PubMed Health⌕ Search

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 613 records · Page 34Linked to original sources
PubMed2005

Osteopathic manipulative treatment of somatic dysfunction among patients in the family practice clinic setting: a retrospective analysis.

CONTEXT: Relatively little has been published about contemporary use of osteopathic manipulative treatment (OMT) in family practice. OBJECTIVE: To provide an "epidemiology" of somatic dysfunction, assessing prevalence and severity of somatic dysfunction encountered in the family practice setting, also characterizing physician use of OMT. DESIGN: Retrospective analysis of Outpatient Osteopathic SOAP Note Form data collected in 1998 and 1999 by 20 osteopathic medical trainee-investigators under the supervision of seven site-based osteopathic physicians. SETTING: Three university-based, osteopathic family practice clinics. RESULTS: The authors analyzed records for 1331 patient encounters and 424 adult patients. The mean (SD) age of patients was 56.9 years (16.2 years), and 71% were women. The median number of days between repeat encounters was 29 days. Somatic dysfunction was diagnosed in 418 (31%) patient encounters, affecting a total of 1199 anatomic regions (2.9+/-1.2 anatomic regions per patient). Investigators used OMT in 335 (25%) patient encounters to treat a total of 952 anatomic regions (2.8+/-1.2 anatomic regions per patient). For women, the odds ratio for receiving OMT was 1.4 (95% confidence interval [CI], 1.0-2.2); for patients using analgesics, anti-inflammatory agents, or muscle relaxants, the odds ratio was 2.2 (95% CI, 1.2-4.1). Immediately after OMT, investigators reported that patients' somatic dysfunction resolved or improved in a total of 747 (96%) anatomic regions and remained unchanged in 32 (4%) anatomic regions (P<.001). The authors used cluster analysis to classify anatomic regions by prevalence and severity of somatic dysfunction. CONCLUSION: Somatic dysfunction was diagnosed in almost one-third of patient encounters. In one-quarter of patient encounters, investigators used OMT.

Family Practice↗
PubMed1979

Teaching interpersonal skills in family practice: results of a national survey.

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.

Educational Measurement↗
PubMed1990

The epidemiology of hypertension in family practice in Cape Town.

A prevalence study of hypertension in 8 family practices in low socio-economic areas of Cape Town examined 1,046 patients over the age of 15 years. The crude prevalence rate of hypertension was 20.26%. There was no significant sex difference. Systolic pressure, diastolic pressure and hypertensive status increased with age and body mass index (BMI). There were complex relationships with regard to sex in that the female sex was predictive of hypertensive status after the age of 45 years unexplained by differences in BMI. After adjusting for age, BMI and sex differences, widowhood, poor education, obesity, a family history of hypertension or stroke and a past history of hypertension were significant predictors of hypertensive status. Smoking status, occupational social class or property ownership were not predictive. Fifty-one per cent of hypertensive subjects were treated. Of those receiving treatment, 30% were controlled resulting in a control prevalence of only 18%. Younger male subjects were better controlled by treatment. A strong need for improved diagnosis and treatment of hypertension in family practice exists in this region.

Adolescent↗
PubMed1989

Incidence of diseases of the lower respiratory tract in family practice and low level air pollution.

A simple contact registration in family practices in an urban area in the Netherlands was shown to be a suitable instrument for measuring and analysing the incidence of diseases of the lower respiratory tract. This incidence showed a topographical and a temporal variation. The topographical component was related to the sulphur dioxide (SO2) air pollution in the different districts. The temporal component consisted partly of seasonal variations and partly of short-term variations. A moderate effect of the SO2 air pollution on the temporal variation was observed, but it was weak, possibly owing to the relatively low levels of SO2 in Amsterdam. The present study shows that contact registration in family practices may yield useful data for epidemiological analysis.

Adolescent↗
PubMed1995

Economic viability of a model rural family practice.

