websites. The doctor has both a ‘complementary’ and ‘substitute’ role with respect to Internet information. Conclusions Online rating websites can play a major role in supporting patients’ informed decisions on which healthcare providers to seek advice from, thus potentially fostering patients’ choice in healthcare. Subjects who seek and provide feedback on doctor-ranking websites, though, are unlikely to be representative of the overall patients’ pool. In particular, they tend to over-represent opinions from non-White British, medium–low-income patients who are not satisfied with their choice of the healthcare treatments and the level of information provided by their GP. Accounting for differences in the users’ characteristics is important when interpreting results from doctor-rating sites. PMID:23148340
-
Ridd, Matthew; Shaw, Alison; Lewis, Glyn; Salisbury, Chris
2009-04-01
The patient-doctor relationship is an important but poorly defined topic. In order to comprehensively assess its significance for patient care, a clearer understanding of the concept is required. To derive a conceptual framework of the factors that define patient-doctor relationships from the perspective of patients. Systematic review and thematic synthesis of qualitative studies. Medline, EMBASE, PsychINFO and Web of Science databases were searched. Studies were screened for relevance and appraised for quality. The findings were synthesised using a thematic approach. From 1985 abstracts, 11 studies from four countries were included in the final synthesis. They examined the patient-doctor relationship generally (n = 3), or in terms of loyalty (n = 3), personal care (n = 2), trust (n = 2), and continuity (n = 1). Longitudinal care (seeing the same doctor) and consultation experiences (patients' encounters with the doctor) were found to be the main processes by which patient-doctor relationships are promoted. The resulting depth of patient-doctor relationship comprises four main elements: knowledge, trust, loyalty, and regard. These elements have doctor and patient aspects to them, which may be reciprocally related. A framework is proposed that distinguishes between dynamic factors that develop or maintain the relationship, and characteristics that constitute an ongoing depth of relationship. Having identified the different elements involved, future research should examine for associations between longitudinal care, consultation experiences, and depth of patient-doctor relationship, and, in turn, their significance for patient care.
-
Importance and benefits of the doctoral thesis for medical graduates
Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke
2016-01-01
Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious. PMID:26958656
-
Quality of nursing doctoral education in seven countries: survey of faculty and students/graduates.
Kim, Mi Ja; Park, Chang Gi; McKenna, Hugh; Ketefian, Shake; Park, So Hyun; Klopper, Hester; Lee, Hyeonkyeong; Kunaviktikul, Wipada; Gregg, Misuzu F; Daly, John; Coetzee, Siedine; Juntasopeepun, Phanida; Murashima, Sachiyo; Keeney, Sinead; Khan, Shaheen
2015-05-01
This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. A descriptive, cross-country, comparative design was employed. Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. © 2015 John Wiley & Sons Ltd.
-
The virtual continuity in learning programme: results.
Wood, Eleanor; Tso, Simon
2012-08-01
The implementation of the European Working Time Directive and specialty-driven care has resulted in the loss of continuity of patient care, and thus a loss of continuity in learning. We proposed a potential solution to this fragmentation of junior doctor workplace learning in the Virtual Continuity in Learning Programme (VCLP). The VCLP enables the doctor to follow the virtual patient journey (of an actual patient who is no longer under their care) using the Virtual Consulting Room (VcR), and to understand the rationale behind clinical decision making prior to completing their case-based discussion (CbD) work-based assessments. Fifty-seven out of 62 (92%) of foundation doctors (Homerton University Hospital, London, UK) consented to participate in the study. Web-tracking software was used. Fifty-three out of 57 (93%) doctors completed an initial questionnaire. Twenty-nine out of 57 (51%) doctors returned a follow-up questionnaire 6 months later. Eleven doctors were interviewed in three focus groups: the VcR user group; the VcR non-user group; and a mixed group. The data was analysed qualitatively. Tracking showed 33.3 per cent (19/57) of doctors used the VcR over a 6-month period. Interestingly doctors used the VcR in a range of situations, not solely as instructed. Results enabled us to understand how doctors learn and their perception of using the VCLP to support their learning and completion of work-based assessments. Foundation doctors use the educational resources available, including the VcR, to help structure their workplace learning. The majority of VcR users found it particularly useful for just-in-time learning. The VCLP offers support to junior doctors learning during their preparation for case-based discussion. © Blackwell Publishing Ltd 2012.
-
Lee, Joo Eun; Kim, Tae Hyun; Cho, Kyoung Hee; Han, Kyu-Tae; Park, Eun-Cheol
2017-06-08
There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013. Pneumonia admissions to acute care hospitals among 7446 inpatients older than 65 were examined. We conducted a multivariate Cox proportional hazard model to analyze the association between the number of doctors per bed and 30-day readmission, as well as that of pneumonia-specific 30-day readmission with the combined effects of number of doctors per bed and number of beds. Overall, 1421 (19.1%) patients were readmitted within 30 days and 756 (11.2%) patients were readmitted for pneumonia within 30 days. Patients with pneumonia treated by very low or low number of doctors per bed showed higher readmission (pneumonia-specific readmission: hazard ratio [HR] = 1. 406, 95% confidence interval [CI] = 1.072-1.843 for low number of doctors per bed; all-cause readmissions: HR = 1.276, 95% CI = 1.026-1.587 for very low number of doctors per bed, and HR = 1.280, 95% CI = 1.064-1.540 for low number of doctors per bed). This empirical study showed that patients with pneumonia cared for in hospitals with more doctors were less likely to be readmitted. Pneumonia-specific 30-day readmission was also significantly associated with the combined effect of the number of doctors and the number of hospital beds.
-
Work-family conflict and burnout among Chinese doctors: the mediating role of psychological capital.
Wang, Yang; Liu, Li; Wang, Jiana; Wang, Lie
2012-01-01
The aim of this study was to investigate the relation between work-family conflict and burnout, and the mediating role of psychological capital (PsyCap) in the relation between work-family conflict and burnout, among Chinese doctors. This cross-sectional study was performed during the period of September/October 2010. A questionnaire that comprised work-family conflict assessed by the work-family conflict scale, PsyCap assessed by the PCQ-24 scale and burnout assessed by the Maslach Burnout Inventory-General Survey (MBI-GS), as well as age and gender, was distributed to 1,300 doctors in Liaoning Province, China. A total of 1,011 effective respondents became our final study subjects. Hierarchical linear regression analyses were performed by using SPSS 17.0 to explore the mediating role of PsyCap in the relation between work-family conflict and burnout. Both work interfering family conflict (WIF) and family interfering work conflict (FIW) were positively related with emotional exhaustion and cynicism among both male and females doctors. However, WIF was positively related with professional efficacy only among male doctors, whereas FIW was negatively related with professional efficacy among both male and female doctors. PsyCap partially mediated the relation between WIF and professional efficacy among male doctors and partially mediated the relations of FIW with emotional exhaustion, cynicism and professional efficacy among female doctors. Work-family conflict was associated with burnout among Chinese doctors. PsyCap was a mediator between work-family conflict and burnout. PsyCap might be a positive resource to reduce the negative effect of work-family conflict on burnout of doctors, especially female doctors, in China.
-
Professional values and reported behaviours of doctors in the USA and UK: quantitative survey
Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G
2011-01-01
Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour. PMID:21383386
-
Li, Tongtong; Lei, Trudy; Sun, Fiona; Xie, Zheng
2017-04-18
To strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors' job satisfaction under the context of health sector reform and investigate the associated factors. Data was obtained from a survey of village doctors across three Chinese provinces in 2014. Using a multistage sampling process, quantitative data was collected from village doctors through the self-administered questionnaire and analyzed by multilevel logistic regression models. Qualitative data was collected through face-to-face semi-structured interviews on both village doctors and health managers. Theoretical coding was then conducted to analyze qualitative data. Among the 1221 respondents, 48.6% felt satisfied with their job. Older village doctors with less of a workload and under high-level integrated management were more likely to feel satisfied with their job. Village doctors who earned the top level of monthly income felt more satisfied, while on the county level, those who lived in counties with the highest GDP felt less satisfied. However, enrollment in a pension plan showed no significant difference in regards to village doctors' job satisfaction. Among 34 participants of qualitative interviews, most believed that age, income, and integrated management had a positive influence on the job satisfaction, while pension plan and basic public health care policies exhibited negative effects. Also, the increasing in availability of healthcare and health resources along with local economic development had negative effects on village doctors' job satisfaction. Village doctors' job satisfaction was quite low in regards to several determinants including age, income, workload, enrollment in a pension plan, integrated management, and county economic and medical availability development.
-
Attitude and practice of patients and doctors towards complementary and alternative medicine.
Junaid, Rabyyan; Abaas, Mustafa; Fatima, Batool; Anis, Irma; Hussain, Mehwish
2012-08-01
To determine the attitude towards complementary and alternative medicine among the doctors and patients. The study was carried out at Civil Hospital Karachi and Liaquat National University Hospital, Karachi during April to September 2010. Two sets of questionnaires were developed separately for doctors and patients. Each set consisted of queries regarding demographic data of patients and doctors. The questionnaire for the patients contained questions reflecting the general attitude, mode of complimentary and alternative medicine usage, disease referred and the underlined reasons behind pricking the options. The questionnaires for doctors in general laid focus on the personal opinion about the practice not only for their own use, but also related to their concern towards those patients who used complimentary and alternative medicine. Predictive analysis software statistics 18 was used for statistical analysis. Of the patients, 237 (59.3%) used complimentary and alternative medicine. Herbal medicine followed by homeopathic medicine were the most commonly used therapies. Fever and cough were the most common diseases for which patients used the options. The preference was mainly based on inter-personal communications, reliance on complimentary and alternative medicine, and financial restriction. Concealing from the doctors was common in patients. Only 62 (34.4%) out of 180 doctors used complimentary and alternative medicine themselves. Refusal by other doctors was because they considered the option ineffective, obsolete and unsatisfactory. About half of the doctors forbade the patients to use such therapies, but 31% (n=73) patients ignored the doctor's advice. The use of complimentary and alternative medicine is highly prevalent in our society by patients irrespective of their social class. Preference for such therapies, on the other hand, is quite low among medical doctors as they consider allopathic medicine to be effective.
-
Workplace violence against resident doctors in a tertiary care hospital in Delhi.
Anand, Tanu; Grover, Shekhar; Kumar, Rajesh; Kumar, Madhan; Ingle, Gopal Krishna
2016-01-01
Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. This study was done among doctors working in a tertiary care hospital in Delhi. Data were collected by using a self-administered questionnaire containing items for assessment of workplace violence against doctors, its consequences among those who were assaulted, reporting mechanisms and perceived risk factors. Of the 169 respondents, 104 (61.4%) were men. The mean (SD) age of the study group was 28.6 (4.2) years. Sixty-nine doctors (40.8%) reported being exposed to violence at their workplace in the past 12 months. However, there was no gender-wise difference in the exposure to violence (p=0.86). The point of delivery of emergency services was reported as the most common place for experiencing violence. Verbal abuse was the most common form of violence reported (n=52; 75.4%). Anger, frustration and irritability were the most common symptoms experienced by the doctors who were subjected to violence at the workplace. Only 44.2% of doctors reported the event to the authorities. 'Poor communication skills' was considered to be the most common physician factor responsible for workplace violence against doctors. A large proportion of doctors are victims of violence by their patients or relatives. Violence is being under-reported. There is a need to encourage reporting of violence and prepare healthcare facilities to tackle this emerging issue for the safety of physicians.
-
Career destinations of University of Ghana Medical School graduates of various year groups.
Lassey, A T; Lassey, P D; Boamah, M
2013-06-01
To report on the current career destination of the University of Ghana Medical School (UGMS) qualified doctors in the year groups, 1998, 2000, 2003, 2005 and 2008. Interview of doctors from each year group currently working at the Korle-Bu Teaching Hospital corroborated by phone calls to the doctors. All Ghanaian doctors from each graduating year group. 1. Current location of employment in Ghana or abroad, 2. Gender ratios of the doctors retained in Ghana. Three hundred and seventy-two (372) UGMS doctors consisting of 353 Ghanaians and 19 foreign students graduated over the five year groups. Of the 353 Ghanaians, 113 emigrated, while all but one of the 240 living in Ghana, practice medicine. The retention rate improved from 54.2% in 1998 to 86.3% in 2008. The overall retention rate however is 68.0% while the retention rates for the male and female doctors were 69.3% and 64.6% respectively. Of the 177 doctors practicing in Ghana from the first 4 year-groups (i.e. 1998, 2000, 2003 and 2005,) 139 (i.e. 31, 31, 34 and 43 from the respective year groups) have either completed postgraduate training or are in the residency training programme. Thus 78.5% of these doctors working in Ghana have opted for postgraduate training. The establishment of the GCPS and to a lesser extent the introduction of the ADHA before it appear to have slowed down the medical brain drain as more and more doctors avail themselves of the local opportunities. The GCPS therefore needs supporting effectively in order to continue to be a strong incentive for the retention of doctors in Ghana, apart from helping to staff district general hospitals with specialists.
-
Sennekamp, Monika; Paulitsch, Michael A; Broermann, Marischa; Klingebiel, Thomas; Gerlach, Ferdinand M
2016-01-01
In Germany, medical doctorates are regularly criticized for their insufficient quality. In order to improve the quality of doctorates and to support doctoral candidates, a department-wide doctoral research program was established at the Goethe University of Frankfurt am Main in 2011 taking into account the practical needs of doctoral students at the School of Medicine. The program development proceeded in several steps: in the first step (2009/2010), a pilot study with eleven doctoral candidates was carried out at the Institute of General Practice. Their ratings of the perceived relevance and their own knowledge of 15 topics of scientific work were used to identify a provisional need for support. Subsequently an interdisciplinary panel of experts established the program throughout the faculty. Since its implementation, a requirements analysis in the form of questionnaires has been continuously carried out in order to assess the doctoral students' prior knowledge and their preferences expressed. At the same time, systematic searches for support programs in other medical fields have been conducted throughout Germany on several occasions. On the basis of the pilot study, the research results and the expert panel discussions the following topics were found to be particularly relevant: principles of good scientific practice, literature search, reference management, organization and structure of a doctoral thesis, formatting of Word documents, clinical epidemiology and data management. A specific, stepwise development process was used to design a concept for the faculty of medicine that pays close attention to the knowledge and interests of doctoral candidates. The establishment of the doctoral research program in Frankfurt and the results of its evaluation are presented in a second article (Paulitsch et al., 2016). Copyright © 2016. Published by Elsevier GmbH.
-
Professional values and reported behaviours of doctors in the USA and UK: quantitative survey.
Roland, Martin; Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G
2011-06-01
BACKGROUND The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. METHOD 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. RESULTS UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. DISCUSSION The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.
-
Wu, Dan; Wang, Yun; Lam, Kwok Fai; Hesketh, Therese
2014-01-01
Objective To explore the factors influencing doctors’ job satisfaction and morale in China, in the context of the ongoing health system reforms and the deteriorating doctor–patient relationship. Design Cross-sectional survey using self-completion questionnaires. Study setting The survey was conducted from March to May 2012 among doctors at the provincial, county and primary care levels in Zhejiang Province, China. Results The questionnaire was completed by 202 doctors. Factors which contributed most to low job satisfaction were low income and long working hours. Provincial level doctors were most dissatisfied while primary care doctors were the least dissatisfied. Three per cent of doctors at high-level hospitals and 27% of those in primary care were satisfied with the salary. Only 7% at high-level hospitals were satisfied with the work hours, compared to 43% in primary care. Less than 10% at high levels were satisfied with the amount of paid vacation time (3%) and paid sick leave (5%), compared with 38% and 41%, respectively, in primary care. Overall, 87% reported that patients were more likely to sue and that patient violence against doctors was increasing. Only 4.5% wanted their children to be doctors. Of those 125 who provided a reason, 34% said poor pay, 17% said it was a high-risk profession, and 9% expressed concerns about personal insecurity or patient violence. Conclusions Doctors have low job satisfaction overall. Recruitment and retention of doctors have become major challenges for the Chinese health system. Measures must be taken to address this, in order to ensure recruitment and retention of doctors in the future. These measures must first include reduction of doctors’ workload, especially at provincial hospitals, partly through incentivisation of appropriate utilisation of primary care, increase in doctors’ salary and more effective measures to tackle patient violence against doctors. PMID:25552614
-
[Carl Gillmeister: the first Doctor of veterinary medicine in Mecklenburg--and in Germany (1834)].
Kuhlmann, W; Schäffer, J
2004-02-01
German schools and faculties of veterinary medicine did not receive the sovereign right to award the degree "Doctor medicinae veterinarae" until the early twentieth century. Until then, in the nineteenth century there were two possibilities for veterinarians to earn a doctoral degree, usually referred to as the title of "Doctor": 1. On the basis of an exceptionally excellent dissertation and after very stringent examination a candidate could be awarded the degree "Dr. med." by the faculty of a medical school, or, if the candidate had studied at a philosophical faculty, the degree "Dr. phil." 2. A doctoral degree specifically in veterinary medicine could be earned only at a medical faculty. The Medical Faculty of the University of Giessen awarded the degree "Doctor in arte veterinaria" for the first time in 1832. In this study we prove that Giessen was not the first German university to award a doctorate in veterinary medicine, a priority which has never been questioned in the literature. As early as 1829, veterinarians could earn the degree "Doctor artis veterinariae" at the Medical Faculty of the University of Rostock, where three such awards are documented between 1829 and 1831. The designation "medicina" was also intially avoided in Rostock. Therefore, of particular significance is the discovery of a fourth such document from the Rostock University Archives, the doctoral diploma of Carl Jacob Friedrich Gillmeister, who at the age of 22 was awarded the degree "Doctor medicinae veterinariae" in Rostock after a successful defense. This is the earliest, but also the last archival record of the German doctoral degree in veterinary medicine in the modern sense, because after Gillmeister no veterinarian could earn a doctoral degree in Rostock further more. Gillmeisters vita sheds light on the times and the difficulties of the veterinary profession in the poor agricultural area of Mecklenburg.
-
The doctor-patient relationship as a toolkit for uncertain clinical decisions.
Diamond-Brown, Lauren
2016-06-01
Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. I answer these questions by examining obstetrician-gynecologists' narratives regarding how they make decisions when faced with uncertainty in childbirth. Between 2013 and 2014, I performed 21 semi-structured interviews with obstetricians in the United States. Obstetricians were selected to maximize variation in relevant physician, hospital, and practice characteristics. I began with grounded theory and moved to analytical coding of themes in relation to relevant literature. My analysis renders it evident that some physicians use the doctor-patient relationship as a toolkit for dealing with uncertainty. I analyze how this process varies for physicians in different models of care by comparing doctors' experiences in models with continuous versus fragmented doctor-patient relationships. My key findings are that obstetricians in both models appealed to the ideal of patient-centered decision-making to cope with uncertain decisions, but in practice physicians in fragmented care faced a number of challenges to using the doctor-patient relationship as a toolkit for decision-making. These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding how the doctor-patient relationship and model of care affect physician decision-making, and for forming policy on the optimal structure of medical work. Copyright © 2016 Elsevier Ltd. All rights reserved.
-
Aging village doctors in five counties in rural China: situation and implications.
Xu, Huiwen; Zhang, Weijun; Gu, Linni; Qu, Zhiyong; Sa, Zhihong; Zhang, Xiulan; Tian, Donghua
2014-06-28
The aging population, rapid urbanization, and epidemiology transition in China call for the improvement and adaptation of the health workforce, especially in underserved rural areas. The aging of village doctors (the former "barefoot doctors") who have served the rural residents for many decades has become a warning signal for the human resources for health in China. This study aims to investigate the village doctors' aging situation and its implications in rural China. The data reviewed were obtained from the baseline survey of a longitudinal study of rural health workforce in five counties in rural China in 2011. Using a stratified multi-stage cluster sampling process, the baseline data was collected through the self-administered structured Village Doctor Questionnaire. Descriptive analyses, correlation analyses, and multivariate linear regression with interaction terms were conducted with the statistics software Stata 12.0. The average age of the 1,927 village doctors was 49.3 years (95% CI 48.8 to 49.9), 870 (45.2%) of whom were aging (50 years or older). Both the age and the recruitment time of the village doctors were demonstrated to have a bimodal distribution. A greater proportion of the male village doctors were aging. Furthermore, aging of the village doctors was significantly correlated to their education level, type of qualification, practicing methods, and their status as village clinic directors (P <0.05, respectively). As shown in the regression models, aging village doctors provided significantly more outpatient services to rural residents (P <0.01) but without an increase in income, and their expected pension was lower (P <0.01), compared with their non-aging counterparts. Aging of village doctors is a serious and imperative issue in China, which has a complex and profound impact on the rural health system. Greater attention should be paid to the construction of the pension system and the replenishment of the village doctors with qualified medical graduates.
-
Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane
2015-04-21
The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation. A retrospective cohort design was used to determine an association between year of primary medical qualification and doctors' test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman's correlation and regression models. Doctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p < 0.001 and OSCE r = 0.37, p < 0.001). Qualification year was associated with test performance in doctors under investigation even when controlling for sex, ethnicity and qualification region. Regression analyses showed that qualification year was associated with knowledge test, OSCE and communication skills performance of doctors under investigation when other variables were controlled for. Among volunteer doctors this was not the case and their performance was more strongly related to where they qualified and their ethnic background. Furthermore, volunteer doctors who qualified before the introduction of Single Best Answer and OSCE assessments, still outperformed their peers under investigation. Earlier graduates under fitness to practise investigation performed less well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC's fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.
-
Matsumoto, Hisashi; Motomura, Tomokazu; Hara, Yoshiaki; Masuda, Yukiko; Mashiko, Kunihiro; Yokota, Hiroyuki; Koido, Yuichi
2013-04-01
Since 2001, a Japanese national project has developed a helicopter emergency medical service (HEMS) system ("doctor-helicopter") and a central Disaster Medical Assistance Team (DMAT) composed of mobile and trained medical teams for rapid deployment during the response phase of a disaster. In Japan, the DMAT Research Group has focused on command and control of doctor-helicopters in future disasters. The objective of this study was to investigate the effectiveness of such planning, as well as the problems encountered in deploying the doctor-helicopter fleet with DMAT members following the March 11, 2011 Great East Japan Earthquake. This study was undertaken to examine the effectiveness of aeromedical disaster relief activities following the Great East Japan Earthquake and to evaluate the assembly and operations of 15 doctor-helicopter teams dispatched for patient evacuation with medical support. Fifteen DMATs from across Japan were deployed from March 11th through March 13th to work out of two doctor-helicopter base hospitals. The dispatch center at each base hospital directed its own doctor-helicopter fleet under the command of DMAT headquarters to transport seriously injured or ill patients out of hospitals located in the disaster area. Disaster Medical Assistance Teams transported 149 patients using the doctor-helicopters during the first five days after the earthquake. The experiences and problems encountered point to the need for DMATs to maintain direct control over 1) communication between DMAT headquarters and dispatch centers; 2) information management concerning patient transportation; and 3) operation of the doctor-helicopter fleet during relief activities. As there is no rule of prioritization for doctor-helicopters to refuel ahead of other rotorcraft, many doctor-helicopters had to wait in line to refuel. The "doctor-helicopter fleet" concept was vital to Japan's disaster medical assistance and rescue activities. The smooth and immediate dispatch of the doctor-helicopter fleet must occur under the direct control of the DMAT, independent from local government authority. Such a command and control system for dispatching the doctor-helicopter fleet is strongly recommended, and collaboration with local government authorities concerning refueling priority should be addressed.
