SEARCH · PubMed Health

Results for “Family Practice”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources

PubMed1998

Family practice residency program sites on the World Wide Web.

BACKGROUND AND OBJECTIVES: The World Wide Web is a rapidly expanding entity, and family practice residencies have begun using this technology through the development of Web sites. Our objective was to survey Web sites devoted to family practice residencies. METHODS: We sent a national survey to 451 family practice residency directors. RESULTS: Of 241 returned surveys, 113 residencies reported an existing Web site. Seventy-four percent of Web sites were created by faculty, but 31% also involved residents in creation. Resident recruitment was the most successful goal of Web sites; 42% of programs reported "moderate" to "very successful" results. However, most programs reported that it was too early to evaluate the goals listed in the survey. CONCLUSIONS: Family practice residencies have an increasingly significant presence on the Web. The development, content, and goals of the sites are similar across programs regardless of creation date, but the evaluation of the success of these goals is at an early stage for most programs.

Computer Communication Networks↗

PubMedDate not supplied

Entry of US medical school graduates into family practice residencies: 1990-1991 and ten-year summary.

This is the tenth report prepared by the American Academy of Family Physicians on the percentage of each medical school's graduates who entered family practice residency programs. Approximately 10.7% of the 15,433 graduates of United States medical schools between July 1989 and June 1990 were first-year residents in family practice in October 1990. This compares to 10.8% in the previous year. The Mountain region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1990; the Middle Atlantic and New England regions continued with the lowest percentages. Medical school graduates from publicly funded medical schools were nearly twice as likely to be first-year residents in family practice in October 1990 as were graduates from privately funded schools. The percentages for each medical school have varied substantially from year to year in the 10 years that the AAFP has reported this information. The average percentage for each medical school for the last 10 years, as well as the cumulative percentage for each medical school, are reported.

Career Choice↗

PubMed2006

[Use of rofecoxib in family practice in the north of Netherlands, 2000-2004: background and consequences].

OBJECTIVE: To gain insight into the trends in the prescription ofrofecoxib, the medication and disease histories of rofecoxib users, and the occurrence of cardiac complications during the follow-up. DESIGN: Longitudinal comparative study in family practice. METHOD: Based on the data from family practices (17 family physicians) affiliated with the Registration Network Groningen, a network with about 30,000 patients in the northern part of the Netherlands, the incidence and prevalence ofrofecoxib use were determined per 1000 patients at risk for every quarter during the period 2000-2004. Data on duration, dosage and indications were taken from the rofecoxib prescriptions. Differences in morbidity between rofecoxib users and the users of traditional NSAIDs were compared using logistic regression, and differences between the two groups in the occurrence of cardiac complications were assessed by means of Cox regression analysis. RESULTS: During the period investigated, rofecoxib was prescribed with increasing frequency in family practice; there was a total of 1784 prescriptions for 509 patients. The drug was used increasingly for short durations and for a growing number of indications. Rofecoxib was selectively prescribed to former users of traditional NSAIDs. The occurrence of acute myocardial infarction, stroke or 'transient ischaemic attack' in the follow-up period was associated especially with pre-existing cardiovascular disease, but these complications were also seen more often among patients without pre-existing cardiovascular disease who used rofecoxib than among those who used the traditional NSAIDs (the difference was not significant). CONCLUSION: The observations indicate that, via a process of channelling, rofecoxib was prescribed to a highly-specific population of patients who, paradoxically, were at a higher risk of developing the same cardiac complications with which rofecoxib had been shown to be associated in randomised clinical trials.

Aged↗

PubMed1991

Patient satisfaction with gynecologic care provided by family practice resident physicians.

This study assessed the impact on patient satisfaction of second-year family practice residents participating in a one-month gynecology rotation at a university-owned satellite ambulatory care facility. Its purpose was to examine whether residents can be incorporated into university-operated satellite health centers for patient care and resident education without decreasing patient satisfaction. With the exception of one item on the patient satisfaction questionnaire, results showed no significant difference in patient satisfaction ratings between one family practice faculty physician and five family practice residents. This finding supports increased efforts to incorporate residents into academic ambulatory care satellites in limited direct patient care roles similar to those described in this report.

Evaluation Studies as Topic↗

PubMed1994

Methods of recruiting and selecting residents for U.S. family practice residencies.

