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Timothy C Evans

Publications and source records attributed to Timothy C Evans.

6 recordsLinked to original sources

Academic degrees and clinical practice characteristics: the University of Washington physician assistant program: 1969-2000.

CONTEXT: The physician assistant profession has been moving toward requiring master's degrees for new practitioners, but some argue this could change the face of the discipline. PURPOSE: To see if there is an association between physician assistants' academic degrees and practice in primary care, in rural areas, and with the medically underserved. METHODS: Surveys were sent to 880 graduates of the first 32 University of Washington physician assistant classes through 2000. Respondents noted their academic degree at program entry and the highest degree attained at any time up to the time of survey. Relationships between practice characteristics and academic degree levels were tested by unadjusted odds ratios and logistic regression after controlling for year of graduation and sex. RESULTS: Of the 478 respondents, 54% worked in primary care, about 30% practiced in nonmetropolitan communities, and 42% reported providing care for the medically underserved. Respondents with no degree (33% of total at entry, 24% at survey) were significantly more likely than degree holders to work in primary care and nonmetropolitan areas. Respondents with no degree at program entry were significantly more likely, and those with no degree at the time of the survey were marginally more likely, to self-report work with the medically underserved. CONCLUSION: Respondents with no academic degree are significantly more likely to demonstrate a commitment to primary, rural, and underserved health care. These findings may inform the national debate about the impact of required advanced degrees on the practice patterns of nonphysician providers.

Educational Status↗

Thyroid disease.

Evaluation and treatment of thyroid disease is a common feature of primary care medicine. Nevertheless, the dose of thyroid hormone used to treat hypothyroidism is frequently not titrated to normalize the TSH, engendering the risks of under- or overtreatment. Other hypothyroid patients remain symptomatic even with normalized TSH on levothyroxine alone. Some of these patients improve symptomatically when liothyronine is added to the treatment regimen. Subclinical hypothyroidism and hyperthyroidism are also relatively common in primary care medical practice, and appropriately selected patients probably benefit from treatment. In the follow-up of patients treated for thyroid cancer, the use of rhTSH improves patient comfort considerably while allowing sensitive screening for persistent or recurrent cancer.

Animals↗

A multifaceted intervention in support of diabetes treatment guidelines: a cont trial.

OBJECTIVE: in an academic family practice clinic, we performed a controlled trial of a multifaceted intervention versus usual care for managing diabetes. Providers received didactic training and computerized compliance feedback to support staged diabetes management, an evidenced-based approach to diabetes care. RESEARCH DESIGN AND METHODS: one firm of the clinic practice received the intervention, the other served as the control group during a 14-month baseline period and a 14-month study period. HbA1(c) was the principal outcome measure. RESULTS: there was a significant 0.71% difference in change in HbA1(c) values between the intervention and control firms (P=0.02). The subgroup with the greatest improvement in HbA1(c) was those subjects who started the intervention with a HbA1(c) above 8%. The overall improvement in glycemic control could not be explained by differences in visit frequency or the aggressiveness of drug therapy. There were no changes in healthcare utilization or costs between the two firms. CONCLUSION: in an academic family practice clinic, a multifaceted intervention in support of diabetes treatment guidelines modestly improved glycemic control without incurring additional costs. The improvement was mostly due to mitigation of the natural deterioration in control usually seen. Further efforts are required to involve all patients in co-managing their diabetes.

Blood Pressure↗