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 775 records · Page 43Linked to original sources

PubMed1980

Predicting compliance with a regimen of digoxin therapy in family practice.

The ability of family physicians to predict patients' compliance with a regimen of digoxin therapy was studied by an analytic survey. Compliance was assessed by a pill count at a home visit and measurement of the serum digoxin level in a blood sample obtained at that visit. Of 74 patients 70% were found to be taking more than 80% of their pills and 86% had a therapeutic serum digoxin level. The 10 physicians were unable to predict compliance better than chance, even for the 58 patients they had known for 5 or more years. Physicians should be cautious in predicting compliance, and when they prescribe oral digoxin therapy they should monitor the patient's compliance by means of the serum digoxin levels.

Adult↗

PubMed1986

A comparison of family practice clinics and free-standing emergency centers: organizational characteristics, process of care, and patient satisfaction.

Because of the increasing popularity of free-standing emergency care centers as a source of primary care services, this cross-sectional study was conducted to compare four of them with two family practice centers that provided extended hours. A total of 2,339 patient encounters were examined with data obtained from both physicians and patients. The factors that were found to be a basis for discrimination between the two types of practice were the cost of care and the patient's satisfaction with convenience and personal attention from the physicians. The overall average costs were significantly higher for the free-standing centers ($45) as compared with the family practice clinics ($27). Convenience and time factors, including waiting time, time spent with the physician, time to get an appointment, clinic location, and out-of-pocket cost, all produced a higher level of satisfaction for the free-standing clinic patients. Conversely, the personal concern of the physician and the ability to see the same physician brought higher levels of satisfaction for the family practice clinic patients. The free-standing emergency center is clearly becoming a significant factor in the delivery of primary care with evidence to suggest that patients are willing to pay a premium for convenience.

Ambulatory Care Facilities↗

PubMedDate not supplied

Colorado family practice graduates' preparation for and practice of emergency medicine.

BACKGROUND: Family physicians provide care in emergency departments, especially in rural areas; however, no published data describe how they perceive their preparation for emergency practice. We surveyed graduates of Colorado family practice residencies concerning their emergency medicine practice, their comfort working in emergency departments, and their perceived preparation for practicing emergency medicine. METHODS: Seventy recent graduates of Colorado residencies were surveyed regarding their location, work in emergency departments, contact with emergency medical services (EMS) personnel, and perceptions about their emergency medical training. RESULTS: Forty-five percent of respondents practiced in rural settings, 33% worked in emergency departments (56% rural, 14% urban), 60% reported contact with EMS personnel (91% rural, 32% urban), 54% believed their training adequately prepared them for working in emergency departments (82% rural vs 32% urban), 63% of rural and 22% of urban respondents indicated they wanted more major trauma experience during training, 70% reported discomfort with managing trauma, and 44% were interested in a 6-month emergency medicine fellowship. CONCLUSIONS: Most respondents believed their training in emergency medicine was adequate; however, most also reported discomfort with trauma management. Improved training for family physicians who provide emergency care could include expanded trauma care opportunities, increased work with EMS personnel, and postresidency training.

Advanced Cardiac Life Support↗

PubMed2003

Treatment of hypercholesterolemia in patients with diabetes at a family practice office.

BACKGROUND: Patients with diabetes have an increased risk of developing coronary heart disease (CHD) and therefore need optimal management of hypercholesterolemia. Previous studies have shown that management of these patients remains suboptimal. OBJECTIVE: Our study aimed to determine the extent to which patients with diabetes in a family practice setting in Delaware are being managed according to national guidelines for the management of hypercholesterolemia. METHODS: Using a retrospective medical chart review, we identified all active patients with diabetes in a family practice office. We determined the percentage of patients who had a low-density lipoprotein (LDL) documented in their chart and the percentage of patients who received LDL screening within the past year. We then stratified the sample into three different categories of LDL level (< 100 mg/dl, 100-129 mg/dl, and > or = 130 mg/dl) and determined the percentage of patients who were on lipid-lowering therapy within each stratum. RESULTS: According to the medical record review, 80.30% of the active patients with diabetes had an LDL recorded in their chart. Of the patients with diabetes, 57.99% had an LDL measurement taken within the past year. Of this group, 41.03% had an LDL < 100 mg/dl, 31.41% had an LDL between 100 and 129 mg/dl, and 25.00% had an LDL > or = 130 mg/dl. Of the total number of patients with an LDL < 100 mg/dl, 53.93% were on lipid-lowering agents, while 38.18% of the patients with an LDL > or = 130 mg/dl were on lipid-lowering agents. Of the patients with an LDL measurement taken in the past year, 67.19% of those with an LDL < 100 mg/dl were on lipid-lowering medications, while 43.59% of patients with an LDL > or = 130 mg/dl were on lipid-lowering medications. CONCLUSIONS: In a Delaware family practice office, the screening rate for hyperlipidemia in patients with diabetes is similar to that found in other studies, but still leaves room for improvement. Lipid control rates are somewhat better than the rates reported in previous studies, but they are still not optimal. While many of the patients requiring lipid-lowering therapy are on these medications, a substantial minority has an LDL of < 100 mg/dl without being on medications. Although these findings may reflect patient preference to defer medications, it suggests that there is room for improvement with medical therapy.