-
Woolf, Katherine; Cave, Judith; McManus, I Chris; Dacre, Jane E
2007-12-05
Anecdotes abound about doctors' personal illness experiences and the effect they have on their empathy and care of patients. We formally investigated the relationship between doctors' and medical students' personal illness experiences, their examination results, preparedness for clinical practice, learning and professional attitudes and behaviour towards patients. Newly-qualified UK doctors in 2005 (n = 2062/4784), and two cohorts of students at one London medical school (n = 640/749) participated in the quantitative arm of the study. 37 Consultants, 1 Specialist Registrar, 2 Clinical Skills Tutors and 25 newly-qualified doctors participated in the qualitative arm. Newly-qualified doctors and medical students reported their personal illness experiences in a questionnaire. Doctors' experiences were correlated with self-reported preparedness for their new clinical jobs. Students' experiences were correlated with their examination results, and self-reported anxiety and depression. Interviews with clinical teachers, newly-qualified doctors and senior doctors qualitatively investigated how personal illness experiences affect learning, professional attitudes, and behaviour. 85.5% of newly-qualified doctors and 54.4% of medical students reported personal illness experiences. Newly-qualified doctors who had been ill felt less prepared for starting work (p < 0.001), but those who had only experienced illness in a relative or friend felt more prepared (p = 0.02). Clinical medical students who had been ill were more anxious (p = 0.01) and had lower examination scores (p = 0.006). Doctors felt their personal illness experiences helped them empathise and communicate with patients. Medical students with more life experience were perceived as more mature, empathetic, and better learners; but illness at medical school was recognised to impede learning. The majority of the medical students and newly qualified doctors we studied reported personal illness experiences, and these experiences were associated with lower undergraduate examination results, higher anxiety, and lower preparedness. However reflection on such experiences may have improved professional attitudes such as empathy and compassion for patients. Future research is warranted in this area.
-
The experience of international nursing students studying for a PhD in the U.K: A qualitative study
2011-01-01
Background Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Methods Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Results Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Conclusions Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students. PMID:21668951
-
Pagaiya, Nonglak; Kongkam, Lalitaya; Sriratana, Sanya
2015-03-01
In Thailand, the inequitable distribution of doctors between rural and urban areas has a major impact on access to care for those living in rural communities. The rural medical education programme 'Collaborative Project to Increase Rural Doctors (CPIRD)' was implemented in 1994 with the aim of attracting and retaining rural doctors. This study examined the impact of CPIRD in relation to doctor retention in rural areas and public health service. Baseline data consisting of age, sex and date of entry to the Ministry of Health (MoH) service was collected from 7,157 doctors graduating between 2000 and 2007. There were 1,093 graduates from the CPIRD track and 6,064 that graduated through normal channels. Follow-up data, consisting of workplace, number of years spent in rural districts and years within the MoH service, were retrieved from June 2000 to July 2011. The Kaplan-Meier method of survival analysis and Cox proportional hazards ratios were used to interpret the data. Female subjects slightly outnumbered their male counterparts. Almost half of the normal track (48%) and 33% of the CPIRD doctors eventually left the MoH. The retention rate at rural hospitals was 29% for the CPIRD doctors compared to 18% for those from the normal track. Survival curves indicated a dramatic drop rate after 3 years in service for both groups, but normal track individuals decreased at a faster rate. Multivariate Cox proportional hazards modelling revealed that the normal track doctors had a significantly higher risk of leaving rural areas at about 1.3 times the CPIRD doctors. The predicted median survival time in rural hospitals was 4.2 years for the CPIRD group and 3.4 years for the normal track. The normal track doctors had a significantly higher risk of leaving public service at about 1.5 times the CPIRD doctors. The project evaluation results showed a positive impact in that CPIRD doctors were more likely to stay longer in rural areas and in public service than their counterparts. However, turnover has been increasing in recent years for both groups. There is a need for the MoH to review and improve upon the project implementation.
-
2014-01-01
Background Good mentoring is a key variable for determining success in completing a doctoral program. We identified prevailing mentoring practices among doctoral students and their mentors, identified common challenges facing doctoral training, and proposed some solutions to enhance the quality of the doctoral training experience for both candidates and mentors at Makerere University College of Health Sciences (MakCHS). Methods This cross-sectional qualitative evaluation was part of the monitoring and evaluation program for doctoral training. All doctoral students and their mentors were invited for a half-day workshop through the MakCHS mailing list. Prevailing doctoral supervision and mentoring guidelines were summarised in a one-hour presentation. Participants were split into two homogenous students’ (mentees’) and mentors’ groups to discuss specific issues using a focus group discussion (FGD) guide, that highlighted four main themes in regard to the doctoral training experience; what was going well, what was not going well, proposed solutions to current challenges and perceived high priority areas for improvement. The two groups came together again and the note-takers from each group presented their data and discussions were recorded by a note-taker. Results Twelve out of 36 invited mentors (33%) and 22 out of 40 invited mentees (55%) attended the workshop. Mentors and mentees noted increasing numbers of doctoral students and mentors, which provided opportunities for peer mentorship. Delays in procurement and research regulatory processes subsequently delayed students’ projects. Similarly, mentees mentioned challenges of limited; 1) infrastructure and mentors to support basic science research projects, 2) physical office space for doctoral students and their mentors, 3) skills in budgeting and finance management and 4) communication skills including conflict resolution. As solutions, the team proposed skills’ training, induction courses for doctoral students-mentor teams, and a Frequently Asked Questions’ document, to better inform mentors’, mentees’ expectations and experiences. Conclusion Systemic and infrastructural limitations affect the quality of the doctoral training experience at MaKCHS. Clinical and biomedical research infrastructure, in addition to training in research regulatory processes, procurement and finance management, communication skills and information technology, were highlighted as high priority areas for strategic interventions to improve mentoring within doctoral training of clinician scientists. PMID:24410984
-
Baqi, Shehla; Albalbeesi, Amal; Iftikhar, Sundus; Baig-Ansari, Naila; Alanazi, Mohammad; Alanazi, Awadh
2017-01-01
The Kingdom of Saudi Arabia (KSA) is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30%) participated, of which 129 (42.4%) were females and 231 (76%) were Saudi nationals. The average age was 32.4 years (±SD: 8.7). The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4), hospital benefits (62.2% p-value = 0.06) or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207). However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091). A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002). However, of 54 consultants, only 18 (33.3%) were women. Over half of the women (52.3%) reported that they never wear the face veil. Only a minority of male and female doctors (12.2%) believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5%) whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-value<0.0001). Of 304 participants, 210 (69.1%) said that they would still choose to become a doctor with approximately equal proportions between males and females (68% vs 70.5%, p-value = 0.79). In conclusion, our survey of male and female doctors at a government university hospital in Saudi Arabia revealed that the majority believed there was gender equality amongst doctors in terms of salaries, benefits, opportunities for promotion and entry into any field of medicine or pediatrics, but not surgery. However, there were significantly fewer women at consultant positions, a deficiency that needs to be addressed.
-
Iftikhar, Sundus; Baig-Ansari, Naila
2017-01-01
The Kingdom of Saudi Arabia (KSA) is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30%) participated, of which 129 (42.4%) were females and 231 (76%) were Saudi nationals. The average age was 32.4 years (±SD: 8.7). The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4), hospital benefits (62.2% p-value = 0.06) or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207). However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091). A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002). However, of 54 consultants, only 18 (33.3%) were women. Over half of the women (52.3%) reported that they never wear the face veil. Only a minority of male and female doctors (12.2%) believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5%) whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-value<0.0001). Of 304 participants, 210 (69.1%) said that they would still choose to become a doctor with approximately equal proportions between males and females (68% vs 70.5%, p-value = 0.79). In conclusion, our survey of male and female doctors at a government university hospital in Saudi Arabia revealed that the majority believed there was gender equality amongst doctors in terms of salaries, benefits, opportunities for promotion and entry into any field of medicine or pediatrics, but not surgery. However, there were significantly fewer women at consultant positions, a deficiency that needs to be addressed. PMID:29073172
-
Coming back from the edge: a qualitative study of a professional support unit for junior doctors.
Wainwright, Elaine; Fox, Fiona; Breffni, Tailte; Taylor, Gordon; O'Connor, Michael
2017-08-23
It is known that many trainee doctors around the world experience work satisfaction but also considerable work stress in the training period. Such stress seems to be linked to multiple factors including workload, level of support and growing cultural inculcation into unwillingness to show any personal or professional weakness. In the United Kingdom, junior doctors are qualified medical practitioners who have gained a degree in Medicine and are now working while training to become a specialist (consultant) or a general practitioner. The period of medical training can be particularly stressful for some UK junior doctors, in common with their counterparts in other countries. UK Postgraduate Medical Deaneries provide support for those who need it via Professional Support Units (PSUs); however little is known about the perceptions and experiences of the doctors who access and utilise this support. This study aimed to generate qualitative insight into how the (PSU) provided by one UK Deanery is experienced by the trainees who accessed it. We aimed to investigate whether such experience intersects with the progressive socialisation of trainee doctors into the notion that doctors do not get ill. Through in-depth telephone interviews with eight female junior doctors, we explored the benefits and problems associated with using a PSU with reference to the formation of trainee doctors' professional identities, and conducted a thematic analysis. Themes identified illustrate the process of accepting, accessing and benefiting from PSU support. These are: Medical identity intact (it will never happen to me); Denial of disrupted medical identity; Being on the edge: accepting help; Role of PSU in 'recovery' process; Repaired identity / coming back from the edge; Different ways to be a doctor. The gendered sample occurred simply as it was females who responded to study invitations. Whilst we present some related aspects (such as "manning up" as part of keeping going), analyses of this small sample showed that medical identity as a doctor in training was more salient than a gendered experience of help seeking in this study. This study highlights the initial reluctance of female junior doctors to seek help from the PSU, as acknowledging their own difficulties spoiled their identity as a competent doctor. However, once engaged with the PSU, the findings exemplify its role in repairing medical identity, by offering different and acceptable ways to be a doctor. We interpret these findings within Goffman's theoretical framework of stigma conferring a spoiled identity on recipients, and how this may then be repaired. Reducing the stigma attached to initial help-seeking among junior doctors is crucial to increase ease of access to the PSU and to improve the experiences of doctors who encounter challenges during their training.
-
ERIC Educational Resources Information Center
Antoniou, Alexander-Stamatios; Cooper, Cary L.; Davidson, Marilyn J.
2008-01-01
Primary work stressors and job satisfaction/dissatisfaction in Greek Junior Hospital Doctors (JHDs) are investigated to identify similarities and differences in the reports obtained from male and female hospital doctors. Participants in the study included 32 male and 28 female Greek hospital doctors who provided information through…
-
ERIC Educational Resources Information Center
Parker-Jenkins, Marie
2018-01-01
Does one need really need boundaries between doctoral supervisor and supervisee when talking about mature learners? Drawing on reflection from her extensive experience, the author believes it is critical to maintain this divide. There is an increase in doctoral students, proliferation of doctoral programmes globally and practices which vary from…
-
ERIC Educational Resources Information Center
Carpenter, Serena; Makhadmeh, Naheda; Thornton, Leslie-Jean
2015-01-01
A mentor can be of great importance to doctoral student success and progress. While many have studied student perceptions of the process, research regarding how doctoral faculty mentors interpret and enact mentoring practices is less evident. To address this empirical gap, a doctoral student mentor functions measure was created. The measure is…
-
Reshaping Doctoral Education: International Approaches and Pedagogies
ERIC Educational Resources Information Center
Lee, Alison, Ed.; Danby, Susan, Ed.
2011-01-01
The number of doctorates being awarded around the world has almost doubled over the last ten years, propelling it from a small elite enterprise into a large and ever growing international market. Within the context of increasing numbers of doctoral students this book examines the new doctorate environment and the challenges it is starting to face.…
-
Purposes, Diversities, and Futures in MFT Doctoral Education
ERIC Educational Resources Information Center
Woolley, Scott R.
2010-01-01
Doctoral education in marital and family therapy (MFT) plays a crucial role in the future of the field. In this article, I write about the purposes, diversities, and futures of MFT doctoral education from the perspective of having hired 18 full-time MFT faculty over the last 13 years. I argue that the field needs well-rounded doctoral-level…
-
A Non-Western Doctoral Program in Theology for Africans in Africa
ERIC Educational Resources Information Center
Starcher, Richard L.
2004-01-01
While students from many non-Western contexts continue to stream to Europe and North America to pursue theological doctoral degrees, new theological doctoral programs are springing up around the world. Many of these new programs appear to be adopting (more or less uncritically) one or another of the Western models of doctoral program design.…
-
PhD versus DSW: A Critique of Trends in Social Work Doctoral Education
ERIC Educational Resources Information Center
Howard, Tyriesa
2016-01-01
Social work educators are in a phase of reintroducing the doctor of social work (DSW) degree and refining distinctions between PhD and DSW doctoral programs. This article examines how the two options have been prey to a noticeable "seesaw of precedence", resulting in a debatable history of social work's approach to doctoral education…
-
ERIC Educational Resources Information Center
Collins, Bethan
2015-01-01
Supervision is an essential part of doctoral study, consisting of relationship and process aspects, underpinned by a range of values. To date there has been limited research specifically about disabled doctoral students' experiences of supervision. This paper draws on qualitative, narrative interviews about doctoral supervision with disabled…
-
ERIC Educational Resources Information Center
Taylor, Carol A.
2011-01-01
This article discusses findings from a UK Higher Education Academy project, which used digital video to promote doctoral students' reflexivity. The project aimed to facilitate doctoral students' research skills through the making of videonarratives; create spaces for reflexivity on the relations between research, narrative and identity; and…
-
ERIC Educational Resources Information Center
Kosh, Emily P.
2014-01-01
Personality affects relationships. During the doctoral education, the second most important factor in degree completion, after financial support, is the student-advisor relationship. Approximately half of doctoral students do not finish their degrees. While it is known mentors have a profound impact on the success of doctoral students, the effect…
-
University Positioning and Changing Patterns of Doctoral Study: The Case of the University of Bath
ERIC Educational Resources Information Center
Jamieson, Ian; Naidoo, Rajani
2007-01-01
The study examines the changing nature of doctoral study in higher education in the context of significant global changes in higher education. From its origins with Humboldt, the trajectory of doctoral study is traced through the traditional Ph.D, the extended "American model", to the professional doctorate. A university case study…
-
ERIC Educational Resources Information Center
Gardner, Susan K.
2009-01-01
Sixty doctoral students and 34 faculty members were interviewed in departments identified as having high and low doctoral student completion rates at one institution in the United States in order to examine the cultural contexts and structures that facilitate or hinder doctoral student completion. This paper outlines the differences in…
-
How the Doctorate Contributes to the Formation of Active Researchers: What the Research Tells Us
ERIC Educational Resources Information Center
Sinclair, Jennifer; Barnacle, Robyn; Cuthbert, Denise
2014-01-01
While much research focuses on factors contributing to doctoral completion, few studies explore the role of the doctorate in forming active researchers with the skills, know-how and appetite to pursue research post-completion. This article investigates 15 existing studies for evidence of what factors in the doctoral experience may contribute to…
-
ERIC Educational Resources Information Center
Hakkarainen, Kai Pekka; Wires, Susanna; Keskinen, Jenni; Paavola, Sami; Pohjola, Pasi; Lonka, Kirsti; Pyhältö, Kirsi
2014-01-01
The purpose of the present study was to investigate knowledge-creating agency by examining doctoral students' accounts of their pursuits, using structured interviews. We examined all of the talk apparently related to agency of 13 doctoral students taking part in collective doctoral training in two, highly regarded Finnish research communities…
-
1969 & 1980 Science and Engineering Doctorate Supply and Utilization.
ERIC Educational Resources Information Center
National Science Foundation, Washington, DC.
This study is limited to science and engineering doctorates (both PhD and Doctor of Arts) and spans the period 1969 to 1980--a period for which most of the factors likely to have a significant effect on the supply and utilization of doctorates are known or can be reasonably anticipated. The basic methodology involves statistically projecting past…
-
Succeeding with Your Doctorate
ERIC Educational Resources Information Center
Wellington, Jerry; Bathmaker, Ann Marie; Hunt, Cheryl; McCulloch, Gary; Sikes, Pat
2005-01-01
The aim of this book is to support, inform and guide students (and by implication their supervisors) through a doctoral programme. The book is intended for students working towards either a "taught" doctorate (such as an EdD) or a course of study leading to a PhD. The authors recognize that doctoral programmes have changed and these changes are…
-
Reexamining the Structure of Hemingway's "The Doctor and the Doctor's Wife."
ERIC Educational Resources Information Center
Mulvey, James
2003-01-01
Considers how Hemingway's "The Doctor and the Doctor's Wife" is a model of Edgar Allan Poe's aesthetic of the short story. Examines this work on many levels. Concludes that great writers, such as Ernest Hemingway, challenge readers to find the clues, to connect the dots, to pay attention to the "little details." (SG)
-
Connecting Online: Can Social Networking and Other Technology Support Doctoral Connectedness?
ERIC Educational Resources Information Center
Rockinson-Szapkiw, Amanda J.; Heuvelman-Hutchinson, Lorene; Spaulding, Lucinda
2014-01-01
The purpose of this study was to examine the influence of online doctoral students' interactions via peer initiated and university initiated technology on their sense of connectedness. The participants of this study were 132 doctoral candidates enrolled in an online Doctor of Education program located in the United States. Findings from this study…
-
"Tough Love and Tears": Learning Doctoral Writing in the Sciences
ERIC Educational Resources Information Center
Aitchison, Claire; Catterall, Janice; Ross, Pauline; Burgin, Shelley
2012-01-01
Contemporary changes to the doctorate mean student researchers are likely to be expected to write differently, write more and more often, and yet, despite a growing interest in doctoral education, we still know relatively little about the teaching and learning practices of students and supervisors vis-a-vis doctoral writing. This paper draws from…
-
ERIC Educational Resources Information Center
Gu, Jibao; Lin, Yu; Vogel, Doug; Tian, Wen
2011-01-01
Doctoral graduate research performance (DRP) is recognized as one of the most critical indices for evaluation of the success of doctoral education. Doctoral graduates with high research performance directly reflect a higher ability in academic research and academic achievement. Consequently, identifying which factors influence DRP is potentially…
-
Doctorate Recipients from United States Universities: Summary Report, 1999.
ERIC Educational Resources Information Center
Sanderson, Allen R.; Dugoni, Bernard L.; Hoffer, Thomas B.; Myers, Sharon L.
This is the thirty-third in a series of reports on research doctorates awarded by colleges and universities in the United States. The data presented in this report are from the annual Survey of Earned Doctorates, a census of research doctoral recipients who earned their degrees between July 1, 1998, and June 30, 1999. This survey, conducted since…
-
Going for the Gold Tassel: Getting a Doctoral Degree
ERIC Educational Resources Information Center
Burton, Clark A.
2005-01-01
The purpose of this article was to explain the constructs of doctrine and doctorate to the fire service. The methodology applied the Carnegie Foundation review of the doctorate as the basics for explaining what stewards of the fire service discipline will do with a doctoral degree. Although the fire service is an interdisciplinary occupation, the…
-
Data and Performativity in Doctoral Education: Information Gaps and Suggestions for Overcoming Them
ERIC Educational Resources Information Center
Wainerman, Catalina; Matovich, Iván
2016-01-01
Since the mid-1990s, there has been an abrupt growth of doctoral enrollments and doctoral programs in Argentina and Latin America. However, completion rates at this education level are far from satisfying. Attrition rates in Social Sciences doctoral programs "are known" to be high, and higher in Social Sciences and Humanities (which will…
-
The Future of Marketing Scholarship: Recruiting for Marketing Doctoral Programs
ERIC Educational Resources Information Center
Davis, Donna F.; McCarthy, Teresa M.
2005-01-01
As demand for business education is rising, the production of business doctorates continues to fall. Between 1995 and 2001, new business doctorates declined 18%, dropping to the lowest point since 1987. In the same time frame, new marketing doctorates dropped by 32%. This article reports the results of a study designed to (1) assess enrollment…
-
Alternative and Professional Doctoral Programs: What Is Driving the Demand?
ERIC Educational Resources Information Center
Servage, Laura
2009-01-01
As part of an overall massification of higher education, enrollments in doctoral programs are expanding. At the same time, doctoral studies are subject to much scrutiny and reform in Australia, the UK and the United States. This work examines policy documents related to doctoral reform from these countries in order to offer a critique of their…
-
ERIC Educational Resources Information Center
Gopaul, Bryan
2011-01-01
This conceptual article uses the tools of Pierre Bourdieu (1977, 1986, 1990) to examine the socialization of doctoral students by suggesting that the processes of doctoral study highlight inequities among students. Using Young's (1990) social justice approach as a framework to complement the ideas of Bourdieu, I demonstrate how aspects of academic…
-
ERIC Educational Resources Information Center
Flowers, Jim; Lazaros, Edward
2009-01-01
It takes an honest look for a technology teacher to determine whether he or she should engage in doctoral study. Doctoral programs have a rather high attrition rate, as high as 40 or 50%, and university resources might be better spent on those who have a greater chance of succeeding. However, for those who take the plunge, doctoral studies can be…
-
ERIC Educational Resources Information Center
Pyhältö, Kirsi; Vekkaila, Jenna; Keskinen, Jenni
2015-01-01
Although supervision has been identified as one of the central determinants of the doctoral experience, there is still an insufficient understanding of the ways in which supervisors and doctoral students perceive supervisory activities. The study focuses on exploring the fit between doctoral students' and supervisors' perceptions of who are…
-
Child Development and the Coworking of Doctor and Teacher: A Waldorf School Doctor's Perspective.
ERIC Educational Resources Information Center
Karnow, Gerald F.
This paper draws on the nearly 20 years' experiences of a school doctor working with teachers at the Rudolf Steiner School in New York City to describe general principles of assessing child development in relation to educational progress. The paper contrasts the customary role of school doctors (related to conducting physical examinations for…
-
ERIC Educational Resources Information Center
Thompson, Carla J.
2014-01-01
The study included an assessment of doctoral students, graduate faculty, and curriculum considerations to determine the degree of infusion of research integrity and responsible conduct of research (RCR) principles within a Doctor of Education program. Study results showed substantial increases in doctoral candidates' knowledge levels of RCR,…
-
English as an Additional Language (EAL) "viva voce": The EAL Doctoral Oral Examination Experience
ERIC Educational Resources Information Center
Carter, Susan
2012-01-01
Is the doctoral "viva voce" a reasonable method of examination? This exploratory paper proposes that the doctoral "viva voce" (oral examination) is a slightly different hurdle for doctoral candidates for whom English is an additional language (EAL, also termed ESL) than for those whose first language is English. It investigates…
-
[From doctor-patient relationship to a collaborative one].
Engeström, Yrjö
2013-01-01
In the historical development, the relationship between the patient and the doctor has gradually become increasingly objectified. Since then, a patient-centered or holistic way of thinking has become a normative model, towards which attempts have been made to change the patient-doctor relationship. The patient-doctor relationship must, however, be widened to a new type of relationship that links several doctors treating the same patient into collaboration and requires a new kind of working culture. We refer to this new concept as negotiated knotworking. Negotiation aims at an adequate, not complete mutual understanding.
-
2014-04-01
doctor or nurse possible and 10 is the best personal doctor or nurse possible, what number would you use to rate your personal doctor or nurse ?” For...was it to get a personal doctor or nurse you are happy with?” For access to specialist doctor: “In the last 12 months, how much of a problem, if any...additional information. Connect with GAO on Facebook, Flickr, Twitter, and YouTube . Subscribe to our RSS Feeds or E-mail Updates. Listen to our Podcasts
-
Doctor Competence and the Demand for Healthcare: Evidence from Rural China.