BACKGROUND AND OBJECTIVES: A model rural clinic was established by the Quincy Family Practice Residency Program with the financial support of sponsoring local hospitals. The purpose of the study was 1) to determine the financial viability of such a model practice and 2) to determine the practice's financial effect on the sponsoring hospitals. METHODS: The rural practice was established in a medically underserved area 30 miles from the sponsoring hospitals. A cost analysis of months 7-18 of operation was performed, including an analysis of charges generated at the sponsoring hospitals. Theoretical models of practice to enhance economic viability were explored. RESULTS: The 3,051 office visits fell short of expectations. These visits generated a net practice income of $18,596. Had the practice sought full payment for these visits instead of accepting Medicare assignments, the net income potential would have been $39,182. Growth of the practice until it reached the average size of a typical rural family practice (6,000 annual visits) would produce a net income of $67,113 with Medicare assignments and $103,578 if Medicare assignments were not accepted. Had the practice been a federally designated rural health clinic, a mid-level practitioner with physician supervision could have generated a net practice income of $53,640 for 3,051 visits or $138,863 for 6,000 visits. Referrals from the model clinic for laboratory work, radiology, and hospital admissions generated $9.17 in charges for the sponsoring hospitals for each dollar charged by the clinic. CONCLUSIONS: The financial viability of rural practices is adversely affected by the Medicare reimbursement system. Our model clinic had a positive economic effect on the sponsoring hospitals, suggesting that innovative collaborative sponsorship of such clinics may be mutually beneficial.

Costs and Cost Analysis↗
PubMedDate not supplied

Continuity of care and patient satisfaction in a family practice clinic.

BACKGROUND: Continuity is a tenant central to family practice. Continuity is associated with improved satisfaction in populations that can easily change providers. However, little is known about the importance of continuity where patients are assigned providers. METHODS: A pretested survey was distributed to patients of a family practice residency clinic in a military medical center for a week's period. Results were analyzed using chi2, unpaired t test, correlation matrices, and linear regression for patient satisfaction. RESULTS: The response rate was 68.3%. Responders were not more likely to be seeing their primary care provider (PCP). Regression analysis revealed that 12% of patient satisfaction was associated with long-term continuity rates, 23% by PCP satisfaction, and 17% by how easy it was to make the appointment. For high clinic users (>10 visits/year), 78% of patient satisfaction is determined by PCP satisfaction and long-term continuity rates. A subset of patients (13%) values choice of appointment time or other providers over PCP continuity. Satisfaction is not diminished in this group despite low long-term continuity (P <.05 for all results). CONCLUSIONS: Patient satisfaction is associated with continuity, especially for high clinic users. Although continuity is important, a subset of patients values the ability to see other providers and to change providers.

Ambulatory Care Facilities↗
PubMed1992

Colposcopy in family practice: pilot studies of pain prophylaxis and patient volume.

In a family practice office with volume representative of an average one-person practice, the implementation of colposcopy services was studied. During six months, 257 patients received Papanicolaou (PAP) smears. These patients represented 16.2% of the total 1,585 female patient visits for ages greater than 16. Of the 257 cytology specimens, 10.1% (26) revealed dysplasia or evidence of Human Papilloma Virus (HPV), indicating the need for colposcopic examination. Pathology reports of all biopsied cases confirmed the presence of dysplasia or HPV. These results suggest that the average family physician might reasonably anticipate about 100 colposcopy sessions per year, assuming each patient receives a diagnostic and a therapeutic colposcopic evaluation. In the course of colposcopy services in a family practice, 46 patients underwent 67 colposcopic examinations with cervical biopsy and/or cryotherapy in the office. Some patients received nonsteroidal anti-inflammatory medication 30-60 minutes before the procedure, with selection according to physician preference. All patients rated the pain experienced during the procedure on a 10-point visual-analog scale. Pain scores were significantly lower in those who received medication. Overall, patients tolerated the procedure well and there were no reported complications. Because of the possibility of such factors as the placebo effect influencing these results, a randomized, placebo-controlled, double-blind study will be needed to verify the findings.