Adult↗

PubMed1981

Teaching the behavioral science component in a family practice residency: social work role.

The article describes a social work-oriented behavioral science component within a family practice residency training program. The identified goal of teaching the behavioral science component is the development of skills in the area of interpersonal (physician-patient) relationships. To this end, a lecture series, self-awareness growth groups, and counseling experiences by residents are used. Whereas a number of disciplines deal with human interaction and behavior and are included under the "behavioral science" rubric, the paper shows the particular effectiveness of a social worker's direction in meeting the behavioral science training needs of family practice residents.

Behavioral Sciences↗

PubMedDate not supplied

Implementing pharmacy services in a family practice.

As medical groups compete for patients in the healthcare marketplace, they will continue to evaluate ways to control costs and expand services. One alternative to a traditional family practice is offered at the South Omaha Family Practice Clinic--a model group practice that includes on-site pharmacy services. Designed and maintained by the University of Nebraska College of Medicine, the group's medical and pharmacy services provide continuity of patient care through an integration of medical and prescription records.

Family Practice↗

PubMed1978

The use of epidemiologic methods in family practice.

Epidemiologic methods of research can be readily used in family practice. Since the 19th century, family physicians have used epidemiologic methods in making important contributions to the understanding of disease. Using these methods requires an organized practice including patient registers, encounter data, and detailed records. Descriptive studies can define certain characteristics that are related to disease. Case-control and cohort studies can provide evidence for the association of risk factors and disease. A stepwise outline for carrying out a study is presented.

Epidemiologic Methods↗

PubMedDate not supplied

Local anesthesia for neonatal circumcisions: are family practice residents likely to use it?

Dorsal penile nerve block with lidocaine (DPNB) is a local anesthetic technique for neonatal circumcision which is both effective and consistent with ethical concerns for infant welfare. As such, it should be included in training programs that prepare residents to care for newborns. To assess the current level of DPNB use by residents in a family practice training program and to identify attitudes and other factors that relate to use, a survey was sent to 127 residents in the Department of Family Practice and Community Health, University of Minnesota. Of the 101 respondents, 55% had used DPNB, and 17% could be characterized as high users, employing the technique for over one half of the circumcisions they performed. Residents with comprehensive understanding of the newborn's capacity to feel pain were more likely to be using DPNB than their less well-informed counterparts. Four factors were identified as predicting use: cooperation of nursery staff for the procedure, accessibility of instruction in PNB technique, belief that PNB is effective in reducing infant pain, and likelihood of parents giving consent for PNB. These results suggest strategies which may be implemented by family practice educators who wish to promote the principles and techniques of DPNB.

Anesthesia, Local↗

PubMed1977

Distribution of physicians in family practice and other medical specialties in Texas, 1969-1973: a statistical review.

This article documents distributional patterns of allopathic family practice physicians (including general practitioners) in Texas as compared with allopathic physicians in all other medical specialties in the state during the period 1969-1973, for which there are reliable data. Statistical analysis of this information shows that there was a significant difference between the growth of family practice compared to all other medical specialties in both metropolitan and nonmetropolitan counties. This study draws no conclusions that the medical needs in many of these areas are not being met, since patient travel may, to some degree, compensate for disproportionate physician distribution. There is no unanimous agreement on what constitutes an ideal ratio of physicians in any specialty to a population in so-called "medically underserved" areas.

