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At least 829 records · Page 46Linked to original sources
PubMed1992

Reasons for contact in family practice. An Icelandic multicentre study on content of practice.

To establish data on the patient's reasons for a contact, as a part of data on content of Icelandic family practice, a prospective practice audit was made of 16 Icelandic health centres with computerized contact data from 1 January to 31 December 1988. The study comprised 16 community health centres in Iceland and their target population, 12 rural and four urban. The reasons for contact in the study group are analysed. A total of 284348 reasons for contact were analysed; 36-39% were for symptoms and 44-50% were initiated by health professionals. The latter included renewal of prescriptions, which comprised 17-18% of all reasons for contact. Musculoskeletal symptoms were the most common symptomatic complaint, 6.6-7.3% of all reasons for contact. The five most often stated symptoms were: rash, cough, cold, lower limb symptoms, and fever. A "reason for contact" record increases the understanding of the patient's presenting complaint, as well as the patient's agenda in each contact. This record gives an opportunity to follow the presenting complaint in the continuous process of care i. e. reason for contact diagnosis, management, and follow-up. We are reminded that common things are common in family practice; nevertheless more research is needed to understand the process of care.

Community Health Centers↗
PubMed1977

Developing behavioral science for a family practice residency.

The development of behavioral science in a family practice residency has first to be structured around a statement of purpose and adequate goals. These goals can only be implemented when the purely custodial function of the medical profession is rejected and the ethical responsiblity of the physician to society is allowed to direct the role innovations that must be incorporated. It is the person of the physician as a diagnostic and therapeutic tool that must be cultivated. The curriculum presented has included behavioral science conferences, a one-month behavioral science rotation, a two-month orientation program, behavioral science clinical attendings, and a personal counseling program for each resident throughout the three years of training. To be complete, such a program requires the further refinement of behavioral objectives that allow reliable evaluation and redefinition by residents and faculty.

Behavioral Sciences↗
PubMed1988

Protecting against HIV exposure in family practice.

The magnitude of the AIDS epidemic is exceeding the predictions of a short time ago. Since AIDS patients are being encountered more frequently in family practice, the possibility of accidental exposure to HIV has become a source of concern. By exercising specific precautions and by minimizing misconceptions about the epidemiology of AIDS, physicians can provide reassurance and protection to their employees in the family practice setting.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Cardiopulmonary resuscitation at a community hospital with a family practice residency.

The cardiopulmonary resuscitation (CPR) experience of a family practice residency program within a community hospital was reviewed for the period of July 1, 1979, to June 30, 1981. CPR was attempted 300 times on 242 patients experiencing cardiopulmonary arrest. The emergency department and operating room were excluded from the study. Successful resuscitation was accomplished in 145 instances (48.3 percent). Short-term survival (survival for greater than 24 hours) occurred in 111 instances (37 percent). Thirty-four (14 percent) of the 242 patients resuscitated survived to be discharged from the hospital. The most common primary diagnosis of the patients experiencing cardiac arrest was coronary heart disease. The length of time of each of the code conditions was determined, and its relationship to overall survival rates was found to be inversely proportional. Advanced age did not adversely affect the final outcome of successful attempts. This study reaffirmed the expectation that consistently good results can be obtained if the physician, staff, and resuscitation team members are properly prepared and clear role delineation exists.

Adult↗
PubMed1984

Public policy review. A ten-year progress report on a family practice residency network in northern California.

We are now beginning to be able to evaluate the results of the rapid growth of family practice residency training programs during the past decade. Because this growth has been supported by federal and state funds, it is particularly important to review these programs to measure their progress toward the public policy goals established by legislation. The University of California, Davis, School of Medicine has been an innovator and leader in training family physicians. Graduates of the UC Davis Network of Family Practice Residency Programs are locating in medically underserved areas and are helping to respond to the perceived problems of specialty and geographic maldistribution of physicians.

Area Health Education Centers↗
PubMed1989

An epidemiological follow-up survey of persistent pain sufferers in a group family practice and specialty pain clinic.

The course and prognosis of persistent pain are largely unknown. In addition, follow-up studies of chronic pain sufferers have come from specialized pain clinics and have ignored the question of how representative this special group is to the general population who suffer persistent pain. Because health care planners are assumed to require these data for projection of health care needs, it is important to determine the course of persistent pain in those persistent pain sufferers in the general population as well as those referred to a specialty clinic. An epidemiological study compared 2 groups of self-reported persistent pain sufferers from a Family Practice Clinic and a Specialty Pain Clinic over a 2 year period. All subjects reporting a persistent problem with pain at the time of the initial survey were contacted 2 years later to determine whether the initial differences between the 2 groups remained constant over time and whether there were any changes within each group over time. Despite the similarities between the study groups on multiple socioeconomic and demographic variables, the Specialty Pain Clinic group remained distinctly different from the Family Practice pain sufferers on many pain behavior and emotional variables. Thirteen percent of the persistent pain sufferers from the Pain Clinic group and 36% of the persistent pain sufferers from the Family Practice group no longer reported pain as a problem at follow-up. Of those pain sufferers from either group who continued to experience pain at 2 years follow-up, their pain became more intermittent, psychological distress factors improved, and the use of health services decreased. The implications are that persistent pain does not necessarily continue forever and that persistent pain sufferers in the general population have a better prognosis than those who are referred to a Specialty Pain Clinic. All follow-up studies need to be interpreted in light of these findings.

