"Death talk": debating euthanasia and physician-assisted suicide in Australia.
Explore the source record for details and available documents.
Australia↗
SEARCH · PubMed Health
Results for “PHYSICIANS”
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.
American College of Physicians Ethics Manual. Part I: History of medical ethics, the physician and the patient, the physician's relationship to other physicians, the physician and society. Ad Hoc Committee on Medical Ethics, American College of Physicians.
Explore the source record for details and available documents.
Advertising↗
When a physician marries a physician: effect of physician-physician marriages on professional activities.
OBJECTIVE: To determine whether more Canadian family physicians are marrying other physicians and to examine the influence of physician-physician marriages on FPs' professional activities. DESIGN: Secondary analysis of a population survey (mailed questionnaire) using regression analysis. SETTING: Canadian family medicine. PARTICIPANTS: Family physicians who responded to the 2001 National Family Physician Workforce Survey conducted by the College of Family Physicians of Canada (CFPC) (13 088 respondents; 51.3% response rate). MAIN OUTCOME MEASURES: The main outcome measure was self-reported hours spent on professional activities during a typical week. Other information used in this analysis included marital status (currently married or not), hours spent providing dependent care each week, age (65 and older or younger than 65), sex, practice location (rural or not), and age of youngest child (younger than 6 or not). These factors were previously reported to affect amount of time spent on professional activities. Decade of graduation was used descriptively; having a physician spouse was considered a variable in the regression. RESULTS: About 86% of FPs were married; 16% of these were married to other physicians. The proportion of physician-physician marriages increased over time, mainly because male physicians increasingly married female physicians. The youngest cohort had the highest proportion of physician-physician marriages (20%). Having a physician spouse significantly reduced the hours devoted to professional practice. After taking into account the effects of other factors known to influence extent of professional activities, on average, female FPs in physician-physician marriages worked about 5 hours less weekly than other female physicians, and male FPs worked about 3 hours less weekly than other male physicians. The effect of other factors was consistent with previous reports of their influence on professional activities. CONCLUSION: These findings have implications for medical human resource planning. The cumulative effect on physicians' work time that physician-physician marriages have must be considered. Two physicians married to each other might be a marker for a couple with high discretionary income that allows them to make a lifestyle choice of reducing work time. If this is the case, reduction in professional activities is more likely to be found among FPs whose spouses can command a high salary.
Adult↗
Perceptions of the role of the physician assistant: degree of agreement between physician and physician assistant concerning activities, settings, and responsibility in primary care settings.
An investigation of the differences in the perceptions of the role of physician assistant between physicians and physician assistants in the same primary care practice was conducted. A sample of six practices (one physician and one physician assistant from each practice), obtained from six Appalachian counties in New York State, was examined. Data was collected through the administration of a questionnaire, personal interviews, and on-site activity observations. Comparisons were made for two items: Number of errors between physicians' or physician assistants' perceptions and actual observations for a specified group of 23 activities, and the number of discrepancies between physicians' and physician assistants' perceptions for the same 23 activities. Study results produced significant numbers of errors and discrepancies suggesting that certain barriers to communication exist between the physicians and physician assistants and that a substantial amount of physician-physician assistant activity interaction is necessary to ensure positive conformance of standard duties and functions to practice goals and objectives.
Attitude of Health Personnel↗
Involving physicians in TQM. To gain physician support for quality management, hospital administrators must treat physicians as customers.
The process of integrating physicians into a hospital's total quality management (TQM) program is not simple. Physicians will not view TQM as an acceptable strategy in the absence of a positive working relationship with hospital managers. Physicians must see hospital managers as colleagues who can help improve their medical practices both in efficiency and patient care. The first step in involving physicians in TQM is creating an environment that enhances physician relationships. The CEO should be actively involved with the medical staff, and senior hospital managers should work at cultivating physician relationships. Physician needs and the centrality of the physician-management relationship should enter into every management discussion. Also, managers must solicit physician feedback regularly. Managers can introduce physicians to TQM by accompanying them to off-site TQM programs for a few days. Managers should also coordinate a continuing education program at the hospital, inviting a physician to address medical staff about TQM. Physicians are more likely to respond positively to one of their peers than they would to a consultant or business manager. Managers should then invite hospital-based physicians to participate on TQM interdisciplinary teams to resolve a problem chosen by the senior medical staff. The problem should be one that promises to be a quick fix, thereby ensuring demonstrable success of TQM and allaying any doubts. After an initial demonstration of TQM's success, the cycle is repeated. A year or two later, managers should invite off-site clinicians to join interdisciplinary teams on issues important to them.
Hospital Administration↗
Physician, practice, and patient characteristics related to primary care physician physical and mental health: results from the Physician Worklife Study.
