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PubMed1986

Visits to selected health care practitioners: United States, 1980.

This report, based on data from the 1980 National Medical Care Utilization and Expenditure Survey, presents statistical estimates on visits to different types of practitioners by the noninstitutionalized civilian population of the United States. The report does not include dental visits, telephone visits, emergency room visits, or visits in which a physician was also seen. The practitioners whose visits are reported vary from the highly independent practitioners with doctorate degrees (opticians, chiropractors, podiatrists, and many psychologists); to the nurses, paramedics, social workers, and counselors who often provide services less independently; to the physical therapists and the laboratory, radiology, and other technicians who largely provide services under physician prescriptions or on teams headed by physicians. In general it was found that the most independent practitioners (optometrists, chiropractors, and podiatrists) tended most to provide services in their own facilities and to be paid directly by the patients or their families. Persons who visited technicians and physical therapists almost invariably saw a physician at least once during the year. Physicians were visited by 70.8 percent of the population. Persons seeing physicians averaged 4.5 visits to them during the year. There were nearly twice as many physician visits--by the survey's definition--than there were visits to all of the other types of practitioners reported on here. Nearly three-fourths of the physician visits took place in the doctors' offices, and about one-twentieth in doctors' clinics. The patient or the patient's family paid 40 percent of the charges for physician visits, and insurance and prepayment plans paid another 30 percent. Each of the remaining practitioner types is compared with all others and with physicians in terms of particular features of their practices. Following are some of the more notable findings for the respective practitioners: Nurses made more visits to the home than any other practitioner type. They also accounted for more clinic visits. More than half of the nurse visits for specific problems involved respiratory or circulatory diseases. Visits to nurses were the least expensive kind of visits reported. Most people who saw optometrists saw them only once or twice during the year. Optometry visits usually took place in the optometrist's office and usually involved eye examinations for glasses. The average visit was expensive, partly because it often included the cost of the eyeglasses. People who saw chiropractors tended to see them often during the year. Visits were usually in the chiropractor's office or clinic. The problems presented to chiropractors most often involved musculoskeletal diseases or injuries.(ABSTRACT TRUNCATED AT 400 WORDS)

Allied Health Personnel↗
PubMedDate not supplied

Consultant post prospects in medical specialties.

Consultant post prospects for Specialist Registrars (SpRs) in all the medical specialties have been analysed using the databases of the Royal College of Physicians and the Joint Committee on Higher Medical Training (JCHMT). A 'bulge' in the numbers of SpRs obtaining Certificates of Completion of Specialist Training (CCSTs) is anticipated over the next 2-3 years, but this effect will be alleviated by the increasing trend to spend extra years in research or flexible training. There are profound differences between the specialties in the ratios of SpRs holding National Training Numbers (NTNs) to consultants, and in the proportions of female SpRs, and these factors will markedly influence consultant post prospects. The outlook within most specialties is favourable, but this is critically dependent on the rate of consultant expansion over the next few years.

Female↗
PubMedDate not supplied

Attachments in public health for physicians.

Hospital-based specialist registrars in Nottingham are offered six month secondments in public health medicine. These attachments give clinicians valuable skills in public health and an opportunity to influence the development of local health service provision. Other skills gained are an understanding of the balance between health promotion and disease treatment; the management of limited resources; an appreciation of the effects of social deprivation; the chairing and preparing of committee meetings; and contact tracing of communicable diseases. We strongly recommend the experience gained from working in a lively public health department.

Education, Medical↗
PubMed2002

[Emergency care in tropical areas: status report based on surgical emergencies in Senegal].

Management of surgical emergencies in Senegal is characterized by a mismatch between supply of facilities and demand for care. The situation has been complicated by runaway urban growth. Two situations can be distinguished in rural zones and in the major city of Dakar. The common features in both locations are chronic underfunding, absence of pre-hospital emergency and rescue services, and inadequacy of health care facilities to manage emergency situations. In urban and rural areas, hospital are oversollicited, poorly designed and managed in terms of infrastructure and equipment, and understaffed in terms of surgeons and qualified paramedical personnel. The main differences between urban and rural areas involve the volume and type of surgical emergencies with a constantly increasing number of trauma emergencies in cities. Solving these problems will require a specific national plan to develop emergency care services in general. This plan will require coordination of funding, re-organisation of hospital facilities, and hiring and training of qualified personnel (surgeons and paramedical staff).

Delivery of Health Care↗