WorldWideScience

Sample records for general practitioners trained

  1. General practitioners as educators in adolescent health: a training evaluation.

    Science.gov (United States)

    Van de Mortel, Thea; Bird, Jennifer; Chown, Peter; Trigger, Robert; Ahern, Christine

    2016-03-22

    General practitioners play an important role in the primary care of adolescents in both community and clinical settings. Yet studies show that GPs can lack confidence, skills and knowledge in adolescent health. This study evaluates the effectiveness of an innovative training intervention on medical participants' knowledge and confidence as adolescent health educators in a school setting. 15 general practitioners, 12 general practice registrars and 18 medical students participated in an adolescent health education workshop followed by field experience in health education sessions in secondary schools. The mixed method design included a pre and post intervention survey and focus group interviews. Mean scores on the Confidence to Teach scale increased significantly (3.34 ± 0.51 to 4.09 ± 0.33) (p teaching skills especially lesson planning and design, practicing experiential teaching strategies and finding the 'sweet spot' when communicating with adolescents. Some participants reported that these skills would transfer to the practice setting. An applied training intervention that uses evidence-based, experiential teaching strategies and focuses on developing knowledge and practical teaching skills appropriate for the health education of adolescents can enhance knowledge and confidence to engage in community-based adolescent health education.

  2. Training medical students in general practice: a qualitative study among general practitioner trainers in Sri Lanka.

    Science.gov (United States)

    Ramanayake, R P J C; De Silva, A H W; Perera, D P; Sumanasekera, R D N; Athukorala, L A C L; Fernando, K A T

    2015-01-01

    Worldwide Family Medicine has gained an important place in the undergraduate medical curriculum over the last few decades and general practices have become training centers for students. Exposure to patients early in the disease process, out patient management of common problems, follow up of chronic diseases and psychosocial aspects of health and disease are educational advantages of community based training but such training could have varying impact on patients, students and trainers. This study explored the views of General Practitioner (GP) trainers on their experience in training students. This qualitative study was conducted among GP trainers of the faculty of medicine, University of Kelaniya, Sri Lanka, to explore their experience on wide range of issues related to their role as GP trainers. The interviews were recorded and transcribed verbatim. Themes expressed were identified. Altruistic reasons, self-satisfaction, self-esteem and opportunity to improve their knowledge were the motivations for their involvement in teaching. Teachers were confident of their clinical and teaching skills. They perceived that patients were willing participants of the process and benefited from it. There was a positive impact on consultation dynamics. Time pressure was the major problem and ideal number of trainees per session was two. They were willing to attend teacher training workshops to update their knowledge. GP trainers driven by altruistic reasons were willing participants of student training process. The perceived advantages of involvement of teaching for trainers and patients were an encouragement for potential trainers. University should organize training sessions for trainers which will boost their knowledge, confidence and teaching skills which will eventually benefit students.

  3. French general practitioners' prescribing high-dosage buprenorphine maintenance treatment: is the existing training (good) enough?

    Science.gov (United States)

    Feroni, Isabelle; Peretti-Watel, Patrick; Masut, Alain; Coudert, Christine; Paraponaris, Alain; Obadia, Yolande

    2005-01-01

    In France, since 1996, any general practitioner (GP) can prescribe high-dosage buprenorphine maintenance treatment (BMT) for opioid-dependent patients. The health authorities initially provided mandatory specific training, but since 1998, such training is only delivered by specialized networks and the pharmaceutical industry. Among a random sample of GPs from southeastern France (N=345), we found that many untrained GPs, as well as a significant minority of trained GPs, were likely to prescribe an ineffective dosage of buprenorphine or a potentially dangerous treatment (BMT+a short half-life benzodiazepine). These results highlight the necessity to edit clear guidelines, especially concerning situations of polyaddiction and psychiatric comorbidity, and to extend and improve BMT training in France with a renewed involvement of health authorities for quality control of such training. They even suggest that GPs' participation to specialized training sessions should become a mandatory prerequisite for prescribing BMT.

  4. Resource effects of training general practitioners in risk communication skills and shared decision making competences.

    Science.gov (United States)

    Cohen, David; Longo, M F; Hood, Kerenza; Edwards, Adrian; Elwyn, Glyn

    2004-08-01

    Involving patients more in decisions about their own care requires doctors to be trained in effective ways of communicating information and in developing competences to negotiate levels of patient involvement which are most appropriate for each case. The aim of this study was to determine the cost of such training and identify which service resource variables are subsequently affected. An explanatory cluster randomized crossover trial was carried out which involved training general practitioners (GPs) in the use of risk communication (RC) tools, shared decision making (SDM) competences or both. Continuing care by GPs of patients with one of four chronic conditions (menopausal symptoms, menorrhagia, atrial fibrillation, prostatism) was reviewed before and after training. Cost of training was assessed by prospective monitoring of resources used. Data on prescribing, referrals and investigations were collected via questionnaires to participating practitioners. Data on follow-up GP consultations were extracted from medical records. Three two-level logistic models were performed to investigate the probability of training having an effect on prescribing, referrals and investigations ordered at the review consultation. Training cost pound 1218 per practitioner which increased the cost of a consultation by pound 2.89. Training in SDM or combined with RC significantly affected the probability of a prescription being issued to women with menopausal symptoms and menorrhagia (although RC on its own had no effect) but did not significantly affect prescribing for patients with prostatism or atrial fibrillation. It did not significantly affect the probability of investigations, referrals or follow-up GP visits for any of the conditions. Unless training has a major influence on consultation length, it is unlikely to have any major impacts on cost.

  5. Variation in spirometry utilization between trained general practitioners in practices equipped with a spirometer.

    NARCIS (Netherlands)

    Poels, P.J.E.; Schermer, T.R.J.; Jacobs, A.; Akkermans, R.P.; Hartman, J.; Bottema, B.J.A.M.; Weel, C. van

    2006-01-01

    OBJECTIVE: To explore spirometry utilization among general practitioners and identify practitioner and practice-related factors associated with spirometry utilization. DESIGN: Multivariate multilevel cross-sectional analysis of a questionnaire survey. SETTING: Some 61 general practices involved in a

  6. General practitioners knowledge, practice and training requirements in relation to doping in sport.

    Science.gov (United States)

    Woods, C B; Moynihan, A

    2009-01-01

    This study examined General Practitioner's (GP) knowledge, practice and training requirements in relation to doping in sport in Ireland. All 2083 GPs on the Irish College of General Practitioners (ICGP) register received a postal questionnaire, yielding a 37% response rate (N=771, 63% male, average age 46.2 +/- 9SD, range 28-74 years). Results revealed that 14% (112) deemed their knowledge of doping agents to be good or very good, 12% (94) had completed specific training modules in doping or sport, and 24% (183) were connected with a specific sport as a team doctor/advisor. Over one in four (28%: 217) had been consulted for advice on doping in Sport, 33% (256) possessed the current list of prohibited substances, and 25% (190) knew of the Irish Sports Council's drug-testing procedures. The current initiatives to discourage doping in sport were felt to be ineffective, and although 92% (716) indicated that GPs had a role to play in the prevention of doping in sport, only 9% (66) felt adequately trained for such a role. There was overwhelming support for further training among GPs, although the most appropriate method of providing training is complex and requires strategic planning.

  7. Effectiveness of oncogenetics training on general practitioners' consultation skills: a randomized controlled trial

    NARCIS (Netherlands)

    Houwink, E.J.; Muijtjens, A.M.M.; Teeffelen, S.R. van; Henneman, L.; Rethans, J.J.; Jagt, L.E. van der; Luijk, S.J. van; Dinant, G.J.; Vleuten, C.P.M. van der; Cornel, M.C.

    2014-01-01

    PURPOSE: General practitioners are increasingly called upon to deliver genetic services and could play a key role in translating potentially life-saving advancements in oncogenetic technologies to patient care. If general practitioners are to make an effective contribution in this area, their geneti

  8. Professional training and roles of community pharmacists in malaysia: views from general medical practitioners.

    Science.gov (United States)

    Hassali, Ma; Awaisu, A; Shafie, Aa; Saeed, Ms

    2009-01-01

    This pilot study aimed to explore the perceptions of general medical practitioners (GPs) towards the professional training and roles of community pharmacists. A self-administered questionnaire was distributed to all private clinics (n=160) run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners' level of agreement using a 5-point Likert-type scale. Of 160 GPs, 80 returned the questionnaire (response rate 50%). The respondents agreed that: GPs should consider the community pharmacists' recommendations whenever there is/are any problem(s) with the prescriptions given by them (46.3%); community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%); the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%); if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients' pharmacotherapeutic outcomes (77.5%). The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.

  9. Training General Practitioners to Detect Probable Mental Disorders in Young People During Health Risk Screening.

    Science.gov (United States)

    Ambresin, Anne-Emmanuelle; Otjes, Christiaan P; Patton, George C; Sawyer, Susan M; Thuraisingam, Sharmala; English, Dallas R; Haller, Dagmar M; Sanci, Lena A

    2017-09-01

    The purpose of the study is to investigate whether a training intervention increases general practitioners' (GPs) detection sensitivity for probable mental disorders in young people. Forty general practices were randomized to an intervention (29 GPs) or comparison arm (49 GPs). Intervention GPs participated in 9 hours of interactive training on youth-friendly care, psychosocial health risk screening, and responding to risk-taking behavior with motivational interviewing approaches, followed by practice visits assisting with integration of screening processes and tools. Youth aged 14-24 years attending GPs underwent a computer-assisted telephone interview about their consultation and psychosocial health risks. Having a "probable mental disorder" was defined as either scoring high on Kessler's scale of psychological distress (K10) or self-perceived mental illness. Other definitions tested were high K10; self-perceived mental illness; and high K10 and self-perceived mental illness. Psychosocial health risk screening rates, detection sensitivity, and other accuracy parameters (specificity, positive predictive value, and negative predictive value) were estimated. GPs' detection sensitivity improved after the intervention if having probable mental disorder was defined as high K10 score and self-perceived mental illness (odds ratio: 2.81; 95% confidence interval: 1.23-6.42). There was no significant difference in sensitivity of GPs' detection for our preferred definition, high K10 or self-perceived mental illness (.37 in both; odds ratio: .93; 95% confidence interval: .47-1.83), and detection accuracy was comparable (specificity: .84 vs. .87, positive predictive values: .54 vs. .60, and negative predictive values: .72 vs. .72). Improving recognition of mental disorder among young people attending primary care is likely to require a multifaceted approach targeting young people and GPs. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc

  10. PROFESSIONAL TRAINING AND ROLES OF COMMUNITY PHARMACISTS IN MALAYSIA: VIEWS FROM GENERAL MEDICAL PRACTITIONERS

    Directory of Open Access Journals (Sweden)

    SAEED MS

    2009-01-01

    Full Text Available Aim: This pilot study aimed to explore the perceptions of general medical practitioners (GPs towards the professional training and roles of community pharmacists. Methods: A self-administered questionnaire was distributed to all private clinics (n=160 run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners’ level of agreement using a 5-point Likert-type scale. Results: Of 160 GPs, 80 returned the questionnaire (response rate 50%. The respondents agreed that: GPs should consider the community pharmacists’ recommendations whenever there is/are any problem(s with the prescriptions given by them (46.3%; community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%; the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%; if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients’ pharmacotherapeutic outcomes (77.5%. Conclusion: The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.

  11. Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels

    NARCIS (Netherlands)

    Houwink, E.J.; Muijtjens, A.M.; Teeffelen, S.R. van; Henneman, L.; Rethans, J.J.; Jacobi, F.; Jagt, L. van der; Stirbu, I.; Luijk, S.J. van; Stumpel, C.T.; Meijers-Heijboer, H.E.; Vleuten, C.P.M. van der; Cornel, M.C; Dinant, G.J.

    2015-01-01

    General practitioners (GPs) are increasingly called upon to identify patients at risk for hereditary cancers, and their genetic competencies need to be enhanced. This article gives an overview of a research project on how to build effective educational modules on genetics, assessed by randomized con

  12. Oral cancer--current knowledge, practices and implications for training among an Irish general medical practitioner cohort.

    LENUS (Irish Health Repository)

    Ni Riordain, Richeal

    2009-11-01

    This study investigated the current knowledge and practices of general medical practitioners (GMPs) in Ireland regarding the examination of the oral cavity and the detection of oral malignancy and the training they had received at both undergraduate and postgraduate level and since commencing in practice. A questionnaire survey of GMPs in Ireland was conducted. One hundred and fifty four (65.3%) of the practitioners reported regularly examining the oral mucosa of their patients. Almost half of these (n=68) further qualified this response by stating that they only examined the oral mucosa if the patient reported pain in this area or if the patient specifically requested an oral examination for some reason. Eighty one (34.3%) practitioners surveyed felt confident in their ability to detect oral malignancies with the remaining two thirds unsure of whether they would be able to detect oral cancer. There was a significant association between the undergraduate and postgraduate teaching on examination of the oral cavity and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=4.811, p<0.05]. A statistically significant association was also found between the undergraduate and postgraduate teaching on the diagnosis of oral malignant disease and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=6.194, p<0.05]. In conclusion the level of knowledge of Irish general medical practitioners needs to be addressed with appropriate initiatives both at undergraduate level and via CME.