Chronic Disease↗
PubMedDate not supplied

Pharmacy teaching for family practice residents.

Because undergraduate training in pharmacology is insufficient preparation for prescribing drugs appropriately, comprehensive systematic education in clinical pharmacy is essential for family practice residents. A pharmacy curriculum could contribute to improved treatment of disease, decreased health care costs, decreased iatrogenicity and morbidity, lower risk of litigation, and better communication among physicians, pharmacists, and patients. The pharmacy curriculum which has been developed at the family practice residency program in Little Rock, Ark. focuses on problem-solving activities in the clinical setting, primarily utilizing problems from the residents' patient caseloads. A long-term plan of the department is to follow residents into practice in order to examine utilization of what they learned from the pharmacy curriculum.

Curriculum↗
PubMed1982

Graduate follow-up in the University of Wisconsin family practice residency programs.

Between June 30, 1973, and June 30, 1980, 100 family physicians completed their family practice residency training at the University of Wisconsin Medical School. Ninety-seven graduates completed an extensive 13-page mail survey. The primary purposes of the study were to measure the adequacy of the graduate's residency training program and to determine how well the graduates have done as family physicians. A majority of respondents considered themselves adequately prepared in most areas listed with a few noticeable exceptions. For example, 50 percent or more felt underprepared in fracture care, emergency surgery, and applying forceps for vaginal deliveries. For selected administrative and financial aspects of a practice, more than 60 percent felt underprepared. In general, the graduates were satisfied with the potential for practice growth as well as their current level of income. Regarding hospital privileges, between 85 and 93 percent of the graduates were very satisfied with the availability and extent of their privileges. Finally, all 100 graduates are board certified in family practice and at this writing none have changed into another specialty or intend to do so in the foreseeable future.

Accreditation↗
PubMed1987

Orthopaedic teaching: the practicing family doctor's perspective.

Two hundred and two family doctors in practice responded to a survey that identified orthopaedics as a surgical specialty in which they would have benefited from more training. Forty percent felt unprepared to apply casts or manage fractures. Learning objectives were either not used or used ineffectively, according to the majority of respondents. Fifty percent reported that indicating a career interest in family medicine resulted in a negative bias toward them during surgery clerkship. The results indicate the need for an increased allocation of curricular time to orthopaedics and an augmented emphasis on outpatient experiences.

Attitude of Health Personnel↗
PubMed1983

Use of the self-administered Michigan Alcoholism Screening Test in a family practice center.

This study was conducted to examine the feasibility of utilizing the self-administered Michigan Alcoholism Screening Test (MAST) in a family practice center. The main objectives of the study were to extend the scope of investigations using the self-administered MAST in outpatient settings and to consider the amount, nature, and implications of missing data. Of 207 participants, the questionnaire was fully completed by 160 (77 percent). Thirty respondents (18 percent) received positive scores (ie, 6 or higher). Results are compared with similar studies, and suggestions are offered for improving the use of the self-administered MAST in family practice settings.

Alcoholism↗
PubMed1980

Family practice in the predoctoral curriculum: a model for success.

Fifty-five percent of students who began their medical education at the University of Minnesota, Duluth, School of Medicine have elected family practice residencies. A coordinated and concentrated approach to admissions and curriculum, emphasizing family practice as an institutional goal, is described and discussed. As the national average for graduating seniors seems to have stabilized at approximately 13 percent, this approach may serve as a model for other institutions which wish to increase the number of family physicians. Family physicians are heavily involved in all aspects of the teaching program. Institutional parameters which are necessary for success are briefly discussed.

Curriculum↗
PubMedDate not supplied

Effectiveness of a clinical interviewing training program for family practice residents: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: This study evaluated the effectiveness of a clinical interviewing training program for third-year family practice trainees and determined which other factors influence residents' training in clinical communication. METHODS: This was a randomized, multicenter, educational trial involving 193 third-year family practice residents from eight centers in Spain. Centers were randomly assigned to two groups, one of which would undertake a communication skills training program and one of which would not. The program was resident centered, based on residents' practice experience, and provided structured feedback. The main outcome measures were residents' consultation behavior with six standardized patient encounters (three before and three after the training) as measured with the GATHA-RES rating scale by an observer blinded to group assignment of the residents. RESULTS: The intervention group trainees displayed marginally better communication skills at the start of the study than those in the control group. At the end of the study, trainees who had received the training program did not show better communication skills than those who had not received the training program. Factors related to the training center environment, having a teacher trained in clinical interviewing, younger age, and a longer interview duration correlated with better communication skills. CONCLUSIONS: The trial program did not appear to improve the global communication skills of trainees. This study highlights the importance of the trainee's teachers, the residency program environment, and earlier exposure to training in planning future programs to improve residents' communication skills.