OBJECTIVE: To study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, and physical health. DATA SOURCES: Based on a survey of over 5,000 physicians nationwide. Four waves of surveys resulted in 2,325 complete responses. Elimination of ineligibles yielded a 52 percent response rate; 1,411 responses from primary care physicians were used. STUDY DESIGN: A conceptual model was tested by structural equation modeling. Physician job satisfaction and stress mediated the relationship between physician, practice, and patient characteristics as independent variables and physician physical and mental health as dependent variables. PRINCIPLE FINDINGS: The conceptual model was generally supported. Practice and, to a lesser extent, physician characteristics influenced job satisfaction, whereas only practice characteristics influenced job stress. Patient characteristics exerted little influence. Job stress powerfully influenced job satisfaction and physical and mental health among physicians. CONCLUSIONS: These findings support the notion that workplace conditions are a major determinant of physician well-being. Poor practice conditions can result in poor outcomes, which can erode quality of care and prove costly to the physician and health care organization. Fortunately, these conditions are manageable. Organizational settings that are both "physician friendly" and "family friendly" seem to result in greater well-being. These findings are particularly important as physicians are more tightly integrated into the health care system that may be less clearly under their exclusive control.
Adult↗
Professional performance of physician's assistants: a comparison of physician's assistant and physician ratings.
Physician's assistant educational programs have used surveys of their graduates as one method of evaluating educational objectives and curricula. A concern is the validity of physician's assistant self-ratings as measures of job performance. Ratings by supervising physicians have been suggested as more valid measures. In the present study ratings of physician's assistants and their supervising physicians were compared. Physician's assistants and their supervising physicians were interviewed using an interview instrument developed to cover the performance of the physician's assistant in the major activities of primary care practice. While the physicians and physician's assistants disagreed on several measures, in all cases the ratings of the physician's assistants were more conservative. Thus, the physician's assistants did not show any tendency to inflate ratings of their own performance.
Analysis of Variance↗
Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.
Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.
Attitude of Health Personnel↗
Physician religious beliefs and the physician-patient relationship: a study of devout physicians.
The purpose of this study was to determine the type and frequency of religious interactions that occur between devout physicians and their patients. Physicians identified by their peers as having religious or spiritual beliefs that were an important part of their lives were surveyed. Forty physicians responded (response rate 77%). In general, these physicians agreed that their religious beliefs have an important influence on their practice of medicine. Thirty-two percent reported having shared their beliefs with patients. Praying aloud with patients occurred with only 13% of patients, but 67% of respondents reported having done this on at least one occasion. Multivariate analysis showed the physician's religious group to be the most important determinant of sharing beliefs with patients, occurring most commonly with Protestant physicians. In this small sample of devout physicians, physician religious beliefs appear to influence the interactions between physicians and their patients.
Adult↗
Outcome study of substance impaired physicians and physician assistants under contract with North Carolina Physicians Health Program for the period 1995-2000.
The objective of this 6-year retroactive chart review is to compare outcome between chemically dependent physicians and physician assistants under contract with the North Carolina Physicians Health Program (NCPHP). Of 233 physicians 91% had a good outcome, compared to only 59% of 34 physician assistants in this sample (significant by Chi Square method, 99.99% confidence). Fifteen percent of physicians and 37 percent of physician assistants were female with basically the same outcome. Alcohol, followed by opioids, was the predominant substance used by both groups. Most subjects in both groups were between the ages of 30 and 55 with best outcome between the ages of 25-29 and the worst in those over 55. With paucity of data on physician assistants in the literature, the present study may be one of the first to single out this group and compare their recovery rates with those of physicians while receiving similar NCPHP services.
Adult↗
Physician attitudes toward physician extenders: a comparison of nurse practitioners and physician assistants.
A survey of all physicians in the Eighth District Medical Society (Western New York) was conducted in 1975 to determine physician attitudes toward employment of and task delegation to nurse practitioners. The results of this study and one other similar study of nurse practitioners are compared to results of two previous studies examining physician attitudes toward physician assistants. It appears that physicians are somewhat more willing to employ and delegate tasks to a physician's assistant. Some correlates of physician attitudes toward each of the two types of physician extenders are also compared and discussed.
Attitude of Health Personnel↗
Weekly work hours and clinical activities of Canadian family physicians: results of the 1997/98 National Family Physician Survey of the College of Family Physicians of Canada.
BACKGROUND: Health systems planning is a challenging task, exacerbated by a lack of detailed information on the role played by family physicians, as indicated by practice variations across regions and demographic characteristics. Outcome measures used in past studies of family physician practice patterns were not uniform. Furthermore, past research has generally been limited to narrowly defined geographic regions. A national study of family physician practice patterns was undertaken to allow regional-level comparisons of clinical workload and range of medical services offered. METHODS: The 1997/98 National Family Physician Survey was mailed to a sample of 5198 Canadian family physicians and general practitioners (FP/GPs); the overall response rate was 58.4% (3036 questionnaires returned, of which 3004 were analyzable). Sampling strata were based on College of Family Physicians of Canada (CFPC) membership status and regions of Canada. RESULTS: Clinical workload varied considerably across the demographic categories studied. Male physicians reported 8.9 more total weekly work hours than female physicians, but the mean number of medical and clinical services offered did not differ between the sexes. Solo practitioners reported 53.8 (95% confidence interval [CI] 52.7-55.0) total weekly work hours, whereas those practising in multidisciplinary clinics reported 45.0 (95% CI 43.2-46.8) hours. FP/GPs in the Atlantic and Prairie provinces reported 5.6 and 5.1 more weekly work hours, respectively, than the national average of 51.4 (95% CI 50.8-52.0) hours. Finally, FP/GPs who served inner-city populations reported 48.6 (95% CI 46.8-50.5) total weekly work hours, whereas those serving rural populations reported 57.0 (95% CI 54.7-59.2) hours. Mean weekly work hours were similar for all age cohorts less than 65 years. FP/GPs practising in less populated provinces and in rural areas reported the highest numbers of work hours, medical services offered and clinical procedures performed. INTERPRETATION: These data suggest significant variations in FP/GP clinical workload in relation to key demographic variables.