  13. Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels.

    Science.gov (United States)

    Houwink, Elisa J F; Muijtjens, Arno M M; van Teeffelen, Sarah R; Henneman, Lidewij; Rethans, Jan Joost; Jacobi, Florijn; van der Jagt, Liesbeth; Stirbu, Irina; van Luijk, Scheltus J; Stumpel, Connie T R M; Meijers-Heijboer, Hanne E; van der Vleuten, Cees; Cornel, Martina C; Dinant, Geert Jan

    2015-01-01

    General practitioners (GPs) are increasingly called upon to identify patients at risk for hereditary cancers, and their genetic competencies need to be enhanced. This article gives an overview of a research project on how to build effective educational modules on genetics, assessed by randomized controlled trials (RCTs), reflecting the prioritized educational needs of primary care physicians. It also reports on an ongoing study to investigate long-term increase in genetic consultation skills (1-year follow-up) and interest in and satisfaction with a supportive website on genetics among GPs. Three oncogenetics modules were developed: an online Continuing Professional Development (G-eCPD) module, a live genetic CPD module, and a "GP and genetics" website (huisartsengenetica.nl) providing further genetics information applicable in daily practice. Three assessments to evaluate the effectiveness (1-year follow-up) of the oncogenetic modules were designed: 1.An online questionnaire on self-reported genetic competencies and changes in referral behaviour, 2.Referral rates from GPs to clinical genetics centres and 3.Satisfaction questionnaire and visitor count analytics of supportive genetics website. The setting was Primary care in the Netherlands and three groups of study participants were included in the reported studies:. Assessment 1. 168 GPs responded to an email invitation and were randomly assigned to an intervention or control group, evaluating the G-eCPD module (n = 80) or the live module (n = 88). Assessment 2. Referral rates by GPs were requested from the clinical genetics centres, in the northern and southern parts of the Netherlands (Amsterdam and Maastricht), for the two years before (2010 [n = 2510] and 2011 [n = 2940]) and the year after (2012 [n = 2875]) launch of the oncogenetics CPD modules and the website. Assessment 3. Participants of the website evaluation were all recruited online. When they visited the website during the month of February 2013, a

  14. Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels.

    Directory of Open Access Journals (Sweden)

    Elisa J F Houwink

    Full Text Available General practitioners (GPs are increasingly called upon to identify patients at risk for hereditary cancers, and their genetic competencies need to be enhanced. This article gives an overview of a research project on how to build effective educational modules on genetics, assessed by randomized controlled trials (RCTs, reflecting the prioritized educational needs of primary care physicians. It also reports on an ongoing study to investigate long-term increase in genetic consultation skills (1-year follow-up and interest in and satisfaction with a supportive website on genetics among GPs. Three oncogenetics modules were developed: an online Continuing Professional Development (G-eCPD module, a live genetic CPD module, and a "GP and genetics" website (huisartsengenetica.nl providing further genetics information applicable in daily practice. Three assessments to evaluate the effectiveness (1-year follow-up of the oncogenetic modules were designed: 1.An online questionnaire on self-reported genetic competencies and changes in referral behaviour, 2.Referral rates from GPs to clinical genetics centres and 3.Satisfaction questionnaire and visitor count analytics of supportive genetics website. The setting was Primary care in the Netherlands and three groups of study participants were included in the reported studies:. Assessment 1. 168 GPs responded to an email invitation and were randomly assigned to an intervention or control group, evaluating the G-eCPD module (n = 80 or the live module (n = 88. Assessment 2. Referral rates by GPs were requested from the clinical genetics centres, in the northern and southern parts of the Netherlands (Amsterdam and Maastricht, for the two years before (2010 [n = 2510] and 2011 [n = 2940] and the year after (2012 [n = 2875] launch of the oncogenetics CPD modules and the website. Assessment 3. Participants of the website evaluation were all recruited online. When they visited the website during the month of February

  15. services in nigeria: perception of general practitioners

    African Journals Online (AJOL)

    Departments of *Radiology and **General Medical Practice. ... Aim: To determine General Practitioners' perceptions of factors influencing patient's access to ... Health insurance and subsidized services as well as training of personnel are ...

  16. Effectiveness of the palliative care 'Availability, Current issues and Anticipation' (ACA) communication training programme for general practitioners on patient outcomes: a controlled trial.

    Science.gov (United States)

    Slort, Willemjan; Blankenstein, Annette H; Schweitzer, Bart P M; Knol, Dirk L; van der Horst, Henriëtte E; Aaronson, Neil K; Deliens, Luc

    2014-09-01

    Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients' quality of life. Little is known about the effect of training general practitioners in palliative care-specific communication. We hypothesized that palliative care patients of general practitioners exposed to the 'Availability, Current issues and Anticipation' communication training programme would report better outcomes than patients of control general practitioners. To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes. In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire-III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. ISRCTN56722368. General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands. Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire-III and Availability, Current issues and Anticipation Scale. General practitioner participation in the Availability, Current issues and Anticipation training programme did not have a measurable effect on any of the outcomes investigated. Patients reported high levels of

  17. Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

    NARCIS (Netherlands)

    Slort, W.; Blankenstein, A.H.; Schweitzer, B.P.M.; Knol, D.L.; van der Horst, H.E.; Aaronson, N.K.; Deliens, L.

    2014-01-01

    Background: Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients’ quality of life. Little is known about the effect of training general practitioners in palliative care-specific communication. We

  18. Pediatric dentistry for the general practitioner: satisfying the need for additional education and training opportunities.

    Science.gov (United States)

    Stewart, Ray E; Sanger, Roger G

    2014-11-01

    The Pediatric Oral Health Access Program is a joint project of the California Dental Association and the California Society of Pediatric Dentistry. The results have been remarkable in terms of the number of underserved children who have received oral health services. What is less certain is the number of general dentists who, as a result of the training, have been able and willing to provide comprehensive care to more and younger children.

  19. A survey of ENT experience in South West Peninsula general practitioner trainees: how can post-graduate ENT training be improved?

    Science.gov (United States)

    Easto, R H; Reddy, V

    2016-10-01

    To assess how much ENT experience regional general practitioner trainees received, both in their undergraduate and post-graduate training, and to establish if trainees felt they required further ENT training to manage ENT complaints. An online survey was emailed to general practitioner trainees in Cornwall and Devon. Of 200 general practitioner trainees, 121 (60.5 per cent) responded to the survey. Of these respondents, 95.9 per cent felt ENT experience was important as a general practitioner; however, 59.5 per cent had no ENT experience in their post-graduate training. Sixty-five per cent of trainees had not had any formal ENT teaching since leaving medical school; however, 93.4 per cent would attend a 1-day course if offered the opportunity locally. Finally, 75.8 per cent of trainees would have liked an ENT post during their post-graduate training. Further ENT training is required for doctors in general practitioner training schemes to aid improvement of patient care. The most logical way to enhance ENT training in a post-graduate setting is through up-to-date courses held locally with a faculty made up of experts working within the specialty.

  20. Effects of general practitioner training and family support services on the care of home-dwelling dementia patients - Results of a controlled cluster-randomized study

    Directory of Open Access Journals (Sweden)

    Wunder Sonja

    2010-11-01

    Full Text Available Abstract Background More than 90% of dementia patients are cared for by their general practitioners, who are decisively involved in the diagnosis, therapy and recommendation of support services. Objective: To test whether special training of general practitioners alters the care of dementia patients through their systematic recommendation of caregiver counseling and support groups. Method 129 general practitioners enrolled 390 dementia patients and their informal caregivers in a prospective, three-arm cluster-randomized 2-year study. Arm A constituted usual care, in Arm B and C support groups and caregiver counseling (in Arm B one year after baseline, in Arm C at baseline were recommended by the general practitioners. The general practitioners received arm-specific training. Diagnostic and therapeutic behavior of physicians was recorded at baseline. Informal caregivers were questioned in follow-up after 2 years about the utilization of support services. Results The diagnostic behavior of the general practitioners conforms to relevant guidelines. The procedure in newly-diagnosed patients does not differ from previously diagnosed patients with the exception of the rate of referral to a specialist. About one-third of the newly-diagnosed dementia patients are given an anti-dementia drug. The utilization of support groups and counseling increased five- and fourfold, respectively. Utilization of other support services remained low ( Conclusion Trained general practitioners usually act in conformity with guidelines with respect to diagnosing dementia, and partly in conformity with the guidelines with respect to recommended drug therapy. Recommendations of support services for informal caregivers by the general practitioner are successful. They result in a marked increase in the utilization rate for the recommended services compared to offers which are not recommended by the general practitioner. Trial registration ISRCTN68329593

  1. Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study.

    Science.gov (United States)

    van der Biezen, Mieke; Derckx, Emmy; Wensing, Michel; Laurant, Miranda

    2017-02-07

    Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation. A qualitative study was conducted in 2014 in which 7 managers of out-of-hours primary care services and 32 GPs who owned a general practice were interviewed. Three main topic areas were covered in the interviews: the decision-making process in the organisation, considerations and arguments to train and employ a PA/NP, and the tasks and responsibilities of a PA/NP. Employment of PAs/NPs in out-of-hours services was intended to substitute care for minor ailments in order to decrease GPs' caseload or to increase service capacity. Mangers formulated long-term planning and role definitions when changing workforce skill mix. Lastly, out-of-hours services experienced difficulties with creating team support among their members regarding the employment of PAs/NPs. In general practices during office hours, GPs indented both substitution and supplementation for minor ailments and/or target populations through changing the skill mix. Supplementation was aimed at improving quality of care and extending the range of services to patients. The decision-making in general practices was accompanied with little planning and role definition. The willingness to employ PAs/NPs was highly influenced by an employees' motivation to start the master's programme and GPs' prior experience with PAs/NPs. Knowledge about

  2. The discussion of the general practitioner training path%全科医生培养路径探讨

    Institute of Scientific and Technical Information of China (English)

    谢建平; 杜勇; 朱亚梅

    2011-01-01

    以医学本科与专业学位贯通的新学制,通过合理整合课程体系,强化临床实践,创新考核和管理模式,建立和实施规范的住院医师培训制度,以高等医学院校为主导培养高起点全科医生,为医改的顺利推进提供合格的全科医师人才支撑.%The new educational system integrating both medical undergraduate and professional degrees,by integrating the curriculum system rationally,strengthening the clinical practice,innovating the assessment and management mode,establishes and enforces normative resident physician training system to cultivate high-starting point general practitioners led by medical colleges and provide qualified general practitioners,for the purpose of supporting the health reform successfully.

  3. Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme.

    Science.gov (United States)

    Detering, Karen; Silvester, William; Corke, Charlie; Milnes, Sharyn; Fullam, Rachael; Lewis, Virginia; Renton, Jodie

    2014-09-01

    To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training. Training provided to metropolitan and rural settings in Victoria, Australia. 148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia. The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation. The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials. 69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 -0.08). There was a significant improvement (ptraining, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly. A short multimodal interactive education programme improves doctors' confidence with ACP and performance on an ACP patient e-simulation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Does training general practitioners result in more shared decision making during consultations?

    OpenAIRE

    Sanders, A.R.J.; Bensing, J.M.; Essed, M.A.L.U.; Magnée, T.; de Wit, N.J.; Verhaak, P.F.M.

    2016-01-01

    Objective: We conducted a clustered randomised controlled trial to study the effects of shared decision making (SDM) on patient recovery. This study aims to determine whether GPs trained in SDM and reinforcing patients’ treatment expectations showed more trained behaviour during their consultations than untrained GPs. Methods: We compared 86 consultations conducted by 23 trained GPs with 89 consultations completed by 19 untrained GPs. The primary outcomes were SDM, as measured by the OPTION s...

  5. Does training general practitioners result in more shared decision making during consultations?

    NARCIS (Netherlands)

    Sanders, A.R.J.; Bensing, J.M.; Essed, M.A.L.U.; Magnée, T.; Wit, N.J. de; Verhaak, P.F.M.

    2016-01-01

    Objective: We conducted a clustered randomised controlled trial to study the effects of shared decision making (SDM) on patient recovery. This study aims to determine whether GPs trained in SDM and reinforcing patients’ treatment expectations showed more trained behaviour during their consultations

  6. Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study

    NARCIS (Netherlands)

    Biezen, M.G. van der; Derckx, E.; Wensing, M.; Laurant, M.G.

    2017-01-01

    BACKGROUND: Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Phy

  7. Resource effects of training general practitioners in risk communication skills and shared decision making competences.

    NARCIS (Netherlands)

    Cohen, D.; Longo, M.F.; Hood, K.; Edwards, A.; Elwyn, G.