Adolescent↗
PubMed1993

Does teaching by family physicians in the second year of medical school increase student selection of family practice residencies?

BACKGROUND AND OBJECTIVES: Most educators feel that early instruction by family physician teachers increases the probability of students selecting family practice residencies. METHODS: To examine this hypothesis, a retrospective cohort study was performed to evaluate residency selection of students who received their second-year Introduction to Clinical Medicine (ICM) teaching either from family physicians or other specialists (most commonly, internists). RESULTS: For the 971 students who could be followed to residency, 13.6% of those having family physicians as instructors and 15.7% of those having other specialists as instructors chose family practice residencies. The difference is not significant. CONCLUSION: It is probable that the effect of having a family physician as a second-year ICM instructor is not significant enough to be detected by a study of this size and is simply "washed out" by other factors. It is also possible that no positive effect of second-year teaching by family physicians on residency selection exists.

Adult↗
PubMed1979

An analysis of returning patients in family practice.

Morbidity records from eight practices participating for three years in the Virginia Family Practice Data System are analyzed with respect to two mutually exclusive groups of patients: those who return from one year to the next and those who do not return. Initially, substantial interpractice variation in patient return rates is presented, and age and sex characteristics of these patients are examined. The data indicate that approximately 40 percent of patients visiting the practice in one year return in the next, 25 percent return in each of two subsequent years, and only 12 percent return two years hence. Returning patients are found to be significantly older and more likely to be female than non-returning patients. These two groups of patients are then compared in terms of recorded morbidity and workload rates. Specific categories of problems, such as Diseases of the Circulatory System, are associated with returning patients. This paper thus presents empirical evidence which supports common assumptions concerning patients and problems seen in family practice.

Adult↗
PubMed2003

Are family practice residents able to interpret electrocardiograms?

BACKGROUND: Teaching electrocardiogram (ECG) interpretation is a recommended component of the family practice residency curriculum. Published information concerning the ECG interpretation ability of residents is sparse. This study sought to ascertain the baseline knowledge of family practice residents' ECG interpretation skills and extent of improvement after one year of training. METHODS: A 15 ECG examination was administered to 38 PG-1 and 14 upper level residents at 5 residency programs at the beginning of the academic year and to residents at the authors' program at the end of the academic year. Pre-test scores among the five programs were compared using an analysis of variance (ANOVA). Pre-test and post-test scores were compared using a paired randomization test. RESULTS: No difference was found between average scores from each site, or between the beginning and end of the academic year. Residents were more likely to misinterpret items such as myocardial infarction, myocardial ischemia, and atrial fibrillation. CONCLUSIONS: Residents in family practice have considerable deficiencies in ECG interpretation skills. Further studies are needed to determine effective ECG teaching curricula.

Analysis of Variance↗
PubMed1979

Family care in a family practice group.

A fundamental claim of family medicine is that the family physician treats the "whole" family--an ideological principle that guides undergraduate and residency education. Using archival data obtained from a random sample of 500 patients in one group of family physicians, this study analyzed the extent to which this principle is carried out in practice. Physicians trained in family practice residency programs were compared with their colleagues. Family types and marital stability were also examined. Results indicate that in only 28 percent of families (excluding single person households) were all family members seen by the same family physician. This occurred despite the high preponderance and stability of traditional nuclear families in the practice. There was no significant difference in this rate between graduates and nongraduates of approved family practice residency programs.

Adolescent↗
PubMed1993

The service-education linkage: implications for family practice residency programs and community and migrant health centers.

