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Education-practice partnerships: faculty practice as faculty development.

The importance of establishing service-education partnerships in nursing is well recognized. Many such associations will include provisions for faculty practice, ideally occurring within the context of a comprehensive program that advances clearly stated goals put forth by all participants. We describe the continuing clinical education component of faculty practice, and discuss its place within a hypothetical, broader program. Faculty practice is conceptualized as one aspect of ongoing faculty development.

Boston

General practice partnerships: till death us do part?

OBJECTIVES: To investigate applications for general practice partnership vacancies by established general practitioner principals, the reasons for changing partnerships, and the disincentives to these moves. DESIGN: Confidential postal questionnaire. SUBJECTS: Applicants to 367 general practices in the United Kingdom advertising for a new full time partner. MAIN OUTCOME MEASURES: The proportion of job applications containing at least one application from established principals, proportion of principals appointed as new partners, incentives and disincentives to changing partnership. RESULTS: Of 325 replies (89% response rate) received, 292 were suitable for further analysis. 210/241 (87%) of all applications contained some applications from at least one established principal. 12% of all applications were made by principals. 41/296 (14%) of the newly appointed partners had previously been an established principal. The main reasons for leaving the previous partnership were a desire to move locality or not getting on with previous partners. The disincentives to changing partnerships were largely financial, including the cost of the move and loss of income. CONCLUSIONS: It is possible for established principals in general practice to overcome the disincentives and to change partnerships. There did not seem to be any overall prejudice against appointing principals, in contrast to previously published views.

Career Mobility

[Differences in health care provision between 11 ENT partnership practices in 2 health insurance catchment areas].

Medical insurance organizations possess a large amount of production data from individual health care providers and from institutions. These data give insight into the type and amount of health care delivered. The number of admissions, patient days, inpatient and outpatient procedures and three specific procedures, per 100 referred patients and per 1000 insured persons, from 1986 were compared for 11 partnerships of ENT specialists located in the regions of two medical insurance organizations. The raw data were corrected for percentage of persons aged 65 years and older, the percentage of women, the referral practice of the general practitioners in the treated patient population and the number of specialists in each partnership. The differences between the partnerships with the largest and those with the smallest number of items of service amount to a factor 2.9 (admissions per 1000 insured persons) to 6.7 (septum corrections per 1000 insured persons). After introduction of the independent variables, substantial differences still exist, the lowest factor being 1.8 (hearing improvement operations per 1000 insured persons) and the highest 5.6 (outpatient procedures per 1000 insured persons). There is hardly any difference between the groups regarding a procedure with a supposedly clear indication and two procedures with a less defined indication. Further study of the causes of these differences on the individual patient level is necessary.

Catchment Area, Health

Nontraditional education for surgeons.

Some of these programs would not work in every rural (or urban) practice. A partnership practice helps considerably. The ability to step into a medical center position with patient acceptance has been important. We feel that many similar opportunities exist--we have more planned--for other surgeons, and should be utilized. Both our geographic isolation and our small medical community have given us a sense of need for continuing education that is perhaps more acute than that of the urban-based private practicing surgeon. However, one has only to look about at most university surgical grand rounds and to note the paucity of surgeons practicing in those urban communities to realize that the feeling of isolation of the rural surgeon may be a very positive and beneficial force in his continuing education.

Colorado

Professional partnerships in primary care practice.

Professional partnerships in pediatric primary care produce opportunities for blending nursing and medical roles to offer optimal health care to children and families. During the Sixth Annual Pediatric Nursing Conference, held October 4-7, 1990 in San Francisco, issues of role delineation, reimbursement or salary schedules, prescriptive authority, on-call status, malpractice coverage, and hospital privileges were discussed among a distinguished panel of PNPs and physicians.

Humans

M-I-D-D-L-E-G-R-O-U-N-D: Part II. Developing partnerships in practice.

This article describes the process for creating partnerships in nursing. It is Part II of the development of M-I-D-D-L-E-G-R-O-U-N-D, a model for the integration of nursing education and nursing service. Collaboration and community building are the activities that occur as nurses who are "Futuremakers" create the new partnership paradigm. Seven capacities (7 Cs) needed to develop these dynamic partnerships are defined. These capacities can advance caring and healing in nursing.

Communication

Surgeons in the United States. Practice characteristics.

Data on practice characteristics were obtained as part of a national questionnaire study of surgeons in the United States. These included location and organization of surgeons' practices, use of nonphysician personnel, provision of ambulatory care, other professional activities, and variables associated with work load volume. A multivariate analysis was done to examine the relation between operative work loads and various practice characteristics. The variables associated with larger operative work loads were group or partnership practice, principal office not in a hospital, more nonphysician assistants in direct contact with patients, more hospitals in which operations were regularly done, and smaller proportions of nonsurgical patients. Group or partnership practice and nonsurgical practice were found to be most strongly related to operative work load.

Ambulatory Care