    2004-01-01

    RATIONALE, AIMS AND OBJECTIVES: Involving patients more in decisions about their own care requires doctors to be trained in effective ways of communicating information and in developing competences to negotiate levels of patient involvement which are most appropriate for each case. The aim of this

  8. Ways of Improving the Training of Interns Pediatricians and General Practitioners — Family Physicians in «Pediatrics» Discipline

    Directory of Open Access Journals (Sweden)

    S.A. Mokiia-Serbina

    2015-10-01

    Full Text Available Graduates of medical schools having sufficient theoretical and practical skills often have difficulty in communicating with patients — children and their parents, as well as with colleagues. Objective: improving the efficiency of the educational process in the training of interns pediatricians and general practitioners — family physicians in «Pediatrics» course. Methods of the study: theoretical analysis of gathered experience. Results and discussion. During internship at the department, there are used seminars-discussions, seminars — training conferences, seminars — round tables that allows you to work out the tactics of speech, methods of discussion, reasoning of judgments, review, assessment, analysis. Interns most of the time must participate in the examination of a sick child, discussions of the results, conversations with parents. Clinical analysis of patients should be carried out using the method of structured group discussion when each intern can express his views. Interns are involved in scientific work, speak at scientific conferences. The department created a series of ambulatory pediatrics, -during which the intern talks to a child, his parents and he must to conciliate them, to inspire confidence and to prove himself as a specialist. During this course, special attention is paid to the psychological component of medical trai-ning. Clas-ses are conducted by assistant pediatrician, a graduate majoring in «Practical Psychology». Conclusions. The use of interactive teaching methods at different stages of the educational process contributes not only to improvement of theoretical activity, but also the formation in interns of professional qualities of clinical and scientific thinking, competence in the construction and development of interpersonal relations, humanism.

  9. Informal and formal learning of general practitioners

    NARCIS (Netherlands)

    Spaan, Nadia Roos; Dekker, Anne R. J.; van der Velden, Alike W.; de Groot, Esther

    2016-01-01

    Purpose The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach To obtain insight in

  10. Informal and Formal Learning of General Practitioners

    Science.gov (United States)

    Spaan, Nadia Roos; Dekker, Anne R. J.; van der Velden, Alike W.; de Groot, Esther

    2016-01-01

    Purpose: The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach: To obtain insight in various learning processes, semi-structured…

  11. Informal and formal learning of general practitioners

    NARCIS (Netherlands)

    Spaan, Nadia Roos; Dekker, Anne R. J.; van der Velden, Alike W.; de Groot, Esther

    2016-01-01

    Purpose The purpose of this study is to understand the influence of formal learning from a web-based training and informal (workplace) learning afterwards on the behaviour of general practitioners (GPs) with respect to prescription of antibiotics. Design/methodology/approach To obtain insight in var

  12. Burnout contagion among general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.

    2001-01-01

    This study used a representative sample of 507 general practitioners (GPs) to test the hypothesis that burnout is contagious. Following a two-dimensional conceptualization of burnout, it is assumed that burnout is comprised of emotional exhaustion and negative attitudes (i.e., depersonalization and

  13. General practitioners' demand and evaluation for their own post training%全科医师对自身岗位培训的需求和评价

    Institute of Scientific and Technical Information of China (English)

    谢朝辉; 顾利; 傅丽东; 姜梅

    2014-01-01

    Objective To explore the post training needs,training content,training mode and the advantages and disadvantages of the existing training from the general practitioner perspective,in order to provide reasonable suggestions for the management institutions to improve the quality and effect of the post training for all general practitioners.Methods In October,2013 a questionnaire survey was conducted to 197 family physicians for their post training needs,training content and training mode.According to the interview outline,an in-depth individual interview was conducted to 20 leaders and general practitioners from the community health service center in Beijing Xicheng District on the advantages and disadvantages of general medical training.All survey information databases were established using FoxPro 6.0 software and double entry.Package was statistically analyzed with SPSS 19.0 statistical software,qualitative data using rate to represent; interviews with text descriptions,coding classification analysis.Results More than 70% of general practitioners had the demand for strengthening the training of the clinical medicine,the knowledge of humanities and social sciences as well as clinical research methods,but the demand for the training of general medical theory and basic medicine was small,only accounting for 22.50% general practitioners.More than 90.00% of general practitioners were in favor of targeted flexible training methods.More than 85.00% of general practitioners believed that existing training teachers' teaching abilities were very good,and they agreed to open general practitioner training project in medical colleges and universities.The surveyed physicians also made some criticism about too many training departments,low training quality,too many training programs,and training content repetition etc..Conclusion According to the general medical post training needs,human and scientific research of targeted training should be increased by using case

  14. An evaluation of a training placement in general practice for paramedic practitioner students: improving patient-centred care through greater interprofessional understanding and supporting the development of autonomous practitioners.

    Science.gov (United States)

    Ruston, Annmarie; Tavabie, Abdol

    2011-01-01

    To report the extent to which the placement of paramedic practitioner students (PPSs) in accredited general practice (GP) training practices supported their development as autonomous, patient-centred practitioners and fostered interprofessional learning. A case study method was used. Sources of data included semi-structured telephone interviews (eight PPSs, eight GP trainers), an online end of placement survey and placement and assessment documentation. Interview data were transcribed and analysed using the constant comparative method. Accredited training practices in South East England. All respondents were positive that the placement provided a high-quality interprofessional learning environment which provided PPSs with learning opportunities based on assessed need, the support of experienced trainers and access to a wide range of patients and learning situations. The placement enabled PPSs to acquire the appropriate skills, knowledge and understanding to act as autonomous, patient-centred practitioners. The placement provides a sound model for expanding the skills of paramedic practitioners in order to meet the increasing demands for patient-centred, community based health care. It provided them with the skills to treat patients closer to home rather than automatically transporting them to hospital.

  15. Qualitative evaluation of general practitioner training program as viewed by graduates from Shiraz, Fasa and Jahrom Medical Universities

    Directory of Open Access Journals (Sweden)

    FATEMEH SHAHIDI

    2015-07-01

    Full Text Available Introduction: The majority of countries have brought the quality of higher education into focus in the past few years. They have tried to improve the quality of their own higher education. The studies show that Iranian Universities are not at an accepted level in terms of quality. They have encountered several problems which have diminished their quality level. This study aimed at assessing the quality of medical education program as viewed by general practitioners graduated from Shiraz, Fasa and Jahrom Medical Universities. Methods: This is a cross-sectional study. 215 subjects were selected based on a census of all the general practitioners graduated from Shiraz, Fasa and Jahrom Universities during 2011- 2013. The questionnaire used for collecting the data was that of the Association of Graduates from American Medical Colleges. The collected data were then analyzed using SPSS 14 through which such descriptive and bivariate statistics as percentage, means, Standard Deviation and ANOVA were used. The level of significance was set to 0.05. Results: The questionnaire return rate was 97%. As to the graduates’ preclinical experiences, five indices were studied which were assessed as “average” in graduates’ views. However, with respect to their clinical experiences five indices were equally studied, among which such indices as “Communication” were evaluated as “desirable” in view of the graduates from the very three universities. On the contrary, the quality of clinical experiences and technological skills was evaluated as “almost weak”; furthermore, the integration of basic science with required clinical experience was also considered “weak”. Conclusion: It seems essential to set up an annual assessment of general practitioner education program and a review of the medical education program in Iran based on the global medical advancement and international standards.

  16. Group supervision for general practitioners

    DEFF Research Database (Denmark)

    Galina Nielsen, Helena; Sofie Davidsen, Annette; Dalsted, Rikke;

    2013-01-01

    AIM: Group supervision is a sparsely researched method for professional development in general practice. The aim of this study was to explore general practitioners' (GPs') experiences of the benefits of group supervision for improving the treatment of mental disorders. METHODS: One long...... considered important prerequisites for disclosing and discussing professional problems. CONCLUSION: The results of this study indicate that participation in a supervision group can be beneficial for maintaining and developing GPs' skills in dealing with patients with mental health problems. Group supervision......-established supervision group was studied closely for six months by observing the group sessions, and by interviewing GPs and their supervisors, individually and collectively. The interviews were recorded digitally and transcribed verbatim. The data were analysed using systematic text condensation. RESULTS: The GPs found...

  17. The effects of initial participation motivations on learning engagement in transition training for future general practitioners in rural China: perceived deterrents as mediator

    Directory of Open Access Journals (Sweden)

    Guan-yu Cui

    2016-06-01

    Full Text Available Background: For the shortage of high-quality general practitioners (GPs in China's rural areas, Chinese government has taken steps to encourage rural specialists to participate in transition training for future GPs. Specialists’ initial participation motivations and their perceived deterrents during training may play important roles for their learning engagement in the transition training. This study aimed at revealing the relationships among the variables of initial participation motivations, perceived deterrents in training, and learning engagement. Methods: A questionnaire survey was used in this study. A total of 156 rural specialists who participated in transition training for future GPs filled out the questionnaire, which consisted of the measurements of initial participation motivations, perceived deterrents, and learning engagement in training. The data about specialists’ demographic variables were collected at the same time. Results: The variance of initial escape/stimulations motivation significantly predicted the variance of learning engagement through the full mediating role of perceived deterrents in training. In addition, initial educational preparation motivations predicted the variance of learning engagement directly. Conclusions: Specialists’ initial participation motivations and perceived deterrents in training played important roles for learning engagement in the transition training.

  18. [MODERN EDUCATIONAL TECHNOLOGY MASTERING PRACTICAL SKILLS OF GENERAL PRACTITIONERS].

    Science.gov (United States)

    Kovalchuk, L I; Prokopchuk, Y V; Naydyonova, O V

    2015-01-01

    The article presents the experience of postgraduate training of general practitioners--family medicine. Identified current trends, forms and methods of pedagogical innovations that enhance the quality of learning and mastering the practical skills of primary professionals providing care.

  19. Feedback-Training für Lehrärzte in der Allgemeinmedizin [Feedback training for general practitioners involved in teaching

    Directory of Open Access Journals (Sweden)

    Engeser, Peter

    2010-02-01

    Full Text Available [english] Background: Ever since the last amendment to the German Medical Licensing Act took effect in 2002, medical students may complete four months of the Practical Year (PY in general practices. Formative feedback between the teaching general practitioner (GP and the PY student is a key element in creating a learning environment. GPs involved in teaching therefore need further education in giving feedback.Methods: A 4-hour feedback training session for GPs involved in teaching which used standardized patients and students was developed and tested in a pilot study. In role plays, GPs experienced feedback situations. Using an evaluation questionnaire, changes in self-perceived feedback skills were assessed (familiarity of feedback rules, preparation for giving feedback to PY students, possibilities to improve communication skills in doctor–patient situations.Results: Sixteen GPs who were involved or interested in PY teaching participated in the feedback training program. Afterwards, participants said they felt more comfortable in giving formative feedback and more assured in their communication skills. The confidence in their own feedback improved, especially by taking the student’s part in the role plays. An exercise between a standardized patient and a standardized stubborn student was a challenge, but proved to be extremely useful.Conclusion: The opinions of the participating GPs to the feedback training underscore its importance. Therefore, we recommend integrating such a feedback training program into the education of GPs involved in teaching.[german] Hintergrund: Seit der letzten Novelle der Approbationsordnung 2002 besteht die Möglichkeit, ein Tertial des Praktischen Jahres (PJ in Hausarztpraxen zu absolvieren. Konstruktives Feedback zwischen Arzt und PJ-Studenten ist dabei ein zentrales Element in der Gestaltung des Lernumfeldes in der Arztpraxis. Es bedarf dahingehend einer Ausbildung der in die Lehre involvierten

  20. Existentially Oriented Training for Mental Health Practitioners

    Science.gov (United States)

    Goldberg, Carl

    1976-01-01

    The author presents an overview of the role of existentialism in the training of counselors and mental health practitioners. Exercises and skill development techniques are also presented for existentially oriented training of psychotherapists, using a workshop format. (HLM)

  1. 全科医师规范化培训的探索与实践%Exploration and practice in standardized training to general practitioners

    Institute of Scientific and Technical Information of China (English)

    李一梅; 陈力; 缪李丽; 何芸芳; 刘北忠; 龚放; 刘静; 谢波

    2012-01-01

    As a general practitioner's standardized pilot training base of the health ministry, the outhors strain clinical teachers and improve their teaching level through many ways, such as short-term training for general practice and community health service, popularizing general medical knowledge and its teaching method through our hospital newspaper, discussion activities in teaching and research section of general practice, general diagnosis and treatment in community health service center, etc. We have improved the quality of standardized training to general medical residents, through mending of clinical training plan and strengthening of humanistic quality education, such as increasing the number of common case required in learning, add specifications on oncology and geriatrics training, taking part in activities sponsored by the party, the communist youth league or the labor union, visiting human attractions and listening to sociological lecture given by well-known medical experts, etc. Our experience may be a reference to standardized training of general practitioners developed widely in our country.%作为卫生部全科医师规范化培训试点基地,笔者通过多途径开展临床师资培训,如全科医学与社区卫生服务短期师资培训、院报宣传全科医学临床带教知识、全科医学教研室活动、社区卫生服务中心全科诊疗等,提高了临床师资的带教水平;通过改进临床培训方案及加强人文素质培养,如增加常见病的培训病例数、添加对肿瘤科和老年病科实践的具体要求,以及让学员参与党、团、工会组织的学习与活动、参与业务管理部门组织的医疗社会活动、参观人文景点、聆听知名医学专家的人文社会学讲座等,提高了全科医师规范化培训质量,对广泛开展全科医师规范化培训具有一定的借鉴意义.