PURPOSE: To describe the strategies used by family practice program directors to recruit and select residents. METHOD: The residency directors of all 361 U.S. accredited nonmilitary family practice programs in 1992-93 were asked to complete three-page questionnaires regarding program descriptors, curriculum, benefits offered, interview process, and factors affecting their selection of residents. Each program was categorized into one of nine geographic regions. Variation of program characteristics across the regions was assessed using chi-square. RESULTS: A total of 282 directors (78%) returned usable questionnaires. The programs did not differ in benefits offered except that (1) those with low fill rates in the 1992 Match of the National Resident Matching Program were more likely to have additional financial incentives and (2) the programs in areas of high competition went to extra effort and expense to market their residencies through the use of advertising materials (e.g., pens, mugs). The most important factor in selecting applicants was listed as the personal interview by 51% of the directors and performance on clinical rotations by 36%. CONCLUSION: The residency directors' selection decisions were highly influenced by candidates' performances in interviews and on clinical rotations. The programs in the most competitive areas were characterized by greater efforts and increased expenditures of resources for recruiting. More research is needed to assess the values of the different strategies used by programs to recruit and select residents.

Family Practice↗

PubMedDate not supplied

Rural health, family practice, and area health education centers: a national study.

The National Area Health Education Center (AHEC) Program and the family practice specialty were both created around 1970, in part to help meet the health care needs of medically underserved populations. Because these two entities share the common goal of alleviating physician shortages in rural areas, a study was conducted to determine the nature and extent of their interaction. Questionnaires were mailed to all AHEC projects and all nonmilitary family practice residency programs. Response rates were 100% and 79%, respectively. Elective rural rotations (usually preceptorships) are offered by 135 (49%) residencies, but only 84 (31%) require them. Fourteen (64%) AHEC projects interact with family practice residencies; however, only 9% (15/167) of the programs in those states utilize AHEC resources. The authors conclude that additional rural rotations could be offered to family practice residents by taking advantage of under-utilized resources of the National AHEC Program.

Area Health Education Centers↗

PubMed1990

Clinical pharmacists in family practice residency programs.

A project was undertaken to determine the number, specific activities, and demographics of clinical pharmacists directly involved with residency programs in family practice. A survey was mailed to the directors of all 381 family practice residencies, with a request either to forward it to the participating pharmacist or to return the survey if a pharmacist did not directly participate in the teaching program. With two mailings, responses were received from 85.3% of the residencies, with 80 pharmacists completing surveys. While the involvement of pharmacists in family practice residencies was similar to that reported in a survey 9 years ago, academic appointments and funding, in whole or in part by a college of medicine, had increased. This increased involvement may represent an acknowledgment by medical educators in family practice of the value of pharmacists participating in residency programs.

Adult↗

PubMed1973

Physician time-saving by employment of expanded-role nurses in family practice.

Registered nurses working in five family practices in Kingston, Ontario, were given a period of in-service training and supplementary formal instruction at Queen's University to expand their skills and enable them to undertake prescribed procedures in the physicians' offices. Operational data collected from the five practices before and after training was analysed to assess the saving of physician time effected by the expansion of the nurses' activities in providing primary medical care. Physician time was saved in all cases but the amount varied. The results are presented and discussed in relation to staff, physical premises and patterns of practice of the participating physicians. Under the most advantageous practice circumstances in this study, a 33.7% saving in original physician time was obtained. The mean time-saving for the five practices was 18.2%.

Education, Nursing↗

PubMed2001

Job satisfaction of family practice residents.

BACKGROUND AND OBJECTIVES: As new market forces and expanding responsibilities strongly influence our specialty, it is vital to understand issues that affect resident recruitment, retention, and performance. This study evaluated family practice residents' satisfaction with their chosen careers, their individual programs, and many of the other factors that potentially influence and contribute to job satisfaction. METHODS: Data were collected using a 56-item questionnaire that included demographic information and specific questions regarding residency job satisfaction. The questionnaire was mailed to all 28 Texas family practice residency programs. RESULTS: We received resultsfrom 75% of surveyed residents. Overall satisfaction with family practice as a specialty" received the highest satisfaction ranking. Satisfaction with 25 various aspects of family practice residency training was significantly higher in community-based programs, compared with university-based programs, and satisfaction increased with year level of training. Items that were ranked higher by community-based residents included satisfaction with their specific residency program, obstetrics experience, overall learning environment, degree of autonomy, and relationship with specialists. CONCLUSIONS: This report demonstrates a strong degree of overall job satisfaction among family practice residents. In general, residents in community-based programs have a higher level of job satisfaction, compared with residents in university-based programs, and satisfaction increases with vear level of training.

Adult↗

PubMed2001

Residency training in colposcopy: a survey of program directors in obstetrics and gynecology and family practice.