Family Practice↗

PubMed2004

A divisional approach to enhancing research among osteopathic family practice residents.

There is an increasing demand to expose osteopathic family practice residents to research. Within the Department of Family Medicine at the University of North Texas Health Science Center at Fort Worth-Texas College of Osteopathic Medicine, the Division of Education and Research (DEAR) was developed in 1999. The primary focus of DEAR is to provide the necessary resources and knowledge for faculty members and residents to conduct research and accomplish scholarly activities. Guidelines are implemented to ensure the timeliness, efficiency, and completion of each resident's paper. The efficacy of DEAR's policies is evaluated annually through surveying the residents, tracking paper submissions to the resident director, and tracking publications and presentations. The expectation of DEAR's resident research component is full completion of a resident paper suitable for publication in a peer-reviewed journal before graduation. Initial evaluation suggests positive strides toward reaching this goal. Future successes will be determined by monitoring the next few years.

Family Practice↗

PubMedDate not supplied

A pharmacy fellowship in a family practice training program.

An evaluation of the two-year experience since the institution of the postdoctoral pharmacy fellowship in family practice has revealed the program to be a valuable one not only for the fellows completing the program but to the departments cosponsoring this experimental training program. The two individuals who have completed the program have gone to clinical practice positions. In both academic and hospital settings, the fellow gains an understanding of the philosophical basis of family medicine while at the same time gaining specialized experience in an area of interest as well as research design and implementation. The department of family practice has benefited by the provision of additional clinical pharmacy services and education. It has also enabled the department to expand its involvement in research activities.

Education, Pharmacy↗

PubMed1998

International health training in family practice residency programs.

BACKGROUND AND OBJECTIVES: This survey determined the extent of involvement in and support of international health training by family practice residency programs. METHODS: We mailed a 17-item survey about four areas of international health training (curriculum, faculty, financial support, and international health sites) to the 192 family practice residency programs that answered affirmatively to the American Academy of Family Physicians (AAFP) 1996 survey question, "Does your program offer or encourage an elective in an international setting?" RESULTS: Of the surveyed programs, 75% (144/192) responded. Fifty-four percent of programs offered some form of international health curriculum, and 15.3% (22/144) provided significant support for resident involvement in international health, defined as having 1) an international health curriculum, 2) funding support (other than paid salary while away), and 3) at least one faculty member who had done health care work in a developing country in the past 2 years. Of the responding programs, 24.3% (35/144) had none of the three criteria. The number of residents who worked in developing countries most strongly correlated with the number of faculty who have done such work in the past 2 years. Logistic regression suggested that the factors associated with a program having residents who have worked in developing countries in the past 2 years included the number of faculty who worked in developing countries in the past 2 years, the number of months of salary paid while on an international health elective, the length of time a program had offered an international health experience, and paid living expenses while at the international site. CONCLUSIONS: A wide range of support is offered for international health education by programs that are self-identified as offering or encouraging international health rotations. This survey begins to clarify the specific factors associated with placing residents in international training opportunities.

Curriculum↗

PubMed2005

Opiate dependence treatment with buprenorphine: one year's experience in a family practice residency setting.

Buprenorphine became available for office-based treatment of opiate dependence in January 2003, at which time the Underwood-Memorial Hospital Family Practice Residency Program began offering buprenorphine treatment at its family practice center. This article describes the patient selection process, outcomes, and obstacles to treatment. Patients who had a pharmaceutical benefit were much more likely to remain in treatment than those who had to pay for the medication. The authors are not aware of other residency programs currently providing buprenorphine training, and postulate reasons why family physicians in the United States have not readily adopted the office-based opiate treatment model.

Adult↗

PubMedDate not supplied

Promotion criteria for family practice residents: perceptions of program directors.

This study utilized a modified Delphi technique to identify criteria considered important in the promotion of family practice residents. A designated expert panel consisting of the directors of the family practice residency programs in the State of Texas was used as the data source for the study. The Delphi results revealed a marked degree of consensus among the state program directors for 16 of 20 criteria evaluated. The criteria identified did not define comprehensive competency areas or goals. Further studies utilizing this information to develop comprehensive goals or to evaluate a program's current policies are proposed.

