PubMed HealthSearch

Biomedical subjects

F D Scutchfield

Publications and source records attributed to F D Scutchfield.

At least 19 recordsLinked to original sources

The public health leadership institute: leadership training for state and local health officers.

This paper describes the Public Health Leadership Institute (PHLI), a program designed to expand and enhance the leadership skills of senior public health officials. The background of PHLI is discussed, and organizations responsible for its organization, governance and funding are revealed. Methods of selecting a cohort of scholars to participate each year, along with the characteristics of scholars selected, are briefly outlined. A calendar of events and description of PHLI curriculum is included. Specific features of the PHLI program, including peer-learning through electronic conferencing, the one-week learning retreat, and the required action-learning projects are described. Also included are results from an evaluation by 99 participants from the first two years of PHLI's existence. The evaluation is based on a survey of the participants' satisfaction with the program and its personal and institutional effects. The Public Health Leadership Institute provides a model of leadership development for senior public health agency officials. The program has been popular with participants, and the vast majority report improved leadership skills. The personal and organizational effects of PHLI address the deficits in leadership identified in the Institute of Medicine's report, The Future of Public Health.

California

Clinical preventive services: the physician and the patient.

Physicians have positive attitudes and beliefs about providing preventive services. Numerous constraints, however, influence provision of these preventive services, such as system/organizational problems, reimbursement issues, the science of clinical preventive services, and an authoritative source of information to guide physicians. Even in the best of circumstances, physicians are not as effective as they or their patients would like in providing clinical preventive services. The illness orientation is a powerful obstacle for even the most motivated physician to overcome. Many studies suggest activities that could improve physicians' compliance with their own attitudes toward preventive medicine. Patients are important partners in physician-patient interaction, and have a vital part in the provision of preventive services. But in most cases, patients are seen as passive partners in the preventive care service interaction, and this serves the patient and the physician poorly. Patients appear motivated to receive preventive services, but in some cases (e.g., immunizations), they may be misinformed about these services. The presence of a knowledgeable, activated patient will improve the provision of preventive services, and thus enhance community health.

Humans

Testicular self-examination by young men: an analysis of characteristics associated with practice.

This study was conducted to determine the level of testicular self-examination (TSE) awareness and practice and to identify characteristics related to TSE awareness and practice in a sample of college men. A 26-item survey was administered to 404 male college students. Forty-two percent reported they were aware of TSE, more than 41% had been taught TSE, and 22% had examined their testicles at least once in their lifetime. Approximately 8% of the study population reported practicing TSE once a month. The PRECEDE model was used to categorize the significant variables that influenced monthly TSE practice. Age and college class were significant demographic variables; predisposing factors included having heard of testicular cancer, knowing about recommended practice rates, feeling that cancer can be controlled, and awareness of the risk factors associated with testicular cancer. Having been taught TSE was the statistically significant enabling factor. A discussion of TSE in the past 6 months was the significant reinforcing factor.

Adolescent

Barriers to prescribing the Copper T 380A intrauterine device by physicians.

From a questionnaire sent to all obstetricians and gynecologists and all family and general practitioners in San Diego County, California, regarding the Copper T 380A intrauterine device, substantial barriers to prescribing it were identified. Of all physicians responding, 40% reported that they were not recommending the Copper T 380A to anyone, the single most common reason given being concern about medical liability. A lack of knowledge about the new device, a lack of intrauterine device insertion skills, and certain medical practice settings were also important barriers to prescribing it. The new intrauterine device is considered in the context of innovation-diffusion theory. Substantial amounts of education and training and improvement in the medical-legal climate are needed before current barriers to prescribing the new device are removed.

Attitude of Health Personnel

AIDS update.

Acquired immunodeficiency syndrome (AIDS) is a new and frightening epidemic. Epidemiology has clearly delineated the mechanisms of spread as sexual intercourse, transfer of blood, and vertical transfer from infected mother to newborn child. Although much remains to be answered about infection with the AIDS virus, present information will allow containment of its spread while methods of controlling the threat, such as development of vaccine and therapy, are vigorously pursued.

Acquired Immunodeficiency Syndrome

Preventive attitudes, beliefs, and practices of physicians in fee-for-service and health maintenance organization settings.