OBJECTIVE: Our goal was to identify how colposcopy is being taught to residents in obstetrics and gynecology and family practice programs and to see if the program directors think their residents receive sufficient clinical exposure to be adequately trained in colposcopy. STUDY DESIGN: A 30-question survey was sent to all obstetrics and gynecology and family practice residency program directors. The survey included questions about the didactic nature of the colposcopy curriculum, the type of supervision, how resident skills are evaluated, estimates of the numbers and types of patients evaluated, the numbers and types of procedures being done by each resident, and the program director's perception of residents' competence in colposcopy. RESULTS: The overall response rate was 485 of 752 program directors (64.5%). Significantly fewer family practice than obstetrics and gynecology program directors thought they had adequate numbers of colposcopy patients to train their residents. By their program directors' estimates, 86% of family practice residents evaluate 10 or fewer patients with high-grade lesions (versus 16.5% of obstetrics and gynecology residents); 51.4% evaluate 10 patients or fewer with low-grade lesions (versus 6.7% of obstetrics and gynecology residents), and 40.6% evaluate 10 patients or fewer with atypical squamous cells of undetermined significance (versus 3% of obstetrics and gynecology residents). Experience with vulvar disease is also limited. Program directors thought their residents' colposcopy skills were roughly comparable with their general obstetrics and gynecology skills. CONCLUSIONS: It is possible that many program directors underestimate the number of colposcopic examinations required to achieve and maintain colposcopic skills. Many training programs have insufficient clinical volume to properly train residents in colposcopy.

Colposcopy↗

PubMedDate not supplied

Entry of US medical school graduates into family practice residencies: 1989-1990 and nine-year summary.

This is the ninth report prepared by the American Academy of Family Physicians on the percentage of each medical school's graduates who entered family practice residency programs. Approximately 10.8% of the 15,646 graduates of United States medical schools between July 1988 and June 1989 were first-year residents in family practice in October 1989. This compares to 10.7% in the previous year. The West North Central region reported the highest percentage of medical school graduates who are first-year residents in family practice programs in October 1989; the Middle Atlantic and New England regions continued with the lowest percentages. Medical school graduates from publicly funded medical schools were twice as likely to be first-year residents in family practice in October 1989 than were graduates from privately funded schools. The percentages for each medical school have varied substantially from year to year in the nine years that the AAFP has reported this information. The average percentage for each medical school for the last nine years, as well as the cumulative percentage for each medical school, are reported.

Family Practice↗

PubMed1985

The cost and funding of family practice graduate education in the United States.

This paper reports the findings of a national cost survey of 369 nonmilitary family practice graduate education programs in the United States, 1981-82. The purpose of the study was to develop a reliable revenue and cost information data base to enable an understanding of current family practice education costs and funding. The availability of this information will be of assistance in the development of future budgetary plans for family practice graduate education. The results presented are based on 147 programs associated with hospitals using a non-cost center accounting protocol. These programs provided 100 percent complete revenue and cost data (40 percent of the targeted programs). Major sources of income were hospital support (35 percent), patient income (31 percent), and public dollars (28 percent). The mean cost per accredited position was $57,471. Expenses, each at approximately one third of the total, were resident stipends, faculty salaries, and clinic expenses. Statistically significant differences were found only for source of income when program structure, program size, and geographic location were examined. Recommendations for future family practice funding include modification of present reimbursement formulas and other third-party payment mechanisms, increasing hospital support, maintenance of public subsidies, and development of a uniform system of monitoring and evaluating costs of residency programs operated under both cost center and non-cost center accounting protocols.

Accounting↗

PubMed1990

Comprehensive geriatric assessment recommendations: adherence of family practice residents.

A study was performed to determine whether family practice residents followed recommendations made by a comprehensive geriatric assessment clinic. Of 109 consecutive consultations, 27 patients had follow-up visits with family practice residents who participated in the assessment and who subsequently served as their primary care physicians. Adherence of residents to 437 clinic recommendations was monitored for 90 days by medical record review. Although recommendations to begin or increase a medication were followed 85.4% of the time, residents followed recommendations to stop or decrease medications less than 65% of the time. Recommendations to order a specific laboratory test or x-ray examination were acted on 70.3% of the time. Preventive recommendations were followed only 54.3% of the time. Residents' adherence to team-based care plans varied widely by type of recommendation. Special efforts are needed to increase compliance with comprehensive geriatric assessment clinic recommendations, particularly those for preventive services.

Aged↗

PubMed1997

Enhancing procedural training in a family practice residency.