Fe, Eduardo; Powell-Jackson, Timothy; Yip, Winnie
2017-10-01
The agency problem between patients and doctors has long been emphasised in the health economics literature, but the empirical evidence on whether patients can evaluate and respond to better quality care remains mixed and inconclusive. Using household data linked to an assessment of village doctors' clinical competence in rural China, we show that there is no correlation between doctor competence and patients' healthcare utilisation, with confidence intervals reasonably tight around zero. Household perceptions of quality are an important determinant of care-seeking behaviour, yet patients appear unable to recognise more competent doctors - there is no relationship between doctor competence and perceptions of quality. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
-
How Hispanic Patients Address Ambiguous versus Unambiguous Bias in the Doctor's Office
Bean, Meghan G.; Covarrubias, Rebecca; Stone, Jeff
2014-01-01
Two studies examined Hispanic individuals’ preferences for using ten different bias reduction strategies when interacting with a doctor whose beliefs about their group were either ambiguous or clearly biased. Consistent with predictions, participants who imagined interacting with a doctor whose beliefs were ambiguous preferred strategies that facilitate positive doctor-patient interactions, whereas participants whose doctor explicitly endorsed negative stereotypes about their group preferred strategies that address stereotype content. The results also revealed that, regardless of whether the doctor's beliefs were ambiguous or clearly biased, stigma consciousness predicted participants’ preferences for using strategies that address stereotype content. These findings suggest that both doctors’ behavior and individual-level factors influence how minority individuals choose to behave in a healthcare setting. PMID:25395691
-
McKenna, Hugh; Keeney, Sinead; Kim, Mi Ja; Park, Chang Gi
2014-07-01
To evaluate the quality of doctoral education in nursing in the United Kingdom. In recent decades, doctoral education programmes in nursing are increasing worldwide. There are many reasons for this and concerns have been raised regarding the quality of provision in and across countries. To date, the quality of doctoral education on a global level has not been reported in the literature. This United Kingdom study is part of a seven country investigation into the quality of doctoral education in nursing (Australia, Japan, Korea, South Africa, Thailand, United Kingdom and United States of America). A quantitative study using a cross-sectional comparative survey design. An online survey was administered to collect the views of doctoral students and staff members on four domains: programme, faculty/staff, resource and evaluation. The study was carried out between 2010-2012. In most cases, staff perceived these more positively than students and the differences in perception were often statistically significant. Interestingly, many students rated the quality of supervision as excellent, whereas no staff member rated supervision this highly. The crucial importance of resources was confirmed in the path analysis of the four Quality of Doctoral Nursing Education domains. This demonstrates that investment in resources is much more cost-effective than investment in the other domains in relation to improving the overall quality of doctoral education in nursing. This study has wide-ranging implications for how the quality of doctoral education is monitored and enhanced. © 2013 John Wiley & Sons Ltd.
-
Akinyemi, Oluwaseun; Atilola, Olayinka
2013-01-01
The Nigerian health system has been engulfed in a crisis occasioned by a deluge of strike actions by resident doctors in recent times. Dissatisfaction with conditions of service has been cited as the bone of contention. Job satisfaction studies among doctors have provided insights into the contributory factors to recurrent industrial disputes in other climes. This study aims to determine the predictors of job satisfaction among resident doctors in a tertiary healthcare centre in Nigeria. This is with a view to gain some insights into the possible contributory factors to industrial disputes and to discuss the policy implications of such findings. A semi-structured questionnaire was used to obtain socio-demographic characteristics and job-related determinants of job satisfaction among resident doctors. Logistic regression analysis was carried out to determine predictors of job satisfaction. A total of 163 resident doctors completed the study. Overall, 90 (55.2%) of the resident doctors were satisfied with their jobs. Lower age, career advancement opportunities, autonomy of practice, alignment of job with core personal and professional values, and working environment predicted job satisfaction. To restore satisfaction and possibly stem industrial disputes by resident doctors, government of Nigeria needs to sustain current wages while introducing non-financial benefits. There is a need to adopt policies geared towards increasing government spending on health especially in the area of human capacity and infrastructural development, so as to afford resident doctors opportunities for skill acquisition and career development. Copyright © 2012 John Wiley & Sons, Ltd.
-
Roy, Ashim; van der Weijden, Trudy; de Vries, Nanne
2017-06-20
Work design integrates work characteristics having organizational, social and job components which influence employees' welfare and also organizational goals. We investigated the effects of work characteristics and other predictors to job satisfaction, turnover intention, and burnout in doctors of the public primary, public secondary and private facilities of the district health system of Bangladesh. A quantitative study using a self-administered questionnaire containing mostly structured items was conducted among the public and private doctors with a sample size of 384 from 29 out of a total 64 districts of Bangladesh during October and November 2015. All variables including work characteristics and outcomes of interest were based on literature and measured on 5-point Likert scale. Multivariate analysis of variance, bivariate correlation, and multiple regression were the models operated through SPSS version-21. A total of 354 doctors responded. No significant differences were found between public primary and secondary level doctors on combined work characteristics and outcomes variables, which however differed significantly between the public and private doctors. Organizational support was the strongest predictor adversely affecting job satisfaction, turnover intention and burnout of both the public and private doctors; private doctors' experienced more support. The effects of health-professional politics on the public doctors were alarming. Work design of the Bangladesh's health system is in need of ample development. Doing so, improvement in organizational supports is crucial; however, other work characteristics components are also important for enhancing doctors' welfare and health system productivity.
-
Doctors disciplined for professional misconduct in Australia and New Zealand, 2000-2009.
Elkin, Katie J; Spittal, Matthew J; Elkin, David J; Studdert, David M
2011-05-02
To describe professional discipline cases in Australia and New Zealand in which doctors were found guilty of professional misconduct, and to develop a typology for describing the misconduct. A retrospective analysis of disciplinary cases adjudicated in five jurisdictions (New South Wales, Victoria, Queensland, Western Australia and New Zealand) in 2000-2009. Characteristics of the cases (setting, misconduct type, patient outcomes, disciplinary measure imposed), characteristics of the doctors involved (sex, specialty, years since qualification) and population-level case rates (by doctor characteristics). The tribunals studied disciplined 485 doctors. Male doctors were disciplined for misconduct at four times the rate of their female colleagues (91 versus 22 cases per 100 000 doctor-years). Obstetrics and gynaecology and psychiatry were the specialties with the highest rates (224 and 178 cases per 100 000 doctor-years). The mean age of disciplined doctors did not differ from that of the general doctor population. The most common types of offences considered as the primary issue were sexual misconduct (24% of cases), illegal or unethical prescribing (21%) and inappropriate medical care (20%). In 78% of cases, the tribunal made no mention of any patient having experienced physical or mental harm as a result of the misconduct. Penalties were severe, with 43% of cases resulting in removal from practice and 37% in restrictions on practice. Disciplinary cases in Australia and New Zealand have features distinct from those studied internationally. The recent nationalisation of Australia's medical boards offers new possibilities for tracking and analysing disciplinary cases to improve the safety and quality of health care.
-
Laamanen, Ritva; Simonsen-Rehn, Nina; Suominen, Sakari; Brommels, Mats
2010-11-01
The aim of the study was to examine the use of physician services and the willingness to choose an health centre (HC) doctor rather than an alternative (i.e. private, occupational healthcare, other doctor) by the working age population in four municipalities in Finland. In a Southern municipality primary health care was contracted out to a non-profit organization whereas Eastern, Western and South-Western municipalities mainly provided services themselves. A mail survey of a random sample of the 15-64-age population was conducted in 2002 (n = 2,000, response rate 62%). Data were analyzed using descriptive statistics as well as bi- and multivariate logistic regression analyses. Of the respondents, 69% had visited an HC doctor during the past year, and of these, more than 40% had also visited another doctor outside the HC. The willingness to choose an HC doctor varied from 40% to 54% and was highest in the Southern municipality. When significantly associated variables - age, working status, perceived stress in life situation, access to an appointment, perceived interpersonal quality, and visits to doctors - were controlled for, the willingness to choose an HC doctor was, compared with the Southern municipality, less popular only in the Western municipality. The tendency to choose an HC doctor rather than an alternative was quite low, probably reflecting lack of attractiveness of HC to patients. However, contracting out service production did not additionally decrease patients' willingness to choose an HC doctor. More attention should be paid to improving access, interpersonal quality and continuity of care.
-
The medical complaints and disciplinary process in New Zealand: doctors' suggestions for change.
Cunningham, Wayne
2004-07-23
To document New Zealand doctors' opinions about the complaints and disciplinary process, and to develop a proposal for change. A cross-sectional survey of New Zealand doctors randomly selected to include vocationally registered general practitioners, vocationally registered hospital-based specialists, and general registrants. Qualitative (thematic) analysis of written responses was used to categorise doctors' ideas about the complaints system, and to develop a proposal for change 453 doctors responded to the survey. Respondents were aware of the complexity of medicine, the fallibility of doctors, and of tension between societal expectations of care and their ability to meet those expectations. They perceived a societal culture of blame, and indicated that complaints should provide an opportunity for learning (for both complainants and doctors to be heard), and for a satisfactory outcome to be achieved for both doctors and complainants. They indicated that complaints should be resolved rapidly, that frivolous and vexatious complaints should be identified early in the process, and that the role of the media should be minimised. They indicated that the complaints process should be transparent, with complaints tribunals using appropriate advisors and standards of judgment. The proposal for change was a single point of entry for all complaints. New Zealand doctors are aware of the nature of the practice of medicine, and the sociopolitical context of the delivery of care. They support the notion of a Complaints Tribunal providing a single point of entry for all complaints, and which uses a process that is transparently appropriate for both doctors and complainants.
-
The doctor and the patient--how is a clinical encounter perceived?
Adams, Robert; Price, Kay; Tucker, Graeme; Nguyen, Anh-Minh; Wilson, David
2012-01-01
To examine the population distribution of different types of relationships between people with chronic conditions and their doctors that influence decisions being made from a shared-decision making perspective. A survey questionnaire based on recurring themes about the doctor/patient relationship identified from qualitative in-depth interviews with people with chronic conditions and doctors was administered to a national population sample (n=999) of people with chronic conditions. Three factors explained the doctor/patient relationship. Factor 1 identified a positive partnership characteristic of involvement and shared decision-making; Factor 2 doctor-controlled relationship; Factor 3 relationship with negative dimensions. Cluster analysis identified four population groups. Cluster 1 doctor is in control (9.7% of the population); Cluster 2 ambivalent (27.6%); Cluster 3 positive long-term relationship (58.6%); Cluster 4 unhappy relationship (4.4%). The proportion of 18-34 year olds is significantly higher than expected in Cluster 4. The proportion of 65+ year olds is significantly higher than expected in Cluster 1, and significantly lower than expected in Cluster 4. This study adds to shared decision-making literature in that it shows in a representative sample of people with chronic illnesses how their perceptions of their experiences of the doctor-patient relationship are distributed across the population. Consideration needs to be given as to whether it is better to help doctors to alter their styles of interactions to suit the preferences of different patients or if it is feasible to match patients with doctors by style of decision-making and patient preference. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
-
A national survey of Chinese medicine doctors and clinical practice guidelines in China.
Liu, Mengyu; Zhang, Chi; Zha, Qinglin; Yang, Wei; Yuwen, Ya; Zhong, Linda; Bian, Zhaoxiang; Han, Xuejie; Lu, Aiping
2017-09-06
Clinical practice guidelines (CPGs) for Chinese medicine (CM) are being developed to assist doctors with appropriate decisions concerning CM care. To date, there has been little investigation on the perspectives of those to whom the guidelines are directed. A self-administered questionnaire was sent to 4503 doctors in 28 provinces of China in the latter half of 2012. Questions were organized around the topics of knowledge, application, practice changes, beliefs and outcomes of implementation. Basic classificatory data on specialties and years of qualification were also collected. Replies were received from 4495 CM doctors (99.82%). Of these, 85.56% of CM doctors reported being familiar with CPG recommendations, but the overall adherence rate was only 50.39%. The length of time practicing CM may influence the rate of adherence, since 709 doctors (51.90%) with less than 5 years of experience reported never having followed CPGs. Doctors in nine specialties showed a modest degree of homogeneity in their attitudes towards CM diagnosis and treatment, which were generally positive. Most doctors regarded CPG-recommended therapies as safe (92%), economic (84%), and effective (76%). Approximately four-fifths of those questioned selected 'acceptable' (60.84%) and 'acceptable after revision' (19.23%) regarding their comprehensive assessment of the CPGs. An encouraging result from this survey is that the majority of CM doctors support the concept of CPGs for the practice of CM. However, the results of this survey also suggest that improving the adherence of CM doctors to the guidelines remains a major challenge to improving the practice standards for CM.
-
Cultural dimensions in the transition of overseas medical graduates to the UK workplace.
Morrow, Gill; Rothwell, Charlotte; Burford, Bryan; Illing, Jan
2013-10-01
Historically, overseas-qualified doctors have been essential for meeting service needs in the UK National Health Service (NHS). However, these doctors encounter many cultural differences, in relation to training, the healthcare system and the doctor-patient relationship and training. To examine whether Hofstede's cultural model may help us understand the changes doctors from other countries experience on coming to work in the UK, and to identify implications for supervisors and clinical teams. Telephone interviews were conducted with overseas medical graduates before starting work as a Foundation Year One (F1) doctor, followed up after four months and 12 months; and with educational supervisors. Data were analysed using a confirmatory thematic approach. Sixty-four initial interviews were conducted with overseas doctors, 56 after four months, and 32 after 12 months. Twelve interviews were conducted with educational supervisors. The changes doctors experienced related particularly to Hofstede's dimensions of power distance (e.g. in relation to workplace hierarchies and inter-professional relationships), uncertainty avoidance (e.g. regarding ways of interacting) and individualism-collectivism (e.g., regarding doctor-patient/family relationship; assertiveness of individuals). Hofstede's cultural dimensions may help us understand the adaptations some doctors have to make in adjusting to working in the UK NHS. This may promote awareness and understanding and greater 'cultural competence' amongst those working with them or supervising them in their training.
-
Agledahl, Kari Milch; Gulbrandsen, Pål; Førde, Reidun; Wifstad, Åge
2011-11-01
To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient-doctor encounters. Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. A 500-bed general teaching hospital in Norway. 71 doctors working in clinical non-psychiatric departments and their patients. The doctors were concerned about their patients' health and how their medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. The study suggests that the main failing of patient-doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof.
-
Stevenson, Fiona A; Kerr, Cicely; Murray, Elizabeth; Nazareth, Irwin
2007-01-01
Background Both doctors and patients may perceive the Internet as a potential challenge to existing therapeutic relationships. Here we examine patients' views of the effect of the Internet on their relationship with doctors. Methods We ran 8 disease specific focus groups of between 2 and 8 respondents comprising adult patients with diabetes mellitus, ischaemic heart disease or hepatitis C. Results Data are presented on (i) the perceived benefits and (ii) limitations of the Internet in the context of the doctor-patient relationship, (iii) views on sharing information with doctors, and (iv) the potential of the Internet for the future. Information from the Internet was particularly valued in relation to experiential knowledge. Conclusion Despite evidence of increasing patient activism in seeking information and the potential to challenge the position of the doctor, the accounts here do not in any way suggest a desire to disrupt the existing balance of power, or roles, in the consultation. Patients appear to see the Internet as an additional resource to support existing and valued relationships with their doctors. Doctors therefore need not feel challenged or threatened when patients bring health information from the Internet to a consultation, rather they should see it as an attempt on the part of the patient to work with the doctor and respond positively. PMID:17705836
-
What happens when doctors are patients? Qualitative study of GPs.
Fox, Fiona; Harris, Michael; Taylor, Gordon; Rodham, Karen; Sutton, Jane; Robinson, Brian; Scott, Jenny
2009-11-01
Current evidence about the experiences of doctors who are unwell is limited to poor quality data. To investigate GPs' experiences of significant illness, and how this affects their own subsequent practice. Qualitative study using interpretative phenomenological analysis to conduct and analyse semi-structured interviews with GPs who have experienced significant illness. Two primary care trusts in the West of England. A total of 17 GPs were recruited to take part in semi-structured interviews which were conducted and analysed using interpretative phenomenological analysis Results: Four main categories emerged from the data. The category, 'Who cares when doctors are ill?' embodies the tension between perceptions of medicine as a 'caring profession' and as a 'system'. 'Being a doctor-patient' covers the role ambiguity experienced by doctors who experience significant illness. The category 'Treating doctor-patients' reveals the fragility of negotiating shared medical care. 'Impact on practice' highlights ways in which personal illness can inform GPs' understanding of being a patient and their own consultation style. Challenging the culture of immunity to illness among GPs may require interventions at both individual and organisational levels. Training and development of doctors should include opportunities to consider personal health issues as well as how to cope with role ambiguity when being a patient and when treating doctor-patients. Guidelines about being and treating doctor-patients need to be developed, and GPs need easy access to an occupational health service.
-
Adams, A; Realpe, A; Vail, L; Buckingham, C D; Erby, L H; Roter, D
2015-10-01
To determine the impact of doctors' communication style and doctor-patient race concordance on UK African-Caribbeans' comfort in disclosing depression. 160 African-Caribbean and 160 white British subjects, stratified by gender and history of depression, participated in simulated depression consultations with video-recorded doctors. Doctors were stratified by black or white race, gender and a high (HPC) or low patient-centred (LPC) communication style, giving a full 2×2×2 factorial design. Afterwards, participants rated aspects of doctors' communication style, their comfort in disclosing depression and treatment preferences Race concordance had no impact on African-Caribbeans' comfort in disclosing depression. However a HPC versus LPC communication style made them significantly more positive about their interactions with doctors (p=0.000), their overall comfort (p=0.003), their comfort in disclosing their emotional state (p=0.001), and about considering talking therapy (p=0.01); but less positive about considering antidepressant medication (p=0.01). Doctors' communication style was shown to be more important than patient race or race concordance in influencing African Caribbeans' depression consultation experiences. Changing doctors' communication style may help reduce disparities in depression care. Practitioners should cultivate a HPC style to make African-Caribbeans more comfortable when disclosing depression, so that it is less likely to be missed. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
-
Doctors charged with manslaughter in the course of medical practice, 1795-2005: a literature review
Ferner, R E; McDowell, Sarah E
2006-01-01
Objectives: To quantify the number of doctors charged with manslaughter in the course of legitimate medical practice and to classify cases, as mistakes, slips (or lapses), and violations, using a recognized classification of human error system. Design: We searched newspaper databases, Medline, Embase, and the Wellcome library catalogue to identify relevant cases from 1795 to December 2005. Setting: Medical practice in the United Kingdom. Main outcome measure: Number of doctors charged with manslaughter in the course of medical practice. Results: We identified 85 doctors charged with manslaughter since 1795. The number of doctors charged was relatively high in the mid-19th century and the inter-war years, and has dramatically increased since 1990. Sixty of the doctors were acquitted, 22 were convicted, and three pleaded guilty. Most doctors were charged as a consequence of mistakes (37) or slips (17), and a minority because of alleged violations (16). Conclusions: The number of doctors prosecuted for manslaughter has risen steeply since 1990, but the proportion of doctors convicted remains low. Prosecution for deliberately violating rules is understandable, but accounts for only a minority of these cases. Unconscious errors—mistakes and slips (or lapses)—are an inescapable consequence of human actions and prosecution of individuals is unlikely to improve patient safety. That requires improvement to the complex systems of health care. PMID:16738374
-
... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... empagliflozin without talking to your doctor.Ask your pharmacist or doctor for a copy of the manufacturer's ...
-
... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... without talking to your doctor.Your doctor or pharmacist will give you the manufacturer's patient information sheet ( ...
-
... prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. ... without talking to your doctor.Your doctor or pharmacist will give you the manufacturer's patient information sheet ( ...
-
Special Education Doctoral Programs: A 10-Year Comparison of the Suppliers of Leadership Personnel
ERIC Educational Resources Information Center
Smith, Deborah Deutsch; Montrosse, Bianca Elizabeth
2012-01-01
The first article in this special issue is about the doctoral programs, the suppliers of new doctoral graduates in special education. It focuses on one component of a larger effort, the Special Education Faculty Needs Assessment (SEFNA) project, which investigated many aspects of the supply of new doctoral graduates as well as the demand for new…
-
ERIC Educational Resources Information Center
Ramírez, Magdalena Jiménez
2016-01-01
In Spain, the organisation of doctoral studies has been substantially modified to come into line with the changes introduced by the agenda of the Bologna process. These changes have been specified in a number of statements by European Ministers of Education, and have required alterations to Spanish doctoral regulations. The aim of these changes…
-
ERIC Educational Resources Information Center
Greene, Michele G.; And Others
1987-01-01
Using a newly developed coding method, the Geriatric Interaction Analysis system, the interactions of doctors with a matched sample of older and younger patients were audiotaped and scored. Patients and doctors raised fewer psychosocial issues in interviews with older patients than with younger patients. Doctors also responded less well to these…
-
ERIC Educational Resources Information Center
Nevin, Ann I.; Barbetta, Patricia; Cramer, Elizabeth
2009-01-01
The mission for Urban SEALS (Special Education Academic Leaders), a federally funded doctoral preparation program, is to prepare doctoral-level special educators, including those who are culturally and/or linguistically diverse (CLD) to assume leadership roles in the education of urban students with disabilities who are CLD. This report provides…
-
ERIC Educational Resources Information Center
Kyvik, Svein; Olsen, Terje Bruen
2014-01-01
This article examines changes in completion rates and time-to-degree in Norwegian doctoral training over the last 30 years. A steadily increasing share of doctoral candidates holding a fellowship have been awarded their doctoral degree within five years; from 30% of those admitted in 1980 to 60% of those admitted 25 years later. Furthermore, the…
-
ERIC Educational Resources Information Center
Kot, Felly Chiteng; Hendel, Darwin D.
2012-01-01
This article examines the development and growth of professional doctorates in the United States, United Kingdom, Canada, and Australia. It provides an overview of the development of the doctoral degree from its establishment at the universities of Paris and Bologna, and highlights the emergence of new forms of doctorates that have challenged the…
-
ERIC Educational Resources Information Center
Wolhuter, Charl
2011-01-01
The aim of this article is to survey the international literature on doctoral education from a South African perspective. A colossal amount of published research on doctoral education abroad has accumulated in recent years, dwarfing the minuscule number of publications on doctoral education in South Africa. Three major deficiencies in the corpus…
-
The Ph.D. Dissertation: An Analysis of the Doctoral Dissertation as an Information Source.
ERIC Educational Resources Information Center
Boyer, Calvin James
In 1972 American universities will confer 33,700 doctorates. An essential feature of the process which leads to the doctorate is the submission and defense of a dissertation. The doctoral dissertation must embody the results of extended research, be an original contribution to knowledge and include material worthy of publication. It is surprising,…
-
ERIC Educational Resources Information Center
Stephenson, John; Malloch, Margaret; Cairns, Len
2006-01-01
This article contributes to current debates about professional doctorates from a lifelong learning perspective, focusing on those who choose to undertake a doctoral programme in mid- or late career and their responses to the challenge of demonstrating their "doctorateness" as evidenced in their previous and continuing professional work.…
-
Assessment Matters: Some Issues Concerning the Supervision and Assessment of Work-Based Doctorates
ERIC Educational Resources Information Center
Johnson, David
2005-01-01
Since 2000, I have been working towards a professional doctorate at Middlesex University, and I am also working to introduce a work-based doctorate at Coventry University. This paper looks at the issues of supervision and assessment for work-based doctorates, which, I believe, are key to the design of such a programme and affect both the output…
-
ERIC Educational Resources Information Center
Aryan, Bushra
2010-01-01
This study explored the experiences of seven Afghan women pursuing doctoral degrees in a variety of disciplines and programs across the United States. The guiding question for this study was: What factors influence Afghan women's journeys to and experiences in doctoral programs? In an attempt to understand Afghan women doctoral students, I…
-
Investing in learning and training refugee doctors.
Ong, Yong Lock; Trafford, Penny; Paice, Elisabeth; Jackson, Neil
2010-06-01
Medically qualified refugees seek to build a new life and return to clinical medicine. The National Health Service (NHS) in the UK needs to develop a workforce to meet the needs of the communities it serves, and refugee doctors have the potential to contribute to the NHS, using their experience and skills to benefit patients. Fifty-four per cent of refugee doctors in the UK live in London, so in response, the London Deanery (Postgraduate Department of Medical and Dental Education, London University) has undertaken a series of initiatives over the past 8 years assisting refugee doctors back into medical employment. Clinical attachments, supernumerary 6-month posts and general practitioner (GP) training rotations have been offered. The projects, doctors involved, educational provision and outcomes are reported. The obstacles and barriers to returning to substantive posts in medicine are also discussed. Fifty-six per cent of the refugee doctors were known to be working after the schemes, 52 per cent gained substantive posts and 39 per cent entered training grades. Investing in innovative and creative work-based training programmes for refugee doctors is worthwhile, but needs to be adequately resourced if refugee doctors are to bring ultimate benefit to the NHS. © Blackwell Publishing Ltd 2010.