To identify the self-reported differences in preventive practices, attitudes, and beliefs of physicians practicing in fee-for-service (FFS) and health maintenance organization (HMO) settings, we surveyed a 100% sample of primary care physicians practicing in a large, urban, closed-panel HMO and a random sample of physicians, in the same county, who were in an FFS practice. The FFS physicians were more likely to consider behavioral risk factors important than were HMO physicians, and they were more likely to ask their patients about behavioral risk factors. Fee-for-service physicians were more likely than HMO physicians to use continuing medical education courses to upgrade their skills in modifying behavioral risk factors. There was little difference in the self-reported proportion of patients with specific behavioral risks in the FFS and HMO practices. Also, both groups were comparable in their perception of their ability to do behavioral counseling and their perceived success in such counseling. We conclude that FFS physicians are more likely to have positive preventive beliefs, attitudes, and practices than are HMO physicians.

Attitude of Health Personnel

Postgraduate preventive medicine: where do we stand today.

It appears that the specialty of preventive medicine is declining as a viable specialty, with inadequate numbers of practitioners and with a declining number of physicians entering residency training programs. However, additional data are needed to make rough estimates of the level of need in the future. Even without that data, we must begin to address the potential shortage in trained manpower, because there is a trend that cannot be ignored pointing to a potential shortage. Several points must be pursued. All medical students must be exposed to the excitement we all feel about preventive care. Our teaching programs in medical schools must be strengthened to assure that there is rigor in these programs and that the potential of preventive medicine is conveyed. It is imperative to examine the field to discover why so many of our self-designated specialists in preventive medicine are not board-certified. Obviously one reason could be that a hungry job market is taking individuals who have not been trained in preventive medicine; another reason could be that for some reason specialists in the field of preventive medicine may feel that board-certification is not necessary for their career goals. This issue raises many questions about the importance of academic training in preventive medicine. It also points to the importance of addressing mid-career training needs on the part of those self-designated specialists. The question of financing must be addressed as well. Efforts must be developed to assure that the preventive field is reimbursed by major third-party payors, Medicare and Medicaid. Perhaps through these reimbursement mechanisms a way could be found to provide, at least in part, resident stipends. In addition, other mechanisms must be developed to provide support for residents in training in preventive medicine. If as a people we are to fulfill our potential of healthiness and achieve the Objective For Health Promotion and Disease Prevention, we must have trained personnel to do the job.

Certification

National Health Service Corp: a survey of Alabama's scholarship recipients.

In April 1979, 41 Alabama medical students who had received scholarships from the National Health Service Corps (NHSC) were surveyed. The students were predominantly single urban individuals who received their initial NHSC scholarship in the first or second year of medical school. The majority who planned primary care careers were undecided about remaining in the NHSC after their commitment. The students were concerned about the logistics of the NHSC and practice in rural areas. Based on their response, it is suggested that medical schools, The American Medical Student Association, and the NHSC develop a series of activities designed to facilitate the NHSC scholarship recipients subsequent activities in the NHSC. These suggestions include elective credit for NHSC/AMSA (American Medical Student Association) preceptorships, curriculum offering that facilitate the physician's practice in underserved communities, and activities that facilitate the medical school faculties' understanding of the NHSC.

Alabama

Family medicine in the undergraduate medical curriculum.

Family medicine has become an integral part of the under-graduate medical curriculum in many schools. The process of developing this important segment of the curriculum has encountered many difficulties which have centered around the particular phase in which family medicine is introduced in the student's development. The student must recognize family medicine as an academic discipline comparable to, and as important as, other traditional specialties. Through the use of the model practice unit, the development of cognitive behavioral objectives, and the provision of continuity of care experiences during the undergraduate medical curriculum, the student can grow to understand that family medicine is, in fact, as academically strong as other more traditional specialties. This article describes the experience, problems, and the development of these components in one medical school.

Alabama

Alternate methods for health priority assessment.

Four methods for assessing priorities of health problems were use in a 15-county Appalachian region. Despite overall similarities the tendency is for providers to focus on categorical disease problems while consumers focus more on organization and financing problems. Only one of the methods described, community diagnosis, uses objective data; thus, the health professional must assume an educational role and help consumers use and interpret data. Prioritization of health problems allows for more appropriate use of limited resources.

Attitude to Health