SEARCH · PubMed Health

Results for “COLLEGE OF PHYSICIANS OF PHILADELPHIA”

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 109 records · Page 6Linked to original sources

PubMedDate not supplied

Use of standardised assessment scales in elderly hip fracture patients.

Standardised scales recommended by a joint working party from the Royal College of Physicians (RCP) and The British Geriatrics Society (BGS) in 1992 for the assessment of elderly hospitalised patients were employed in an elderly hip fracture population to investigate their feasibility and usefulness in this group. Patients were assessed at the time of their fracture and one, six and 12 months later. An informant was invited to provide information on behalf of patients (39%) who were classified as having significant memory and cognitive impairment (Abbreviated Mental Test score < 7) or if they had some other communication difficulty. Patients and informants found the format and content of the scales acceptable as well as the administration time of around one hour. Difficulties with the depression (Geriatric Depression Scale) and quality of life (Philadelphia Geriatric Center Morale Scale) scales were due to some patients' digressions, and the fact that little change was noted in the scores over the one-year period of follow-up questions their sensitivity. In the cohort of survivors 31% were classified as being depressed at baseline (score > 5) and this rose to 36% at one year. Ten per cent of the surviving patients were classed as dependent by the Barthel Index at the time of their fracture (score < 12) and this increased to 24% at one year. Despite exhibiting a ceiling effect, this scale was the most responsive of the scales at all time points. The social checklist highlighted important aspects for the management of hip fracture patients.

Activities of Daily Living↗

PubMed1991

To centralize or compete is not the issue at hand.

AR's November 1990 issue featured "Stripping the Myths of Merger-mania," by Frederick Thayer, Professor Emeritus, University of Pittsburgh's Graduate School of Public and International Affairs. The article is a provocative effort toward educating healthcare professionals, whose academic backgrounds have been rooted mainly to clinical and technological concerns, regarding the fundamental causes that have led to the current economic environment inside which we struggle to plot strategies to provide patient services on a more equitable basis for the majority of people. In this year's January issue, Herbert Bernstein, Professor of Economics at Drexel University's College of Business and Administration in Philadelphia responded to Thayer's experienced pondering of the why's, how's, and cumulative effect of corporate activity (mergers) on the ongoing well-being of the physical entity resulting from such stripping and learning. The March 1991 issue of AR gave vent to Thayer's subsequent rebuttal. Here, again, are thoughts from Bernstein and Thayer, offered with the intention of exposing AR readers to a perspective of the world a bit removed from acquisition or application of technology, but directly connected to the larger issues that "world leaders" and national policy makers are struggling to cope with. Underlying the thoughts of both Bernstein and Thayer is a desire to do their part to stimulate front line healthcare workers, physicians, and executive-level management to understand the forces at play in the ever-changing face of our economic structure.(ABSTRACT TRUNCATED AT 250 WORDS)

Economic Competition↗

PubMed2005

[New study on the history of anesthesiology--(11) three Japanese doctors who observed William TG Morton's ether anesthesia at the Gross Clinic in 1860].

In January of 1860 the Tokugawa Shogunate dispatched a group of Japanese mission headed by Masaoki Niimi, the first ambassador, to Washington D.C. to exchange ratification of Japan-United States treaty of commerce and amity. On May 22nd the ratification was approved. They left Washington D.C. to move to Baltimore and Philadelphia to visit various sites and institutions. The Niagara sailed from New York with the Japanese mission on board on June 30th. In Philadelphia three Japanese medical doctors visited Jefferson Medical College to observe an operation of lithotomy by Dr Samuel D Gross, professor of surgery. Ether was given by Dr William TG Morton, the man that had succeeded in the public demonstration of ether anesthesia at Massachusetts General Hospital in Boston on October 16, 1846. The doctors might have brought new information on ether anesthesia to Japan, but they only left few traces of providing the information to medical professionals in Japan.

Anesthesia, Inhalation↗

PubMed1992

Students' ratings of otolaryngology clerkship activities: the role of residents.

The present study was conducted with a sample of junior medical students at Jefferson Medical College to investigate the factors that influence students' overall satisfaction with the otolaryngology clerkship. The most important factor related to their overall satisfaction in the clerkship was their experience with residents, followed by experience with attending physicians, quality of rounds, and of lectures. The number of patients the students encountered, and number of rounds and lectures were deemed less important. Based on these findings, the authors of this paper concluded that the residents' role in teaching should be emphasized and students' satisfaction with the otolaryngology clerkship may be enhanced by developing residents' skills in teaching students.