  2. [The general practitioner and insomnia].

    Science.gov (United States)

    Cambron, L; Bruwier, G; De Bock, I; Poirrier, R

    2006-01-01

    A complaint of insomnia has to be analysed, and differentiated from hypochondria and, overall, from hypersomnia. Once confirmed and assessed as acute or chronic, it is often considered a disorder of hyperarousal, that is an imbalance between a central nervous system activating and a central nervous system inhibiting system with subcontinuous overflow from the former. An acute insomnia is less than one month of duration. As a disease, insomnia has to be categorized as a secondary or a primary disorder. Thereafter, it remains to assess the extent of social, psychological and economical interactions. These factors intervene as consequences or perpetuating factors. The capacity to assess the whole situation is really the great strength of the general practitioner who, more than anybody else, is on home ground. Laboratory findings and specialist examination come only as supporting evidence for causal links. A polysomnography realized in a sleep disorder center provides data reinforcing or correcting the diagnosis. From a sound assessment of the disease, the treatment has to be deduced by following a rigorous reasoning, devoid of guilty feelings as they are suggested to patients by mass-media talking, as well as freed from fashionable non medical practices. Today, we know that chronic insomnia is a disease with potential severe consequences and that it does not heal spontaneously.

  3. Increasing the general level of academic capacity in general practice: introducing mandatory research training for general practitioner trainees through a participatory research process

    DEFF Research Database (Denmark)

    Tulinius, Anne-Charlotte; Nielsen, Anni Brit Sternhagen; Hansen, Lars Jørgen

    2012-01-01

    skills, and through the development and implementation of the mandatory programme to gradually empower the GP community to achieve academic capacity by creating a link between the GP researchers and the GP training community. This was done by developing a faculty, giving teaching skills to GP academics......, and research skills to GP clinicians; and creating an awareness of the potential benefits of critical appraisal in training GP surgeries. METHODS: Development and implementation of a faculty and a programme through a participatory action research-inspired project, with process evaluation from the beginning...... of the planning phase. RESULTS: From 2006 to 2009, we built a teaching faculty of 25 teachers among clinical GPs and GP academics; developed the training programme; and delivered the programme to 95 GP trainees. Some of the GP trainees later showed an interest in more substantial research projects, and GP...

  4. General Practitioner Antimicrobial Stewardship Programme Study (GAPS)

    DEFF Research Database (Denmark)

    Avent, Minyon L; Hansen, Malene Plejdrup; Gilks, Charles;

    2016-01-01

    BACKGROUND: There is a strong link between antibiotic consumption and the rate of antibiotic resistance. In Australia, the vast majority of antibiotics are prescribed by general practitioners, and the most common indication is for acute respiratory infections. The aim of this study is to assess...... have previously been demonstrated to be effective at reducing antibiotic prescribing for acute respiratory infections, are: delayed prescribing; patient decision aids; communication training; commitment to a practice prescribing policy for antibiotics; patient information leaflet; and near patient...... testing with C-reactive protein. In addition, two sub-studies are nested in the main study: (1) point prevalence estimation carriage of bacterial upper respiratory pathogens in practice staff and asymptomatic patients; (2) feasibility of direct measures of antibiotic resistance by nose/throat swabbing...

  5. Orthodontic First Aid for General Dental Practitioners.

    Science.gov (United States)

    Sodipo, Ibukunoluwa; Birdsall, Joanne

    2016-06-01

    Orthodontic emergencies occasionally arise and although they can cause discomfort to the patient, they can usually be stabilized by a general dentist and then followed up by the orthodontist. CPD/Clinical Relevance: Patients undergoing orthodontic treatment may initially present to their general dental practitioner with an orthodontic emergency as opposed to their orthodontist. It is therefore important that general dental practitioners are aware of common orthodontic emergencies and their management.

  6. Preventing burnout among general practitioners: is there a possible route?

    DEFF Research Database (Denmark)

    Nielsen, Helena G.; Tulinius, C.

    2009-01-01

    Stress and burnout among general practitioners (GPs) is a serious problem. Some authors suggest supervision groups or Balint groups as a means of preventing burnout and others address how to treat the condition. This paper reports a case study of a supervision group for Danish GPs which, as well...... as training reflective practice, focuses specifically on the prevention of burnout. The concept of compassion fatigue is extended to cover the circumstances reported by some practitioners in supervision Udgivelsesdato: 2009/9...

  7. Demand for general practitioner and internist services.

    Science.gov (United States)

    Guzick, D S

    1978-01-01

    Demand equations for general-practitioner and internist visits were estimated from 1970 CHAS-NORC survey data on health-service utilization and expenditure. Because a large proportion of respondents reported zero visits, observations were grouped according to cross-classified independent variables and regression analyses were performed using group means as data. The results showed significant differences between demand equations for general-practitioner visits and those for internist visits. Of potential importance was an apparent substitution of internists for general practitioners as ability to pay (income or insurance coverage) increased. Own-price elasticities were low for both general practitioners and internists but were even lower for the latter (0.1 to 0.02) than the former (0.2 to 0.3). The demand for services of the two specialties also differed with respect to disability days, age, sex, residence, and race. PMID:738894

  8. Usefulness of a virtual community of practice and web 2.0 tools for general practice training: experiences and expectations of general practitioner registrars and supervisors.

    Science.gov (United States)

    Barnett, Stephen; Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

    2013-01-01

    General practice training is a community of practice in which novices and experts share knowledge. However, there are barriers to knowledge sharing for general practioner (GP) registrars, including geographic and workplace isolation. Virtual communities of practice (VCoP) can be effective in overcoming these barriers using social media tools. The present study examined the perceived usefulness, features and barriers to implementing a VCoP for GP training. Following a survey study of GP registrars and supervisors on VCoP feasibility, a qualitative telephone interview study was undertaken within a regional training provider. Participants with the highest Internet usage in the survey study were selected. Two researchers worked independently conducting thematic analysis using manual coding of transcriptions, later discussing themes until agreement was reached. Seven GP registrars and three GP supervisors participated in the study (average age 38.2 years). Themes emerged regarding professional isolation, potential of social media tools to provide peer support and improve knowledge sharing, and barriers to usage, including time, access and skills. Frequent Internet-using GP registrars and supervisors perceive a VCoP for GP training as a useful tool to overcome professional isolation through improved knowledge sharing. Given that professional isolation can lead to decreased rural work and reduced hours, a successful VCoP may have a positive outcome on the rural medical workforce.

  9. General Practitioner Knowledge Levels About Circumcision

    Directory of Open Access Journals (Sweden)

    Levent Cankorkmaz

    2011-09-01

    Full Text Available Objective: This study was carried out to investigate knowledge levels of general practitioners and their thoughts about circumcision in Middle Anatolia.Materials and Methods: This descriptive and cross-sectional study was carried out with 247 general practitioners working in Sivas. A questionnaire was prepared by the authors using previous reports. Questionnaires were sent to subjects by post. One hundred and seventy eight general practitioners (57 women, 121 men responded and were included in the study. For statistical analysis, Chi-square test was used and p<0.05 value was accepted as significant.Results: 42.1% of subjects believed that circumcision should be performed between 2 and 6 years of age. 2.2% of subjects declared that circumcision could be done at home and 7.3% believed that the location of the operation is not important. 9.6% of subjects believed that the person who performs the circumcision does not have to be a doctor. 21.3% of subjects believed that circumcision could be performed without anesthesia during the newborn period because of undeveloped pain sensation. Conclusion: This study demonstrated that general practitioners, who are the most easily accessible health staff for information about health, do not have updated information about the way to perform circumcision and its necessity. Therefore, it is concluded that education programs about circumcision for general practitioners must be continued and updated.

  10. What are the characteristics of the competent general practitioner trainer?

    NARCIS (Netherlands)

    Boendermaker, PM; Schuling, J; Meyboom-de Jong, B; Zwierstra, RP; Metz, JCM

    2000-01-01

    Background. Increasing attention is being given to the training of doctors to become teachers. This does not apply only to the schooling of teachers in undergraduate medical education: at the postgraduate level, general practitioner trainers (GP-trainers) receive special schooling to prepare them fo

  11. General Practitioners and Involuntary Admission

    DEFF Research Database (Denmark)

    Jepsen, Britta; Lomborg, Kirsten; Engberg, Marianne

    2010-01-01

    in involuntary admissions. Setting: General practice, Aarhus, Denmark. Method: One focus group interview and six individual interviews were conducted with 13 Danish GPs, who had recently sectioned one of their own patients. Results: GPs experienced stress and found the admission procedure time consuming....... They felt that sectioning patients was unpleasant, and felt nervous, but experienced relief and professional satisfaction if things went well. The GPs experienced the doctor-patient relationship to be at risk, but also reported that it could be improved. GPs felt that they were not taken seriously...... by the psychiatric system. Conclusion: The unpleasant experiences and induced feelings resulting from involuntary admissions reflect an undesirable and stressful working environment....

  12. [The Dutch College of General Practitioners' practice guideline "Dizziness"; reaction from a general practitioner's perspective

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The Dutch College of General Practitioners' practice guideline entitled 'Dizziness' concerns a complaint experienced by many people, yet it provides few scientific data to support the recommendations. The standard does, however, provide the general practitioner with some concrete advice: the diagnos

  13. General practitioners and their learning styles.

    Science.gov (United States)

    Lewis, A P; Bolden, K J

    1989-05-01

    Continuing medical education sessions are often poorly attended by general practitioners. One reason may be that these traditionally consist of lectures by hospital consultants with a strong theoretical bias which may have little relevance to the learning needs of general practitioners. To compare the learning styles of teachers and learners in general practice, learning style questionnaires were administered to 50 hospital clinical tutors, 78 general practitioner trainers, 63 trainees and 47 non-trainer principals. The questionnaire covered four different learning preferences: activist, reflector, theorist and pragmatist. The findings showed that the learning styles of hospital tutors and general practitioner trainers were statistically significantly different to those of non-trainer principals and trainees. The tutors and trainers scored much higher on theorist styles and to a lesser extent on reflector and pragmatist styles. There were no significant differences on activist scores. Since teachers tend to teach in their preferred learning style, which may not match the style of the recipients, these findings have implications for continuing medical education in general practice. These implications are discussed.

  14. Prescribing behavior of general practitioners : Competition matters!

    NARCIS (Netherlands)

    Schaumans, C.B.C.

    Background General Practitioners (GP) have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives I investigate whether GPs prescribe more units when confronted with more competition. As

  15. Violence against General Practitioners in Turkey

    Science.gov (United States)

    Aydin, Berna; Kartal, Mehtap; Midik, Ozlem; Buyukakkus, Alper

    2009-01-01

    We aimed to determine the violence against general practitioners (GPs) through their suggestions on its cause and prevention. This is a descriptive cross-sectional study based on self-administered questionnaire answered by a convenience study population consisting of 522 GPs between November and December 2006. Of the participating GPs, 82.8%…

  16. Health care innovation: Working with General Practitioners

    Directory of Open Access Journals (Sweden)

    Moyez Jiwa

    2013-01-01

    Full Text Available The development of innovations for clinical practice warrants active engagement of clinicians in the research process. This requires attention to factors that serve as incentive to participate. The explanation for the success of factors that encourage practitioners to participate in research can be found in sources of satisfaction and dissatisfaction with clinical practice. It is also important to consider intrinsic incentives such as common and troublesome clinical presentations that are related to workload or unsatisfactory clinical encounters. This review will consider each of these factors and suggest ways in which clinicians, especially general practitioners, may be invited to assist on research projects.