Delphi Technique↗

PubMedDate not supplied

Dimensions of happiness: a qualitative study of family practice residents.

BACKGROUND: Happiness is related to both positive and negative forces. Positive factors, or happiers, that compensate for stressors in residency have only recently been recognized in a pilot study of 14 family practice residents. These happiers are positivism, the pursuit of goals, relationships, a religious belief system, and feedback. The purpose of this qualitative study was to describe happiers of residency in family practice in each postgraduate year and relate the findings to established theories on well-being. METHODS: A qualitative interview with participant observation was used to study 59 residents at four family practice residency sites. Interviews were semistructured and audiotaped. Tapes and field notes were analyzed for trends. The Faces Scale was administered as a happiness visual analog scale. RESULTS: The importance of a well-balanced lifestyle, as well as the pursuit of goals, relationships, and accentuation of the positive, were found to be happiers for all residents interviewed. Religious commitment, feedback, and a sense of control or autonomy were important to the level of happiness of more than 60 percent of residents interviewed. Feedback was more important to 1st-year residents, and a sense of control was more important to 2nd-year and 3rd-year residents. CONCLUSION: The seven happiers described in this study were similar to happiness factors reported in the social science literature. Our findings could contribute to theories of resident well-being and further the research on well-being in residency training.

Achievement↗

PubMedDate not supplied

Family practice incidence rates.

BACKGROUND: It is difficult for practicing physicians to understand the annual incidence of disease in terms that are directly relevant to their practices. A simple calculation, called the family practice incidence rate (FPIR), has been developed to assist family physicians in applying epidemiological information to their own patient population. METHODS: By multiplying the annual incidence of a disease by the practice panel size and dividing by the population, it is possible to determine the number of cases a family physician will see in 1 year. When the answer is a fraction, that fraction can be divided into 1 year to determine the number of years required to encounter one case. This formula can be adjusted for panel size, specific percentages of the practice panel and regional variations in incidence rates. RESULTS AND CONCLUSIONS: The FPIR is a convenient model to make the incidence of disease, mortality data, and demographic data immediately available to the practicing physician. Using this calculation will help physicians better understand the patient population they serve.

Data Interpretation, Statistical↗

PubMed1990

Self-reported depression profiles in chronic pain and family practice patients.

This study examined profiles of self-reported depressive symptoms in chronic pain patients (n = 51), family practice outpatients (n = 52), and controls (n = 53) who were receiving neither psychological nor medical treatment and were pain free. Subjects in the three groups were matched for age and sex. The short form of the Multiscore Depression Inventory (SMDI) was used. Chronic pain and family practice groups had similar SMDI profiles, with significant elevations on Low Energy, Pessimism, Sad Mood, and Low Self-Esteem subscales compared with controls. Although both groups of medical patients were depressed compared with control subjects, their SMDI profiles were different from those previously reported for psychiatric inpatients with a diagnosis of depression.

Adult↗

PubMed1995

Use of X-rays in family practice. A multicentre study.

Practicing physicians, faced with pressure to control health care costs, are increasingly being asked to incorporate considerations of cost into their decisions regarding the care they offer their patients. Accordingly, it is of importance to know how the money is spent. The use and cost of X-rays in family practice, and what factors influence it, is not well known. The aim of this study is to analyse the use and the cost of X-ray requests in family practice. A prospective practice study from 16 Icelandic community health centres (HC) with computerised contact data and their target populations, 12 rural and four urban, was carried out. The X-ray requests, numbers, types and cost were analysed. Patient and practice characteristics were used to assess variation in X-ray practices. A total of 5173 X-ray requests were recorded, which comprised 3.2% of all office visits. The mean number of X-ray requests was 24.7 and 14.7/1000 contacts in rural and urban HCs respectively, and 123.1/1000 inhabitants in rural HCs. The X-ray request rate per individual increased with age, but per contact it was highest among young males. Extremity and chest X-rays were the most common requests. For every 1000 individuals added to a practice population, the likelihood of having an X-ray requested decreased by 18%. The use of X-ray examinations in family practices represents approximately 17% of all ambulatory X-ray use in Iceland. The calculated cost of X-rays requested in this study was $6157/1000 inhabitants per year as of October 1993.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