Attitude↗

PubMed1997

Bridging the gap between managed care and academic medicine: an innovative fellowship.

Numerous challenges face academic medicine in the era of managed care. This environment is stimulating the development of innovative educational programs that can adapt to changes in the healthcare system. The U.S. Quality Algorithms Managed Care Fellowship at Jefferson Medical College is one response to these challenges. Two postresidency physicians are chosen as fellows each year. The 1-year curriculum is organized into four 3-month modules covering such subjects as biostatistics and epidemiology, medical informatics, the theory and practice of managed care, managed care finance, integrated healthcare systems, quality assessment and improvement, clinical parameters and guidelines, utilization management, and risk management. The fellowship may serve as a possible prototype for future post-graduate education.

Algorithms↗

PubMed1990

Analgesic use in the emergency department.

The relief of pain is one of the most common reasons for seeking care in an emergency department. We conducted a retrospective chart review to see whether children received analgesic treatment similar to that of adults with the same acute, painful conditions. Charts of 112 pediatric patients from the Children's Hospital of Philadelphia ED and 156 patients from the Medical College of Pennsylvania ED were reviewed. Patient ages ranged from a few months to 97 years. All patients had acute pain due to sickle cell crises (20%), lower-extremity fractures (31%), or second- or third-degree burns (49%). Hospitalization was required in 15% of cases. In the ED, 60% of patients with painful conditions received no pain medication at all. When medications were given, they were usually narcotics. Children (aged 19 years or younger) were much less likely to receive pain medications than adults (P = .001). Those less than 2 years old received analgesics less often than older children (P less than .01). Senior citizens (aged 65 years or older) received analgesics as often as other adults. On discharge from the ED, 55% of all patients had no pain medications prescribed; and children were less likely than adults to receive analgesics at discharge (P less than .001). Pediatricians and emergency physicians are reluctant to use analgesics for children in pain. The data suggest that these physicians need additional education about management of acute pain.

Adolescent↗

PubMed2001

Delivery of pediatric after-hours care by call centers: a multicenter study of parental perceptions and compliance.

BACKGROUND: Despite the rapid growth of centralized call centers to provide after-hours triage to patients of multiple providers, little is known about the perceptions of parents regarding this type of care and their compliance with triage disposition recommendations. DESIGN/METHODS: From August through September 1999, randomized samples of after-hours calls were selected each day from computerized records at 4 pediatric call centers at 1) Children's Hospital, Denver, Colorado; 2) Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; 3) Rainbow Babies and Children's Hospital, Cleveland, Ohio; and 4) All Children's Hospital, St Petersburg, Florida. All participating call centers use the same triage software. Calls were randomly selected to yield at least 250 callers with nonurgent dispositions and 100 with urgent dispositions from each site. Telephone surveys to callers were conducted by an external survey unit 3 to 7 days after the call to the call center. RESULTS: Surveys were completed for 70.5% of those sampled (N = 1561). Parents indicated they were very satisfied or satisfied with aspects of care received from 92.6% (waiting time) to 99.4% (nurse courteousness) of the time. Satisfaction did not differ by site or by recommended disposition of the index call. Most parents (65.2%) reported no preference about speaking with a physician or nonphysician for after-hours care, whereas 27.7% preferred to speak with a physician. Usually speaking with a physician during office hours (odds ratio [OR]: 1.48), feeling it was important that provider knows child's medical history (OR: 3.47), and respondent having an educational level of college graduate or higher (OR: 1.30) were significant predictors of preferring to speak with a physician. Of the 37.0% (N = 723) of parents who reported any change in their relationship with their primary provider as a result of the after-hours call center, 95.7% (N = 691) assessed the change to be positive. Reported compliance with the call center disposition recommendation was 83.3% for urgent referral, 41.0% for next day, 4.5% for visit at a later time, and 78.2% for home care. The major reason given by parents for noncompliance was reporting that they heard a different disposition (76.9% for urgent to 100% for visit at a later time). CONCLUSIONS: Parental satisfaction with pediatric call centers was uniformly high in 4 different geographic locations, and almost all parents who reported any effect on their relationship with their primary provider assessed it as positive. Compliance with recommendations for urgent evaluation or home care was relatively high but for intermediary dispositions was low. In most cases in which noncompliance occurred, parents reported hearing a different disposition. Additional study is needed to clarify whether noncompliance, especially in cases in which an urgent recommendations was made, is attributable to poor nurse communication of the recommended disposition, parental misinterpretation, or parental difference of opinion.