  17. 湖南省全科医生转岗培训效果评价%Position Transition Training for General Practitioners in Hunan Province

    Institute of Scientific and Technical Information of China (English)

    李君; 晏强; 谭晓东; 贺晓华; 方亦兵

    2012-01-01

    Objective To evaluate the effect of position transition training for general practitioners ( GPs ) in Hunan Province. Methods A survey was conducted among GPs who had participated in position transition training programs in 2010 in six randomly selected training bases of Hunan Province. Totally 420 questionnaire copies were distributed and 398 valid copies were collected. Results The subjects' sex ratio was 2. 06 : 1 ( male: female ), average age ( 34. 8 ±11. 2 ) years old, and average work experience ( 13. 0 ±6. 7 ) years. The proportion of assistant doctor, resident doctor, chief physician and above was 52.0% , 35.2% , and 12. 8% , respectively. The proportion of subjects with secondary technical diploma, junior college degree, and bachelor's degree was 16. 8% , 56. 8% , and 26. 4% , respectively. The proportion of full - time trainee and part -time trainee was 44. 2% and 55. 8% respectively. The average economic loss during the training program was ( 7 274. 7 ± 632. 9 ) yuan RMB. The subjects were good at clinical knowledge and skills, but poor at preventive healthcare knowledge and skills and auxiliary examination results. Conclusion Position transition training policies and measures, trainee selection criteria, training base construction, and teaching management should be improved and enhanced.%目的 评价湖南省全科医生转岗培训工作效果,为今后全科医生培养提供政策参考.方法 随机抽取6个全科医生转岗培训基地,对2010年度的培训学员进行整群抽样调查,发放问卷420份,回收有效问卷398份.结果 学员男女性别比为2.06:1,平均年龄(34.8±11.2)岁,平均工作年限(13.0±6.7)年;职称结构:助理医师占52.0%,执业医师占35.2%,主治以上职称医师占12.8%;学历结构:中专占16.8%,大专占56.8%,本科占26.4%.全脱产参与培训者占44.2%,半脱产参与培训者占55.8%;培训期间平均经济损失为(7 274.7±632.9)元.学员对临床知识技能的掌握情况较好,预

  18. Training Conservation Practitioners to be Better Decision Makers

    Directory of Open Access Journals (Sweden)

    Fred A. Johnson

    2015-06-01

    Full Text Available Traditional conservation curricula and training typically emphasizes only one part of systematic decision making (i.e., the science, at the expense of preparing conservation practitioners with critical skills in values-setting, working with decision makers and stakeholders, and effective problem framing. In this article we describe how the application of decision science is relevant to conservation problems and suggest how current and future conservation practitioners can be trained to be better decision makers. Though decision-analytic approaches vary considerably, they all involve: (1 properly formulating the decision problem; (2 specifying feasible alternative actions; and (3 selecting criteria for evaluating potential outcomes. Two approaches are available for providing training in decision science, with each serving different needs. Formal education is useful for providing simple, well-defined problems that allow demonstrations of the structure, axioms and general characteristics of a decision-analytic approach. In contrast, practical training can offer complex, realistic decision problems requiring more careful structuring and analysis than those used for formal training purposes. Ultimately, the kinds and degree of training necessary depend on the role conservation practitioners play in a decision-making process. Those attempting to facilitate decision-making processes will need advanced training in both technical aspects of decision science and in facilitation techniques, as well as opportunities to apprentice under decision analysts/consultants. Our primary goal should be an attempt to ingrain a discipline for applying clarity of thought to all decisions.

  19. [Hyperkalemia - what the general practitioner must know].

    Science.gov (United States)

    Schnyder, Aurelia; Hüsler, Carina; Binet, Isabelle

    2015-03-25

    Hyperkalemia can be a challenge for the general practitioner as it can prove to be benign as well as life-threatening. From a diagnostic point of view, four possibilities have to be differenciated: a pre-analytical cause, potassium release through cell lysis, a potassium shift, a reduced renal excretion of potassium. The first differential diagnosis can often be carried out by a thorough medical history, in particular the medication intake. Also, the first clinical and laboratory investigations can take place at the general practitioner's clinic. If the hyperkalemia proves to be a true hyperkalemia or cannot be explained by poly-medication and known diseases of the patient, not yet identified renal, endocrine or cardiac diseases should be searched for. If a serious condition is identified as the cause of hyperkalemia the patient should be referred to a specialized clinic.

  20. Do general medical practitioners examine injured runners?

    DEFF Research Database (Denmark)

    Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

    2017-01-01

    BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

  1. Consumer preferences for general practitioner services.

    Science.gov (United States)

    Morrison, Mark; Murphy, Tom; Nalder, Craig

    2003-01-01

    This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

  2. 全科医师规范化培训学员科研能力的培养与对策%The cultivation and strategy of scientific research capacity on general practitioner standardization training

    Institute of Scientific and Technical Information of China (English)

    俞婧; 王捷; 马瑾; 武云

    2015-01-01

    针对当前全科医师规范化培训学员科研能力培养比较薄弱的现状,阐述了科研能力培养对全科医学发展及全科医师个人培养的重要性,通过分析各种途径培养科研素质的能力,探讨增强科研意识的作用,以期达到帮助全科医师规范化培训学员更好从事基层医疗和公共卫生工作的效果.%To state the importance of scientific research capability and general practitioners training for the poor scientific innovation conditions of general practitioner standardization training by the analysis of several ways to improve the scientific research capacity and the probe of the impact on strengthening the consciousness of scientific research to help general practitioner to better work in the areas of primary care and public health.

  3. General dental practitioners and hearing impairment.

    Science.gov (United States)

    Messano, Giuseppe Alessio; Petti, Stefano

    2012-10-01

    Hearing impairment (HI) remains a problem among dentists Hearing loss at speech frequencies was recently reported among dentists and dental hygienists. This study aimed to investigate prevalence and factors associated with perceived HI among dentists. In 2009-2010, 100 general dental practitioners (GDPs) and 115 general (medical) practitioners (GPs) (mean ages, 43.7 and 44.4 years) from Rome (Italy), who commenced practice ≥ 10 years ago, were interviewed on a series of occupation- and recreation-related HI risk factors and on HI-associated symptoms (tinnitus, sensation of fullness, hypoacusis). Prevalence of presumptive HI (≥ 1 symptom perceived during workdays and weekends) was assessed and factors associated with presumptive HI were investigated. Prevalence was 30.0% (95% confidence interval, 21.0-39.0%) and 14.8% (95% confidence interval, 8.3-21.3%) among GDPs and GPs, respectively. Occupation (GDP vs. GP), family history of hypoacusis, hypertension, ear diseases and smoking were significantly associated with presumptive HI. Within GDPs alone, significant associations were found for frequent use of ultrasonic scalers, use of dental turbines aged≥1 year and prosthodontics as prevalent specialty. GDPs experienced HI risk than GPs. Such a risk was not generalized to all dentists, but was specific for those who frequently used noisy equipment (aged turbines, ultrasonic scalers) during their daily practice. GDPs with 10 or more years of practice who routinely use potentially noisy equipment, could be at risk of HI. In order to prevent such condition, daily maintenance and periodical replacement of dental instruments is recommended. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. General practitioners' perceptions of COPD treatment

    DEFF Research Database (Denmark)

    Molin, Katrine Rutkær; Egerod, Ingrid; Staun Valentiner, Laura

    2016-01-01

    BACKGROUND: In Denmark, the treatment of COPD is mainly managed by general practitioners (GPs). Pulmonary rehabilitation (PR) is available to patients with COPD in the local community by GP referral, but in practice, many patients do not participate in rehabilitation. The aim of our study...... was to explore 1) GPs' perceptions of their role and responsibility in the rehabilitation of patients with COPD, and 2) GPs' perceptions of how patients manage their COPD. METHODS: The study was based on a qualitative design with semi-structured key-informant interviews with GPs. Investigator triangulation...... the resources to discuss rehabilitation and follow up on individual plans. CONCLUSION: Our study suggested a potential self-reinforcing problem with the treatment of COPD being mainly focused on medication rather than on PR. Neither GPs nor patients used a proactive approach. Further, GPs were not fully...

  5. [Cataract surgery - essentials for the general practitioner].

    Science.gov (United States)

    Amstutz, Ch; Thiel, M A; Kaufmann, Claude

    2010-08-11

    Age-related cataracts are mainly caused by life-long accumulation of oxidative stress on the lens fibres. Symptoms include reduced visual acuity, requiring more light for reading, and glare. The only treatment that provides a cure for cataracts is surgery. Phacoemulsification represents the preferred method of lens removal. It involves fragmentation of the lens using ultrasound and insertion of an artificial intraocular lens. The preoperative assessment the general practitioner provides to surgeon and anesthesia team has an important share in the low complication rate of the procedure in the event of co-existing systemic disease. Growing patient expectation for spectacle independence following cataract surgery is met to some extent using techniques for astigmatism control and presbyo-pia-correcting intraocular lenses.

  6. Video-conferencing: under-used by rural general practitioners.

    Science.gov (United States)

    Robinson, Anske

    2002-01-01

    The objective was to investigate the use of and value General Practitioners place on video-conferencing as a tool in providing rural health care. The participants were 8 rural general practitioners in rural Victoria towns. I found that six out of the eight GPs did not value video-conferencing as a tool to assist with patient care, and the other two GPs were interested in the technology only for certain aspects of support with patient consultations and continuing education. In conclude that there needs to be a review of whether video-conferencing equipment should continue to be implemented in the same way that it has been so far in Victoria, and of the cost-effectiveness of providing video-conferencing facilities in rural health services. In particular, there needs to be a review of whether more training and support for rural general practitioners is needed to increase the uptake of video-conferencing. Alternatively, analysis can be undertaken of the intrinsic value of using video-conferencing as an interactive tool for obtaining specialist support for patient care or undertaking continuing education via video-conferencing, and the program discontinued if it is found to be unwarranted.

  7. Risk communication between general practitioners and patients with hypercholesterolemia

    DEFF Research Database (Denmark)

    Hansen, Bo; Kirkegaard, Pia; Lauritzen, Torsten

      Purpose: It is important that the general practitioners (GPs) are able to intervene to reduce risk of disease. One of the key points in doing so is effective risk communication that decreases uncertainty about choice of treatment and gives the patients a greater understanding of benefits...... and risks of different options. The aim of this PhD-study is to make a model for training GPs in risk communication and to evaluate in a randomized intervention, how training GPs, using the model, affects the patients level of cholesterol, adherence to treatment, number of contacts to health services......, and psychological well-being.    Methods: 40 GPs receive training in risk communication. Each GP selects 7 patients with elevated cholesterol. These patients are informed about the opportunity to receive preventive pharmacological treatment. Another 280 patients receive the same opportunity from 40 GPs without...

  8. Survey on general background and professional competency of general practitioners with standardization training in Beijing%北京市规范化培训全科医生工作情况调查

    Institute of Scientific and Technical Information of China (English)

    边立立; 黄凯; 李肖肖; 杜雪平

    2014-01-01

    采取随机整群抽样的方法,于2013年4-5月在北京市随机抽取5个区的全科医生进行问卷调查,比较经过规范化培训的全科医生(规培组)与未经过规范化培训的全科医生(未规培组)的基本情况及工作、继续教育、科研等方面情况。结果显示,规培组(130人)全科医生具有医师职称的占72.3%(94/130),参加工作时间不到10年的占89.3%(116/130),具有本科以上学历的占97.0%(126/130),82.3%(107/130)者表示愿意参与科研工作。未规培组(189人)全科医生在专业技术职称、教学与科研方面较规培组全科医生存在优势。提示经过规范化培训的全科医生具有较高的学历,对于科研工作有较高的积极性,但其参加社区工作时间较短,在工作、科研和教学方面的优势尚未显现。%One hundred and thirty general practitioners ( GP ) who received standard training ( training group ) and 189 GPs who did not receive standard training ( non-training group ) were selected with cluster random sampling method from five districts in Beijing.A questionnaire survey was conducted from April to May 2013, including basic information , working condition , professional competency and continuing education of the interviewees.The survey showed that 72.3%(94/130) in training group had physician titles;89.3%(116/130 )had work experience <10 y;97.0%(126/130)of them had bachelor degree or above;82.3%(107/130) expressed their interest in scientific research , but the 95.4% of them had no research projects;and 96% had no teaching appointment.GPs in non-training group were in a favorite position of education level and professional competency over those in training groups ; however , the latter were highly enthusiastic in further training and scientific research , and had strong potential for career development.

  9. 上海市全科医师培训工作的回顾与展望(待续)%A Review and Prospects of General Practitioner Training Works in Shanghai City

    Institute of Scientific and Technical Information of China (English)

    许铁峰; 王涛; 张勘

    2011-01-01

    Objective To sum up the practical experience and characteristic of training general practitioners (GP) in Shanghai city in the last twenty years, and think ahead to the future works by reviewing the practice and exploration in GP training. Methods The literature review, on-the-spot investigation and policy documents learning was taken to analyze the reform and development process of general medicine training in Shanghai city. Results The standardized training was comprehensively performed based on the basic principles and characteristics of general medicine; there were a lot of characteristics and praiseworthy practice in the training of general practitioners in Shanghai; some good ideas for the further training works were presented. Conclusion In this paper, a new training model for general practitioners was put forward. The standardized training model, advanced training system, thorough evaluation system, unobstructed talent introducing channels, normative employing mechanism, sure investment, and so on, can improve the effect of the training. This should provide a reference for other cities to gradually establish and improve the general medical residency training system.%目的 回顾上世纪九十年代初以来上海市全科医师培训工作的实践和探索,总结分析本市工作的实践经验和工作特色,并对未来工作发展进行前瞻性思考.方法 采用文献研究、实地调研和政策文件查阅,研究上海市全科医学培训工作的改革发展历程.结果 本文依据全科医学发展基本原则和特征,结合上海市住院医师规范化培训工作的实施,分析总结了上海市全科医师培训工作的特色与亮点,并对进一步开展全科医师培训工作提出了发展思路.结论 本文以上海市全科医师培养工作近二十年来的发展历程,总结提出了规范化培训新模式,并围绕培训工作提出了构建培训体系、建立考评制度、拓宽引进渠道、规范用人机制、

  10. Training oncology practitioners in communication skills.

    Science.gov (United States)

    Baile, Walter F

    2011-10-01

    Many practitioners in oncology receive no or little training in how to effectively communicate with patients and families who are dealing with cancer. Moreover medical teachers are not always aware of the pedagogy of teaching communication skills in a way that results in performance improvement in this area. In this paper a method of small group teaching that was used to instruct medical oncology fellows in the essentials of communication using a retreat format that lasted three days is described. The paper covers the theoretical basis for the teaching format as well as the specific components of the workshops. It describes the process of facilitation using a "learner-centered" approach using standardized patients who take on the role of cancer patients along the trajectory of the illness. It discuss the use of small group process to facilitate skills acquisition and other strategies that facilitate learning such as reflective exercises, open role play and parallel process. It concludes with a consideration of the various ways that such workshops can be evaluated.

