Teaching interviewing skills to students in clinical years: a comparative analysis of three strategies.
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Biomedical subjects
Publications and source records attributed to R A Babineau.
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This study examines the hospital work of four family physicians in group practice in a community of 45,000 in north central Massachusetts. During the study year, these four physicians assumed primary management responsibility for 1,021 hospitalizations for an average of 255 admissions per physician. Most admissions (98 percent) were to a 242-bed community hospital, and these 997 admissions were studied in detail. Obstetrical admissions accounted for 21 percent of the total (not counting newborns), with 169 deliveries. Pediatric admissions (newborn to age 21 years) accounted for 42 percent of the total. Sixteen percent were patients over 65 years of age. One or more consultations were requested in 14 percent of the admissions. Some form of cardiovascular disease constituted the most frequent discharge diagnoses, with newborn care and pregnancy related diagnoses second and third. The four physicians were compared to each other for variables including age/sex profile, discharge diagnoses, length of stay, consultations requested, and admission ratio per ambulatory encounter. In spite of their differences in training and length of time in practice, the four physicians were found to be similar to one another on most of these dimensions.
Recently, there has been growing concern that microbial health hazards can be increased by the use of activated carbon filters in domestic water systems. The present study was undertaken to investigate the effect of carbon filters on the microbial content of water. Results indicated that the microbial content of filtered and unfiltered water increased to about the same level on overnight standing and, in both cases, was reduced by flushing the next day. In addition, the use of activated carbon for the filtration of contaminated well water over a period of 11 weeks had no effect on the total or coliform count. Under use conditions, activated carbon filters were found to have no significant effect on the number of bacteria present in the water.
Physician and practice characterisitics were reviewed in relation to the quality of the doctor-patient relationship in primary medical care. This relationship was defined in terms of communication between physicians and patients, patient satisfaction with care, and physician awareness of patient concerns. The study subjects were mothers of infants and pregnant women, identified from the offices of a random sample of primary care physicians is a single community. The patients of 49 physicians, 363 pregnant women and the mothers of 523 infants were the subjects of the study. When controlled for patient characteristics, communication was better for pediatricians with mothers of infants and for obstetricians with pregnant women as compared with other physicians. Mothers of infants were more highly satisfied with care provided by residency-trained physicians; pregnant women were more satisfied with non-Board certified physicians. Physician awareness of patient concerns presented a mixed pattern of associations with several physicians and practice characteristics. These findings suggest that physician credentials are not consistently associated with the three identified dimensions of the doctor-patient relationship.
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