Adult↗
Physician may be liable for failing to disclose financial conflict of interest. Neade v. Portes.
Explore the source record for details and available documents.
Conflict of Interest↗
Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient.
Physicians' personal characteristics, their past experiences, values, attitudes, and biases can have important effects on communication with patients; being aware of these characteristics can enhance communication. Because medical training and continuing education programs rarely undertake an organized approach to promoting personal awareness, we propose a "curriculum" of 4 core topics for reflection and discussion. The topics are physicians' beliefs and attitudes, physicians' feelings and emotional responses in patient care, challenging clinical situations, and physician self-care. We present examples of organized activities that can promote physician personal awareness such as support groups, Balint groups, and discussions of meaningful experiences in medicine. Experience with these activities suggests that through enhancing personal awareness physicians can improve their clinical care and increase satisfaction with work, relationships, and themselves.
Attitude of Health Personnel↗
Case management by physician assistants and primary care physicians vs emergency physicians.
OBJECTIVES: To determine whether physician assistants' (PAs') and primary care physicians' (PCPs') case management for 5 common primary care medical problems is similar to that of emergency physicians (EPs). METHODS: An anonymous survey was used to compare PAs, PCPs, and EPs regarding intended diagnostic and treatment options for hypothetical cases of asthma, pharyngitis, cystitis, back strain, and febrile child. Published national practice guidelines were used as a comparison criterion standard where available. The participants stated that they treated all of the patients and responded to all of the cases to be included in the survey. The responses of the PA and PCP groups were compared with those of the EP group, and financial charges for care by each group were analyzed. RESULTS: The EPs tended to follow treatment guidelines closer than did other primary care specialists. The management of PCPs and PAs differed from that of EPs, as follows: [table: see text] CONCLUSION: The EPs more closely followed clinical guidelines than did the PAs and PCPs for these standardized clinical scenarios. Although the relationship of such theoretical practice to actual practice remains unknown, use of these clinical scenarios may identify intended practice patterns warranting attention.
Adult↗
Emergency physicians and physician-assisted suicide, Part II: emergency care for patients who have attempted physician-assisted suicide.
Part I of this article reviewed key terms, events, and arguments in the heated national debate regarding physician-assisted suicide (PAS). Part II of the article examines the role of emergency physicians in caring for patients who present to the emergency department after an incomplete or unsuccessful attempt at PAS. The article considers the analogous cases of emergency care for other patients who have attempted suicide and care for terminally ill patients who refuse life-sustaining treatment. Morally relevant features of these situations are identified, including the decisionmaking capacity and the choices of the patient, the opinions of the patient's family or other surrogate decisionmakers, the presenting condition and medical history of the patient, the nature of the patient's suicide attempt, and the physician's own moral convictions. The article evaluates the 3 management options: aggressive intervention to preserve life, palliative care only, and assistance in completing the suicide. It concludes with several general recommendations for addressing these situations.
Emergency Medicine↗
[Old gender patterns still used when physicians are pictured in medical journals. Male physicians are portrayed as active leaders, women physicians as listening, compassionate].
As a part of a medical student' s research project on medical socialisation, the 2002 issue of two Swedish medicaljournals, Läkartidningen and Moderna Läkare, were scrutinized regarding how male and female physicians were represented on pictures. The outward façade was mostly male; 87% of portrays of editorials pictured a man, 81% of career announcements displayed men. Authors of articles and chroniclers more often presented a female face (55%). Photos in reports showed around 60% men and 40 % women, both regarding area and number of photos. These shares corresponded well to the actual share of male and female physicians in Sweden. The content analysis of pictures, however, demonstrated gender features: men were to a much higher degree focused in leading, demonstrating and speaker positions, while women to a higher degree were portrayed as taking part in consultations or caring activities.
Career Mobility↗
Emergency physicians and physician-assisted suicide, Part I: a review of the physician-assisted suicide debate.
Physician-assisted suicide (PAS) has been one of the most hotly debated bioethics and health policy issues of the past decade. Part I of this 2-part article defines key terms in the debate, reviews the history of the debate, and articulates leading arguments for and against legalization of the practice of PAS. Part II of the article will examine the role of emergency physicians in caring for patients who present to the emergency department after an incomplete or unsuccessful attempt at PAS.
Cross-Cultural Comparison↗