  11. General practitioners' experiences as nursing home medical consultants

    OpenAIRE

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-01-01

    OBJECTIVE: To describe general practitioners' experiences of being the principal physician responsible for a nursing home. METHOD: Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. RESULT: Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-li...

  12. [Burnout syndrome in general practitioners of Avila].

    Science.gov (United States)

    Frutos-Llanes, R; Jiménez-Blanco, S; Blanco-Montagut, L E

    2014-10-01

    To determine the level of burnout in general practitioners of Avila and the influence of social, occupational and health factors. A descriptive cross-sectional epidemiological study was conducted and aimed at all Primary Care medical staff of Avila during the first half of 2011, using two questionnaires: the Maslach Burnout Inventory and other sociodemographic, health and occupational variables. A response rate of 51.8% was obtained. The mean age was 48.55±8.16, and 52% were male, 77% married, 45% with tenure, 78% worked in rural centres, and, 82% performed out of hours home visits plus clinics. The prevalence of severe burn out was low (16%) in our study was low. A high prevalence (68%) of moderate/severe level of the condition was found. Being married (P=.012), do not guards (Pburnout in severe or moderate/severe burnout. A moderate level of burnout was found. Contrary to what many doctors thought, the prevalence of the condition in its severe form was low, but was high when taking the severe and moderate/severe forms together. Therefore, measures should be extended to reduce occupational stress of doctors, in order to improve working practices and professional efficiency. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  13. The Influencing Factors of Study Burnout in Yunnan General Standardized Training Practitioners%云南省全科医生规范化培训学员学习倦怠的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    宋巨忞; 姜润生; 李伟明; 毛一晴; 周梅; 吴林雄; 李艳娇; 田波; 张垚

    2016-01-01

    目的:了解云南省全科医生规范化培训学员的培训期间学习倦怠状况及程度,分析其影响因素。方法采用学习状态量表,对云南省6家全科医生规范化培训基地的225名学员进行现场调查,应用有序logistic回归进行统计分析。结果共发放问卷225份,回收有效问卷219份,有效回收率为97.3%。学员学习倦怠得分为(58.16±9.52)分,其中学习倦怠得分为30~90分。78人处于轻度学习倦怠,占总人数的35.6%,141人处于中度或重度学习倦怠,占总人数的64.4%。专门开展全科医生规范化培训基地的学员学习倦怠得分为(60.12±9.03)分,将全科医生规范化培训作为住院医师规范化培训专业之一的基地的学员学习倦怠得分为(56.13±9.70)分,两类基地学员的学习倦怠得分对比,差异具有统计学意义(t=2.97,P<0.01)。经有序logistic回归显示,基地类别为学习倦怠的影响因素(OR=2.00,P<0.05);基地类别(OR=2.29,P<0.01)、性别(OR=1.79,P<0.05)与之前参加过全科医学相关培训(OR=0.43,P<0.05)为情绪倦怠的影响因素。结论专门开展全科医生规范化培训基地的学员学习倦怠较为严重。基地类别为学习倦怠和情绪倦怠的危险因素,专门开展全科医生规范化培训基地的学员学习倦怠较为严重。学习倦怠的程度较为严重;性别为情绪倦怠的危险因素,男性情绪低落的程度比女性高;之前参加过全科医学相关培训是情绪倦怠的保护性因素,之前没有参加过全科医学相关培训的学员情绪倦怠较为严重。%Objective To explore the situation of study burnout in Yunnan general standardized training practitioners, and to study the inlfuence factors of their status. Methods A questionnaire survey with learning status scale and group interview were been took to collect data. We collected a cluster sampling of 6

  14. 上海市全科医师规范化培训的意向调查分析%Intention Survey on the Standardized Training for Residency of General Practitioners in Shanghai

    Institute of Scientific and Technical Information of China (English)

    谢庆文; 朱静芬; 袁婷婷; 冯易; 段慧均; 施榕

    2015-01-01

    Objective To investigate the intention for the standardized training for residency of general practitioners among administrators and teachers in the training bases in Shanghai. Methods We randomly selected 11 hospitals which were authorized by the health departments in Shanghai as the clinical bases of the standardized training for residency of general practitioners. We enrolled 56 people who were on duty on the day of survey,including 20 administrators and 36 teachers of these clinical bases. From May to August 2013 , focus group interview and intention questionnaire survey were conducted on the necessity of strengthening the standardized training for residency of general practitioners,the influencing factors for the training, major problems and suggestions for further improving the training. Results The subjects widely believed that it is necessary to carry out the training;influencing factors for the training included the detachment of the training content from community practice,a lack of communication platform, a lack of matched management and incentive mechanism and low degree of recognition of society toward general practitioners;the major problems were limitation in teaching management mode,the low cognition level of students towards general practice and uneven foundation,a lack of understanding of community health service and general practice among some clinical teachers and detachment of training content from actual work. Conclusion We suggest the comprehensive management mechanism of the standardized training for residency of general practitioners should be developed, the qualification, training and assessment mechanism of clinical teachers should be promoted, the development of general practice subject of the training should be strengthened,and the training programme should be improved.%目的:了解上海市全科医师规范化培训临床基地的管理者与带教师资对培训的意向。方法在2013年上海市卫生部门认定的全科医

  15. Teaching Mode Discussion of Shanghai General Practitioners Standardized Training Community Base%上海全科医师规范化培训社区基地教学模式探讨

    Institute of Scientific and Technical Information of China (English)

    宋锐; 王建弘; 吴晓艳

    2013-01-01

    Objective To understand Shanghai city present situation in standardized training of general practitioners in community practice base teaching, to explore the new teaching mode and assessment method. Method Taken the physicians in the base in Shanghai in standardized training of general practitioners of physicians as the object, our study is divided into the basic theories of learning and community clinical practice two parts.Basic theory study execute batch of smal class teaching, focusing on community common disease/health issues in an integrative treatment, introducing the role play, scene simulation, panel discussions and other forms, during community practice, exert an one-to-one teaching mode for the teachers and training physicians, implementing reciprocal teaching evaluation, paying at ention to the practice ability of learning, interpersonal communication, occupation ethics and medical behavior, ability training based on the primary health care, according to the training program, make corresponding assessment content and assessment method, the training teachers are in charge of class evaluation, and the general teachers of two level assessment. Results 12 physicians in training through the theory study and community clinical practice, have strengthened their medical basic theory and basic skil s, who can quickly adapt to and be familiar with the city community health service work, they has become the primary group general physicians,who do the six in one service in medical, prevention, care, rehabilitation, health education and family planning guidance for general practitioners. Conclusion The standardized training of general practitioners is stil in the stage of exploration, proposed to strengthen the government function, increase investment in general medicine education, put emphasis on community base teachers' continuing education, and establish the assessment system of standardized training of general practitioners, as soon as possible of er guarantee

  16. A Practitioner Friendly and Scientifically Robust Training Evaluation Approach

    Science.gov (United States)

    Griffin, Richard

    2012-01-01

    Purpose: This article seeks to review the current state of workplace learning evaluation, to set out the rationale for evaluation along with the barriers that practitioners face when seeking to assess the effectiveness of training and development. Finally, it aims to propose a scientifically robust and practitioner friendly approach to evaluation.…

  17. Feasibility Analysis of Carrying out the Mental Health Training Systematically for General Practitioners%对全科医生开展系统心理卫生知识与技能培训的可行性研究

    Institute of Scientific and Technical Information of China (English)

    刘冬莹

    2011-01-01

    So far the mental health prohlems have become the major public health and social prohlems. and the demand of the community residents for mental health service has been increasing day by day. In this study the current situation of community mental health service and the necessity to carry on this service are discussed ; the feasibility that the general practitioners serve as the primary force in the community mental health work is analyzed, the clinic knowledge and skills of mental health that the general practitioners should master are systematically summarized, meanwhile , some strategies and measures for carrying on the training are also proposed.%目前心理卫生问题已成为重大的公共卫生和社会问题,社区居民的心理卫生服务需求日益增加.本研究对社区心理卫生工作的现状及开展的必要性进行论述,对以全科医生为主力军开展社区心理卫生工作的可行性进行分析,系统归纳全科医生应掌握的心理卫生知识与技能,同时提出开展培训的措施与对策.

  18. Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners

    NARCIS (Netherlands)

    Leemrijse, C J; de Bakker, D H; Ooms, L; Veenhof, C

    2015-01-01

    BACKGROUND: General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners percepti

  19. Collaboration of general practitioners and exercise providers in promotion of physical activity a written survey among general practitioners.

    NARCIS (Netherlands)

    Leemrijse, C.J.; Bakker, D.H. de; Ooms, L.; Veenhof, C.

    2015-01-01

    Background: General practitioners have an ideal position to motivate inactive patients to increase their physical activity. Most patients are able to exercise in regular local facilities outside the health care setting. The purpose of this study was to get insight into general practitioners percepti

  20. General practitioners' management of the long-term sick role.

    Science.gov (United States)

    Higgins, Angela; Porter, Sam; O'Halloran, Peter

    2014-04-01

    In this paper, we use qualitative research techniques to examine the role of general practitioners in the management of the long-term sickness absence. In order to uncover the perspectives of all the main agents affected by the actions of general practitioners, a case study approach focussing on one particular employment sector, the public health service, is adopted. The role of family physicians is viewed from the perspectives of health service managers, occupational health physicians, employees/patients, and general practitioners. Our argument is theoretically framed by Talcott Parsons's model of the medical contribution to the sick role, along with subsequent conceptualisations of the social role and position of physicians. Sixty one semi-structured interviews and three focus group interviews were conducted in three Health and Social Care Trusts in Northern Ireland between 2010 and 2012. There was a consensus among respondents that general practitioners put far more weight on the preferences and needs of their patients than they did on the requirements of employing organisations. This was explained by respondents in terms of the propinquity and longevity of relationships between doctors and their patients, and by the ideology of holistic care and patient advocacy that general practitioners viewed as providing the foundations of their approach to patients. The approach of general practitioners was viewed negatively by managers and occupational health physicians, and more positively by general practitioners and patients. However, there is some evidence that general practitioners would be prepared to forfeit their role as validators of sick leave. Given the imperatives of both state and capital to reduce the financial burden of long-term sickness, this preparedness puts into doubt the continued role of general practitioners as gatekeepers to legitimate long-term sickness absence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Heart rate responses to Taekwondo training in experienced practitioners.

    Science.gov (United States)

    Bridge, Craig A; Jones, Michelle A; Hitchen, Peter; Sanchez, Xavier

    2007-08-01

    The purpose of this study was to evaluate the heart rate (HR) responses of specific Taekwondo training activities, practiced by experienced practitioners in a natural training environment. Eight male experienced Taekwondo practitioners, with 3- 13 years (5.4 +/- 3.2 years) experience took part in a 5-day Taekwondo training camp. Continuous HR measures were recorded at 5-second intervals during 6 training sessions; each session was observed and notated, and a diary of training activities was recorded. The HR responses were assimilated into 8 fundamental training activities for analysis: elastics, technical combinations, step sparring, pad work, forms, basic techniques and forms, sparring drills, and free sparring. Taekwondo training elicited HR into 64.7-81.4% of HR maximum (%HRmax). Moderate relative exercise intensities (64.7-69.4%HRmax) were elicited by elastics, technical combinations, and step sparring. The remaining 5 training activities elicited hard relative exercise intensities (74.7-81.4%HRmax). One-way repeated-measures analysis of variance with post hoc analysis revealed that elastics, technical combinations, and step sparring elicited significantly lower relative intensities than the remaining training activities (p Taekwondo training activities in this study seemed suitable for cardiovascular conditioning, although different training activities stressed the cardiovascular system to different degrees. Practically, this suggests coaches need to structure Taekwondo training sessions based not only on the technical and tactical needs of practitioners but also in a manner that enables sufficient cardiovascular conditioning for competition.

