[Past, present and future].
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Biomedical subjects
Publications and source records attributed to M Nylenna.
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The medical record is both an indicator of the quality of care, and a means of improving this quality. In addition to being a source of information and a means of communication in the care of patients, the medical record is also becoming a document of increasing legal importance. The content and design of medical records, and how they are kept, should comply with legal requirements. The patients' right to read their own records is well established in Norway. Incomplete records and lack of information will always be held against the doctor in the case of complaints or lawsuits. The medical record provides a good basis for evaluation of care, and a systematic evaluation of medical records, e.g. in groups, is an effective form of medical audit. While the authorities are making an effort to achieve better standardization of medical records, every medical practitioner should do his best to let the everyday use of medical records become an important part of his personal quality assurance.
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Norwegian doctors spend on average 3.4 hours per week reading medical literature. 2/3 of this time is spent on medical journals. These are the main findings in a survey of self-reported reading time among 760 Norwegian doctors. Hospital doctors read more than doctors working outside hospital (3.9 vs. 2.7 hours per week), and internists spend more time reading than surgeons and general practitioners do. All categories of doctors report spending approximately one hour per week reading other material than journals and articles, and the differences between groups as regards reading time are accounted for by differences in the time spent on medical journals. Nine out of ten doctors read Tidsskrift for Den norske laegeforening (the Journal of the Norwegian Medical Association) regularly, and 2/3 read Nordisk Medicine (the Nordic Medical Journal). Every fifth doctor reads at least one out of four specified international journals (British Medical Journal, Lancet, New England Journal of Medicine or JAMA). Only one out of fifteen Norwegian doctors reads Läkartidningen (the Swedish Medical Journal) and Ugeskrift for Laeger (the Danish Medical Journal) on a regular basis.
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National medical journals constitute one of the most visible links which unite the medical profession despite specialities and types of employment. In addition to being informative, instructive, supplying comments and, best of all, entertaining, medical journals have also the responsibility for the professional identity of doctors and development of the roles they play. With their circulation end significance, national medical journals are representatives for culture in the medical world. The Nordic journals have particular tasks as regards the national professional terminology and the national professional environment. The future main challenges for general medical journals will be adjustment to the expectations from the media of the new generations of doctors, clarification of the relationships between journals as organs for qualification and informative channels, and ensuring editorial independence.
A survey comprising 1,077 readers (response rate 70.2%) showed a high degree of satisfaction with the content and presentation in the Journal of the Norwegian Medical Association. The results correspond well with the results from a similar study conducted in 1986. An average reader spends 47 minutes on each issue of the journal, and 89% of the respondents had read more than half of all the latest issues. 92% agree (partly or completely) that the journal provides much valuable information, and 79% agree that the journal maintains a high professional standard. The Journal of the Norwegian Medical Association has gradually adjusted to the needs and wishes of its readers. The proportion of readers who agree that the journal is topical has increased from 77% in 1986 to 85% in 1990 (p less than 0.001). The proportion of readers who agree that the journal is easily read has increased from 63 to 73% over the same period (p less than 0.001). On the other hand, the proportion of readers who think that the journal is uninteresting dropped from 40 to 23% (p less than 0.001).
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