-
Abellán Alemán, José; Leal Hernández, Mariano; Martínez Pastor, Antonio; Hernández Menárguez, Fernando; García-Galbis Marín, José Antonio; Jara Gómez, Purificación
2006-09-01
To find the level of knowledge, the guidelines for action and the monitoring of lipaemia by Spanish primary care and specialist doctors. A self-defined questionnaire of 12 items was designed. Data on the population treated and the subjective evaluation of objectives, and on the management and monitoring of lipid parameters were filled in. A total of 1998 doctors from the whole of Spain took part; 68.8% of the doctors interviewed worked in primary health care and 30.2% in specialist centres or hospitals. A 91% of the doctors said they followed international consensus on monitoring lipaemia. The most commonly used objective therapeutic parameter for treating lipaemia was LDL-cholesterol (83%), followed by total cholesterol (62%), HDL-cholesterol (56%) and triglycerides (51%). If the patient's lipaemia was well controlled, then 21.8% of doctors reduced the doses of lipid-lowerers. In general terms, no great differences were appreciated between the criteria followed by PC and by specialist doctors. The criteria for action on lipaemia could be improved. There are no important differences of view or action in clinical and therapeutic criteria for Lipaemia cases between PC and specialist doctors.
-
[A questionnaire survey of medical cooperation by the Iwaki Medical Association].
Midorikawa, Yasuhiko
2013-12-01
It has been pointed out that currently, Iwaki City faces an insufficiency of doctors working at hospitals, compared with before. Such an insufficiency became more remarkable after the 2011 Tohoku Earthquake and Fukushima Nuclear Disaster, as about 30,000 people relocated to Iwaki City from the evacuation areas. In this regard, the Iwaki Medical Association conducted a questionnaire survey to investigate the problems of medical cooperation and utilize the data to improve medical cooperation within hospitals and clinics. A total of 159 doctors answered the questionnaires: 64% were community physicians, 36% were doctors working at hospitals, and 42% were physicians. About 60% of the doctors were satisfied with the present medical cooperation. Home health care was performed by 25% of the doctors working at hospitals and 45% of the community physicians. Approximately 80% of the doctors felt the need for additional physicians to perform home health care, although more than half of the doctors answered that they do not perform it. Various problems exist in the context of medical cooperation, but many doctors still hope for its improvement, according to the answers in the questionnaires. Efforts have to be exerted further in order to enhance medical cooperation among the health care team.
-
A brief history of dermatovenereology in Dubrovnik.
Bakija-Konsuo, Ana; Marlais, Matko
2012-01-01
Since its inception, Dubrovnik has been associated with medicine. The citizens of Dubrovnik have felt the need for the development and improvement of public health conditions in their city as the basic conditions of their existence. In this context, we focused our attention on the development of dermatology and venereology to date; from the first hospital Domus Christi to the modern hospital Medarevo; from the first doctors to specialist doctors, who have marked dermatovenereology in Dubrovnik and Croatia. Domus Christi started accepting patients in 1540 as a public sector hospital and operated for more than 350 years. In 1847, doctors Pinelli and Lopišić operated on breast cancer in this hospital with the use of ether narcosis (one year after ether narcosis had been discovered). A doctor is first mentioned in Dubrovnik in 1280, until this time it could be said that there were no doctors. Medical operations were performed by barbers. The first written records of a doctor in Dubrovnik practicing in dermatovenereology are those of military doctor Marko Bibica. In the context of Dubrovnik dermatovenereology, we must mention doctor Luko Stulli, who was the first to describe Mal de Meleda.
-
New Zealand doctors' attitudes towards the complaints and disciplinary process.
Cunningham, Wayne
2004-07-23
To examine attitudes held by doctors in New Zealand towards the complaints and disciplinary process. A questionnaire was sent to New Zealand doctors randomly selected to include vocationally registered general practitioners, vocationally registered hospital-based specialists, and general registrants. 598 respondents (33.6% having ever and 66.4% having never received a medical complaint) indicated that New Zealand doctors strongly support society's right to complain, having lay input, a sense of completion, and appropriate advice provided to the complaints process. Doctors also support society's notions of rights and responsibilities, and believe that the medical profession is capable of self-regulation. Fifty percent of doctors do not believe that complaints are a useful tool to improve medical practice. Doctor's attitudes diverge about how they believe society interacts with the profession through the complaints process. They are divided in their opinion as to whether complaints are warranted, whether complainants are normal people, and whether complaints are judged by appropriate standards. Doctor's attitudes towards the complaints and disciplinary system fall on a continuum between being consistent and divergent. Their attitudes are consistent with notions of professionalism, but suggest that using the complaints system to improve the delivery of medical care may be problematic.
-
[Advancement of the medical doctorate].
Baum, C; Förster, R; Schmidt, R E
2009-08-01
The medical doctorate and the subsequent advanced research qualification in medicine have an exceptional position within the natural sciences. While, in the German system, graduation to the degree of a medical doctor is often an initiation into scientific practice, the in-depth scientific education of medical doctors may be achieved in various configurations. In recent years, structured programs for doctorates in medicine and natural sciences have found increasing acceptance, following recommendations of national scientific councils ("Deutsche Forschungsgemeinschaft" and "Hochschulrat"). Hannover Medical School has been offering such programs for a number of years. The StrucMed program increases the quality of medical doctorate studies, typically performed in the third and fourth years of university studies. The Hannover Biomedical Research School (HBRS) combines several programs for a doctorate in natural sciences, creating a platform for an internationally oriented education of post-graduates in various disciplines of life sciences. Evaluating the achievements and career paths of the trainees will contribute to the successful integration of research work in an efficiency-oriented clinical environment.
-
[Perceptual comparison of the "good doctor" image between faculty and students in medical school].
Yoo, Hyo Hyun; Lee, Jun-Ki; Kim, Arem
2015-12-01
The purpose of this study is to analyze the differences in the perception of the "good doctor" image between faculty and students, based on the competencies of the "Korean doctor's role." The study sample comprised 418 students and 49 faculty members in medical school. They were asked to draw images of a "good doctor," and the competencies were then analyzed using the Draw-A-Scientist test and the social network program Netminer 4.0. Of the competency areas, "communication and collaboration with patient" and "medical knowledge and clinical skills" were the most frequently expressed, and "education and research," "professionalism," and "social accountability" were less commonly expressed. Images of a good doctor by the faculty focused on competencies that were directly related to current clinical doctors. Conversely, those by the students expressed various competencies equally. We have provided basic data for faculties and schools to plan various education strategies to help students establish the image of a good doctor and develop the necessary competencies as physicians.
-
Women doctors in Norway: the challenging balance between career and family life.
Gjerberg, Elisabeth
2003-10-01
In most Western countries, women doctors are still underrepresented in the higher positions in the medical hierarchy and in the most prestigious specialities. A crucial question is whether family responsibilities affect female and male career differently. The article examines how Norwegian physicians balance their work and family responsibilities and demonstrates differences in the way doctors combine work and family obligations, between women and compared with men. Among women doctors, the probability of becoming a specialist decreased with an increasing number of children. Moreover, postponing the birth of the first child increased the probability of completing hospital specialities. Although more women than men work part-time, this was the case only for a small proportion of women doctors. Transition from full-time to part-time work is primarily an accommodating strategy to family responsibilities, however strongly influenced by variations in the opportunity structure of different specialities. The findings further demonstrate that being married to another doctor had a positive impact on the career, especially for women doctors.
-
[The virtuous doctor in cinema: the final examination].
Figueroa, Gustavo
2014-10-01
The virtuous doctor has subscribed an oath and by subscribing to this solemn promise, he is committed to live in accordance with the purposes, obligations and virtues established in the medical profession. Cinematic art has shown only a superficial interest in complex aspects of medical profession. An exception is Ingmar Bergman's film "Wild Strawberries", where Professor Isak Borg, a widowed 76-year-old physician, is to be awarded the Doctor Jubilaris degree, 50 years after he received his doctorate at Lund University. During the trip, Isak is forced by a nightmare to reevaluate his professional life as not being a virtuous doctor.
-
Tips for Talking to Your Doctor
... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Working With Your Doctor, Your Health ResourcesTags: Doctor-Patient Relationships, Health Maintenance August 1, 2005 Copyright © American Academy of Family ...
-
... doctor or nurse in a doctor's office or infusion center. It is usually given once every 2 ... injection may cause serious allergic reactions during an infusion and for about 30 minutes afterwards. A doctor ...
-
Lachish, Shelly; Goldacre, Michael J; Lambert, Trevor
2016-05-23
Identifying factors that improve job satisfaction of new doctors and ease the difficult transition from student to doctor is of great interest to public health agencies. Studies to date have focused primarily on the value of changes to medical school curricula and induction processes in this regard, but have overlooked the extent to which institutional support can influence new doctors' enjoyment of and attitude to work. Here, we examine variation in the perceived level of support received by new medical graduates in the United Kingdom (UK) from their employer and whether this influences enjoyment of and attitudes to the first postgraduate year, and whether doctors who perceived a lower level of support were less inclined to intend a long term career in medicine in the UK. All UK medical graduates of 2012 were surveyed in 2013 in a cross-sectional study, towards the end of their first post-graduate year (the 'F1' year of the 2-year Foundation Training Programme for new UK doctors). We used linear regression to assess whether the level of support doctors reported receiving from their employing Trust (Very Good, Good, Adequate, Poor, or Very Poor) was associated with the extent to which they enjoyed their F1 year. Similarly, we assessed the strength of associations between self-reported level of Trust support and doctors' responses to 12 statements about fundamental aspects of their working lives, each assessed on a 5-point scale of agreement. Using χ (2) tests we examined whether doctors' intentions to practise medicine in the UK varied with the level of support they reported receiving from their Trust. The response rate was 45 % (2324/5171). Of 2324 responding junior doctors, 63.8 % reported receiving 'Very Good' (23.6 %) or 'Good' (40.2 %) initial support from their Trust, while a further 27.4 % stated they received 'Adequate' support. 'Poor' support was reported by 5.8 % and 'Very Poor' support by 2.2 %. We found very strong positive associations between the institutional support doctors reported receiving and their enjoyment of the F1 year and their self-expressed attitudes to aspects of their first year of work. Crucially, doctors who reported receiving lower levels of support ('Poor' or 'Very Poor') were significantly less likely to express intentions to continue practising medicine in the UK. The provision of effective institutional support for graduate doctors may promote workplace satisfaction and could help safeguard the long-term retention of junior doctors.
-
[Awareness survey of Healthcare Number System pros and cons according to medical doctors in Japan].
Takahashi, Yoshimitsu; Uryuhara, Yoko; Inoue, Machiko; Okamoto, Shigeru; Kashihara, Hidenori; Kito, Kumiko; Shinohara, Keiko; Mandai, Marie; Morioka, Miho; Tanaka, Shiro; Kawakami, Koji; Nakayama, Takeo
2015-01-01
After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the doctors' characteristics, and analyze the benefits and harms of the System that they identified. A cross-sectional survey was conducted of doctors via the Internet. The participants were selected from a convenience sample of a panel of doctors based on stratified sampling including four groups: working at a hospital and <45 years; working at a hospital and ≥45 years; working at a clinic and <45 years; and working at a clinic and ≥45 years. The main outcome was how many doctors agreed or disagreed with the System. The prevalence was calculated for each group, and their characteristics were examined using multivariable logistic regression analysis. The responses to open-ended questions concerning the Systems' benefits and harms were analyzed using qualitative content analysis. There were 562 respondents (68%). By group, 16/143 (11%), 25/138 (18%), 31/132 (23%), and 43/149 (29%) doctors, respectively, thought that the System was unnecessary. The variables that correlated with the main outcome were age (per 5 years; odds ratio [95% confidence interval], 1.14 [1.01-1.29]) and type of medical facility (working at a clinic; 1.99 [1.30-3.08]). The doctors identified that unifying information could decrease administrative duties, facilitate inter-facility collaboration, and prevent inappropriate medical consultations. This could result in decreased healthcare costs and personalized healthcare. However, the doctors also identified that integrating information and dealing with big data could increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. This could result in deteriorating healthcare. Since some information should not be integrated, the System raises ethical considerations about privacy. Among the doctors surveyed here, 10-30% thought the System was unnecessary. These respondents tended to be older and work at a clinic. The System could decrease the cost of healthcare and enable personalized healthcare but could also increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. Prior to System introduction, we should facilitate consensus-building about protecting and utilizing personal information as well as consider the related ethical issues, and doctors' characteristics and concerns.
-
Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank
2014-01-01
The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to the qualifying medical studies. This proportion, however, increased after the introduction of a curriculum on research methodology and practice in 2010; prospective longitudinal studies will have to clarify whether this is causal or mere chronological coincidence. In summary, the proposed method for determining the process efficiency of a medical faculty's "Dr med" programme has proven to be both feasible and informative. Copyright © 2014. Published by Elsevier GmbH.
-
Headache - what to ask your doctor
... Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... a tension-type headache ? A migraine headache ? A cluster headache ? What medical problems can cause headaches? What ...
-
... causes episodes of severe abdominal pain. Doctor-Patient Communication Doctors often consider SOD in patients who experience ... with a long-term digestive disorder. Doctor–Patient Communication How to Help Your Doctor Help You How ...
-
Weight-loss surgery - before - what to ask your doctor
... your doctor; What to ask your doctor before weight-loss surgery ... perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient - 2013 update: cosponsored by American Association of ...
-
Cholesterol - what to ask your doctor
... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...
-
... your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking primidone, call your doctor. If you are breast-feeding, call your doctor if your child becomes unusually ...
-
ERIC Educational Resources Information Center
Fiegener, Mark K.
2010-01-01
This InfoBrief uses data collected from the 2009 Survey of Earned Doctorates (SED) to report on trends in the numbers of individuals who earn research doctoral degrees from U.S. academic institutions. Postgraduation plans of new doctorate recipients are examined from 2004 to 2009, a period that includes the recent economic decline. The following…
-
Code of Federal Regulations, 2010 CFR
2010-04-01
... sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (C) “Ask a doctor before use if you have liver disease”. (D) “Ask a doctor or pharmacist before use if you are taking the blood... nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (3) “Ask...
-
Code of Federal Regulations, 2014 CFR
2014-04-01
... sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (C) “Ask a doctor before use if you have liver disease”. (D) “Ask a doctor or pharmacist before use if you are taking the blood... nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (3) “Ask...
-
Code of Federal Regulations, 2013 CFR
2013-04-01
... sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (C) “Ask a doctor before use if you have liver disease”. (D) “Ask a doctor or pharmacist before use if you are taking the blood... nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (3) “Ask...
-
Code of Federal Regulations, 2011 CFR
2011-04-01
... sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (C) “Ask a doctor before use if you have liver disease”. (D) “Ask a doctor or pharmacist before use if you are taking the blood... nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (3) “Ask...
-
Code of Federal Regulations, 2012 CFR
2012-04-01
... sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (C) “Ask a doctor before use if you have liver disease”. (D) “Ask a doctor or pharmacist before use if you are taking the blood... nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist.” (3) “Ask...
-
ERIC Educational Resources Information Center
Rainford, Jon
2016-01-01
Twitter and other social networking sites have much to offer doctoral students, especially given that models for doctoral education are increasingly becoming more diverse with more students studying part-time for traditional PhDs, or on programmes such as professional doctorates. Prior research has highlighted the benefits of Twitter but, as other…
-
ERIC Educational Resources Information Center
Parker, Melissa; Sutherland, Sue; Sinclair, Christina; Ward, Phillip
2011-01-01
The purpose of this qualitative study was to initiate a discussion and explore reactions to PETE doctoral education in the United States. A purposeful sample of 27 representatives from doctoral and non doctoral granting programs in the U.S. was interviewed. Analysis resulted in four themes: (a) Is the dog wagging its tail or the tail wagging the…
-
ERIC Educational Resources Information Center
Ampaw, Frim D.; Jaeger, Audrey J.
2011-01-01
The rate of doctoral degree completion, compared to all other degrees, is the lowest in the academy, with only 57 percent of doctoral students completing their degree within a ten-year period. In the science, engineering, and mathematics (SEM) fields, 62 percent of the male students complete their doctoral degree in ten years, which is better than…
-
ERIC Educational Resources Information Center
Szelenyi, Katalin
2013-01-01
Based on ethnographic interviews with 48 doctoral students and 22 faculty members in science and engineering, this study examines the ways in which doctoral students and faculty make market, symbolic, and social meaning of the presence or absence of money in doctoral student socialization and of funding from governmental and industrial sources.…
-
[Customer orientation in ambulant medicine].
Heinrich, M
2014-07-01
Due to developments of the health market, economic aspects of the health system are more relevant. In this upcoming market the patient is regarded as customer and the doctor as provider of medical services. Studies on customer orientation in the ambulant medicine lag behind this dynamic. An aim of the study is to comprehend the attitudes of the doctors referring to the customer orientation. In a second step the findings are discussed according to statements of health-care paticipants. Developments in role comprehension of doctor and patient are focused to gain results in scientific and practical applications. Guideline-supported, partly narrative interviews with n=9 gynaecologists and n=11 general practitioners in Freiburg/Germany are recorded, transcribed and reviewed in a qualitative analysis. The statements of the doctors show patient satisfaction has an incremental meaning sspecially regarding the sequence of patient relationship and economic management of the doctor's workplace. The doctor's role comprehension meets with a refusal of the role of salesman and the patient as customer. The method of interviews is suitable to gather empirical impressions of the doctors. The control sample is adequate, however a bias due to inhomogeneous thematic affinitiy and local social-demographics might be possible. The customer orientation has become an important factor in doctor-patient relationtships. The relevance of the doctor-patient conversation and the risk of misuse of the patient confidence are mentioned by the doctors. The doctor as paternalistic care provider gives way to the customer-focused service provider. The doctor's necessity of autonomyssss and dependency on patient satisfaction have potential for conflict. Intensive mention of customer orientation in medicine in the media emphasises its importance. Rational handling with the possibilities of individual health markets is a prospective challange. Further research could be established in all aspects of customer orientation, especially the changing relevance of ethical responsibility. An enlargement or comparison with other control samples (n>20, other medical subfields, structurally weak areas) could be illuminating. The results of this qualitative study can be used to develop quantitative inquiries. © Georg Thieme Verlag KG Stuttgart · New York.
-
Protest of doctors: a basic human right or an ethical dilemma
2014-01-01
Background Peaceful protests and strikes are a basic human right as stated in the United Nations’ universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Discussion Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors’ strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources. In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. Summary There is no single best answer against or in favor of doctors’ industrial action. The author calls for the debate and discussion to revitalize the understanding of the ethical predicaments of doctors’ strikes with patient care as the priority. PMID:24612947
-
Sex differences in medico-legal action against doctors: a systematic review and meta-analysis.
Unwin, Emily; Woolf, Katherine; Wadlow, Clare; Potts, Henry W W; Dacre, Jane
2015-08-13
The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time. The electronic databases MEDLINE, EMBASE, and PsycINFO were searched from inception to January 2015. Backward and forward citation searching was performed. Journals that yielded the majority of the eligible articles and journals in the medical education field were electronically searched, along with the conference and poster abstracts from two of the largest international medical education conferences. Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time.
-
Tong, Seng Fah; Low, Wah Yun; Ismail, Shaiful Bahari; Trevena, Lyndal; Wilcock, Simon
2013-12-01
Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men. This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated. 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010). Whilst sexual health inquiry should be initiated in an appropriate context, 'perceived receptivity' to sexual health inquiry significantly affected doctors' intention in initiating sexual health inquiry to their male patients. Malaysian men's health may be substantially improved by strategies that assist doctors to identify patient 'receptivity'.
-
The power of compassion: truth-telling among American doctors in the care of dying patients.
Miyaji, N T
1993-02-01
The perceptions of American doctors about their practice regarding truth-telling in the care of dying patients were examined based on semi-structured interviews with 32 physicians in a teaching hospital. The doctors inform patients of their disease using three basic styles; 'telling what patients want to know', 'telling what patients need to know' and 'translating information into terms that patients can take'. These styles are supported by five basic normative principles; 'respect the truth', 'patients rights', 'doctors' duty to inform', 'preserve hope' and 'individual contract between patients and doctors'. These styles and principles suggest that physicians adhere to the recent trends of American medical ethics based on informed consent doctrine, and give the impression that patients have control over obtaining information. But close analysis of their accounts shows that physicians still hold power to control information through their management of the information-giving process. The styles and principles are flexibly interpreted and selectively used in the process so that they facilitate a discourse which justifies, rather than eliminates, the information control. Clinical contexts of information control are analyzed by examining dissimilar manners of providing information about treatment as opposed to prognosis. Physicians give less, and vaguer information about prognosis, citing its uncertainty and lesser relevance to future actions as reasons. Information about treatment is more readily shared in order to counterbalance the negative impact of the news on patients. The analysis reveals that the way doctors control information is closely related to the way they handle aspects of the reality of clinical practice, such as physicians' own emotional coping, institutional and legal constraints, and power relationships among patients, doctors and other care-givers. Situating the findings in the historical context of normative discourse in American medicine, discussion focuses on the issues of trust and power of doctors. The humanistic role of the doctor, although suppressed in the currently dominant, contractual ethical framework, is still powerful in doctors' narratives. It expresses doctors' commitment to patients while preserving their authority. Implications of the individualistic approach to the doctor-patient relationship are also discussed.
-
Spooner, Sharon; Pearson, Emma; Gibson, Jonathan; Checkland, Kath
2017-10-25
This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions. Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors' decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors' attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Junior doctors' preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
-
Gundermann, C; Meier-Hellmann, A; Bauer, M; Hartmann, M
2010-05-01
Several hospitals have issued their own guidelines that regulate the conduct of staff members toward the pharmaceutical industry. The effect of theses guidelines on the attitude of the doctors toward the pharmaceutical industry in Germany has so far been unknown. This study investigated whether hospital doctors with guidelines and those without guidelines differ in their attitude toward the pharmaceutical industry. A retrospective analysis was undertaken to determine the influence of hospital guidelines on the attitude of doctors toward the pharmaceutical industry. In May 2008 all doctors in intensive care of a hospital with and one without guidelines were asked anonymously by a questionnaire about their dealings with the pharmaceutical industry. The response rate was 64.9 % (37/57) and 55.1 % (59/107) respectively. The cooperation rate in both groups was 100 %. In the hospital with guidelines every doctor was on average carrying 0.56 +/- 0.64 pharmaceutical advertising gifts with a company logo, while the average in the institution without guidelines was 1.2 +/- 0.61 advertising gifts (p = 0.026). Whereas 49 % of doctors with guidelines considered the acceptance of advertising gifts as not questionable, 81 % without guidelines did (p = 0.001; RRR = 0.65; 95 % CI = 0.48-0.91). Furthermore, 70 % of doctors in the institution with guidelines compared with 92 % of those doctors in the hospital without guidelines believed that the advertising practices of the pharmaceutical industry had no influence on their prescribing behaviour (p = 0.010; RRR = 3.6; 95 % CI = 1.36-9.52). Both groups of doctors are convinced that other doctors are more influenced by the pharmaceutical industry than they are themselves (51 % with and 37 % without guidelines, p = 0.207). 70 % and 90 %, respectively of all participants considered hospital guidelines setting standards of conduct toward the pharmaceutical industry and those not sponsored by industry to have a positive effect. Every other doctor additionally stated the advice by the pharmaceutical industry was not helpful for his work. Hospital guidelines on relations with the pharmaceutical industry appear to further a critical attitude by physicians regarding the pharmaceutical industry. Georg Thieme Verlag KG Stuttgart. New York.
-
Rahman, Abdul Rashid Abdul; Wang, Ji-Guang; Kwong, Gary Mak Yiu; Morales, Dante D; Sritara, Piyamitr; Sukmawan, Renan
2015-01-01
Hypertension is one of the world's most common health conditions and is a leading risk factor for mortality. Although blood pressure can be modified, there is a large proportion of patients whose blood pressure remains uncontrolled. The aim of this study, termed Edvantage 360°, was to gain a deeper understanding of hypertension management in Asia from the perspective of patients and doctors, and to propose strategies to improve blood pressure control. Conducted in Hong Kong, Indonesia, Malaysia, the Philippines, South Korea, Taiwan, and Thailand, Edvantage 360° was a mixed-methods observational study that used both qualitative and quantitative elements: qualitative interviews and focus groups with patients (N = 110), quantitative interviews with patients (N = 709), and qualitative interviews with doctors (N = 85). This study found that, although there is good understanding of the causes and consequences of hypertension among Asian patients, there is a lack of urgency to control blood pressure. Doctors and patients have different expectations of each other and a divergent view on what constitutes successful hypertension management. We also identified a fundamental gap between the beliefs of doctors and patients as to who should be most responsible for the patients' hypertension management. In addition, because patients find it difficult to comply with lifestyle modifications (often because of a decreased understanding of the changes required), adherence to medication regimens may be less of a limiting factor than doctors believe. Doctors may provide better care by aligning with their patients on a common understanding of successful hypertension management. Doctors may also find it helpful to provide a more personalized explanation of any needed lifestyle modifications. The willingness of the doctor to adjust their patient interaction style to form a 'doctor-patient team' is important. In addition, we recommend that doctors should not attribute ineffectiveness of the treatment plan to patient non-adherence to medications, but rather adjust the medication regimen as needed.