  2. 全科医生临床能力培训效果评价及影响因素分析%Effect of clinical competence training for general practitioners and influencing factors

    Institute of Scientific and Technical Information of China (English)

    刘瑶; 江孙芳; 顾杰; 寿涓; 夏慧玲; 祝墡珠

    2013-01-01

    目的 评估全科医生临床能力培训的效果,为今后进一步完善培训方案、提高培训质量提供科学依据.方法 以2011年7月至2012年10月期间参加上海市全科医生临床能力培训的759名学员为研究对象,比较这些学员参加培训前后的理论和操作成绩,分析影响培训效果的因素,评价培训的实施效果.结果 759名学员中,男性260名(34.26%),女性499名(65.74%);平均工作年限(13.6±7.1)年.学员培训前后理论和实际操作的总成绩分别为(67.40±8.57)分和(73.61±7.20)分,培训前后成绩的差异具有统计学意义(=17.96,P<0.01).培训后实际操作成绩的提高更为明显,培训前后体格检查的成绩分别为(12.90±3.76)分和(14.00±3.51)分,而临床技能成绩分别为(9.41±4.80)分和(13.40±4.02)分,前后成绩的差异均有统计学意义(t值分别为6.31和19.01,均P<0.01).在体格检查项目中,心肺体检、腹部体检、甲状腺检查和神经系统体检4个项目的培训后成绩高于培训前,且差异具有统计学意义(均P <0.05或0.01);而临床技能的所有7个项目的培训后成绩均明显高于培训前(均P<0.01).多元线性回归分析显示,学员培训效果影响因素包括性别、教育程度、专业类别及培训前成绩(P<0.01或<0.05).结论 全科医生培训后理论知识和实际操作能力都有提高,尤其是临床技能操作水平提高更为明显.今后的培训内容应结合社区全科医生实际工作特点,注重临床技能培训,提高社区全科医师的综合素养.%Objective To evaluate the effect of clinical competence training for general practitioners in Shanghai.Methods Total 759 general practitioners participated in clinical competence training from July 2011 to October 2012 in Shanghai.The theoretical and practical operation scores of all the 759 trainees were compared before and after the training and the influencing factors of training effect were analyzed

  3. [The general practitioner is not in the lead on ADHD].

    Science.gov (United States)

    Damoiseaux, Roger A M J

    2015-01-01

    The diagnosis of and therapy for ADHD is complex and should be done by experts in this field. In the Netherlands, a new guideline on ADHD for general practitioners has recently been issued. Although there is some room for general practitioners to start medication for this disorder, the main message is to exercise caution in starting medication in general practice. Many children with ADHD have psychiatric comorbidity and proper diagnosis by a specialist is recommended. The main task of the general practitioner is making the right choice concerning when to refer for further diagnosis. Children sometimes show behaviour which, although it is not always what adults want, does not necessarily require psychiatric intervention and this is what a general practitioner can determine.

  4. The Training of Infant Mental Health Practitioners: The Norway Experience

    Science.gov (United States)

    Slinning, Kari; Vannebo, Unni Tranaas

    2015-01-01

    Today the infant mental health field includes a multidisciplinary team of practitioners with very different training and education needs. Implementation research has shown that appropriate training is a key factor for successful outcomes of an intervention and that supervision and coaching are crucial. All professionals who work with young…

  5. Caring for dementia carers: the role of general practitioners in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, C

    2011-01-29

    BACKGROUND: Dementia patients in Ireland live 8 years on average after diagnosis and health policy aims to ensure patients are cared for in the home for as long as possible. AIM: To assess the role of general practitioners in Ireland caring for dementia carers. METHODS: A PubMed search (1980-2010) was performed using MeSH terms "caregivers or carers", "Dementia or Alzheimer\\'s disease", "family physician or general practitioner". An English language restriction was imposed and the search continued to June 24th 2010. RESULTS: Psychosocial multidisciplinary interventions that unite education, skills training, management of psychological problems and family support in the community are effective in managing the problems of carers and should be facilitated by general practitioners. CONCLUSIONS: Dementia carers form an important yet understated patient group who present unique challenges for general practitioners in Ireland.

  6. Caring for dementia carers: the role of general practitioners in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, C

    2012-02-01

    BACKGROUND: Dementia patients in Ireland live 8 years on average after diagnosis and health policy aims to ensure patients are cared for in the home for as long as possible. AIM: To assess the role of general practitioners in Ireland caring for dementia carers. METHODS: A PubMed search (1980-2010) was performed using MeSH terms "caregivers or carers", "Dementia or Alzheimer\\'s disease", "family physician or general practitioner". An English language restriction was imposed and the search continued to June 24th 2010. RESULTS: Psychosocial multidisciplinary interventions that unite education, skills training, management of psychological problems and family support in the community are effective in managing the problems of carers and should be facilitated by general practitioners. CONCLUSIONS: Dementia carers form an important yet understated patient group who present unique challenges for general practitioners in Ireland.

  7. Dutch occupational physicians and general practitioners wish to improve cooperation

    NARCIS (Netherlands)

    Buijs, P.; Amstel, R. van; Dijk, F. van

    1999-01-01

    Objectives - To investigate cooperation between occupational physicians (OPs) and general practitioners (GPs). Methods - Literature review; structured interviews; questionnaires sent to randomised samples of OPs (n = 232) and GPs (n = 243). Results - Actual cooperation is poor. However, more than 80

  8. Prescription patterns of general practitioners in peshawar, pakistan

    National Research Council Canada - National Science Library

    Raza, Usman Ahmad; Khursheed, Tayyeba; Irfan, Muhammad; Abbas, Maryam; Irfan, Uma Maheswari

    2014-01-01

    To find out prescription patterns of general practitioners in Peshawar. Cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May 2011...

  9. Nurse practitioner education: greater demand, reduced training opportunities.

    Science.gov (United States)

    Forsberg, Ingrid; Swartwout, Kathryn; Murphy, Marcia; Danko, Katie; Delaney, Kathleen R

    2015-02-01

    To document the factors that are increasing the tension between nurse practitioner (NP) educational programs and the clinical training sites needed for NP students. Literature and the faculty experiences garnered over years of placing NP students for clinical training. Several conditions converge to create a situation where sites are increasingly reluctant to precept NP students. The underlying dynamics are diverse and include factors related to the electronic health record, productivity expectations, and the increasing demand for sites as a result of increasing NP enrollments and competing healthcare provider programs. The nursing community should approach this issue strategically and devise an action and policy agenda to support NP training, including federal monies to support NP training in a design that parallels the Graduate Medical Education; recognition of NPs as licensed professionals in advanced training; and identification of meaningful incentives for NP preceptors. ©2014 American Association of Nurse Practitioners.

  10. Evaluating veterinary practitioner perceptions of communication skills and training.

    Science.gov (United States)

    McDermott, M P; Cobb, M A; Tischler, V A; Robbé, I J; Dean, R S

    2017-03-25

    A survey was conducted among veterinary practitioners in the UK and the USA in 2012/2013. Thematic analysis was used to identify underlying reasons behind answers to questions about the importance of communication skills and the desire to participate in postgraduate communication skills training. Lack of training among more experienced veterinary surgeons, incomplete preparation of younger practitioners and differences in ability to communicate all contribute to gaps in communication competency. Barriers to participating in further communication training include time, cost and doubts in the ability of training to provide value. To help enhance communication ability, communication skills should be assessed in veterinary school applicants, and communication skills training should be more thoroughly integrated into veterinary curricula. Continuing education/professional development in communication should be part of all postgraduate education and should be targeted to learning style preferences and communication needs and challenges through an entire career in practice.

  11. Chinese General Practitioner Training Scheme:Challenges and Strategies%全科医生培养模式及其实施中相关问题的思考

    Institute of Scientific and Technical Information of China (English)

    线福华; 路孝琴; 吕兆丰

    2012-01-01

    培养大批合格的全科医生是深化医疗卫生体制改革、实现人人享有基本医疗的保证.如何才能培养出合格的全科医生?这既有对全科医学学科的认识和理解问题,也有建立全科医生培养标准和培养模式问题.本文主要介绍了我国现阶段全科医生培养的主要模式,即"5+3"模式和"3+2"模式;也介绍了通过不同的"5+3"培养项目(全科医师规范化培训和专业型研究生培养)同时实现合格全科医生培养的目标,以及通过两个项目如何实现全科医生规范化培养与研究生学历、学位接轨的实施路径.同时,本文还提出了促进全科医生培养主要模式实施的必要条件、实施中可能遇到的问题及其应对策略的思考.%Sufficient qualified general practitioners ( GPs ) is critical for further health care system reform to reach the goal that every citizen has equal access to affordable primary health care. To train qualified GPs, we need to have accurate and thorough understanding of general practice based on which to establish suitable training standards and schemes. This article introduces two main GP training schemes in China, i. e. the " 5+3" and " 3+2" schemes. Residency training and postgraduate education are two options of the " 5+3" scheme. We suggest a pathway to integrate residency training and postgraduate diploma and degree. We also discuss the prerequisites, challenges, and strategies in the implementation of Chinese GP training schemes.

  12. Survey of Irish general practitioners' preferences for continuing professional development.

    Science.gov (United States)

    Maher, B; O'Neill, R; Faruqui, A; Bergin, C; Horgan, M; Bennett, D; O'Tuathaigh, C M P

    2017-06-14

    Doctors' continuing professional development (CPD) training needs are known to be strongly influenced by national and local contextual characteristics. Given the changing national demographic profile and government-mandated changes to primary care health care provision, this study aimed to investigate Irish General Practitioners' (GPs) perceptions of, and preferences for, current and future CPD programmes. A cross-sectional questionnaire, using closed- and open-ended questions, was administered to Irish GPs, focusing on training needs analysis; CPD course content; preferred format and the learning environment. The response rate was 719/1000 (71.9%). GPs identified doctor-patient communication as the most important and best-performed GP skill. Discrepancies between perceived importance (high) and current performance (low) emerged for time/workload management, practice finance and business skills. GPs identified clinically-relevant primary care topics and non-clinical topics (stress management, business skills, practice management) as preferences for future CPD. Flexible methods for CPD delivery were important. Gender and practice location (urban or rural) significantly influenced CPD participation and future course preference. The increasing diversity of services offered in the Irish primary care setting, in both clinical and non-clinical areas, should be tailored based to include GP practice location and structure.

  13. Preconception care by family physicians and general practitioners in Japan

    Directory of Open Access Journals (Sweden)

    Fetters Michael D

    2005-07-01

    Full Text Available Abstract Background Preconception care provided by family physicians/general practitioners (FP/GPs can provide predictable benefits to mothers and infants. The objective of this study was to elucidate knowledge of, attitudes about, and practices of preconception care by FP/GPs in Japan. Methods A survey was distributed to physician members of the Japanese Academy of Family Medicine. The questionnaire addressed experiences of preconception education in medical school and residency, frequency of preconception care in clinical practice, attitudes about providing preconception care, and perceived need for preconception education to medical students and residents. Results Two hundred and sixty-eight of 347 (77% eligible physicians responded. The most common education they reported receiving was about smoking cessation (71%, and the least was about folic acid supplementation (12%. Many participants reported providing smoking cessation in their practice (60%, though only about one third of respondents advise restricting alcohol intake. Few reported advising calcium supplementation (10% or folic acid supplementation (4%. About 70% reported their willingness to provide preconception care. Almost all participants believe medical students and residents should have education about preconception care. Conclusion FP/GPs in Japan report little training in preconception care and few currently provide it. With training, most participants are willing to provide preconception care themselves and think medical students and residents should receive this education.

  14. Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

    DEFF Research Database (Denmark)

    Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

    2014-01-01

    general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. Conclusions It is acceptable to inquire about IPV...