INTRODUCTION: Access to quality primary health care for our country's underserved populations is a challenge for both the government and physicians. The Division of Medicine, through funding priorities and other initiatives, is encouraging family practice educators to train residents and students for work in community and migrant health centers (C/MHCs) in underserved areas. The objective of this research was to study linkages between family practice residency programs and C/MHCs and determine the reasons for affiliation, disadvantages and advantages, predictors of successful linkages, and common errors in the linkage agreement. METHODS: We conducted in-depth telephone interviews with the directors of 13 of the 19 family practice residency programs identified as having linkages with C/MHCs. RESULTS: All interviewees at residency programs indicated that their programs had a mission to serve underserved patients. The most commonly cited constraining factor cited by both residency programs and C/MHCs was financial support for residents, on-site faculty, and support staff. Many programs reported that residents training at the C/MHC were able to gain a community health perspective and practice community-oriented primary care. Finally, financing the relationship involved many different approaches, ranging from the residency paying all of the salaries, to a sharing of salaries by the residency, state, and/or hospital, to C/MHC paying the salaries either through its own funds or through grant support. DISCUSSION: These data provide an assessment of the current issues that family practice residencies must address to implement service-education linkages. They provide an empirical basis to outline the steps involved in forming a linkage between a residency and a C/MHC.

Community Health Centers↗
PubMed1993

Family practice in Cuba: evolution into the 1990s.

A group of practising physicians, family practice academicians and medical students visited Cuba in 1991. The purpose of this visit was to assess the current status of the discipline of family medicine in the country. Numerous interviews were conducted with practising family physicians, Cuban medical physicians in other medical specialties, the medical school faculty, patients and officials from the Ministry of Public Health. A summary of the content of these interviews constitutes the following paper. The authors conclude that the Cubans have developed a medical care system that has its basis in family practice, and provides a model which could be emulated not only in less developed, but also in more developed countries.

Cause of Death↗
PubMed1977

A nurse practitioner in a family practice residency: role description and impact on continuity of the practitioner-patient relationship.

The nurse practitioner and physician's assistant are new health practitioners providing primary health care. When teamed with family physicians, these new health practitioners can extend patient services. Family physicians should be trained to work with new health practitioners effectively. Presented is a model where a nurse practitioner and family practice residents work as co-practitioners in a family practice unit. A nurse practitioner in this role can improve the continuity of the relationship between patient and provider in a family practice residency.

Comprehensive Health Care↗
PubMed1993

Why first-year family practice residents choose their residency programs.

BACKGROUND AND OBJECTIVES: This study identifies some of the factors that influenced program selection by first-year family practice residents. METHODS: In a national survey, 660 new first-year residents from 159 family practice programs responded to a questionnaire that asked them to cite the most important factors in choosing their program and rejecting other programs. RESULTS: The most important factors in selecting a program were location, reputation, faculty, and residents. The most important factors in deciding against other programs were location, reputation, residents, and curriculum. CONCLUSION: Our findings suggest that recruiters of first-year family practice residents need to address these factors in their recruiting efforts.

Adult↗
PubMed2000

The reflecting team: an innovative approach for teaching clinical skills to family practice residents.

BACKGROUND AND OBJECTIVES: This paper provides a description and evaluation of the reflecting team approach as a teaching method for family practice residents. We have used the reflecting team approach in our longitudinal behavioral health program for 6 years. Our purpose in using this approach is to 1) teach listening and interviewing skills, 2) teach systems-oriented psychosocial interventions, and 3) provide behavioral health consultations for patients. METHODS: A five-item, self-administered, open-ended questionnaire evaluating the reflecting team approach was administered to a sample of family practice residents. RESULTS: Completed questionnaires were received from 18 of the 22 family practice residents participating in the longitudinal behavioral health program (a response rate of 82%). Responses to the questionnaire items indicated that the residents understood the purpose of the reflecting team approach and felt that they had acquired a variety of clinical skills from the approach, including listening and interviewing skills, positive reframing of patients' problems, how to give positive feedback to promote behavioral change, and increased knowledge of psychosocial assessment procedures and treatment methods. CONCLUSIONS: The residents' responses to the questionnaire items indicated that they perceived the reflecting team approach to be a practical and useful method for learning a variety of clinical skills.

Adult↗
PubMed1979

A model for communication skills development for family practice residents.

The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.

Communication↗