-
Nesting doctoral students in collaborative North-South partnerships for health systems research.
Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E; Sauerborn, Rainer; Fonn, Sharon
2014-01-01
The European Union (EU) supports North-South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). The aim of this study was to explore the challenges of, and facilitating factors for, 'nesting' doctoral students in North-South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North-South projects. There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North-South partnerships as a contribution to the strengthening of local research capacity.
-
Gordon, Lisi; Jindal-Snape, Divya; Morrison, Jill; Muldoon, Janine; Needham, Gillian; Siebert, Sabina; Rees, Charlotte
2017-12-01
To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? A qualitative longitudinal study underpinned by MMT theory. Four training areas (health boards) in the UK. 20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews. Data were analysed cross-sectionally and longitudinally using thematic Framework Analysis. Participants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee-trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees' children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees' new roles). Priority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for several years into the trained doctor role. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
-
Failing to retain a new generation of doctors: qualitative insights from a high-income country.
Humphries, Niamh; Crowe, Sophie; Brugha, Ruairí
2018-02-27
The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors. This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice. Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration. Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce self-sufficiency.
-
Bell, Sigall K; Mejilla, Roanne; Anselmo, Melissa; Darer, Jonathan D; Elmore, Joann G; Leveille, Suzanne; Ngo, Long; Ralston, James D; Delbanco, Tom; Walker, Jan
2017-04-01
Patient advocates and safety experts encourage adoption of transparent health records, but sceptics worry that shared notes may offend patients, erode trust or promote defensive medicine. As electronic health records disseminate, such disparate views fuel policy debates about risks and benefits of sharing visit notes with patients through portals. Presurveys and postsurveys from 99 volunteer doctors at three US sites who participated in OpenNotes and postsurveys from 4592 patients who read at least one note and submitted a survey. Patients read notes to be better informed and because they were curious; about a third read them to check accuracy. In total, 7% (331) of patients reported contacting their doctor's office about their note. Of these, 29% perceived an error, and 85% were satisfied with its resolution. Nearly all patients reported feeling better (37%) or the same (62%) about their doctor. Patients who were older (>63), male, non-white, had fair/poor self-reported health or had less formal education were more likely to report feeling better about their doctor. Among doctors, 26% anticipated documentation errors, and 44% thought patients would disagree with notes. After a year, 53% believed patient satisfaction increased, and 51% thought patients trusted them more. None reported ordering more tests or referrals. Despite concerns about errors, offending language or defensive practice, transparent notes overall did not harm the patient-doctor relationship. Rather, doctors and patients perceived relational benefits. Traditionally more vulnerable populations-non-white, those with poorer self-reported health and those with fewer years of formal education-may be particularly likely to feel better about their doctor after reading their notes. Further informing debate about OpenNotes, the findings suggest transparent records may improve patient satisfaction, trust and safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
-
Intolerance and Violence Against Doctors.
Singh, Meharban
2017-10-01
Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics. There is a need to arrest the development of further distrust between doctors and their patients/relatives, otherwise it will compromise all achievements of medical science and adversely affect healing capabilities of doctors. Rude and aggressive behavior of the patients or their family members, and arrogant and lackadaisical approach of the doctor, adversely affects the doctor-patient relationship and the outcome of the patient. The doctors, hospital administration and government must exercise "zero tolerance" with respect to acts of violence against healthcare professionals. It is possible to reduce the incidence of intolerance against doctors but difficult to eliminate it completely. The healthcare providers should demonstrate greater compassion and empathy with improved communication skills. The hospitals must have adequate infrastructure, facilities and staff to handle emergencies without delay and with due confidence and skills. The security of healthcare providers, especially in sensitive areas, should be improved by having adequate number of security guards, frisking facilities, extensive CCTV network and availability of "Quick response team" to handle unruly mob. In case of any grievances for alleged mismanagement, the public should handle the situation in a civilized manner and seek redressal through Medical Protection Act and legal avenues. Laws to prevent violence against doctors do exist but they need to be made more stringent and implemented properly.
-
Vázquez, María-Luisa; Vargas, Ingrid; Garcia-Subirats, Irene; Unger, Jean-Pierre; De Paepe, Pierre; Mogollón-Pérez, Amparo Susana; Samico, Isabella; Eguiguren, Pamela; Cisneros, Angelica-Ivonne; Huerta, Adriana; Muruaga, María-Cecilia; Bertolotto, Fernando
2017-06-01
Improving coordination between primary care (PC) and secondary care (SC) has become a policy priority in recent years for many Latin American public health systems looking to reinforce a healthcare model based on PC. However, despite being a longstanding concern, it has scarcely been analyzed in this region. This paper analyses the level of clinical coordination between PC and SC experienced by doctors and explores influencing factors in public healthcare networks of Argentina, Brazil, Chile, Colombia, Mexico and Uruguay. A cross-sectional study was carried out based on a survey of doctors working in the study networks (348 doctors per country). The COORDENA questionnaire was applied to measure their experiences of clinical management and information coordination, and their related factors. Descriptive analyses were conducted and a multivariate logistic regression model was generated to assess the relationship between general perception of care coordination and associated factors. With some differences between countries, doctors generally reported limited care coordination, mainly in the transfer of information and communication for the follow-up of patients and access to SC for referred patients, especially in the case of PC doctors and, to a lesser degree, inappropriate clinical referrals and disagreement over treatments, in the case of SC doctors. Factors associated with a better general perception of coordination were: being a SC doctor, considering that there is enough time for coordination within consultation hours, job and salary satisfaction, identifying the PC doctor as the coordinator of patient care across levels, knowing the doctors of the other care level and trusting in their clinical skills. These results provide evidence of problems in the implementation of a primary care-based model that require changes in aspects of employment, organization and interaction between doctors, all key factors for coordination. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
-
Brugha, Ruairí; McAleese, Sara; Dicker, Pat; Tyrrell, Ella; Thomas, Steve; Normand, Charles; Humphries, Niamh
2016-06-30
International recruitment is a common strategy used by high-income countries to meet their medical workforce needs. Ireland, despite training sufficient doctors to meet its internal demand, continues to be heavily dependent on foreign-trained doctors, many of whom may migrate onwards to new destination countries. A cross-sectional study was conducted to measure and analyse the factors associated with the migratory intentions of foreign doctors in Ireland. A total of 366 non-European nationals registered as medical doctors in Ireland completed an online survey assessing their reasons for migrating to Ireland, their experiences whilst working and living in Ireland, and their future plans. Factors associated with future plans - whether to remain in Ireland, return home or migrate to a new destination country - were tested by bivariate and multivariate analyses, including discriminant analysis. Of the 345 foreign doctors who responded to the question regarding their future plans, 16 % of whom were Irish-trained, 30 % planned to remain in Ireland, 23 % planned to return home and 47 % to migrate onwards. Country of origin, personal and professional reasons for migrating, experiences of training and supervision, opportunities for career progression, type of employment contract, citizenship status, and satisfaction with life in Ireland were all factors statistically significantly associated with the three migratory outcomes. Reported plans may not result in enacted emigration. However, the findings support a growing body of evidence highlighting dissatisfaction with current career opportunities, contributing to the emigration of Irish doctors and onward migration of foreign doctors. Implementation of the WHO Global Code, which requires member states to train and retain their own health workforce, could also help reduce onward migration of foreign doctors to new destination countries. Ireland has initiated the provision of tailored postgraduate training to doctors from Pakistan, enabling these doctors to return home with improved skills of benefit to the source country.
-
Doctors' use of mobile devices in the clinical setting: a mixed methods study.
Nerminathan, Arany; Harrison, Amanda; Phelps, Megan; Alexander, Shirley; Scott, Karen M
2017-03-01
Mobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care. To explore how doctors use mobile devices in the clinical setting and understand drivers for use. A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper-based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team. Doctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient-centred and that respects patient privacy. © 2016 Royal Australasian College of Physicians.
-
Zhang, Fengfan; Luo, Zhenni; Chen, Ting; Min, Rui; Fang, Pengqian
2017-05-01
Objective The aim of the present study was to explore prominent factors affecting turnover intentions among public hospital doctors in urban areas, particularly in Xiangyang City, Hubei Province, a middle-level city in central China. Methods Questionnaires were used to collect data from 284 public hospital doctors. Pearson's Chi-squared was used to assess whether sociodemographic and other factors were related to the turnover intentions of public hospital doctors. Binary logistic regression was performed to determine the significant factors that influence turnover intentions. Results The analysis revealed that 28.2% of public hospital doctors intended to leave the hospital where they were currently employed. Dissatisfaction with working conditions and hospital management processes, as well as work pressures, were significant factors contributing to the turnover intentions of public hospital doctors. Conclusion Research into turnover intentions indicates that public hospital doctors surveyed in urban China give greater weight to their professional environment and career development rather than salary in their employment decisions. What is known about the topic? Turnover of medical staff is a concern to hospital administrators because it is costly and detrimental to organisational performance and quality of care. Most studies have focused on the effects of individual and organisational factors on nurses' intentions to leave their employment. Income dissatisfaction was one of the determining factors of turnover intentions in previous studies. What does this paper add? The satisfaction of public hospital doctors with regard to income is not a determining factor of turnover intentions. In contrast with findings of previous studies, the doctors in public hospitals in urban China in the present study gave greater weight to their professional environment and career development in their employment decisions. What are the implications for practitioners? The findings suggest that health service managers and policy makers should pay greater attention to the factors affecting public hospital doctors' turnover intentions. This study will be useful for optimising public hospital management and minimising the turnover of doctors in China.
-
Bianchi, Eleonora F; Bhattacharyya, Mimi R; Meakin, Richard
2016-01-01
Objective To explore the views of senior doctors on mental illness within the medical profession. Background There has been increasing interest on the issue of doctors’ mental health. However, there have been few qualitative studies on senior doctors’ general attitude towards mental illness within the medical profession. Setting Large North London teaching hospital. Participants 13 hospital consultants and senior academic general practitioners. Methods A qualitative study involving semi-structured interviews and reflective work. The outcome measures were the themes derived from the thematic framework approach to analysis. Results Four main themes were identified. (1) ‘Doctors’ attitudes to mental illness’—doctors felt that there remained a significant stigma attached to suffering from a mental illness within the profession. (2) ‘Barriers to seeking help’—doctors felt that there were numerous barriers to seeking help such as negative career implications, being perceived as weak, denial and fear of prejudice. (3) ‘Support’—doctors felt that the use of support depended on certainty concerning confidentiality, which for occupational health was not thought to be guaranteed. Confiding in colleagues was rare except among close friends. Supervision for all doctors was raised. (4) ‘General Medical Council (GMC) involvement’—doctors felt that uneasy referring colleagues to the GMC and the appraisal and revalidation process was thought not to be thorough enough in picking up doctors with a mental illness. Conclusions Owing to the small size of this study, the conclusions are limited; however, if the findings are confirmed by larger studies, they suggest that greater efforts are needed to destigmatise mental illness in the profession and improve support for doctors. Additional research should be carried out into doctors’ views on occupational health services in managing doctors with mental illness, the provision of supervision for all doctors and the effectiveness of the current appraisal and revalidation process at identifying doctors with a mental illness. PMID:27638497
-
Epilepsy - what to ask your doctor - child
What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...
-
The Plight of the Woman Doctoral Student
ERIC Educational Resources Information Center
Holmstrom, Engin Inel; Holmstrom, Robert W.
1974-01-01
This study investigated factors underlying discrimination against woman doctoral students. Analyses revealed that faculty attitudes and behavior toward woman doctoral students contributed significantly to their emotional stresses and self-doubts. (Author/NE)
-
Babitsch, Birgit; Braun, Tanja; Borde, Theda; David, Matthias
2008-01-01
Background Emergency departments continuously provide medical treatment on a walk-in basis. Several studies investigated the patient's perception of the doctor-patient relationship, but few have asked doctors about their views. Furthermore, the influence of the patient's ethnicity and gender on the doctor's perception remains largely unanswered. Methods Based on data collated in three gynaecology (GYN)/internal medicine (INT) emergency departments in Berlin, Germany, we evaluated the impact of the patient's gender and ethnicity on the doctors' satisfaction with the course of the treatment they provided. Information was gathered from 2.429 short questionnaires completed by doctors and the medical records of the corresponding patients. Results The patient's ethnicity had a significant impact on the doctors' satisfaction with the doctor-patient relationship. Logistic regression analysis showed that the odds ratio (OR) for physician satisfaction was significantly lower for patients of Turkish origin (OR = 2.6 INT and 5.5 GYN) than for those of German origin. The main reasons stated were problems with communication and a perceived lack of urgency for emergency treatment. The odds ratios for dissatisfaction due to a lack of language skills were 4.48 (INT) and 6.22 (GYN), and those due to perceived lack of urgency for emergency treatment were 0.75 (INT) and 0.63 (GYN). Sex differences caused minor variation. Conclusion The results show that good communication despite language barriers is crucial in providing medical care that is satisfactory to both patient and doctors, especially in emergency situations. Therefore the use of professional interpreters for improved communication and the training of medical staff for improved intercultural competence are essential for the provision of adequate health care in a multicultural setting. PMID:18405351
-
Isaksson Ro, Karin E; Tyssen, Reidar; Gude, Tore; Aasland, Olaf G
2012-05-01
Burnout and mental distress in working doctors increase the risk for both suboptimal treatment of patients and negative health consequences for the doctors. Doctors have low rates of sickness absence and are reluctant to seek help, especially for mental distress. We examined whether a spell of sickness absence after a counselling intervention could predict reduction in emotional exhaustion among doctors at work 3 years later. A 3-year follow up after a counselling intervention for burnout at the Resource Centre Villa Sana in Norway in 2003-05 was completed by 184/227 doctors. Self-report assessments were administered at baseline, 1-, and 3-years. The effect of number of weeks of sickness absence on reduction in emotional exhaustion among doctors working 3 years after the intervention was assessed by linear regression. Of the 184 doctors completing assessment, 149 were working at 3-year follow up. Emotional exhaustion (scale 1-5) was significantly reduced at follow up (from 3.00±0.96 to 2.37±0.79, p<0.001). The number of weeks of sickness absence after the intervention was a significant positive predictor of this reduction (β=0.31, p<0.001), also after including sex, age, neuroticism, reduction of work hours, and other forms for treatment in the model. The number of weeks of sickness absence after a counselling intervention for burnout had a positive predictive effect on reduction in emotional exhaustion among doctors at work 3 years later. Sick leave thus seems to "prevent" later burnout, which can be of importance both for their patients and for the doctors themselves.
-
de Waard, Claudia S; Poot, Antonius J; den Elzen, Wendy P J; Wind, Annet W; Caljouw, Monique A A; Gussekloo, Jacobijn
2018-06-01
Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs). Cross-sectional survey. Older persons (n = 653, median age 87 years; 69.4% female) living in 41 residential homes. Patient satisfaction (report mark) and perceived doctor-patient relationship (Leiden Perioperative care Patient Satisfaction questionnaire); relationships were examined by comparing medians and use of regression models. The median satisfaction score was 8 (interquartile range 7.5-9; range 0-10) and doctor-patient relationship 65 (interquartile range 63-65; range 13-65). Higher satisfaction scores were related to higher scores on doctor-patient relationship (Jonckheere Terpstra test, p for trend <.001) independent of gender, age, duration of stay in the residential home, functional and clinical characteristics. Adjusted for these characteristics, per additional point for doctor-patient relationship, satisfaction increased with 0.103 points (β = 0.103, 95% CI 0.092-0.114; p < .001). In those with a 'low' doctor-patient relationship rating, the percentage awarding 'sufficient or good' to their GP for 'understanding about the personal situation' was 12%, 'receiving attention as an individual' 22%, treating the patient kindly 78%, and being polite 94%. In older persons, perceived doctor-patient relationship and patient satisfaction are related, irrespective of patient characteristics. GPs may improve patient satisfaction by focusing more on the affective aspects of the doctor-patient relationship. Key Points Examination of the perceived doctor-patient relationship as a variable might better accommodate patients' expectations and improve satisfaction with the provided primary care.
-
[Salary and clinical productivity among physicians in Norwegian somatic hospitals 2001-2008].
Johannessen, Karl-Arne
2010-09-23
Analysis of the future need for medical doctors necessitates an assessment of their productivity. The goals of this study were to analyze the relation between doctors' work force and the increased activity in hospitals, and to describe the development of working hours and salary for hospital doctors in a gender perspective. Information about man-labour years, working time and salary for doctors in Norwegian somatic hospitals was retrieved for the period 2001-2008. Number of hospital stays, DRG points and outpatient consultations per man-labour year are used as measures of doctors' clinical productivity. The percentage of female doctors increased from 34.7 % to 42.2 %. The mean annual salary increased more for men (14.4 % higher in 2001 and 16.6 % higher in 2008) than women. Total salary costs for doctors increased by 69.9 % (from 3.66 bill to 6.22 bill. NOK); 42.6 % of this increase was generated by new positions (1 306 man-labour years, + 21.2 %). Labour years from extended working hours increased by 6.8 % (constituting 1043 labour years in 2008; 12.2 % of the total), but the average extended labour time per doctor decreased (-16.7 % for women and -9.6 % for men). The number of hospital stays increased by 13.2 %, DRG points increased by 12.4 % and outpatient consultations increased by 9.3 % per doctor's work year in the period 2001-2008. Higher salaries for men may be explained by age, more men in senior positions and longer working hours than for women. The productivity of Norwegian doctors still increased from 2001 to 2008 (taking into account the increase in salary).
-
Did You Hear the One About the Doctor? An Examination of Doctor Jokes Posted on Facebook
Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L
2014-01-01
Background Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. Objective We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. Methods We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or “laughing out loud”) as well as the total number of Facebook “likes” the joke received. Results Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5% vs 37.3%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). Conclusions This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor. PMID:24550095
-
Brown, Ted; Crabtree, Jeffrey L; Mu, Keli; Wells, Joe
2015-04-01
Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.
-
Consultation behaviour of doctor-shopping patients and factors that reduce shopping.
Ohira, Yoshiyuki; Ikusaka, Masatomi; Noda, Kazutaka; Tsukamoto, Tomoko; Takada, Toshihiko; Miyahara, Masahito; Funakoshi, Hiraku; Basugi, Ayako; Keira, Katsunori; Uehara, Takanori
2012-04-01
To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping. Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping. A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P < 0.001). Logistic regression analysis selected the following factors as independent determinants of the cessation of doctor shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01). Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors. © 2010 Blackwell Publishing Ltd.
-
National neonatal resuscitation training program in Nigeria (2008-2012): a preliminary report.
Disu, E A; Ferguson, I C; Njokanma, O F; Anga, L A; Solarin, A U; Olutekunbi, A O; Ekure, E N; Ezeaka, V C; Esangbedo, D O; Ogunlesi, T A
2015-01-01
Routine institutional training of doctors and nurses on newborn resuscitation have commenced, to improve the quality of resuscitation available to high-risk babies, in Nigeria, as a means of reducing newborn deaths in the country. Perinatal asphyxia contributes to 26% of newborn deaths in Nigeria. Perinatal asphyxia results when babies have difficulty establishing spontaneous respiration after birth. Between 2008 and 2012, doctors and nurses drawn from all the geo-political zones were trained using the Neonatal Resuscitation Training (NRT) manual of the American Heart Association and the American Academy of Pediatrics. Questionnaire-based, cross-sectional surveys of doctor and nurse trainees from the six geo-political zones in Nigeria were conducted eight months after the primary training, to evaluate the post-training neonatal resuscitation activities. Over the period of study, 357 doctors and 370 nurse/midwives were primarily trained in NRT. The overall ratio of step down training was 1:22 with 1:18 for doctors and 1:26 for nurses. In 2008, the delivery attendance rates were 11 per doctor and 9 per nurse/midwife. These rates increased to 30 per doctor and 47 per nurse in 2012. Between 88 and 94% of the doctors and between 72 and 93% of the nurses successfully used bag and mask to help babies breathe in the post-training period. The nurses used bag and mask for infant resuscitation more frequently, compared to doctors, with the rate fluctuating between two-to-one and four-to-one. Over the years, 87 to 94% of the doctors and 92 to 97% of the nurses/midwives trained other birth attendants. The NRT in Nigeria is well-subscribed and the frequency of secondary training is good.
-
Borrott, Narelle; Kinney, Sharon; Newall, Fiona; Williams, Allison; Cranswick, Noel; Wong, Ian; Manias, Elizabeth
2017-07-01
To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. Communication between health professionals influences medication incidents' occurrence and safe care. An ethnographic study was undertaken. Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital. Data were transcribed verbatim and thematically analysed using the Medication Communication Model. The actual communication act revealed health professionals' commitment to effective medication management and the influence of professional identities on medication communication. Nurses and doctors were dedicated to providing safe, effective medication therapy for children, within their scope of practice and perceived role responsibilities. Most nurses and junior doctors used tentative language in their communication while senior doctors tended to use direct language. Irrespective of language style, nurses actively engaged with doctors to promote patients' needs. Yet, the medical hierarchical structure, staffing and attendant expectations influenced communication for medication management, causing frustration among nurses and doctors. Doctors' lack of verbal communication of documented changes to medication orders particularly troubled nurses. Nurses persisted in their efforts to acquire appropriate orders for safe medication administration to paediatric patients. Collaborative practice between nurses and doctors involved complex, symbiotic relationships. Their dedication to providing safe medication therapy to paediatric patients facilitated effective medication management. At times, shortcomings in interdisciplinary communication impacted on potential and actual medication incidents. Understanding of the complexities affecting medication communication between nurses and doctors helps to ensure interprofessional respect for each other's roles and inherent demands. Interdisciplinary education delivered in healthcare organisations would facilitate greater clarity in communication related to medications. Encouraging the use of concise, clear words in communication would help to promote improved understanding between parties, and accuracy and efficacy of medication management. © 2016 John Wiley & Sons Ltd.
-
Tang, Xinfeng; Yang, Fahui; Tang, Tan; Yang, Xuemei; Zhang, Weijun; Wang, Xiaohua; Ji, Li; Xiao, Yun; Ma, Kun; Wang, Ying; Kong, Xianglei; Wang, Jianping; Liu, Jun; Xu, Qian; Tian, Donghua; Qu, Zhiyong
2015-01-01
The delivery of mental health services in rural China has been notably limited due to lack of qualified mental health professionals among other impeding factors. A village doctor-based cognitive behavioral therapy intervention may be one way of improving accessibility. The purpose of this study was to explore the advantages and challenges of implementing this intervention, as delivered by trained village doctors, to treat late-life depression in rural China. We conducted one focus group discussion with 10 village doctors, 10 individual interviews with each of the village doctors, and individual interviews with 19 older adults. The topic guides were advantages and challenges of the intervention program from the perspective of the village doctors and older adults. Interviews were audio-recorded, transcribed, coded using NVivo 8, and analyzed using thematic analysis. The village doctors stressed the importance of role-playing and using instructive manuals in the training. Proper supervision was also a key component of the program. The benefits received from the intervention for the village doctors and the elders were positive such that both the doctors and the older adults were willing to implement/receive this intervention. Cultural and political factors (renqing and perceived policy consideration) facilitated the elders' access to mental health services. Challenges included a lack of real therapy (in contrast to role-playing) demonstrated in the training and lack of a step-by-step manual based on different types of problems encountered. Other impediments to the successful implementation of the intervention included the time constraints of village doctors and the presence of other people when conducting the intervention. The present study has demonstrated that the intervention program is likely to be an acceptable geriatric depression intervention in rural China if several challenges are appropriately addressed.
