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 865 records · Page 48Linked to original sources
PubMed1989

Quality of care in family practice: does residency training make a difference?

As the proportion of physicians who enter residency training in family practice steadily increases, so does the need to evaluate the impact of their training and postgraduate education on the quality of care in their practices. We audited the practices of 120 randomly selected family physicians in Ontario, who were separated into four groups: nonmembers of the College of Family Physicians of Canada (CFPC), members of the CFPC with no certification in family medicine, certificated members without residency training in family medicine and certificated members with residency training in family medicine. The practices were assessed according to predetermined criteria for charting, procedures in periodic health examination, quality of medical care and use of indicator drugs. Generally the scores were significantly higher for CFPC members with residency training in family medicine than for those in the other groups, nonmembers having the lowest scores. Patient questionnaires indicated no difference in satisfaction with specific aspects of care between the four groups. Self-selection into residency training and CFPC membership may account for some of the results; nevertheless, the findings support the contention that residency training in family medicine should be mandatory for family physicians.

Adult↗
PubMedDate not supplied

Medical student perceptions of family practice opportunities.

This study was conducted to obtain information concerning family practice opportunities in Chicago and to compare the actual availability with students' perceptions of such opportunities. Questionnaires received from 85 hospital administrators (98% response rate) indicated that 93% of the Chicago-area hospitals had open staff positions for family physicians. Comparison data were obtained from another questionnaire completed by 201 medical students (39%). The students' average estimate of the percentage of hospitals having positions available for family physicians was 45%. This suggested that the students greatly underestimated the availability of staff positions for family physicians.

Attitude of Health Personnel↗
PubMed1998

Symptoms of depression in residents: a South Carolina Family Practice Research Consortium study.

PURPOSE: To determine correlations between residents' scores on psychological inventories and their demographics and personal histories. METHOD: The authors followed all family practice residents in South Carolina from July 1993 to January 1996. They invited the residents to take a battery of psychological inventories every July and January during the study. The inventories included the Beck Depression Inventory (BDI) and the Profile of Mood States (POMS). The participating residents also filled out personal and family history questionnaires at each test administration. RESULTS: Of the 350 residents in family practice training during the study, 284 took the BDI at least once and 280 took the POMS at least once. Cross-sectional data indicated that 3% of those taking the BDI and 7% of those taking the POMS showed significant depressive or mood-disturbance symptoms, levels similar to those found in previous studies. Analyses found correlations between residents' descriptions of poor physical or emotional health, unhappy childhoods, current high stress in training, or doubt about specialty choice and high scores on the two inventories. No such correlation was found between high inventory scores and age, sex, race, duration of training, season of the year, exercise pattern, recent life events, income, or level of indebtedness. CONCLUSIONS: Although the results of this study may not be generalizable, medical educators and those who counsel physicians during graduate training may want to take note of the correlations between certain answers to questions about personal history and higher levels of depression and mood disturbance as measured by psychological inventories.

Adult↗
PubMed1990

A knowledge assessment of combat stress reaction in Army Family Practice residents.

Combat stress reaction occurs when a soldier's ability to function effectively is impaired by overwhelming stressors in a combat environment. During recent wars, Combat stress reaction has accounted for 30% to 40% of all casualties. Army Family Physicians can expect to be assigned to frontline medical units in time of war and, therefore, should be able to accurately diagnose and treat combat stress reaction. This paper reports an investigation of the knowledge Army Family Practice residents have of combat stress reaction. The results show that Army Family Practice residents are deficient in their knowledge of combat stress reaction.

Clinical Competence↗
PubMed1990

Predictive validity of the American Board of Family Practice In-Training Examination.

Most research into the validity of graduate medical education in-training examinations has focused on construct validity and concurrent validity issues. This study examined the predictive validity of the American Board of Family Practice In-Training Examination using multivariate analysis of all U.S. family practice residents who took the certification examination in either 1987 or 1988. Results of these two certification examinations were analyzed for the cohorts of physicians who had taken in-training examinations as first-, second-, and third-year residents. Multiple regression analysis showed that the composite score, and all but one part-score, of each in-training examination were independently predictive of performance on the certification examination. This study also found that the older residents did less well on the certification exam, and that men and women each did better on selected portions of the examination. The implications of these findings for in-training examinations in other specialties and for program directors and residents are discussed.

Achievement↗
PubMed1980

Tetanus and diphtheria immune status of patients in a family practice.

