1992 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
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Adolescent↗
Biomedical subjects
C Clancy
Publications and source records attributed to C Clancy.
Primary care and health care reform: the next 100 days.
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Delivery of Health Care↗
Internists' practices in health promotion and disease prevention. A survey.
OBJECTIVE: To estimate internists' use of disease prevention and health promotion activities, and to explore demographic, professional, behavioral, psychological, cognitive, and organizational factors associated with the use of such practices. DESIGN: Mail survey. SETTING AND SUBJECTS: A sample of 2610 members and fellows of the American College of Physicians (ACP) participated in the study. They engaged in patient care activities more than 20 hours per week and were stratified by gender and region. They lived in four geographic areas of the United States (Northeast, Southeast, Central, and West), comprising 21 ACP regions. MEASUREMENTS: A questionnaire requesting background information as well as information about personal health; record keeping; use of immunizations (pneumococcal, influenza, tetanus, hepatitis B); use of screening tests and procedures for detecting cancer (breast examination, Papanicolaou smear, stool occult blood test) and other diseases (electrocardiograms, cholesterol level tests, chest radiographs); and behavioral counseling to promote health (in the areas of smoking, exercise, and alcohol and seat belt use). MAIN RESULTS: Internists used effective preventive interventions less frequently and ineffective practices more frequently than experts recommend. Internists' use of health promotion and disease prevention activities is associated with habit, attitude, and a lack of adequate knowledge. Younger physician age, general internal medicine practice, and personal health promotion and disease prevention practices were strongly associated with more appropriate use of recommended practices (P less than 0.01). CONCLUSIONS: Internists' use of disease prevention and health promotion activities falls short of expert recommendations. Programs to improve the delivery of preventive services might be aimed at improving physicians' personal health practices, might be directed toward patients, and might include the development of effective systems to remind physicians.
Counseling↗
The counseling practices of internists.
OBJECTIVES: To determine the counseling practices of a group of internists in the areas of smoking, exercise, and alcohol and seat belt use, and to determine the associations among physicians' personal health habits and their counseling practices. DESIGN: A random stratified sample of members and fellows of the American College of Physicians in 21 regions selected to represent all areas of the United States. Because of the relatively small proportion of women in this group, they were oversampled. SETTING: Physicians' practices. PARTICIPANTS: One thousand three hundred and forty-nine internists (members or fellows of the College) returned questionnaires, for a response rate of 75%; 52% defined themselves as general internists. INTERVENTIONS: A questionnaire was used to obtain information on internists' use of cigarettes, alcohol, and seat belts and their level of physical activity. Data were obtained on the indications used for counseling and the aggressiveness of counseling about each of these four habits. MEASUREMENTS AND MAIN RESULTS: Bivariate and logistic regression analyses were used to compare the tendencies of internist subgroups both in using various indications for counseling and in the thoroughness of counseling. Generalists were more likely than specialists to counsel at least once all patients who were at risk and to be more aggressive in counseling. Ninety percent of respondents counseled all of their patients who smoked, but 64.5% never discussed the use of seat belts. Only 3.8% of these internists currently smoked cigarettes, 11.3% drank alcohol daily, 38.7% were extremely or quite active, and 87.3% used seat belts all or most of the time. Among men internists, for every habit except alcohol use, personal health practices were substantially associated with counseling patients; for example, nonsmoking internists were more likely to counsel smokers, and very physically active internists were more likely to counsel about exercise. Among women internists, being very physically active was associated with counseling more patients about exercise and alcohol use. CONCLUSIONS: The low level of self-reported counseling among these internists suggests that further emphasis on training in these skills is needed. The association between personal and professional practices suggests that medical schools and housestaff training programs should support health promotion activities for future internists.
Adult↗
Take a fresh look at discharge planning.
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Aged↗
U.S. women physicians' assessment of the quality of healthcare they receive.
Surveys of women's perceptions of quality and satisfaction with healthcare are widely administered and reported, yet no similar studies of women physicians' perceptions have been conducted. We analyzed related data from the Women Physicians' Health Study, a nationally representative sample of 4501 U.S. women physicians. Among U.S. women physicians, 39% thought the healthcare they personally received was excellent, 37% considered it to be very good, 19% good, 4% fair, and 1% judged their healthcare to be poor quality. Physicians may be especially rigorous judges of healthcare quality, and their assessment of the healthcare they receive is generally positive, an encouraging finding. However, as physicians are highly qualified to assess and potentially obtain high-quality healthcare and as they generally did not judge the care they received to be excellent, the findings also suggest that there are opportunities for improvements in the quality of women's healthcare.
Adult↗
Are employees satisfied? A survey of occupational health services.
With stepped-up efforts to contain costs, there is widespread concern that medical facilities and insurance carriers are not paying enough attention to accident prevention. This recent study of occupational health services reveals that patients supported by private insurance appear to be less than satisfied with the quality of care when they are treated for work-related injuries or illnesses in industrial clinics. However, when a health or safety consultant is on staff, patient attitudes improve markedly. There is clearly an increasing role for health educators in facilitating a better understanding among patients of industrial medical resources.
Accidents, Occupational↗
Labelled for life.
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Adaptation, Psychological↗