-
Skjeggestad, Erik; Norvoll, Reidun; Sandal, Gro M; Gulbrandsen, Pål
2017-06-01
Many medical doctors work outside their countries of origin. Consequently, language barriers and cultural differences may result in miscommunication and tension in the workplace, leading to poor performance and quality of treatment and affecting patient safety. However, there is little information about how foreign doctors and their colleagues perceive their collaboration and handle situations that can affect the quality of health services. Individual, semi-structured in-depth interviews were conducted with two groups of informants: 16 doctors who had recently started working in Norway and 12 unrelated Norwegian-born healthcare providers who had extensive experience of working with doctors from foreign countries. The interviews were analysed according to the systematic text condensation method. The foreign doctors described themselves as newcomers and found it difficult to speak with their colleagues about their shortcomings because they wanted to be seen as competent. Their Norwegian colleagues reported that many new foreign doctors had demanding work schedules and therefore they were reluctant to give them negative feedback. They also feared that foreign doctors would react negatively to criticism. All participants, both the new foreign doctors and their colleagues, reported that they took responsibility for the prevention of misunderstandings and errors; nevertheless, they struggled to discuss such issues with each other. Silence was the coping strategy adopted by both the foreign doctors and native healthcare professionals when facing difficulties in their working relationships. In such situations, many foreign doctors are socialized into a new workplace in which uncertainty and shortcomings are not discussed openly. Effective leadership and procedures to facilitate communication may alleviate this area of concern.
-
Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009†
Goldacre, Michael J.; Fazel, Seena; Smith, Fay; Lambert, Trevor
2013-01-01
Background Recruitment of adequate numbers of doctors to psychiatry is difficult. Aims To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. Method Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). Results One, three and five years after graduation, 4–5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists’ choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave ‘job content’ as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. Conclusions Junior doctors’ views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation. PMID:23099446
-
Did you hear the one about the doctor? An examination of doctor jokes posted on Facebook.
Davis, Matthew A; Haney, Carol Sue; Weeks, William B; Sirovich, Brenda E; Anthony, Denise L
2014-02-13
Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or "laughing out loud") as well as the total number of Facebook "likes" the joke received. Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5% vs 37.3%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor.
-
Barriers to becoming a female surgeon and the influence of female surgical role models.
Kerr, Hui-Ling; Armstrong, Lesley Ann; Cade, Jennifer Ellen
2016-10-01
We aim to investigate the reasons that medical students and junior doctors who are women are less likely to pursue a career in surgery compared with their male counterparts. An anonymous questionnaire was distributed to female final year medical students and female junior doctors in two UK hospitals between August and September 2012. Topics included career choice, attitudes to surgery, recognition of female surgical role models and perceived sexual discrimination. 50 medical students and 50 junior doctors were given our survey. We received a 96% response rate; 46 medical students and 50 junior doctors. 6/50 (12%) junior doctors planned a career in surgery compared with 14/46 (30%) medical students. 'Work-life balance' was the main reason cited for not wishing to pursue surgery (29/46 (63%) medical students and 25/50 (50%) junior doctors). 28/46 (61%) medical students and 28/50 (56%) junior doctors had encountered a female surgical role model; only five students and two junior doctors felt that these were influential in their career decision. Of those who had not, approximately 40% in each group felt that if they had, they may have considered surgery. Approximately 30% in each group had encountered female surgeons that had dissuaded them from a surgical career. Work-life balance is still cited by female junior doctors as being the main deterrent to a surgical career. The paucity of female role models and some perceived sexual discrimination may cause female doctors to discount surgery as a career. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
-
Leckie, Jackie; Bull, Ray; Vrij, Aldert
2006-12-01
The objective of the study was to discover which aspects of doctor communication behaviours are more or less desirable to patients who are attending medical outpatients clinics. Two hundred and twenty patients took part in the study, which was undertaken in four phases. In phase one, patients completed a 10-item questionnaire where they indicated, by means of a five-point scale, their preferences for doctor communication behaviours. In phases two and three patients qualitatively expressed the meaning that they ascribed to terminology that is used by some researchers to define doctor communication behaviours. In the final phase of the study a 12-item questionnaire was developed by integrating the phase one questionnaire and patients' report from phases two and three. Patients indicated, by means of a five-point scale, their preferences for different communication behaviours that might be used by doctors. Patient's preferences were ranked in terms of the most to the least preferred behaviours. The findings suggest that patients most prefer consultations where doctors give information spontaneously and display affective behaviours. They least preferred consultations where medical matters are discussed and where information is not forthcoming. Furthermore, the finding suggests that the use of blanket terms by researches in defining doctor communication can lead to differences in interpretation by patients. The methods developed in the study appear to provide a useful tool to discover patients' desires in terms of doctor communication. The rank scale developed in the study could prove useful to medical practice. It could, for example, provide a straightforward method whereby doctors could readily access researcher's recommendations about communication. Furthermore, the scale could be used in various healthcare settings in order to discover if different patient groups vary in terms of the doctor communication they desire.
-
Diabetes - low blood sugar - self-care
... doctor right away. Talk to Your Doctor or Nurse If you use insulin and your blood sugar ... frequently or consistently low, ask your doctor or nurse if you: Are injecting your insulin the right ...
-
Talking With Your Doctor: MedlinePlus Health Topic
... Doctor (For Teens) (Nemours Foundation) Also in Spanish Working with doctors and nurses (Department of Health and Human Services, Office on Women's Health) Seniors Living with Multiple Health Problems: What Older Adults ...
-
Febrile seizures - what to ask your doctor
... I do? When should I call the doctor? Alternative Names What to ask your doctor about febrile ... Philadelphia, PA: Elsevier; 2016:chap 593. Read More Epilepsy - overview Febrile seizures Fever Seizures Patient Instructions Epilepsy ...
-
Concussion - what to ask your doctor - child
What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... What type of symptoms or problems will my child have? Will my child have problems thinking or ...
-
Taking Medicines Safely: At Your Doctor's Office
... on. Feature: Taking Medicines Safely At Your Doctor's Office Past Issues / Summer 2013 Table of Contents Download ... Articles Medicines: Use Them Safely / At Your Doctor's Office / Ask Your Pharmacist / Now, It's Your Turn: How ...
-
Ileostomy - what to ask your doctor
Ostomy - what to ask your doctor; What to ask your doctor about ileostomy or colostomy; Colostomy - what ... the stoma? Does insurance cover the cost of ostomy supplies? What should I do if there is ...
-
Group B Strep Infection: Prevention in Newborns
... quickly; doctors cannot give antibiotics before labor begins. Penicillin is the most common antibiotic that doctors prescribe, ... antibiotics to women who are severely allergic to penicillin. Women should tell their doctor or nurse about ...
-
[Doctor's attendance in police custody].
Chariot, Patrick
2012-06-01
Medical examination is a right for every person detained in police custody in France. Examination of detainees usually takes place in the police station so that the doctor can assess the conditions in which the detainee is being held. In some cases, such as type I diabetes care, detainees need to be examined and treated in a hospital. Doctors are subject to a duty of care and prevention. Description of recent traumatic injuries is part of the doctor's mission. They should prescribe any ongoing treatment which needs to be continued, as well as any emergency treatment required. Custody officers may monitor the detainee and administer medication. Doctor's opinion should be given in a national standard document. If the doctor considers that the custody conditions are disgraceful, they may refuse to express an opinion as to whether the detainee is fit for custody.
-
Cilliers, Louise
2010-01-01
The didactic letters prefacing Marcellus's On Drugs are examined. It appears that one reason for writing such didactic letters was to equip the addressee with sufficient knowledge to enable him to avoid consulting a doctor, since there was great dissatisfaction with the quality of service rendered and the fees charged by doctors. The letters in the collection will be shown to represent various levels of healers, from the professional city doctor, to the army doctor, to the educated layman. They will also be scrutinized for evidence of the level of expertise of doctors in the late fourth and fifth centuries. Finally, the evidence will be compared with the criteria set some two centuries earlier by Galen in his blueprint for the examination of physicians.
-
Pandit, M S; Pandit, Shobha
2009-07-01
A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment.
-
Ding, Yan; Smith, Helen J; Fei, Yang; Xu, Biao; Nie, Shaofa; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin
2013-01-01
The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance. To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention. The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province. Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts. Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.
-
Cave, J; Woolf, K; Dacre, J; Potts, H W W; Jones, A
2007-01-01
A number of studies have identified problems with undergraduate oncology teaching. We have investigated how well prepared newly qualified doctors (first foundation year, or FY1 doctors) are for treating patients with cancer. Twenty-five FY1 doctors and 15 senior doctors participated in interviews. We turned the emergent themes into a questionnaire for all 5143 UK FY1 doctors in 2005. The response rate was 43% (2062 responses). Sixty-one percent of FY1 doctors had received oncology teaching at medical school, but 31% recalled seeing fewer than 10 patients with cancer. Forty percent of FY1 doctors felt prepared for looking after patients with cancer. Sixty-five percent felt prepared for diagnosing cancer, 15% felt they knew enough about chemotherapy and radiotherapy, and 11% felt prepared for dealing with oncological emergencies. Respondents believed medical students should learn about symptom control (71%) and communication skills (41%). Respondents who had received oncology teaching were more likely to feel prepared for looking after patients with cancer (OR 1.52; 95% CI 1.14–2.04). Preparedness also correlated with exposure to patients with cancer (OR 1.48; 95% CI 1.22–1.79). We have found worryingly low levels of exposure of medical students to patients with cancer. First foundation year doctors lack knowledge about cancer care and symptom control. Oncologists should maintain involvement in undergraduate teaching, and encourage greater involvement of patients in this teaching. PMID:17667931
-
Prichard, David; Collins, Niamh; Boohan, Mairead; Wall, Catherine
2011-04-01
International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors' attitudes toward undergraduate medical education.
-
[Is it pertinent to investigate the relations between physicians and the drug industry].
Moliner, Javier; Mozota, Julián; Abad, José María; Casaña, Laura; Júdez, Diego; Rabanaque, María José
2009-04-01
To analyse the opinions of physicians on the appropriateness of research into the relationships between doctors and pharmaceutical industry, and to evaluate the usefulness of email survey in this research. Survey via email of 373 authors of papers published in Spanish medical journals in 2007. The relationships between doctors and the industry was measured by asking doctors what they had received from industry during last year, the value in euro, and the number of visits from industry representatives. The response rate was 28.2%. Most physicians (90.5%) considered the study appropriate. Only 3.2% of doctors refused to take part in the study due to disagreeing with methodology. A total of 92.8% received something from industry during last year (62% cost associated with professional meetings, 60% material for continuing medical education). Mean value of gifts received was 900 euro (60-12,000 euro). By sex, women apparently received more drug samples, and men more payments for consulting or enrolling patients in trials. Doctors practicing in hospitals seemed to receive more gifts than primary care doctors, particularly trips or lunch. Number of visits of industry representatives (from 5 to 10 weekly) was associated with more gifts to doctors. The vast majority of doctors agree with the appropriateness of researching into the relationships between doctors and the pharmaceutical industry. Relationships between physicians and industry appear to be intensive, as seen in other studies. Response rate was low, but the simplicity and speed of the method are valuable advantages.
-
Cave, J; Woolf, K; Dacre, J; Potts, H W W; Jones, A
2007-08-20
A number of studies have identified problems with undergraduate oncology teaching. We have investigated how well prepared newly qualified doctors (first foundation year, or FY1 doctors) are for treating patients with cancer. Twenty-five FY1 doctors and 15 senior doctors participated in interviews. We turned the emergent themes into a questionnaire for all 5143 UK FY1 doctors in 2005. The response rate was 43% (2062 responses). Sixty-one percent of FY1 doctors had received oncology teaching at medical school, but 31% recalled seeing fewer than 10 patients with cancer. Forty percent of FY1 doctors felt prepared for looking after patients with cancer. Sixty-five percent felt prepared for diagnosing cancer, 15% felt they knew enough about chemotherapy and radiotherapy, and 11% felt prepared for dealing with oncological emergencies. Respondents believed medical students should learn about symptom control (71%) and communication skills (41%). Respondents who had received oncology teaching were more likely to feel prepared for looking after patients with cancer (OR 1.52; 95% CI 1.14-2.04). Preparedness also correlated with exposure to patients with cancer (OR 1.48; 95% CI 1.22-1.79). We have found worryingly low levels of exposure of medical students to patients with cancer. First foundation year doctors lack knowledge about cancer care and symptom control. Oncologists should maintain involvement in undergraduate teaching, and encourage greater involvement of patients in this teaching.
-
Ntuli, Samuel T; Maboya, Edwin
2017-09-27
The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.
-
Doctors' tacit knowledge on coping processes of oral cancer patients: A qualitative study.
Rana, Madiha; Czens, Franziska; Wingartz, Franziska; Gellrich, Nils-Claudius; Rana, Majeed
2016-12-01
The implicit knowledge of doctors about coping, quality of life and factors which have an influence on these aspects were investigated. In addition, they were asked about the need for psychological support in clinical practice. Doctors (n = 40) working in the field of oral and maxillofacial surgery, otorhinolaryngology and oncology were interviewed about coping and quality of life of patients, the course of therapy and experiences in the doctor-patient interaction based on a semi-structured interview. The data were analyzed using qualitative content analysis. Hundred percent of the doctors pointed out that patients with oral cancer are a special clientele which definitely needs to have psycho-oncological support. Eighty seven percent of the doctors divide their patients based on their style of coping into two groups: the one who are depressive and do not cope well and active patients who are able to stand their diagnosis. Ninety five percent of the doctors cite personality and social support as key factors affecting the quality of life and style of coping. Lack of time and lack of support from psychologists were given as the main obstacle for holistic treatment. Doctors have very specific ideas about the coping mechanisms and problems of their patients. These theories may have an impact on the doctor-patient relationship and should be considered in more detail. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
-
Quality of nursing doctoral education in Korea: towards policy development.
Ja Kim, Mi; Gi Park, Chang; Kim, Minju; Lee, Hyeonkyeong; Ahn, Yang-Heui; Kim, Euisook; Yun, Soon-Nyoung; Lee, Kwang-Ja
2012-07-01
This article is a report on an international study of the quality of nursing doctoral education; herein, we report findings for Korea. Specific aims were to: examine the validity and reliability of the quality of nursing doctoral education questionnaire; and identify contributing factors and domain(s) for improvement. The quality of nursing doctoral education has been a worldwide concern with the recent rapid increase in number of nursing doctoral programmes around the world, and comprehensive evaluation is needed for policy recommendations. A cross-sectional descriptive study, conducted from October 2006 to January 2007, used an online questionnaire evaluating four domains: programme, faculty, resources and evaluation. Seven deans, 48 faculty, 52 graduates and 87 students from 14 nursing schools participated. Content and construct validity, and construct reliability of the questionnaire were established. Overall, participants reported that the perceived quality of private universities/schools was significantly higher than that of public/national universities. A higher ratio of doctoral to non-doctoral students was significantly associated with higher quality. The domains of programme, faculty and resources were highly correlated. The programme was the most important domain; availability of sufficient materials and information for students most needed improvement. Overall, faculty perceived the quality of the programme, faculty and resources as more positively than did the graduates and students. This study provides useful policy guidance for nurse educators worldwide for improving doctoral programmes and faculty's role in educating students. Further study is recommended that examines contributing factors to quality doctoral education. © 2011 Blackwell Publishing Ltd.
-
Perceptions of doctors on being treated by a doctor just completing the house job.
Ahmad, Amina; Haque Shaikh, Siraj Ul; Tayyab, Muhammad; Gardezi, Javed Raza
2014-12-01
To determine the percentage of medical teachers and fresh doctors who feel that graduating doctors are competent or incompetent to handle common ailments and to evaluate the reasons for their perceptions. Sequential mixed method. First phase extending from December 2010 to December 2011 and second phase was conducted in March 2014. First phase comprised electronic distribution of questionnaire to 100 medical teachers and fresh doctors working in hospitals attached with 5 private and 5 public sector medical colleges of Lahore and Karachi to rate an average house officer on a frequency scale of 1 - 6 and do self-assessment, in case of a fresh doctor. The second phase included interviews of 20 medical teachers to explore justification for their rating in the survey questionnaire and for triangulation of data. Quantitative data was analyzed through SPSS version 15 to calculate frequencies and percentages and interviews were analyzed through quasi-statistical approach. In survey, 38.36% out of 73 medical teachers and 30% out of 20 medical teachers in interviews confirmed their confidence on consulting fresh doctors for common ailments as opposed to 61.64% and 70% respectively, expressing their dissatisfaction. Self-assessment of fresh doctors indicated that 40% are confident in handling common medical conditions as opposed to 33.3% out of 75 respondents, who are not confident about their clinical skills. Faculty and self-assessment of fresh doctors has a fair overlap, indicating room for further improvement in the house job training program.
-
Cultural and musical activity among Norwegian doctors.
Nylenna, Magne; Aasland, Olaf Gjerløw
2013-06-25
The cultural and musical activity of Norwegian doctors was studied in 1993. We wished to re-examine their cultural and musical activity, analyse the development and study the correlation with satisfaction, health and other leisure activities. In the autumn of 2010, a survey was undertaken among a representative sample of economically active Norwegian doctors. The survey asked the same questions as in 1993, and the responses were also compared to the population studies conducted by Statistics Norway. We also used a cultural index that we have developed ourselves. Altogether 1,019 doctors (70%) responded to the survey. They reported a higher level of cultural activity in 2010 than in 1993, measured in terms of reading of non-medical literature and visits to the cinema, theatre and concerts. The doctors engaged in musical activity of their own especially frequently: 58% reported to be able to play an instrument, and 21% reported to play on a regular basis, which is more than among other academic professions. We found a significant correlation between the doctors' level of cultural activity and their job satisfaction, general satisfaction, self-reported health and physical activity. The doctors who engage most frequently in cultural activities are thus most satisfied with their work and with life in general. Furthermore, they also have better self-reported health. Norwegian doctors give priority to cultural and musical activities. The assertion that doctors are particularly fond of music is more than just a myth.
-
Rahman, M Hafizur; Agarwal, Smisha; Tuddenham, Susan; Peto, Heather; Iqbal, Mohammad; Bhuiya, Abbas; Peters, David H
2015-07-01
Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions. This study was conducted in Chakaria, a rural sub-district of Bangladesh. Focus group discussions and in-depth interviews were conducted, along with a quantitative survey to understand practice perceptions. Data analysis was performed using grounded theory and bivariate statistical tests. We surveyed 43 MRs and 83 village doctors through 22 focus group discussions and 33 in-depth interviews. MRs have a higher average per capita monthly expenditure compared to village doctors. MRs are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less (p<0.001). MRs are the principal information source about new medications for the village doctors. Furthermore, incentives offered by MRs and credit availability influence the prescription practices of village doctors. MRs being the key player in providing information about drugs to village doctors might influence their prescription practices. Improvements in the quality of healthcare delivered to the rural poor in informal provider-based health markets require stricter regulations and educational initiatives for providers and MRs. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
-
Gulbrandsen, Pål; Førde, Reidun; Wifstad, Åge
2011-01-01
Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. PMID:21610269
-
ERIC Educational Resources Information Center
Roh, Jin-Young
2015-01-01
Using data from the Survey of Earned Doctorates by the National Science Foundation, this study examines factors influencing foreign doctorate recipients' decisions to stay in the United States after they complete their degrees. This study expands the existing literature on human capital theory on migration decision by exploring the variables that…
-
ERIC Educational Resources Information Center
Kim, Dongbin; Roh, Jin-young
2017-01-01
This study explores whether patterns of doctorate attainment among Chinese and Korean international students in the USA have changed over time, both in terms of quantity (i.e., number of international students) and quality (i.e., the selectivity of the undergraduate and doctoral institutions), and whether these changes reflect the improvements in…
-
[The image of the ancient Indian pharmacists in the Chinese Buddhist scriptures].
Wang, D W; Gao, Y X
2016-09-28
In the Chinese Buddhist Scriptures, there are many stories or topics about the ancient Indian pharmacist, however, they are not the Medicine Buddha as people knows, but real doctors. In the Chinese Buddhist Scriptures, the doctors gave the medical service to the monks and the laymen. Some of them are respected as the "miracle doctor" or the "king of doctor" , influencing the medicine of ancient East Asian.
-
ERIC Educational Resources Information Center
Roh, Jin-Young
2013-01-01
This study examines the trend of foreign doctorate recipients from U.S. higher education institutions who decided to stay in the United States after their degree completion, and it explores individual, institutional, and country factors predicting whether the foreign doctorate recipients stay in the United States or return home. Analyzing data…
-
Numbers of U.S. Doctorates Awarded Rise for Sixth Year, but Growth Slower. InfoBrief. NSF 10-308
ERIC Educational Resources Information Center
Fiegener, Mark K.
2009-01-01
U.S. academic institutions awarded 48,802 research doctorate degrees in 2008, the sixth consecutive annual increase in U.S. doctoral awards and the highest number ever reported by the Survey of Earned Doctorates (SED). This number represents an increase of 1.4% over the 2007 total (48,112), the smallest annual increase over the 6-year span.…
-
ERIC Educational Resources Information Center
Christensen, Mette K.; Lund, Ole
2014-01-01
Scholarly communities are dependent on and often measured by their ability to attract and develop doctoral students. Recent literature suggests that most scholarly communities entail ecological niches in which the doctoral students learn the codes and practices of research. In this article, we explore the microclimate in an ecological niche of…
-
Communication skills in context: trends and perspectives.
van Dalen, Jan
2013-09-01
Doctor-patient communication has been well researched. Less is known about the educational background of communication skills training. Do we aim for optimal performance of skills, or rather attempt to help students become skilled communicators? An overview is given of the current view on optimal doctor-patient communication. Next we focus on recent literature on how people acquire skills. These two topics are integrated in the next chapter, in which we discuss the optimal training conditions. A longitudinal training design has more lasting results than incidental training. Assessment must be in line with the intended learning outcomes. For transfer, doctor-patient communication must be addressed in all stages of health professions training. Elementary insights from medical education are far from realised in many medical schools. Doctor-patient communication would benefit strongly from more continuity in training and imbedding in the daily working contexts of doctors. When an educational continuum is realised and attention for doctor-patient communication is embedded in the working context of doctors in training the benefits will be strong. Training is only a part of the solution. In view of the current dissatisfaction with doctor-patient communication a change in attitude of course directors is strongly called for. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
-
Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital
Chen, Qiwei; Yang, Lan; Tighe, Scott S.
2017-01-01
Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39) of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39) mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39) showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor's relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals. PMID:28409052
-
Dynamics between doctors and managers in the Italian National Health Care System.
Vicarelli, Giovanna M; Pavolini, Emmanuele
2017-11-01
This article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co-optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among self-employed doctors working with the NHS. © 2017 Foundation for the Sociology of Health & Illness.
-
Wrede-Sach, Jennifer; Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike
2013-01-01
Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.
-
Effect of breaking bad news on patients' perceptions of doctors
Barnett, Mandy M
2002-01-01
The breaking of bad news is a routine but difficult task for many health professionals. There are numerous anecdotes of insensitive practice but the subject has attracted little systematic research. We therefore interviewed 106 patients with advanced cancer (from an original sample of 195) to assess their perceptions of the doctors involved in their care. Aspects of the ‘breaking bad news’ event were recorded during discussion of the illness history and were subsequently rated. Participants were also asked to nominate doctors under the headings ‘most helpful’ and ‘less helpful’, and completed standardized psychological screening questionnaires. In 94 of the 106 cases the bad news had been given by a doctor, usually a surgeon. Of the 13 doctors categorized as ‘most helpful’ when breaking bad news, 8 were general practitioners; of the 7 categorized as ‘less helpful’ all were surgeons. 69% of patients were neutral or positive about the bad-news consultation, but 20% were negative and 6% very negative. Doctors in surgical specialties were significantly more likely to be rated poorly than non-surgical specialists or general practitioners. Surgeons were the group of doctors most likely to break bad news, but non-surgical doctors were rated more positively in performance of the task. This finding has implications for training. PMID:12091508
-
Consideration Sets and Their Role in Modelling Doctor Recommendations About Contraceptives.