Sera obtained randomly from 37 patients seen at a family practice center were evaluated for protective antibodies against tetanus and diphtheria using in vivo toxin neutralization methods. The patients' ages ranged from 1 to 99 years. Seventy-four percent and 83 percent of patients were found to have protective antitoxin titers against tetanus and diphtheria, respectively. No significant differences in immune status were detected among different sexes or races. Whereas the mean age of subjects susceptible to tetanus was significantly greater than for those with protective antibody levels, this was not the case with diphtheria. It is postulated that natural diphtheria infection may be responsible for the high degree of protection noted among older subjects surveyed. Practical as well as educational benefits that may be obtained from a study of this nature are discussed.

Adolescent↗
PubMedDate not supplied

Prevalence of multimorbidity among adults seen in family practice.

PURPOSE: There are few valid data that describe the extent of multimorbidity in primary care patients. The purpose of this study was to estimate its prevalence in family practice patients by counting the number of chronic medical conditions and using a measure that considers the severity of these conditions, the Cumulative Illness Rating Scale (CIRS). METHODS: The study was carried out in the Saguenay region (Québec, Canada) in 2003. The participation of adult patients from 21 family physicians was solicited during consecutive consultation periods. A research nurse reviewed medical records and extracted the data regarding chronic illnesses. For each chronic condition, a severity rating was determined in accordance with the CIRS scoring guidelines. RESULTS: The sample consisted of 320 men and 660 women. Overall, 9 of 10 patients had more than 1 chronic condition. The prevalence of having 2 or more medical conditions in the 18- to 44-year, 45- to 64-year, and 65-year and older age-groups was, respectively, 68%, 95%, and 99% among women and 72%, 89%, and 97% among men. The mean number of conditions and mean CIRS score also increased significantly with age. CONCLUSIONS: Whether measured by simply counting the number of conditions or using the CIRS, the prevalence of multimorbidity is quite high and increases significantly with age in both men and women. Patients with multimorbidity seen in family practice represent the rule rather than the exception.

Comorbidity↗
PubMedDate not supplied

A comparison of resident perceptions of training experience at university and community based family practice residencies.

To determine if differences exist in the perception by residents of the adequacy of training at university or community based programs, a survey was conducted of all 1987 family practice residency graduates in the United States. Of the 2,363 questionnaires mailed and reviewed by graduates, 1,583 were returned (66.8% response rate). Respondents completed the survey within approximately 18 months of completing residency training. The results indicate that overall satisfaction with training, as well as the perception of adequacy of preparation for practice, lessened with increasing university affiliation of the training program (P less than .05). The findings reported here also suggest that university based family practice residency graduates are much more likely to report being treated like "second-class citizens" by attendings and residents of other specialties. In addition, satisfaction with educational rotation experiences is less if competing residencies exist at the institution sponsoring the residency.

Attitude of Health Personnel↗
PubMed1983

Adolescent health care in family practice.

This paper describes the 12,414 health care problems of 3,657 adolescent patients visiting 12 Colorado family practices (4 rural, 3 urban, and 5 residency practices) over a one-year period. All 12 practices utilize the Family Medicine Information System, a selectively automated system for storing and analyzing medical, family, and billing data. Age-sex distribution, visiting patterns, and morbidity are described for patients between 13 and 20 years of age. The 25 most frequent adolescent diagnoses account for 74 percent of visits, and 134 diagnoses account for 95 percent of pediatric visits. Significant sex differences and differences among early, middle, and late adolescent age groups are described. All diagnostic categories are explored in detail, and comparisons are made between urban, rural, and residency practices.

Adolescent↗
PubMed1993

Remission of dysphagia in a 9-year-old treated in a family practice office setting.

This case report demonstrates the effectiveness and practicality of hypnosis when used in a family practice office setting. I used my previously established rapport to induce a trance rapidly to evaluate a 9-year-old girl who came to my office with dysphagia that developed after choking on food. Her problem was resolved after three hypnotic sessions, accomplished during routine office visits.

Child↗
PubMed1996

The prevalence of sexual harassment among female family practice residents in the United States.

The purpose of this study was to determine the prevalence of sexual harassment as defined by the AMA among female family practice residents in the United States. Of all 1,802 U.S.FP female resident physicians surveyed, a total of 916, or 51%, completed a survey of which 32% reported unwanted sexual advances, 48% reported use of sexist teaching material, 66% reported favoritism based on gender, 36% reported poor evaluation based on gender, 37% reported malicious gossip, 5.3% reported punitive measures based on gender, and 2.2% reported sexual assault during residency. Thirty two percent of respondents reporting sexual harassment experienced negative effects including poor self-esteem, depression, psychological sequelae requiring therapy, and in some cases, transferring training programs. Sexual harassment is a common occurrence among family practice residents during residency training. Further studies are needed to examine the effect of sexual harassment policies instituted by the American Graduate Council on Medical Education on the prevalence of sexual harassment in medical training since the time of this study.