Community Health Services↗

PubMed1994

Primary care and nonprimary care physicians' concerns in practice and perceptions of medical school curriculum.

The purpose of the present study is to address the issue of physicians' concerns in practice and their perception of a medical school's curriculum with an emphasis on comparisons between primary and nonprimary care physicians. The sample consisted of 663 physicians who graduated from Jefferson Medical College (JMC) between 1982 and 1986, and also responded to a mailed questionnaire. Comparisons were made between physicians in primary care (n=234) and in nonprimary care (n=429) specialties on their responses regarding concerns in medical practice and evaluation of the medical school curriculum. Primary care physicians were more concerned about the time for their professional development whereas nonprimary care physicians were more concerned about an oversupply of physicians in their specialties, prospective hospital payment, and malpractice litigation. Regardless of the specialties, the physicians overall seemed very concerned about their personal time. Interpersonal skills were regarded by all respondents as an important aspect of the medical school's curriculum. The importance of psychological, social, and cultural factors in the curriculum was strongly supported by these physicians' responses, particularly among primary care and women physicians.

Attitude of Health Personnel↗

PubMedDate not supplied

Beliefs about breast cancer risk and use of postmenopausal hormone replacement therapy.

BACKGROUND: Postmenopausal hormone replacement therapy (HRT) decreases the risks of coronary heart disease and osteoporosis, but increases the risk of breast cancer. Although only 20-30% of postmenopausal women in the United States take HRT, the relationship between breast cancer risk perception and use of HRT is not known. OBJECTIVE: To assess the impact of belief that HRT increases breast cancer risk and high perceived risk of breast cancer on the use of HRT. DESIGN: Cross-sectional mailed survey. PARTICIPANTS: 189 randomly selected postmenopausal women from a general internal medicine practice in the Philadelphia area. MAIN RESULTS: Of the 268 women (67%) who returned surveys, 189 were postmenopausal; 70 (37%) were currently using HRT and 21 (11 %) had previously used HRT. Respondents' mean age was 59.6 years; 64% were Caucasian, and 33% had completed college. Fifty-nine women (33%) thought HRT increased the risk of breast cancer, 22 (12%) thought it did not, and 100 (55%) were unsure. Mean perceived lifetime risk of breast cancer was 31% (range 0%-100%). After multivariate adjustment, current use of HRT was inversely associated with age (OR 0.96 for each one-year increase, 95% CI 0.940.98), and positively associated with Caucasian race (OR 2.73, 95% CI 1.40-5.32). Use of HRT was not associated with belief that HRT increases the risk of breast cancer, breast cancer risk perception, or perceived severity of breast cancer. CONCLUSIONS: Belief that HRT increases the risk of breast cancer and high perceptions of breast cancer risk may not be important barriers to use of HRT. Efforts to improve decision making about HRT should focus on previously established barriers, such as perceptions of menopause and lack of physician discussion, rather than misconceptions about breast cancer risk.

Attitude to Health↗

PubMed2004

[William W. Cadbury and canton hospital].

William W. Cadbury M.D. was born in Philadelphia, USA and graduated from the Medical College of Pennsylvania University. It was nearly 40 years since he arrived in Canton (Guangzhou) in 1909 and left at retirement age. He taught western medicine in Canton Christian College and worked as a medical doctor in Canton Hospital, the oldest western medical hospital in the Orient. He was regarded as a famous foreign doctor and an excellent professor in internal medicine in the Republic of China. He wrote At the point of Lancet: 100 years of Canton Hospital 1835 - 1935, which recorded the achievement made by American missionary doctors, particularly the pioneers such as Peter Parker M.D. and John G. Kerr. M.D. So far the book is still an important reference for the studies on history of western medicine in China and the history of modern medical exchange between China and other countries.

China↗

PubMed1992

Impact of a quality assurance program on gastrointestinal endoscopy.