Fiebig, Denzil G; Viney, Rosalie; Knox, Stephanie; Haas, Marion; Street, Deborah J; Hole, Arne R; Weisberg, Edith; Bateson, Deborah
2017-01-01
Decisions about prescribed contraception are typically the result of a consultation between a woman and her doctor. In order to better understand contraceptive choice within this environment, stated preference methods are utilized to ask doctors about what contraceptive options they would discuss with different types of women. The role of doctors is to confine their discussion to a subset of products that best match their patient. This subset of options forms the consideration set from which the ultimate recommendation is made. Given the existence of consideration sets we address the issue of how to model appropriately the ultimate recommendations. The estimated models enable us to characterize doctor recommendations and how they vary with patient attributes and to highlight where recommendations are clear and when they are uncertain. The results also indicate systematic variation in recommendations across different types of doctors, and in particular we observe that some doctors are reluctant to embrace new products and instead recommend those that are more familiar. Such effects are one possible explanation for the relatively low uptake of more cost effective longer acting reversible contraceptives and indicate that further education and training of doctors may be warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
-
Cherry, M Gemma; Fletcher, Ian; Berridge, Damon; O'Sullivan, Helen
2018-04-01
To investigate whether and how doctors' attachment styles and emotional intelligence (EI) might influence patients' emotional expressions in general practice consultations. Video recordings of 26 junior doctors consulting with 173 patients were coded using the Verona Coding Definition of Emotional Sequences (VR-CoDES). Doctors' attachment style was scored across two dimensions, avoidance and anxiety, using the Experiences in Close Relationships: Short Form questionnaire. EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test. Multilevel Poisson regressions modelled the probability of patients' expressing emotional distress, considering doctors' attachment styles and EI and demographic and contextual factors. Both attachment styles and EI were significantly associated with frequency of patients' cues, with patient- and doctor-level explanatory variables accounting for 42% of the variance in patients' cues. The relative contribution of attachment styles and EI varied depending on whether patients' presenting complaints were physical or psychosocial in nature. Doctors' attachment styles and levels of EI are associated with patients' emotional expressions in primary care consultations. Further research is needed to investigate how these two variables interact and influence provider responses and patient outcomes. Understanding how doctors' psychological characteristics influence PPC may help to optimise undergraduate and postgraduate medical education. Copyright © 2017 Elsevier B.V. All rights reserved.
-
Marceau, Lisa; McKinlay, John; Shackelton, Rebecca; Link, Carol
2011-12-01
To estimate the relative contribution of patient attributes, provider characteristics and organizational features of the doctors' workplace to the diagnosis and management of diabetes. In a factorial experimental design doctors (n = 192) viewed clinically authentic vignettes of 'patients' presenting with identical signs and symptoms. Doctor subjects were primary care doctors stratified according to gender and level of experience. During an in-person interview scheduled between real patients, doctors were asked how they would diagnosis and manage the vignette 'patients' in clinical practice. This study considered the relative contribution of patient, doctor and organizational factors. Taken together patient attributes explained only 4.4% of the variability in diabetes diagnosis. Doctor factors explained only 2.0%. The vast majority of the explained variance in diabetes diagnosis was due to organizational factors (14.3%). Relative contributions combined (patient, provider, organizational factors) explained only 20% of the total variance. Attempts to reduce health care variations usually focus on the education/activation of patients, or increased training of doctors. Our findings suggest that shifting quality improvement efforts to the area which contributes most to the creation and amplification of variations (organizational influences) may produce better results in terms of reduced variations in health care associated with diabetes. © 2010 Blackwell Publishing Ltd.
-
[Differences in attitude toward patient-centeredness in patients and physicians].
Kim, Min-Jeong
2013-06-01
There have been studies on the patient-centeredness of medical students and physicians in South Korea, but no result has presented the patient-centered attitude of patients and doctors. So, this study intended to compare the attitudes of patients and doctors toward the roles that patients and physicians should play in the health care process. One hundred and fifteen doctors and 264 patients participated in this survey using a structured questionnaire, including sociodemographic data and Patient Practitioner Orientation Scale (PPOS). The PPOS comprises sharing (sharing information, take part in decision making) and caring (respecting one's feelings, interpersonal relationships) subscales. The PPOS scores of the doctors and patient were 3.02 and 3.20. In detail, the doctors' sharing and caring scores were and 3.02 and 3.48, and the those of patients were 3.14 and 3.12, respectively. This results are enough to demonstrate that patients are likely to be patient-centered with regard to sharing and that doctors tend to be patient-centered in terms of caring. The patients' desire to obtain medical information and take part in decision making (sharing) are greater than those of doctors. Doctors had more patient-centered attitude than patients in terms of respects for one's feelings and interpersonal relationships (caring).
-
The hospital doctor of today - still continuously on duty.
Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw; Rø, Karin Isaksson
2016-10-01
Norwegian hospital doctors emphasise the value of working hard and efficiently and of a high degree of attendance in the workplace. This helps establish social norms that guide behaviour within the professional culture. It is important to examine what consequences these values may entail when the doctor also needs to cater to his or her own needs. We conducted eight focus-group interviews and three individual interviews among a total of 48 senior consultants and specialty registrars working in the areas of surgery, psychiatry and internal medicine. Total N = 48; 56 % women. The interviews were analysed with the aid of systematic text condensation. When Norwegian hospital doctors wish to appear as good doctors, they see that this entails consequences for the interrelationships with colleagues, the management and the work-life balance. Conflicts of interest arose between senior consultants and specialty registrars. Management initiatives to deal with absence, adaptation of the job to the life stage of each individual doctor and increased management involvement among doctors were among the measures proposed. Better mutual knowledge between doctors and management with regard to each other’s values and responsibilities could constitute key premises for structural changes, for example in terms of better planning of leaves of absence and opportunities for adaptation of work schedules to the life stage of the persons concerned.
-
Doctors as managers of healthcare resources in Nigeria: Evolving roles and current challenges
Ojo, Temitope Olumuyiwa; Akinwumi, Adebowale Femi
2015-01-01
Over the years, medical practice in Nigeria has evolved in scope and practice, in terms of changing disease patterns, patients' needs, and social expectations. In addition, there is a growing sentiment especially among the general public and some health workers that most doctors are bad managers. Besides drawing examples from some doctors in top management positions that have performed less creditably, critics also harp on the fact that more needs to be done to improve the training of doctors in health management. This article describes the role of doctors in this changing scene of practice and highlights the core areas where doctors' managerial competencies are required to improve the quality of healthcare delivery. Areas such as health care financing, essential drugs and supplies management, and human resource management are emphasized. Resources to be managed and various skills needed to function effectively at the different levels of management are also discussed. To ensure that doctors are well-skilled in managerial competencies, the article concludes by suggesting a curriculum review at undergraduate and postgraduate levels of medical training to include newer but relevant courses on health management in addition to the existing ones, whereas also advocating that doctors be incentivized to go for professional training in health management and not only in the core clinical specialties. PMID:26903692
-
Jensen, Sarah B; Phillips, Christine B
2013-12-01
This study explores the attitudes of Australian evangelical Christian doctors to healing, suffering and good practice, using in-depth interviews. Doctors described an intellectualised faith, in which medical care was conceived in itself as a way of bearing witness. The alleviation of suffering, for these doctors, included supporting patients to rediscover purpose and meaning in their lives. There was diversity of opinion about evangelising, with many feeling that this was a contingent activity best conducted outside the consultation. This cohort of doctors, mostly non-denominational, had consciously engaged in work with the poor and marginalised as an expression of their faith.
-
Chamsi-Pasha, Hassan; Albar, Mohammed A.
2016-01-01
The doctor-patient relationship is an intricate concept in which patients voluntarily approach a doctor and become part of a contract by which they tend to abide by doctor’s instructions. Over recent decades, this relationship has changed dramatically due to privatization and commercialization of the health sector. A review of the relevant literature in the database of MEDLINE published in English between 1966 and August 2015 was performed with the following keywords: doctor-patient relationship, physician-patient relationship, ethics, and Islam. The Muslim doctor should be familiar with the Islamic teachings on the daily issues faced in his/her practice and the relationship with his/her patients. PMID:26837392
-
Refractive eye surgery - what to ask your doctor
... surgery; Nearsightedness surgery - what to ask your doctor; LASIK - what to ask your doctor; Laser-Assisted In ... Academy of Ophthalmology. Questions to ask when considering LASIK. San Francisco, CA. American Academy of Ophthalmology. December ...
-
High blood pressure - what to ask your doctor
What to ask your doctor about high blood pressure; Hypertension - what to ask your doctor ... problems? What medicines am I taking to treat high blood pressure? Do they have any side effects? What should ...
-
For People with Osteoporosis: How to Find a Doctor
... How to Find a Doctor For People With Osteoporosis: How to Find a Doctor Isabel Johnson, age ... and your special needs. Medical Specialists Who Treat Osteoporosis After an initial assessment, it may be necessary ...
-
Cleary, Michelle; Hunt, Glenn E; Jackson, Debra
2011-10-01
Commonly, the expression 'PhD' evokes a level of trepidation amongst potential candidates from both the clinical and academic spheres. In contemporary settings, a Doctor of Philosophy is highly regarded and increasingly necessary for a successful academic nursing career. The aim of this paper is to explore the options for doctoral education for nurses, and consider the role of the doctorate in career planning for nursing, and in the attainment of career goals. Here we discuss some key issues and practicalities including career planning, selecting a doctoral program, choosing a university, supervision, committees and panels, achieving a work-life balance and dealing with conflict. The PhD process should be an enriching and satisfying experience which may lead to enhanced professional and personal growth; however, there are potential pitfalls that nurses should be aware of before embarking on doctoral training. Future studies are needed to assess the impact of the different doctorates offered to see if, in fact, they are advancing nursing practice and research endeavours.
-
Sansone, Lori A.
2012-01-01
Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments. PMID:23346518
-
[Santa Claus is perceived as reliable and friendly: results of the Danish Christmas 2013 survey].
Amin, Faisal Mohammad; West, Anders Sode; Jørgensen, Carina Sleiborg; Simonsen, Sofie Amalie; Lindberg, Ulrich; Tranum-Jensen, Jørgen; Hougaard, Anders
2013-12-02
Several studies have indicated that the population in general perceives doctors as reliable. In the present study perceptions of reliability and kindness attributed to another socially significant archetype, Santa Claus, have been comparatively examined in relation to the doctor. In all, 52 randomly chosen participants were shown a film, where a narrator dressed either as Santa Claus or as a doctor tells an identical story. Structured interviews were then used to assess the subjects' perceptions of reliability and kindness in relation to the narrator's appearance. We found a strong inclination for Santa Claus being perceived as friendlier than the doctor (p = 0.053). However, there was no significant difference in the perception of reliability between Santa Claus and the doctor (p = 0.524). The positive associations attributed to Santa Claus probably cause that he is perceived friendlier than the doctor who may be associated with more serious and unpleasant memories of illness and suffering. Surprisingly, and despite him being an imaginary person, Santa Claus was assessed as being as reliable as the doctor.
-
[Doctor-patient relationship in the context of a changing society].
Siebzehner, Miriam Ines; Balik, Chaya; Matalon, Andre
2008-12-01
During the 20th century doctors gained a special status in the medical system, which is about to change as a consequence of a change in the doctor-patient relationship and in the characteristics of the labor market in health care. Some changes correspond with the adoption of business terms within the medical system. The doctor is represented as a supplier of services, while the patient is a consumer. From patient-centered care, the doctor-patient relationship changed to a costumer-supplier of services, as is the case in other fields of the consumer society. This article analyzes the changes in the patterns of the doctor-patient interactions in the light of the changes in society over the last decades such as: the creation of regulations and laws on patients' rights; the establishment of organizations that represent the sick, the distribution of knowledge and information by means of mass communication, changes in the status of the doctors, the academization of other health professionals and changes in the management of health care to a more financially viable approach to the costs of health.
-
Junior hospital doctors' views on their training in the UK.
Panayiotou, B. N.; Fotherby, M. D.
1996-01-01
To ascertain the views of senior house officers and registrars on the educational and training component of their posts, a questionnaire was sent to all full-time doctors working in training posts in general and/or geriatric medicine at three district general and three teaching hospitals. Completed questionnaires were received from 64 (61%) of 105 doctors who were contacted. Most had a careers counsellor or tutor, although less than two-thirds thought they had benefited from this arrangement. The majority of doctors attended at least two medical tutorials or meetings per week; most wanted to attend more but were unable to because of other work commitments. Supervision by more senior staff on the ward was deemed by most to be satisfactory, but less so in out-patient clinics. Overall, one-third of doctors thought that training was inadequate and three-quarters wanted a greater amount of formal education. The majority of junior doctors' time was spent on routine work and most considered :training' constituted less than 10% of their working time. Doctors in training require more sessions designated as educational, with protected time to attend these. PMID:8949591
-
Partial and impartial ethical reasoning in health care professionals.
Kuhse, H; Singer, P; Rickard, M; Cannold, L; van Dyk, J
1997-08-01
To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed to a randomly selected sample of doctors and nurses. 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed.
-
Partial and impartial ethical reasoning in health care professionals.
Kuhse, H; Singer, P; Rickard, M; Cannold, L; van Dyk, J
1997-01-01
OBJECTIVES: To determine the relationship between ethical reasoning and gender and occupation among a group of male and female nurses and doctors. DESIGN: Partialist and impartialist forms of ethical reasoning were defined and singled out as being central to the difference between what is known as the "care" moral orientation (Gilligan) and the "justice" orientation (Kohlberg). A structured questionnaire based on four hypothetical moral dilemmas involving combinations of (health care) professional, non-professional, life-threatening and non-life-threatening situations, was piloted and then mailed to a randomly selected sample of doctors and nurses. SETTING: 400 doctors from Victoria, and 200 doctors and 400 nurses from New South Wales. RESULTS: 178 doctors and 122 nurses returned completed questionnaires. 115 doctors were male, 61 female; 50 nurses were male and 72 were female. It was hypothesised that there would be an association between feminine subjects and partialist reasoning and masculine subjects and impartialist reasoning. It was also hypothesised that nurses would adopt a partialist approach to reasoning and doctors an impartialist approach. No relationship between any of these variables was observed. PMID:9279744
-
... be continued if your doctor decides that you will benefit from additional treatment.Your doctor may also need to delay your treatment and reduce your dose if you experience certain side effects. ... doctor will give you medication to prevent nausea and vomiting ...
-
Questions to ask your doctor after knee replacement
... replacement - after - what to ask your doctor; Knee arthroplasty - after - what to ask your doctor ... Mihalko WM. Arthroplasty of the knee. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics . 13th ed. Philadelphia, PA: ...
-
Questions to ask your doctor before knee replacement
... before; Before knee replacement - doctor questions; Before knee arthroplasty - what to ask your doctor ... Mihalko WM. Arthroplasty of the knee. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics . 13th ed. Philadelphia, PA: ...
-
Ventricular Septal Defect (VSD)
... hears a murmur while listening to your baby's heart with a stethoscope. Sometimes VSDs can be detected by ultrasound before ... murmur your doctor hears when listening to your heart with a stethoscope. When to see a doctor Call your doctor ...
-
Medical Care and Your 1- to 3-Month-Old
... for you to ask questions. What Happens at the Office Visit During these early months, your doctor will ... doctor and get guidelines for when to call the office. When to Call the Doctor Some common medical ...
-
Diagnosis of Constipation in Children
... you can share it with the doctor. Physical exam During a physical exam, a doctor may check your child’s blood pressure , ... or pain masses, or lumps perform a rectal exam During a physical exam, a doctor may check ...
-
Doctors writing outside the square.
Hurley, Thomas H
2011-01-17
Publications written by doctors about subjects outside their professional activities are often widely read and may be more enduring than their technical publications. Dr Graeme Robertson, Sir Clive Fitts and Professor Richard Lovell were three doctors from Victoria who wrote with skill and artistry about subjects outside their professional work. Here I discuss these publications and the reasons these doctors came to write them, and offer some reasons for the enduring interest of these publications.
-
ERIC Educational Resources Information Center
King, Darren; Eisl-Culkin, Judy; Desjardins, Louise
2008-01-01
"Doctorate Education in Canada: Findings from the Survey of Earned Doctorates, 2005/2006" is the third paper in a series of reports written by the Learning Policy Directorate of Human Resources and Social Development Canada (HRSDC) and the Centre for Education Statistics of Statistics Canada. Each report presents an overview of doctoral…
-
Doctor-Shopping Behavior among Patients with Eye Floaters
Tseng, Gow-Lieng; Chen, Cheng-Yu
2015-01-01
Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters. PMID:26184266
-
Doctor-Shopping Behavior among Patients with Eye Floaters.
Tseng, Gow-Lieng; Chen, Cheng-Yu
2015-07-13
Patients suffering from eye floaters often resort to consulting more than one ophthalmologist. The purpose of this study, using the Health Belief Model (HBM), was to identify the factors that influence doctor-shopping behavior among patients with eye floaters. In this cross-sectional survey, 175 outpatients who presented floaters symptoms were enrolled. Data from 143 patients (77 first time visitors and 66 doctor-shoppers) who completed the questionnaire were analyzed. Descriptive and logistic regression analyses were performed. We found that women and non-myopia patients were significantly related with frequent attendance and doctor switching. Though the HBM has performed well in a number of health behaviors studies, but most of the conceptual constructors of HBM did not show significant differences between the first time visitors and true doctor-shoppers in this study. Motivation was the only significant category affecting doctor-shopping behavior of patients with eye floaters.
-
Engelbach, Ute; Dannecker, Martin; Kaufhold, Johannes; Lenz, Cynthia; Grabhorn, Ralph
2008-06-01
This qualitative study examines the relationship between doctors and HIV-infected patients with regard to problems of adherence. Objective hermeneutics was used to analyze the scene of a doctor-patient conversation produced through psychodrama. Specific traits shared by the patients in question were a confused regulation of closeness and distance as well as a non-maintenance of the traditional asymmetry within the doctor-patient relation. The patients faced the doctors on a level of diffuse social relations and showed the tendency to involve the doctor into their community. The conclusion for a model explaining patients' adherence may be: it exist an individual level of the need for being accepted by the doctor as somebody particular. If this level is reached, i. e. individual claims are met and personal desires are satisfied, the patient will follow the physician's advice. Authors discuss whether the model is compatible with the conflict of self-esteem.
-
Burnout and Doctors: Prevalence, Prevention and Intervention
Kumar, Shailesh
2016-01-01
Doctors are exposed to high levels of stress in the course of their profession and are particularly susceptible to experiencing burnout. Burnout has far-reaching implications on doctors; patients and the healthcare system. Doctors experiencing burnout are reported to be at a higher risk of making poor decisions; display hostile attitude toward patients; make more medical errors; and have difficult relationships with co-workers. Burnout among doctors also increases risk of depression; anxiety; sleep disturbances; fatigue; alcohol and drug misuse; marital dysfunction; premature retirement and perhaps most seriously suicide. Sources of stress in medical practice may range from the emotions arising in the context of patient care to the environment in which doctors practice. The extent of burnout may vary depending on the practice setting; speciality and changing work environment. Understanding dynamic risk factors associated with burnout may help us develop strategies for preventing and treating burnout. Some of these strategies will be reviewed in this paper. PMID:27417625
-
Hospital doctors' career structure and misuse of medical womanpower.
Bewley, B R; Bewley, T H
1975-08-09
Biological and culturel differences between men and women lead to severe discrimination against women doctors who bear the burdens of pregnancy, child-rearing, and housework. These lead, from equality within medical school and at qualification, to increasing failure to obtain posts commensurate with their innate abilities. Women doctors who temporarily and partially drop out of full-time practice have been studied frequently, but men (who are equally expensive to train) have not, despite their disappearing from National Health Service practice through emigration, death, alcoholism, suicide, or removal from the Medical Register. In a working lifetime of forty years, a woman doctor with an average family is likely to do seven-eighths of the work of a doctor who has not had to carry the primary responsibility of bearing and rearing children. Doctors with dependants are handicapped, and a separate career structure might be set up for them. Supernumerary consultant posts are proposed.
-
Sablik, Zbigniew; Samborska-Sablik, Anna; Drożdż, Jarosław
2013-06-20
The aim of our work is to present the universality of burnout syndrome among physicians worldwide and to demonstrate selected aspects of the relationship between patients and doctors as a common factor predisposing to burnout. We looked up 20 original pieces of research from the Medline database published in the last 10 years to determine the prevalence of burnout among doctors in different countries. In all quoted works a remarkable percentage of doctors of interventional and non-interventional specialties suffered burnout. Because it is the relationship with patients that constitutes a key denominator for their work, in the discussion we have exposed an important aspect of it, destructive patient games, described on the basis of transactional analysis. Since universal burnout causes a deterioration of doctors' service, for the optimal good of the patient to survive preservation of the doctor's well-being in the patient-doctor relationship is needed everywhere.
-
Legal aspects of cruise medicine - can a non-US ship's doctor be sued for malpractice in Florida?
Dahl, Eilif
2014-01-01
An English ship's doctor treated a non-US female patient for abdominal discomfort on a foreign-flagged cruise ship off the coast of Haiti. In Mexico the patient underwent abdominal surgery, followed by complications, for which her lawyers wanted to take the ship's doctor to court in Florida, USA. A trial court granted their wish, but this decision was reversed on appeal as the factors discussed were insufficient to establish Florida jurisdiction over the ship's doctor. The decision is not about whether malpractice occurred; it is about limiting the possibility of taking the ship's doctor to a court in a location preferred by the plaintiffs' lawyers. The appeal court ruling is important for non-US doctors working as independent contractors on cruise vessels that visit US ports, and it will hopefully prevent some of the more frivolous law suits from being filed in the future.
-
The use of medical quality indices as a performance-enhancement tool for community clinics.
Elhayany, A
2001-12-01
One of the most important issues for a country, its population and doctors is the effective use of its health system. The extensive variation in doctors' performance leads to a tremendous waste of resources. To combat this, and at the same time ensure that medical quality plays a role when making decisions on interventions, it is essential to equip doctors and clinic directors with information on the quality of the medical care they are providing. In order to assist clinic directors in maintaining medical quality, Clalit Health Services has developed comparative medical indices enabling doctors to compare their performance to that of their colleagues, as well as to the standard and their performance over time. The development of an index to evaluate the quality of medical treatment offered in clinics provides doctors and the health system with an essential tool to lessen the existing variation among doctors and to enhance and evaluate performance.
-
Changes in Doctors' Working Hours: A Longitudinal Analysis.
Joyce, Catherine M; Wang, Wei C; Cheng, Terence C
2015-10-01
The study examined changes in doctors' working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply. © The Author(s) 2015.
-
Are there too many or too few physicians in Spain? Is emigration the timeless resource.
Sánchez-Sagrado, T
2013-10-01
At the end of the last century, several Spanish doctors had to migrate overseas looking for a decent job. No decent jobs were offered by then in Spain. Last decade, the lack of doctors was a problem and a great social alarm was born. Mechanisms to attract doctors form overseas and medical training, both uncontrolled, were settled in, to get the numbers right. The result was a surplus of qualified health professionals. Today, overseas doctors who were invited to come and native doctors, both, trained for specific health situations have to leave the country. An extraordinary planning never heard of in neighbouring countries due to its "inefficiency". It was characteristic its lack of capability to take advantage of health professional's abilities - doctors and nurses-, its lack of population's health education, its waste of resources in training and its uncontrolled immigration. Copyright © 2012 Elsevier España, S.L. All rights reserved.
-
Manpower and portfolio of European ENT.