Adult↗
PubMed1967

A hard look at the future of family practice.

The progressive fall in the status and numbers of general practitioners has produced a dangerous void in the field of comprehensive medical care. The Millis Commission and other national study committees have recommended that family practice be made a board-certified specialty in order to restore the status and numbers of family physicians. The scope of family practice that is envisioned, however, would be so restricted in depth as to raise serious doubts that sufficient medical graduates would be attracted to careers in this new specialty. Better training in broadly-based general or family practice-rather than a specialty board, per se-is the only realistic way to elevate status and attract more medical students to this field.

California↗
PubMed1990

Continuity of care in a family practice residency program. Impact on physician satisfaction.

One of the primary benefits of continuity of care is its influence upon patient and physician satisfaction. This prospective pilot study involved a cohort of 14 second- and third-year family practice residents and 4 full-time faculty at a community hospital-based family practice residency in Cleveland, Ohio. Rates of continuity that physicians experience were calculated using the usual provider continuity (UPC) measure of continuity, and were correlated with physician satisfaction with outpatient care using a practice satisfaction scale (PSS) developed specifically for this purpose. Residents and faculty were also asked to rank order the importance of several aspects of outpatient care, including continuity of care. The results indicate that both residents and faculty value continuity of care highly compared with other aspects of outpatient care. The average continuity rates were 59% for second-year residents, 54% for third-year residents, and 82% for faculty. The UPC continuity measure correlated highly with the PSS scores (corrected r2 = .55; P less than .001). The data support the hypothesis that continuity of care with patients is an important determinant of resident and faculty physician satisfaction with their outpatient experience.

Adolescent↗
PubMed1979

Orthopedic problems in family practice: incidence, distribution, and curricular implications.

The spectrum of orthopedic problems encountered by family physicians in everyday practice has received little study in the past. This paper presents and analyzes the incidence and distribution of orthopedic problems in general/family practice based on four sources of secondary data. These sources include the National Ambulatory Medical Care Survey, a Family Practice Service in a large military teaching hospital, a state wide study in Virginia, and two community-based family practice settings in Washington State. Orthopedic problems constitute about ten percent of all office visits in family practice. Over one half of these involve chronic, nontraumatic musculoskeletal problems. Major differences are noted in the distribution of sprains, strains, and fractures in adults and children. Fractures of the hand, foot, forearm, lower leg, and clavicle comprise between 50 and 80 percent of fractures seen in the settings under study. This kind of information should be helpful in better defining goals and methods for graduate training of family practice residents in orthopedics.

Family Practice↗
PubMed1982

Pediatric health care in family practice.

This paper describes the 32,926 health care problems of 9,117 pediatric patients visiting 12 Colorado family practices (4 rural, 3 urban, and 5 residency practices) over a one-year period. All 12 practices utilize the Family Medicine Information System (FMIS), a selectively automated system for storing and analyzing medical, family, and billing data. Age-sex distribution, visiting patterns, and morbidity are described for patients under 18 years of age. The 25 most frequent pediatric diagnoses account for 77 percent of visits, and 121 diagnoses account for 94 percent of pediatric visits. All diagnostic categories are explored in detail, and comparisons are made among urban, rural, and residency practices.

Adolescent↗
PubMed1997

Domestic violence among family practice patients in midsized and rural communities.

BACKGROUND: This study was designed to determine the prevalence and character of domestic violence among female patients at three family practice clinics (FPCs) in communities of varying sizes. METHODS: Structured interviews with 127 consecutive, consenting women were conducted in three FPCs in midwestern communities with populations of 85,000, 8000, and 3000. The main outcome measures included patient self-reports of emotional, social, physical, and sexual violence, and reasons for their clinic visit. RESULTS: Women at the clinics in the smaller communities were significantly older, reflecting their communities' demographics. Fewer women in the larger community than in the rural settings reported currently having a violent partner (12% vs 25%, P = .01). In the total sample, 46% reported violence from a previous or current partner. Emotional and social abuse were associated with moderate violence (eg, slapping and pushing), severe violence (eg, punching and kicking), and use of weapons. Sexually abused women were emotionally abused and often physically battered. Forty-six percent of currently battered women reported abuse at least once a week, and most (81%) visited their respective clinics for episodic care. CONCLUSIONS: Domestic violence is a prevalent health problem in all family practice settings. The finding that women in the larger community were less likely to be in a current battering relationship may reflect the effectiveness of local intervention programs. Because battered women present primarily for episodic care, physicians should routinely screen for battery, provide education about violence, assess the danger, review safety plans, and refer women appropriately.

Ambulatory Care Facilities↗