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Biomedical subjects

M R Haug

Publications and source records attributed to M R Haug.

29 records · Page 2Linked to original sources
PubMed1980

Practice location preferences at entry to medical school.

Previous studies of the geographical maldistribution of physicians suggest that choice of practice location follows from specialty selection and residency location, although it is plausible that the causal order is reversed. To aid in disentangling the causal order, the locational preferences of entering medical students are analyzed. The findings show that the majority of students prefer a small town or mid-size city for practice and about 70 percent prefer primary care--general practice, internal medicine, or pediatrics. Moreover, nearly 60 percent desire a solo or small-group practice of no more than five physicians. Unexpectedly, the factor which best predicts preference for practice locale is not specialty but form of practice organization, which explains 13 percent of the variance in selected geographic location when other factors are controlled. The relationship between preferences for solo or small-group practice and small or mid-size communities may be explained by a common underlying disposition to independence, autonomy, and freedom from bureaucratic control.

Adult↗
PubMed1979

Public challenge of physician authority.

A sample survey of the public in a midwestern state substantiates the existence of widespread challenges to the authority of physicians, a phenomenon previously reported only impressionistically in the media. Attitudes tending to reject physicians' right to direct their interaction with patients characterized more than half the sample and were related to younger age, higher educational level, and greater health knowledge, with a consumerist and anti-authority stance also explanatory. Actual challenging behavior occurred at least once for about half the group, but in this instance was related less to age and knowledge than to more extensive experience with the health care system, as well as a lack of trust in people in general and doctors' competence in particular. However, explained variance was modest, arguing that other variables, not identified in this study, are at work. Surprisingly, respondents' health status, race, sex, and pattern of insurance coverage had little impact on either attitude or behavior, while both knowledge and a general tendency to reject authority were influential factors. Implications for physician-patient relations in the future are discussed in light of a number of social changes, including the rising educational level of the American public.

Age Factors↗
PubMed1976

Service delivery structure and continuity of care: a case study of a pediatric practice in process of reorganization.

The effects of the reorganization of a medical practice on continuity of care were investigated in a case study of a changing pediatric practice. Continuity, which has often been conceptualized as one indicator of quality of care, was measured by an index of which the numerator was the number of visits with own pediatrician and the denominator was the total number of pediatric visits for the year. Increased number of pediatricians and incorporation of the practice into an academic setting resulted in a decline of continuity of care accompanied by a rise in the number of doctor visits for acute illness care. Patient satisfaction, although related in some of its aspects to continuity, was by and large unaffected by the change. The consequences of changes in practice size and goal complexity for interpersonal aspects of patient care and quality of care are discussed.

Comprehensive Health Care↗
PubMed1976

The erosion of professional authority: a cross-cultural inquiry in the case of the physician.

The extent to which the erosion of professional authority observed in the United States is also occurring in the United Kingdom and the U.S.S.R. is examined in the case of the primary care physician. Informal interviews with health practitioners in these diverse societies revealed that the model of the professions which bases physicians' autonomy and authority on the occupational characteristic of a monopoly of specialized knowledge is subject to some revision. Education of the patient emerged as a critical factor in eroding physician authority in both countries, while patient age affected authority relations differentially in the two societies. Despite variations in the level of bureaucratization of health care, the role of the physician, as gatekeeper to non-medical benefits, served to counteract the erosion trend in both. The legacy of deference to the upper classes in Great Britain and in the U.S.S.R., an ideology of health as a citizen's obligation plus the "mothering' ambience of a largely female personnel are varying societal characteristics which also affect physician authority.

Age Factors↗
PubMed1975

Comprehensive pediatric care: the patient viewpoint.

Two meanings of the term comprehensive care are delineated. The first refers to a wide scope of health services, the second to a humanistic approach to the patient. Findings from a sample of patients from one pediatric practice suggest that the two meanings constitute two independent variables with respect to patient expeciations. Patient responses to questions regarding their expectations of the pediatrician revealed a tendency to hold a traditional disease orientation. Comprehensive care as a broad scope of health services that include mother guidance in child rearing is not a common goal for mothers utilizing the pediatric practice under study. On the other hand, a comprehensive approach by the pediatrician is a standard shared by most respondents in the sample: high priority is accorded the pattern of the personal physician with whom a patient forms a continuous doctor-patient relationship which instills in the patient trust that the physician's recommendations are based on thorough knowledge of the patient as an individual.

Black or African American↗
PubMedDate not supplied

Stress, health, and depressive symptoms in older adults at three time points over 18 months.

This descriptive study is a secondary analysis of data that examined depressive symptoms in a random sample of 429 community-dwelling adults aged 65 years and older. Participants were classified as having consistently high (n = 20). consistently low (n = 327), or fluctuating (n = 82) levels of depressive symptoms, based on scores from the Center for Epidemiological Studies-Depression Scale (CES-D; L. S. Radloff, 1977) at three time points over the course of 18 months. Differences in stress (life events and daily hassles), health (self-assessed health and physical complaints), and biographic variables among the 3 groups were examined. One quarter of the sample reported high depressive symptoms at least once over 18 months. There were significant differences among the 3 symptom groups on each of the stress and health measures and on marital status. The findings support the relationship among stress, health, and depressive symptoms over time. Implications for clinicians and researchers are discussed.

Aged↗