BACKGROUND AND OBJECTIVES: Teaching outpatient procedures is a major responsibility of family practice residencies. This requires equipment, faculty expertise, and curricula. This report documents one residency program's attempt to enhance the teaching of outpatient procedures. METHODS: We tabulated all office procedures completed during the years 1993 through 1996 at a family practice residency program in the southeastern United States. We compared the number of procedures and dollar charges before and during an educational intervention designed to increase the number of procedures performed and to improve procedural training of residents. The intervention consisted of hiring a full-time procedural nurse and new procedural equipment. RESULTS: The residency program spent $177,000 over 4 years to improve procedural training, but income from procedures was estimated to be only $127,000. From 1993 to 1996, the total number of annual procedures increased from 322 to 540. Both the number of procedures and procedural income declined in the final year of the project when the procedural nurse assumed other clinical and administrative duties. CONCLUSIONS: Volume and teaching of common procedures in a family practice residency program can be enhanced by a dedicated effort, but this effort requires considerable staffing and financial resources.

Costs and Cost Analysis↗

PubMed1995

Factors associated with research productivity in family practice residencies.

BACKGROUND: Research productivity and the associated features of research productivity in family practice residencies have not been well described. The objectives of this study are to describe residency research productivity and identify the set of independent factors that best characterize programs at various levels of productivity. METHODS: A 23-item survey was mailed to 226 randomly selected family practice residency directors. The survey included items on program demographics, mentoring, resident and faculty research activities, and program research resources. Factor and discriminant analyses were performed to identify the major independent factors associated with productivity. RESULTS: A total of 154 completed surveys were received for a response rate of 68%. Based on a cross tabulation of grants per program and publications per faculty, 22% of programs had high productivity, 46% had medium productivity, and 32% had low productivity. The significant factors of mentor support, amount of research activity, and program size contributed independently to the classification of programs by relative level of research productivity. These associations remained significant when university programs were excluded. CONCLUSIONS: Family practice residencies with relatively higher research productivity are more likely to have three characteristics than lower productivity programs: availability of a research mentor, more faculty research activities, and larger program size.

Efficiency↗

PubMed1997

Establishing proficiency in flexible sigmoidoscopy in a family practice residency program.

BACKGROUND AND OBJECTIVES: Fiberoptic flexible sigmoidoscopy (FFS) is widely used by family physicians to evaluate abdominal problems and screen for colorectal cancer. We evaluated data on exams performed by family practice residents to determine the number of supervised procedures needed for technical proficiency at FFS. METHODS: We reviewed data recorded from all FFS procedures done at a family practice residency from October 1986-July 1994. RESULTS: A total of 262 exams were performed by 55 residents at the Family Practice Center. There was modest correlation between increasing numbers of exams and increased unassisted depth of insertion (UDI). Maximum UDI was achieved after 10-15 supervised exams. Factors such as patient gender, prior surgery, and preparation quality were also significantly correlated with UDI. Significant differences in training experience and patient selection were seen between male and female residents. CONCLUSIONS: Maximal UDI is reached after 10-15 procedures. Differences in training experiences and successful UDI based on resident gender should be studied further.

Adolescent↗

PubMed1978

Treatment of obesity in family practice.

This paper describes the experience of a senior family practice resident in managing obesity using behavior modification techniques. Weight reduction was begun and continued by 9 of 32 identified obese patients. Patients who were successful in losing weight were those who kept accurate intake diaries, returned for follow-up, and had made prior attempts at weight loss. Patients who were unsuccessful in losing weight were those who kept incomplete intake diaries, had no continuing physician-patient relationship with the investigator, and had made no prior attempts at weight loss. The method management described allowed efficient use of physician time so that the time required was well within the limits set by a busy family practice setting.

Adolescent↗

PubMed1983

Ten central elements of family practice.

Previous studies of the content of family practice have analyzed the discipline in terms of the clinical problem content. Taking a different approach, a study group analyzed the care given to patients by family physicians irrespective of the specific clinical problems. Working with a reference group of family physicians in private practice, ten central elements were identified: (1) comprehensiveness of care, (2) anticipation of problems and continuity of care, (3) personal relationships with a patient, (4) medical knowledge and skills characteristic of family medicine, (5) values and attitudes that enhance family medicine, (6) problem definition and medical decision making, (7) problem management and resource coordination, (8) care of the individual within the family context, (9) involvement with the community, and (10) attentiveness to practice organization. This study provides a different point of departure for the design and evaluation of educational programs in family practice.

Adult↗