The impact of a quality assurance committee on documentation and use of gastrointestinal endoscopy was assessed. The committee, fulfilling Joint Commission on Accreditation of Healthcare Organizations criteria, performed retrospective (1984-1985) and prospective (1986-1988) reviews of all endoscopies. Criteria were developed from American College of Physicians and American Society for Gastrointestinal Endoscopy guidelines. All reviews of procedures that were questioned were returned to physicians for clarification. After reconsideration of the response, procedures were judged either justified or unjustified. There has been significant improvement in the quality of endoscopy reporting and documentation. The rate of questioned procedures decreased from 21.6% (95% confidence interval (CI), 20.1-23.1) in 1984-1985 to 9.2% (95% CI, 7.9-10.4) (P less than 0.01) in 1988. Improvement in use was reflected in the significant decrease in the rate of unjustified procedures from 8.2% (95% CI, 7.2-9.2) in 1984-1985 to 1.5% (95% CI, 1.0-2.0) (P less than 0.01) in 1988. Most importantly, this process curtailed the previously noted 10% annual increase in the number of endoscopic procedures (P less than 0.01).

Endoscopy, Gastrointestinal↗

PubMed1990

Differences in professional activities, perceptions of professional problems, and practice patterns between men and women graduates of Jefferson Medical College.

Differences between men and women graduates of one medical school in practice patterns, professional activities, and problems were investigated. A questionnaire was mailed in 1986 to 600 physicians, randomly selected from 1,102 who had graduated from Jefferson Medical College of Thomas Jefferson University between 1977 and 1981. Four hundred fifty (364 men and 86 women) responded (75%). The women were less likely than the men to be employed full-time; however, proportionately more women than men held full-time academic appointments, treated patients from low-income families, and served in underserved areas in inner cities. The women reported working fewer hours per week and having fewer patients than did the men. The women published scientific articles as often as did the men but were less likely to serve on professional committees, receive professional awards, or develop medical procedures. The women were less concerned about the oversupply of physicians and malpractice litigation. Implications of the findings for health manpower planning and practice pattern expectations are discussed.

Adult↗

PubMed1997

Barrier precautions in trauma resuscitation: real-time analysis utilizing videotape review.

Blood-borne pathogens threaten all individuals involved in emergency health care. Despite recommendations by the Centers for Disease Control and the American College of Emergency Physicians, documented compliance with universal precautions in trauma resuscitation has been poor. The purpose of this study was to determine the factors that predispose to noncompliance with barrier precautions at a level I trauma center. Videotapes of trauma resuscitations performed during 1 month (n = 66) were reviewed. Full compliance with barrier precautions was documented in 89.1% of health care workers. Of the noncompliant health care workers, 50.7% were emergency department personnel and 47.8% were first responders to the trauma resuscitation area. Barrier precaution compliance improved from 62.5% to 91.8% with prenotification of patient arrival. Immediate access to barrier equipment is essential for all potential in-hospital first responders. Prehospital communication systems should be optimized to ensure prenotification.

Blood-Borne Pathogens↗

PubMed2000

The role of the medical school in rural graduate medical education: pipeline or control valve?

Although rural-based graduate medical education is critically important in the training of competent rural family physicians, the number of physicians selecting these programs is highly dependent on what happens earlier in the pipeline, i.e., during medical school. Using the experience and outcomes research from Jefferson Medical College's Physician Short-age Area Program, as well as from published literature describing six other medical school programs with similar goals, this paper addresses the important role of these programs in substantially increasing the number of physicians interested in rural family practice. Although each of these programs differs in its structure, all contain three core features: a strong institutional mission; the targeted selection of students likely to practice in rural areas, predominantly those with rural backgrounds; and a focus on primary care, especially family practice. Outcomes show that all seven programs have been highly successful. Medical schools, therefore, can have a major impact on the number of rural physicians they produce by acting not only as a pipeline or conduit to residency programs, but also as a control valve, beginning as early as the admissions process. In order to maximize their impact on the supply and training of rural family physicians, rural residency programs should understand, support, collaborate with and help develop medical school programs whose mission is to provide rural physicians.

Career Choice↗

PubMed1991

Reexamination of relationships between students' undergraduate majors, medical school performances, and career plans at Jefferson Medical College.

A reexamination of the possible relationships between medical students' undergraduate academic majors and their medical school performances and career plans seems appropriate, given the continuing changes in the characteristics of the medical school applicant pool in the last several years. This study investigated these relationships by comparing cognitive and noncognitive characteristics of medical students who had had different undergraduate majors. The study sample consisted of 812 students who entered Jefferson Medical College between 1985 and 1988. They were classified into six categories based on their undergraduate majors: biological, chemical and physical, social and behavioral, other sciences, humanities and arts, and indeterminate majors. Results indicated that performances in the basic science component of medical education were about the same for students with different undergraduate majors. The groups had similar rates of delayed graduation, but the attrition rate was highest for students who had majored in humanities and arts. The students in undergraduate disciplines traditionally oriented toward medicine (biological, physical, and chemical sciences) were younger and had made the decision to become a physician at earlier ages than had their counterparts with undergraduate majors in social sciences and humanities. Also, the groups differed with regard to their estimates of their future incomes and plans for professional activities after graduation. Similarities concerning the students' preferred professional activities were also noticed among the groups.