Family Practice↗
PubMed1981

Growth and maturation of a model family practice: a five-year prospective study.

New medical practices go through a process of growth and maturation. In this study, a newly established model family practice was examined prospectively in order to describe the changes in the patient population and utilization patterns as the practice developed. Cross sections of the registered patient population were sampled randomly after the first and the sixth year of practice operation, and the results were analyzed. As part of the analysis, the population using the practice was examined from three points of view: those who were registered with the practice, those actually using the practice during the sample periods, and those using the practice "out-of-hours." During the five-year study period, practice volume tripled and the operation began to approach financial self-sufficiency. The characteristics of the patient population using the clinic changed markedly. The mean patient age increased, the number of welfare patients decreased, and the clinic population grew to resemble more closely the demographic profile of the surrounding area. The study proved to be very useful as a tool for examining the structure of this model family practice and evaluating the educational relevance of the patient population to the needs of the residents.

Catchment Area, Health↗
PubMedDate not supplied

Perceptions of family practice residents toward care of the elderly.

Family practice residents were surveyed to determine their perceptions of working with geriatric patients. Three areas were surveyed: residents' views of the elderly, their comparisons of the elderly with younger patients and their ideas of what it would be like to work with elderly patients. The results show that generally residents have positive views of geriatric patients. Residents see the elderly as comparing favorably with younger people. Also, they view the elderly as possessing favorable personality characteristics, such as a sense of humor, preference for independence, flexibility, and being easy to work with. Although residents are positive about working with the elderly, they do feel some ambivalence toward working in stroke-rehabilitation programs, as well as with geriatric patients who have lost contact with reality. Medical educators need to be aware of the perceptions that residents have concerning the geriatric patient, since this type of patient will in the future comprise a larger percentage of the resident's practice.

Aged↗
PubMed1990

Quality assurance for family practice trainees in the USA and the UK: too little too late?

A postal survey about opinions of quality assurance and the methods used to teach this subject was sent to all family practice course organizers in England, Wales and Scotland, and to all family practice residency directors in the USA. Opinions of quality assurance were more positive from the American responders. A wide variety of teaching methods was employed, with review of records for the quality of care more common in the USA, but trainees in the UK were more likely to participate in quality assurance, rather than merely being exposed to it. However, the proportion of trainees in either country that undertook projects was disappointingly low. The teaching of quality assurance to trainees needs to be given a higher priority in both the USA and UK.

Attitude of Health Personnel↗
PubMed2005

Is chronic widespread pain a predictor of all-cause morbidity? A 3 year prospective population based study in family practice.

OBJECTIVE: To investigate whether chronic widespread pain predicts illness seen in general practice in a 3 year followup period. METHODS: A postal questionnaire was conducted in an adult family practice population sample of 3968, and there were 2606 responders (66%). From the 2296 responders who consented to their record review, we identified 184 subjects with chronic widespread pain and assessed their outcome based on the first recorded morbidity within each of 15 categories during a 3 year followup period of computerized family practice records. Psychological distress at baseline was also measured using the Hospital Anxiety and Depression scale. RESULTS: Of the survey responders, 2089 subjects (91%) completed the full 3 year followup period. Out of the 15 main morbidity categories examined, 11 were associated with pain status at baseline. The strongest associations between chronic widespread pain at baseline and subsequent morbidity, adjusted for age, sex, and social deprivation, were for musculoskeletal (MSK) disorders (rate ratio 4.36; 95% confidence interval 3.2-5.9), accidents (2.46; 95% CI 1.2-5.1), mental health disorders (2.24; 95% CI 1.5-3.3), dermatological disorders (2.16; 95% CI 1.6-2.9), and infections (1.96; 95% CI 1.3-2.9). Controlling for psychological distress reduced the strength of associations between chronic widespread pain and future morbidity, but 9 of the 11 were still statistically significant. In the 3 year followup period, an estimated 7.7% of all non-MSK and 12.6% of all MSK morbidity consultations were related to chronic widespread pain as reported at baseline. CONCLUSION: People who report chronic widespread pain subsequently consult more frequently about non-MSK and MSK problems than people with no pain, and this is not explained by psychological distress. The overall impact on healthcare use is substantial. Our study provides more evidence for overlap and links between morbidities that may be part of a larger pathological or somatization syndrome.

Adolescent↗