Luxenberger, W; Lahousen, T; Mollenhauer, H; Freidl, W
2014-03-01
The aim of this study is to evaluate highly variable ENT manpower among European countries. A descriptive study design is used. Manpower in medicine is highly variable among European countries. EU and associated countries are keeping officially appointed representatives to the European Union of medical specialists--otorhinolaryngology section (UEMS--ORL section). UEMS--ORL section is running a working group for manpower in ENT collecting data regarding demographics and ENT manpower in European countries. These ENT manpower data are presented in this paper and compared to available data concerning manpower in European medicine in general. To further evaluate these huge differences, representatives of the particular countries were also asked to fill out a questionnaire concerning specifics of ENT healthcare in their country. Furthermore, typical tasks of ENT doctors based on the official UEMS logbook for ENT training were listed and could be rated regarding their frequency, performed in everyday routine of an average ENT doctor of the country. Divergences in doctors/inhabitants ratios were remarkable within European countries, but disparities in ENT manpower were even more so. The ratio of ENT doctors/inhabitants was the lowest in Ireland (1:80,000) and Great Britain (1:65,000). Greece (1:10,000), Italy, Czech Republic, Lithuania, Poland and Slovakia (1:12,000) were--at the time of the study--the countries with the highest density of ENT doctors. The EU average for 2009 was (1:21,000). The presence of non-surgical working ENT doctors was significantly associated with higher densities of ENT doctors, whereas the necessity of being referred to an ENT doctor (gatekeeping or similar measures) was not. Estimated average waiting times for an appointment in non-urgent, chronic conditions, respectively, diseases were highly variable and predominantly showed a significant correlation to the ENT doctors/inhabitants ratio in the investigated countries. But also for acute conditions like acute hypacusis, dysphonia and hemoptysis, significant differences correlating to the ENT doctors/inhabitants ratio in waiting times for an ENT appointment were found. Estimated frequencies of different ENT tasks in everyday routine were extremely diverse as well, however, without detectable correlations to the ENT doctors/inhabitants ratio. In countries like Great Britain, Ireland, Malta and The Netherlands ENT doctors are primarily seen and serving as surgeons. In most Central European countries like Germany, Austria, Czech Republic, Poland and Slovakia, ENT doctors aside of surgery are also dealing with high percentages of conservative medicine, which may include vast fields like the management of Allergology, Phoniatrics, Audiology, etc. In some countries ENT doctors are even playing a significant role in primary health care as well. These various portfolios of ENT may be one explanation for the huge difference in numbers of European ENT manpower.
-
Job satisfaction of village doctors during the new healthcare reforms in China.
Zhang, Xiaoyan; Fang, Pengqian
2016-04-01
Objective China launched new healthcare reforms in 2009 and several policies targeted village clinics, which affected village doctors' income, training and duties. The aim of the present study was to assess village doctors' job satisfaction during the reforms and to explore factors affecting job satisfaction. Methods Using a stratified multistage cluster sampling process, 935 village doctors in Jiangxi Province were surveyed with a self-administered questionnaire that collected demographic information and contained a job satisfaction scale and questions regarding their work situation and individual perceptions of the new healthcare reforms. Descriptive analysis, Pearson's Chi-squared test and binary logistic regression were used to identify village doctors' job satisfaction and the factors associated with their job satisfaction. Results Only 12.72% of village doctors were either satisfied or very satisfied with their jobs and the top three items leading to dissatisfaction were pay and the amount of work that had to be done, opportunities for job promotion and work conditions. Marriage, income, intention to leave, satisfaction with learning and training, social status, relationship with patients and satisfaction with the new healthcare reforms were significantly associated with job satisfaction (P<0.05). Conclusions China is facing critical challenges with regard to village doctors because of their low job satisfaction. For future healthcare reforms, policy makers should pay more attention to appropriate remuneration and approaches that incentivise village doctors to achieve the goals of the health reforms. What is known about the topic? Village doctors act as gatekeepers at the bottom tier of the rural health system. However, the policies of the new healthcare reform initiatives in China were centred on improving the quality of care delivered to the rural population and reducing fast-growing medical costs. There have been limited studies on village doctors' reactions to these reforms. What does this paper add? The findings of the present study indicate that in the process of implementing the new healthcare reforms, village doctors' overall job satisfaction is low and most respondents are dissatisfied with the reforms. The factors affecting job satisfaction include income, training, social status, relationship with patients and satisfaction with the reforms. What are the implications for practitioners? Health reform policy makers should ensure village doctors feel appropriately remunerated and are motivated while aiming to reduce the financial burden on patients. The views of stakeholders (i.e. patients and village doctors) should be considered when designing future health reforms.
-
Ifediora, Chris
2015-01-01
The after-hours house call (AHHC) service in Australia is growing, but studies have never explored the doctor variables associated with burnout and stress within the service. This study fills this knowledge gap. To determine the doctor variables associated with burnout and stress among doctors involved in AHHC. A quantitative, questionnaire-based survey of all 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home visiting doctor-service provider. The Maslach Burnout Inventory (MBI) was used to assess burnout over a 12-month period from October 2013 to September 2014. Ordinal logistics regression was used to identify significant associations. There were 168 valid responses received, giving a 56 per cent response rate. The most significant factor associated with reduced stress and burnout is the adoption of self-protection measures while on the job. Such measures include the use of chaperones, the use of panic alarms or buttons, adopting de-escalation techniques, and reliance on relevant surgery policies. Other associations with reduced stress include the attainment of postgraduate fellowships (vocational registration), working less than 24 hours per week, being in legally recognised partnerships, and being male. Conversely, having general practice as a career, being under 40 years of age, and obtaining primary medical degrees from Australia (as opposed to overseas) are all associated with increased burnout for doctors involved in AHHC. A number of doctor variables have been found to significantly reduce burnout in AHHC Among these, the adoption of self-protective measures and the attainment postgraduate fellowships, where possible, should be encouraged among practitioners involved in the service.
-
Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs
2012-12-01
Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.
-
Chilcoat, Howard D; Coplan, Paul M; Harikrishnan, Venkatesh; Alexander, Louis
2016-08-01
Doctor-shopping (obtaining prescriptions from multiple prescribers/pharmacies) for opioid analgesics produces a supply for diversion and abuse, and represents a major public health issue. An open cohort study assessed changes in doctor-shopping in the U.S. for a brand extended release (ER) oxycodone product (OxyContin) and comparator opioids before (July, 2009 to June, 2010) versus after (January, 2011 to June, 2013) introduction of reformulated brand ER oxycodone with abuse-deterrent properties, using IMS LRx longitudinal data covering >150 million patients and 65% of retail U.S. prescriptions. After its reformulation, the rate of doctor-shopping decreased 50% (for 2+ prescribers/3+ pharmacies) for brand ER oxycodone, but not for comparators. The largest decreases in rates occurred among young adults (73%), those paying with cash (61%) and those receiving the highest available dose (62%), with a 90% decrease when stratifying by all three characteristics. The magnitude of doctor-shopping reductions increased with increasing number of prescribers/pharmacies (e.g., 75% reduction for ≥2 prescribers/≥4 pharmacies). The rate of doctor-shopping for brand ER oxycodone decreased substantially after its reformulation, which did not occur for other prescription opioids. The largest reductions in doctor-shopping occurred with characteristics associated with higher abuse risk such as youth, cash payment and high dose, and with more specific thresholds of doctor-shopping. A higher prescriber and/or pharmacy threshold also increased the magnitude of the decrease, suggesting that it better captured the effect of the reformulation on actual doctor-shoppers. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
-
Press, Valerie G.; Meltzer, David O.; Arora, Vineet M.
2016-01-01
Summary Summary Background Wearable face-mounted computers such as Google Glass™, Microsoft HoloLens™, and Oculus’ Rift®, are increasingly being tested in hospital care. These devices challenge social etiquette, raise privacy issues, and may disrupt the intimacy of the doctor patient relationship. We aimed to determine patients’ perception of and their privacy concerns with an archetype of wearable face-mounted computer devices, Google Glass. Methods Hospitalized inpatients were asked about their familiarity with Glass, how comfortable they would be and if they would be concerned about privacy if their physician wore Glass, if the use of Glass would affect their trust in their physician, and if they would want their physician to wear Glass if it improved their care. Results Most (73%) respondents were unfamiliar with Glass, though 64% would be comfortable if their doctor wore Glass. Under half (46%) of respondents were concerned about privacy with the use of Glass. Seventy-six percent (76%) of respondents stated their doctor wearing Glass would not affect their trust in their doctor. Patients concerned about their privacy were less likely to trust their doctor if their doctor wore Glass (17% vs. 0%, p<0.01). Sixty-five percent (65%) of respondents would want their doctor to wear Glass if it improved their care. Conclusion Most patients appear open to and would want their doctor to use face-mounted wearable computers such as Glass, even when unfamiliar with this technology. While some patients expressed concerns about privacy, patients were much less concerned about wearable technologies affecting the trust they have in their physician. PMID:27730249
-
Lambert, Trevor W; Smith, Fay; Goldacre, Michael J
2016-03-01
To report doctors' views about the European Working Time Directive ('the Directive'). Survey of the medical graduates of 2002 (surveyed in 2013-2014). Medical graduates. UK. Questions on views about the Directive. The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work-life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors' training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Senior doctors agreed that the Directive benefited doctors' work-life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.
-
Brown, M; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P
2010-01-01
Background The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Method Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Results Four main themes were identified. Under “Doctors shift rotas”, doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. “Education and training” focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. “Work/life balance” reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. “Social support structures” focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. Conclusions The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors. PMID:21127102
-
Doctor and pharmacy shopping for controlled substances.
Peirce, Gretchen L; Smith, Michael J; Abate, Marie A; Halverson, Joel
2012-06-01
Prescription drug abuse is a major health concern nationwide, with West Virginia having one of the highest prescription drug death rates in the United States. Studies are lacking that compare living subjects with persons who died from drug overdose for evidence of doctor and pharmacy shopping for controlled substances. The study objectives were to compare deceased and living subjects in West Virginia for evidence of prior doctor and pharmacy shopping for controlled substances and to identify factors associated with drug-related death. A secondary data study was conducted using controlled substance, Schedule II-IV, prescription data from the West Virginia Controlled Substance Monitoring Program and drug-related death data compiled by the Forensic Drug Database between July 2005 and December 2007. A case-control design compared deceased subjects 18 years and older whose death was drug related with living subjects for prior doctor and pharmacy shopping. Logistic regression identified factors related to the odds of drug-related death. A significantly greater proportion of deceased subjects were doctor shoppers (25.21% vs. 3.58%) and pharmacy shoppers (17.48% vs. 1.30%) than living subjects. Approximately 20.23% of doctor shoppers were also pharmacy shoppers, and 55.60% of pharmacy shoppers were doctor shoppers. Younger age, greater number of prescriptions dispensed, exposure to opioids and benzodiazepines, and doctor and pharmacy shopping were factors with greater odds of drug-related death. Doctor and pharmacy shopping involving controlled substances were identified, and shopping behavior was associated with drug-related death. Prescription monitoring programs may be useful in identifying potential shoppers at the point of care.
-
Grover, S. A.; Lowensteyn, I.; Esrey, K. L.; Steinert, Y.; Joseph, L.; Abrahamowicz, M.
1995-01-01
OBJECTIVE--To evaluate the ability of doctors in primary care to assess risk patients' risk of coronary heart disease. DESIGN--Questionnaire survey. SETTING--Continuing medical education meetings, Ontario and Quebec, Canada. SUBJECTS--Community based doctors who agreed to enroll in the coronary health assessment study. MAIN OUTCOME MEASURE--Ratings of coronary risk factors and estimates by doctors of relative and absolute coronary risk of two hypothetical patients and the "average" 40 year old Canadian man and 70 year old Canadian woman. RESULTS--253 doctors answered the questionnaire. For 30 year olds the doctors rated cigarette smoking as the most important risk factor and raised serum triglyceride concentrations as the least important; for 70 year old patients they rated diabetes as the most important risk factor and raised serum triglyceride concentrations as the least important. They rated each individual risk factor as significantly less important for 70 year olds than for 30 year olds (all risk factors, P < 0.001). They showed a strong understanding of the relative importance of specific risk factors, and most were confident in their ability to estimate coronary risk. While doctors accurately estimated the relative risk of a specific patient (compared with the average adult) they systematically overestimated the absolute baseline risk of developing coronary disease and the risk reductions associated with specific interventions. CONCLUSIONS--Despite guidelines on targeting patients at high risk of coronary disease accurate assessment of coronary risk remains difficult for many doctors. Additional strategies must be developed to help doctors to assess better their patients' coronary risk. PMID:7728035
-
Löffler-Stastka, Henriette; Seitz, Tamara; Billeth, Sabrina; Pastner, Barbara; Preusche, Ingrid; Seidman, Charles
2016-09-01
Gender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed. A total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires. Female doctors and students tended to describe the doctor-patient communication with positive attributes, such as "helpful", "sentimental", "voluble", "sociable", "gentle", "yielding" and "peaceful". Male students and physicians, on the other hand, described doctor-patient communication as "overbearing", "robust" and "inhibited". The most frequent associations females had with the term doctor-patient communication were "empathy", "confidence", "openess", while the most frequent association of the male colleagues was "medical history". Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about "the power over the patient". This study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.
-
Ruiz Moral, Roger; Rodríguez Salvador, Juanjo; Pérula, Luis; Fernández, Isabel; Martínez, Jorge; Fernández, María Jesús; Yun, Antonio; Arboníes, Juan Carlos; Cabanás, María Auxiliadora; Luque, Luis; Mont, María Angeles
2006-11-30
Chronic diseases represent a challenge for health systems and the professionals most involved in chronic care. Despite biomedical advances, the results of care for chronic problems are not as good as they should be. To find out what doctors and patients think of care for some of the main chronic illnesses; to detect concrete areas of deficit and lack of satisfaction felt by both sides and possible lines of improvement; to raise mutual understanding between patients and doctors. Forty-one patients with fibromyalgia or diabetes mellitus, carers for people with Alzheimer's and breast cancer patients. Forty-three family doctors involved in health care delivery to this kind of patient. Four discussion groups. Transcription and syntactical, semantic and pragmatic contents analysis, with both pre-established and emerging categories of consensus. Patients thought, with different nuances as a function of the problem put forward, that questions of respectful, human and integrated care, clear and suitable information, and consistent follow-up were important and insufficiently covered by doctors and health services. Doctors thought that many of their efforts in caring for these patients were useless, and thought it important to reconsider their clinical responsibilities and the patient-doctor relationship. Doctors highlighted the limitations in the health care resources available for working with these patients. To tackle prevalent chronic problems requires, in the view of doctors and patients, important modifications that are related mainly to the kind of relationship between the two, with new clinical responsibilities and certain organisational care delivery features.
-
Toynbee, Mark; Al-Diwani, Adam Aj; Clacey, Joe; Broome, Matthew R
2016-03-01
An impasse in negotiations between the Department of Health (DoH) and the British Medical Association in November this year led to an overwhelming vote for industrial action (IA) by junior doctors. At the time of writing, a last minute concession by DoH led to a deferment of IA to allow further negotiations mediated by the Advisory, Conciliation and Arbitration Service. However, IA by junior doctors remains a possibility if these negotiations stall again. Would the proposed action be ethically justifiable? Furthermore, is IA by doctors ever ethically defendable? Building on previous work, we explore important ethical considerations for doctors considering IA. The primary moral objection to doctors striking is often claimed to be risk of harm to patients. Other common arguments against IA by doctors include breaching their vocational responsibilities and possible damage to their relationship with patients and the public in general. These positions are in turn countered by claims of a greater long-term good and the legal and moral rights of employees to strike. Absolute restrictions appear to be hard to justify in the modern context, as does an unrestricted right to IA. We review these arguments, find that some common moral objections to doctors striking may be less relevant to the current situation, that a stronger contemporary objection to IA might be from a position of social justice and suggest criteria for ethically permissible doctor IA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
-
Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures.
Henderson, Lesley; Carter, Simon
2016-12-01
There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of 'the doctor' in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of 'the doctor' is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which 'the simple country doctor' is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a 'post 9/11' world can be expressed and explored. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
-
Brown, M; Tucker, P; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P
2010-12-01
The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.
-
Exploring the safety measures by doctors on after-hours house call services.
Ifediora, Chris
2015-01-01
Aggression against doctors involved in after-hours house calls (AHHC) is widely perceived to be high. It is, however, unclear how doctors who perform this service manage the risk of aggressive patients during home visits. The aim of this paper is to explore if and how doctors manage the risk of violence against them during AHHC. A survey was designed and administered to all 300 Australian-based doctors engaged in AHHC under the National Home Doctor Service (NHDS). The survey was conducted from September 2014 to November 2014. There were 172 responses (57.3 per cent). Only 43 per cent of respondents adopted personal protective measures. The remaining 57 per cent had none; of those 6 per cent had never considered protective measures, and 31.8 per cent were aware of the risk of violence, but were unsure of what to do. Measures adopted include the use of chaperones/security personnel (34.1 per cent), dependence on surgery policies (31.2 per cent), de-escalation techniques (15.2 per cent), panic buttons (7.2 per cent), personal alarms (6.1 per cent), and others (6.5 per cent). Females were more likely to adopt personal protective measures than males (OR 4.94; p<0.01; CI 1.70-14.34), and Australian-trained doctors were less likely to do so relative to overseas-trained doctors (OR 0.35; p=0.04; CI 0.12-0.99). Just over half of the doctors involved in AHHC took no precautions against aggressive attacks while on duty, and nearly one-third relied on the policies of their employing surgeries.
-
Encouraging formative assessments of leadership for foundation doctors.
Hadley, Lindsay; Black, David; Welch, Jan; Reynolds, Peter; Penlington, Clare
2015-08-01
Clinical leadership is considered essential for maintaining and improving patient care and safety in the UK, and is incorporated in the curriculum for all trainee doctors. Despite the growing focus on the importance of leadership, and the introduction of the Medical Leadership Competency Framework (MLCF) in the UK, leadership education for doctors in training is still in its infancy. Assessment is focused on clinical skills, and trainee doctors receive very little formal feedback on their leadership competencies. In this article we describe the approach taken by Health Education Kent, Sussex and Surrey (HEKSS) to raise the profile of leadership amongst doctors in training in the South Thames Foundation School (STFS). An annual structured formative assessment in leadership for each trainee has been introduced, supported by leadership education for both trainees and their supervisors in HEKSS trusts. We analysed over 500 of these assessments from the academic year 2012/13 for foundation doctors in HEKSS trusts, in order to assess the quality of the feedback. From the analysis, potential indicators of more effective formative assessments were identified. These may be helpful in improving the leadership education programme for future years. There is a wealth of evidence to highlight the importance and value of formative assessments; however, particularly for foundation doctors, these have typically been focused on assessing clinical capabilities. This HEKSS initiative encourages doctors to recognise leadership opportunities at the beginning of their careers, seeks to help them understand the importance of acquiring leadership skills and provides structured feedback to help them improve. Leadership education for doctors in training is still in its infancy. © 2015 John Wiley & Sons Ltd.
-
How do patients perceive ambulatory psychiatric care and what are their needs?
Małus, Aleksandra; Galińska-Skok, Beata; Konarzewska, Beata; Szulc, Agata
2018-03-14
The quality of a doctor-patient relationship plays a vital role in all fields of medicine. In the case of psychiatry, this role is special as it provides the foundation for the whole therapeutic process. The aim of this study was to investigate the patient's perspective on psychiatric visits: patient's attitudes towards the psychiatrist, patient's view of the patient-psychiatrist relationship, and the patient's needs and expectations from this relationship. 615 psychiatric outpatients responded to the anonymous questionnaires connected with their attitudes towards the psychiatrist, evaluation of the doctor, and expectations from psychiatric care. The study was conducted in 10 out of 30 public centres for psychiatric care in north-eastern Poland. Generally, the patients liked and positively evaluated their psychiatrists. Patient's liking for the doctor was connected with the feeling that the doctor also liked the patient, as well as with perceiving the doctor as competent and willing to meet the patient. The longer the treatment with a particular psychiatrist and the rarer need to consult the doctor, the more positive attitude and evaluation of the doctor patients had. According to the patients, the most significant expectations were associated with both conversation with the doctor and receiving emotional support. The key phase for forming the patient-psychiatrist relationship was the first stage of cooperation in which patients created their attitudes towards the doctor without modifying them at further stages. Thus, further studies on learning and developing the ability to establish the relationship with the patient, inspiring the patient's trust and making psychiatric appointments comfortable from the first meeting, will be highly valuable.
-
Lambert, Trevor; Smith, Fay; Goldacre, Michael J
2015-12-01
Doctors who graduated in the UK after 2005 have followed a restructured postgraduate training programme (Modernising Medical Careers) and have experienced the introduction of the European Working Time Regulation and e-portfolios. In this paper, we report the views of doctors who graduated in 2008 three years after graduation and compare these views with those expressed in year 1. Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. 3228 UK medical graduates. Comments on work, education and training. Response was 49% (3228/6538); 885 doctors wrote comments. Of these, 21.8% were unhappy with the standard of their training; 8.4% were positive. Doctors made positive comments about levels of supervision, support, morale and job satisfaction. Many doctors commented on poor arrangements for rotas, cover and leave, which had an adverse effect on work-life balance, relationships, morale and health. Some doctors felt pressured into choosing their future specialty too early, with inadequate career advice. Themes raised in year 3 that were seldom raised in year 1 included arrangements for flexible working and maternity leave, obtaining posts in desired locations and having to pay for courses, exams and conferences. Many doctors felt training was available, but that European Working Time Regulation, rotas and cover arrangements made it difficult to attend. Three years after graduation, doctors raised similar concerns to those they had raised two years earlier, but the pressures of career decision making, family life and job seeking were new issues.
-
Adolescent health--a descriptive study of a school doctor clinic.
Chavasse, M; North, D; McAvoy, B
1995-07-14
To describe a school doctor clinic at a New Zealand secondary school. A three phase study was designed and conducted at a coeducational secondary school in Auckland. Firstly, a health questionnaire was developed to assess adolescents' perceptions of their health status and use of primary health care services. The second phase was descriptive study of a newly established school doctor clinic. The doctor clinic was run twice weekly over a 3 month period in 1993. The third phase of the study was a clinic-based satisfaction survey. A 75% response rate was achieved, with a total of 221 health questionnaires completed from 292. Although the majority of students (n = 184, 84%) considered themselves healthy, 16% (n = 36) described their health as only 'fair' or 'poor'. Seventy one percent (n = 157) of students had seen their general practitioner in the preceeding twelve months. Thirteen percent (n = 142) of the school population consulted the school doctor clinic. Significantly more female, Maori and European students attended the school doctor clinic compared with the school demography. The commonest diagnoses for the doctor clinic were respiratory, skin and musculoskeletal problems. Thirty one percent of the diagnoses related to recognised adolescent health needs such as contraception, sexual health, nutrition, and psychosocial problems. Over two thirds of students at the first consultation had not seen another health provider. Students perceived that the doctor clinic overcame barriers such as access, cost and confidentiality. The school doctor clinic was well utilised, overcame some barriers to access and addressed many recognised adolescent health needs.
-
Nicotine lozenges may cause side effects. Tell your doctor if either of these symptoms is severe or does not go away: heartburn ... doctor immediately: mouth problems irregular or fast heartbeat Nicotine lozenges may cause other side effects. Call your doctor if you have any unusual ...
-
Concussion - what to ask your doctor - adult
... Adult brain injury - what to ask your doctor; Traumatic brain injury - what to ask the doctor ... Begaz T. Traumatic brain injury (adult). In: Adams JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 73. Giza CC, ...
-
Rotar, A M; Botje, D; Klazinga, N S; Lombarts, K M; Groene, O; Sunol, R; Plochg, T
2016-05-24
Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making responsibilities in strategic hospital management areas is positively associated with the level of implementation of quality management systems. Our findings suggest that doctors are increasingly involved in hospital management in OECD countries, and that this may lead to better implemented quality management systems, when doctors take up managerial roles and are involved in strategic management decision making.
-
[Parent-doctor relations in oncology: a qualitative approach].
Grau, C; Rubio, Claudia Grau; Espada, M C; Barón, Ma Carmen Espada; Fortes, M C; Fortes del Valle, Ma Carmen
2010-01-01
We want to learn how parents of children with cancer perceive their relationship with hospital staff, especially with doctors. We used group-based qualitative methodology. The sample is composed of 14 mothers/fathers whose children contracted the disease more than two years previously. All parents want information that is both intelligible and detailed. The word cancer has a strong social stigma and is avoided when giving information to parents and to children. Communication between doctors and parents can lead to situations of tension during diagnosis and relapses. Parents trust the professionalism of doctors. Parents also want doctors to be competent and to have human qualities. The preparation of reports by physicians is the task most criticized by parents.