Career Choice↗

PubMed2005

Board certification in obstetrics and gynecology: associations with physicians' demographics and performances during medical school.

OBJECTIVE: This study was undertaken to investigate the relationship of demographics, medical school performance, and licensing examination scores to board certification. STUDY DESIGN: A longitudinal follow-up study of graduates of Jefferson Medical College between 1968 and 1994 identified in the AMA Physicians' Professional Data (AMA-PPD) file as practicing obstetrics and gynecology in 2003. Demographics, grades, and licensing examination scores had been collected prospectively. Board certification status was obtained from the AMA-PPD in 2003. Bivariate differences were evaluated with t tests. Logistic regression was used to evaluate multivariate relationships to board certification status. RESULTS: Of 310 physicians in obstetrics and gynecology, 291 (94%) were board certified. Those without certification were more likely to be underrepresented minorities, to have been older in medical school, and to have weaker academic records. Logistic regression indicated that scores on step 2 of the United States Medical Licensing Examination were the single most important predictor of achieving board certification. Those with scores of 200 or higher were 7 times more likely to achieve certification than those below 200. CONCLUSION: Age, gender, and minority status are not independent predictors of achieving board certification. A low score on United States Medical Licensing Examination step 2 is a risk factor for not achieving certification.

Adult↗

PubMed1997

Alma Dea Morani, MD: a pioneer in plastic surgery.

Alma Dea Morani was the first female member of the American Society of Plastic and Reconstructive Surgeons. She is now retired from active practice and living in Philadelphia, but her life continues to reflect her role as a plastic surgeon. She was drawn to medicine by the Women's Medical College of Pennsylvania (now part of Allegheny University), graduating in 1931. Her love of art, which she learned from her sculptor/father, Salvatore Morani, drew her to plastic surgery. Her difficulty obtaining training in the specialty would have caused others to abandon the goal, but she pursued it with great vigor. Her career path as a plastic surgeon was diverse and challenging. She returned to the Women's Medical College to start her practice, treating the broad spectrum of problems that we all see, and rose to the rank of clinical professor of surgery. In that capacity she was a role model for a whole generation of women who, in turn, acted as mentors for many others to pursue careers in plastic surgery. Dr Morani never shied from politics, playing an international role in women's issues in health care and medical education. Throughout all of this she maintained her interest in art not only as a collector, but as an artist, creating her own works until just a few years ago. Dr Morani was the driving force behind the creation of the Morani Gallery of Art at the Medical College of Pennsylvania. This facility is the only ongoing art gallery and collection at any medical school in the United States. As a tribute to her, the chair of surgery at Allegheny University is endowed in her name. She continues to serve as an inspiration to all of us-from medical students to practicing physicians of all types-not only with her ideas, but with the realization that through active participation with the world of art we become stronger, more humane physicians. Alma Dea Morani has inspired a generation of women to pursue careers in plastic surgery. At 89 years of age she continues to serve as an inspiration to young physicians, especially women, who wish to combine the skills of a plastic surgeon with an appreciation of the role of art in the maturation of the individual.

Art↗

PubMed2006

The administration of music therapy training clinics: a descriptive study.

A two-part study was conducted to describe issues and administrative practices related to university and college affiliated music therapy training clinics. First, all 72 AMTA academic directors were surveyed in order to discover (a) which programs had a clinic, and (b) the reasons why other directors did not operate a clinic. Second, 12 survey respondents, who reported that they were involved with a training clinic, participated in in-depth interviews discussing: (a) their motivations for establishing a clinic, (b) the possible effects of a clinic on the community, (c) the individuals and groups involved in clinic operations, d) clinic space and equipment, (e) policy and procedure topics, (f) specific administrative practices related to clients and students, (g) finances, (h) research (i) quality assurance, (j) dual roles, and (k) liability issues. The administrative practices described by the interviewees varied greatly across clinics and provided a wealth of information that could be considered both useful and thought provoking for those interested in operating a music therapy clinic.

Administrative Personnel↗