  15. Can an EASYcare based dementia training programme improve diagnostic assessment and management of dementia by general practitioners and primary care nurses? The design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lucassen PL

    2008-04-01

    Full Text Available Abstract Background Early diagnosis of dementia benefits both patient and caregiver. Nevertheless, dementia in primary care is currently under-diagnosed. Some educational interventions developed to improve dementia diagnosis and management were successful in increasing the number of dementia diagnoses and in changing attitudes and knowledge of health care staff. However, none of these interventions focussed on collaboration between GPs and nurses in dementia care. We developed an EASYcare-based Dementia Training Program (DTP aimed at stimulating collaboration in dementia primary care. We expect this program to increase the number of cognitive assessments and dementia diagnoses and to improve attitudes and knowledge of GPs and nurses. Methods The DTP is a complex educational intervention that consists of two workshops, a coaching program, access to an internet forum, and a Computerized Clinical Decision Support System on dementia diagnostics. One hundred duos of GPs and nurses will be recruited, from which 2/3 will be allocated to the intervention group and 1/3 to the control group. The effects of implementation of the DTP will be studied in a cluster-randomised controlled trial. Primary outcomes will be the number of cognitive assessments and dementia diagnoses in a period of 9 months following workshop participation. Secondary outcomes are measured on GP and nurse level: adherence to national guidelines for dementia, attitude, confidence and knowledge regarding dementia diagnosis and management; on patient level: number of emergency calls, visits and consultations and patient satisfaction; and on caregiver level: informal caregiver burden and satisfaction. Data will be collected from GPs' electronic medical records, self-registration forms and questionnaires. Statistical analysis will be performed using the MANOVA-method. Also, exploratory analyses will be performed, in order to gain insight into barriers and facilitators for implementation and

  16. 标准化病人在全科住院医师接诊技能培训中的应用%Application of standardized patients in consultation skills training for resident general practitioners

    Institute of Scientific and Technical Information of China (English)

    江孙芳; 张渊; 周容; 祝墡珠

    2010-01-01

    Objective To assess standardized patients (SP) in resident general practitioners training for their consultation skills to explore its role in clinical competence training. Methods SP are employed in standardized training for 52 resident general practitioners in Shanghai during May to July 2008 to assess trainees' clinical consultation skills, including medical history taking and physical examinations, as well as clinical competencies of trainers including medical history taking, physical examinations, clinical thinking (diagnosis, differential diagnosis and treatment plans), health education, medical record writing,and reception time management. Feedback and appraisal for their consultation skills were provided by SP later. Problems encountered in trainees' consultation were discussed in group manner with their trainers.And two mouths later, assessment with SPs was undergone again for their consultation skills to compare their scores in consultation skills and percentages of them passing the assessment before and after training. Results Trainees were enrolled in the training aged (28±1 ) years in average ( with a ratio of men to women of 19/33 ). Percentage of trainees passing the assessment by SP for consultation skills was significantly higher after training (88.5%) than that before it (46. 2% ) ( P 0. 05 ). Conclusions Application of SP can effectively enhance consultation skills of the trainees,especially in their medical history taking and physical examinations. However, there is still rooms to improvein their clinical thinking.%目的 评价标准化病人(standardized patients,SP)在全科住院医师接诊技能培训中的作用.方法 采用SP对2008年5月至7月上海市全科医师规范化培训的52名全科住院医师的接诊技能进行评价,其中SP评估内容为临床技能(包括病史采集、体格检查);教师评估内容包括临床技能(病史采集和体格检查)、临床思维(诊断、鉴别诊断和治疗计划)、健康教育

  17. Problems and Reflection of General Practitioner Job_transfer Training From the Perspective of Demand Theory%需要理论视角下全科医生转岗培训的问题与反思

    Institute of Scientific and Technical Information of China (English)

    毛良

    2016-01-01

    本文基于马斯洛需要层次理论分析当前全科医生转岗培训中存在的问题,认为全科医生定位出现偏失,转岗培训含金量较低,不符合需要规律。在比较分析国内外全科医生培养模式基础上,以马斯洛5种需要理论为认识工具,提出基本需--求体现职业“安全度”;社交需--求拓展职业能力的“宽度”;自我实现要彰显社会的“认可度”。在课程目标建设上要体现知识“高度”;在考核认证体系上要体现“难度”;在培训基地建设上要塑造“品牌”,并强调要注重“关键能力”培养,使全科医生转岗培训富有含金量,以工作内在的吸引力促进全科医生制度的健康发展。%Based on Maslow' s hierarchy of needs theory,the paper analyzed the problems existing in general practitioner job _ transfer training,and found that there is deviation in GP positioning and the training has low value and does not meet the needs. Based on the training model in China and abroad and using Maslow's hierarchy of needs theory as a tool,we suggest that occupational " safety" should be reflected in the requirement of basic needs;expanding " breadth" of vocational ability should be required in the aspect of social needs;social " recognition degree" should be presented in the aspect of self _realization. The " height" of knowledge should be shown in the development of program objectives;" difficulty" should be reflected in the system of evaluation and certification;" brand" should be established in the development of training bases,and the training of " key abilities" should be focused in order to increase the value of training and promote the healthy development of GP by inherent attractiveness.

  18. Referrals from general practitioners to a social services department.

    Science.gov (United States)

    Sheppard, M G

    1983-01-01

    One year's referrals from general practitioners to a social services department were studied. There was a low referral rate and a bias towards women, the elderly and the less affluent. The referrals were predominantly made for practical help with problems of ill health. A high proportion of clients were allocated to non-social work staff, and the social service intervention, generally of short duration, showed a sympathetic response to the practical requests of general practitioners. The limited use of social workers by doctors is considered to be the result of ignorance or scepticism about psychodynamic social work skills. Closer liaison between general practitioners and social workers, and a clearer presentation by social workers of their professional skills, are suggested solutions to this problem.

  19. Motivation for the choice of a general practitioner--attitudes of practitioners and patients.

    Science.gov (United States)

    Budak, A; Tiljak, H; Katić, M

    1994-01-01

    The aim of this study was to find out if any significant changes occurred after introducing, the free choice of a general practitioner (GP) into primary health care. The determinants of patients' choice and GP's attitudes regarding this matter were tested. A survey was conducted in 1992 by distributing questionnaires to 71 GP's and 292 patients who chose these GPs. The questionnaires were composed selectively for GPs and patients, and they all answered them anonymously. The group of GPs consisted of 37 (52.1%) GPs with vocational training and of 31 (43.7%) GPs without vocational training. The patients evaluated the GPs' characteristics as very important in choosing a particular GP. Of medium importance were the surgery characteristics (where it was situated, work organization, equipment), and recommendations were the least important. Most frequently, the patients chose a particular GP because he was already the GP of one of the family members. The GPs assessed the family to be the most important determinant for a patient to choose a particular GP. Surgery characteristics (distance and work organization) were evaluated as being of medium importance. The recommendations of a friend were of medium importance, and the recommendations of medical staff were not important, according to the opinion of the surveyed GPs. The only occurrence detected in the survey was that of a "return" phenomenon, in which patients returned to their old GPs, which was a direct consequence of the implementation of the free choice principle into health care practice. The results of this study match the results of similar studies already published, and they are argumented theoretically.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Does the Use of Multifactorial Training Methods Increase Practitioners' Competence?

    Science.gov (United States)

    Pittman, Corinthus Omari; Lawdis, Katina

    2017-01-01

    Skilled therapy practitioners are required by their governing associations to seek professional development per licensure requirements. These requirements facilitate clinical reasoning and confidence during patient care. There are limited online professional development workshops, especially ones that offer multifactorial training as an…

  1. Surgical instruction for general practitioners: how, who and how often?

    LENUS (Irish Health Repository)

    Collins, Anne M

    2010-07-01

    Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

  2. Child health and general practitioners' management, 1987 - 2001.

    NARCIS (Netherlands)

    Otters, H.; Schellevis, F.

    2006-01-01

    This contribution compares the presentation and management of childhood morbidity (0-17 years) in general practice in 2001 with that in 1987. In the Netherlands, childhood morbidity presented to the general practitioner (GP) has changed: (infectious) skin problems have become more important. In 2001

  3. General practitioner knowledge, skills and attitudes to eating disorders

    OpenAIRE

    Doherty, Sally; McNamee, Lisa

    2015-01-01

    Given that general practitioners are perfectly placed to detect eating disorders this summer research study aimed to examine general practitioners’ knowledge, skills and attitudes towards eating disorders. The study aimed to compile a national picture of the diagnosis, referral practices, and management of eating disorders in primary care in Ireland.

  4. Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice

    DEFF Research Database (Denmark)

    Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

    2014-01-01

    were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. This study provides important...... practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. It is acceptable to inquire about IPV with women in Denmark...... in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support...

  5. Evaluation of clinical competence training model for general practitioners in Shanghai%上海市全科医师临床能力培训模式效果评价

    Institute of Scientific and Technical Information of China (English)

    夏慧玲; 刘瑶; 顾杰; 寿涓; 祝墡珠; 江孙芳

    2016-01-01

    Objective To evaluate the clinical competence training model for community general practitioners (GPs).Methods Total 759 Gps participated in clinical ability training course (training group) between July 2011 and October 2012.The course included lectures,group discussion,role play,simulation for theoretical teaching;and video demonstration,scene teaching and medical simulator for physical examination and surgical skill training.Other 703 Gps without participating in training course were selected as control group.The examination consisting of theoretical and clinical skill tests were carried out and the results were compared between two groups.Results The participants included 260 males (34.2%) and 499 females (65.8%) were with an average service year of 13.9 ± 7.0 and 72.8% of them hold bachelor degree.There were no significant differences in gender composition,work seniority and educational level between the two groups (P > 0.05).Before and after training the total scores of the training group were (67.39 8.57) and (73.62 ± 7.19) respectively,(68.67 8.31) and (65.73 ±9.02) respectively for the control group.Before training,the total score and theoretical results of control group were significantly higher than those of training group (all P < 0.01),and there was no significant difference between the two groups in physical examination and operation skill.After training,the total scores and the individual scores (written examination,physical examination and operation skill) of training group were significantly increased,compared with those before training (all P < 0.01),and those of control group (all P < 0.01).Conclusions The clinical competences training model can improve the theoretical knowledge and clinical ability of community general practitioners.%目的 探讨提高社区全科医师临床能力的培训模式、教学方法,评估其效果,从而进一步完善培训方案.方法 将2011年7月至2012年10月期间759名参加上海市全

  6. The PULSAR primary care protocol: a stepped-wedge cluster randomized controlled trial to test a training intervention for general practitioners in recovery-oriented practice to optimize personal recovery in adult patients.

    Science.gov (United States)

    Enticott, Joanne C; Shawyer, Frances; Brophy, Lisa; Russell, Grant; Fossey, Ellie; Inder, Brett; Mazza, Danielle; Vasi, Shiva; Weller, Penelope June; Wilson-Evered, Elisabeth; Edan, Vrinda; Meadows, Graham

    2016-12-20

    General practitioners (GPs) in Australia play a central role in the delivery of mental health care. This article describes the PULSAR (Principles Unite Local Services Assisting Recovery) Primary Care protocol, a novel mixed methods evaluation of a training intervention for GPs in recovery-oriented practice. The aim of the intervention is to optimize personal recovery in patients consulting study GPs for mental health issues. The intervention mixed methods design involves a stepped-wedge cluster randomized controlled trial testing the outcomes of training in recovery-oriented practice, together with an embedded qualitative study to identify the contextual enablers and challenges to implementing recovery-oriented practice. The project is conducted in Victoria, Australia between 2013 and 2017. Eighteen general practices and community health centers are randomly allocated to one of two steps (nine months apart) to start an intervention comprising GP training in the delivery of recovery-oriented practice. Data collection consists of cross-sectional surveys collected from patients of participating GPs at baseline, and again at the end of Steps 1 and 2. The primary outcome is improvement in personal recovery using responses to the Questionnaire about the Process of Recovery. Secondary outcomes are improvements in patient-rated measures of personal recovery and wellbeing, and of the recovery-oriented practice they have received, using the INSPIRE questionnaire, the Warwick-Edinburgh Mental Well-being Scale, and the Kessler Psychological Distress Scale. Participant data will be analyzed in the group that the cluster was assigned to at each study time point. Another per-protocol dataset will contain all data time-stamped according to the date of intervention received at each cluster site. Qualitative interviews with GPs and patients at three and nine months post-training will investigate experiences and challenges related to implementing recovery-oriented practice in primary

  7. The importance of gender of patients and general practitioners in relation to treatment practices for overweight

    DEFF Research Database (Denmark)

    Rohde, Jeanett Friis; Hessner, Marie Vik; Lous, Jørgen

    2014-01-01

    and treatment practices among Danish general practitioners (GPs), in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. DESIGN: Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment...

  8. Minimally invasive periodontal therapy for general practitioners.

    Science.gov (United States)

    Ryder, Mark I; Armitage, Gary C

    2016-06-01

    There remains a high prevalence of mild-to-moderate forms of periodontal diseases in both developed and developing countries. Although many periodontal specialty practices currently place strong emphasis on implant surgery, periodontal plastic surgery and esthetics, general dentists and hygienists have often assumed more responsibility than periodontal specialty practices for the diagnosis, treatment, assessment and maintenance, and possible referral, of their patients. To address these current trends and challenges, this volume of Periodontology 2000 presents a series of topics on the basic biological principles of periodontal disease, as well as on approaches to diagnosis, treatment planning and treatment, in what is called 'conservative' or 'noninvasive' periodontal therapy. These topics include risk assessment of the periodontal condition; reduction, elimination and/or control of etiologies and risk factors, including mechanical, antimicrobial and host-modulation approaches; considerations for evaluation of clinical outcomes based on treatment approaches; and selected topics in laser therapy, halitosis and gingival recession.

  9. Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

    Science.gov (United States)

    Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

    2016-09-01

    Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

  10. [Increasing immunization coverage in adults and elderly by creating structural relationships with general practitioners].

    Science.gov (United States)

    Conversano, M; Busatta, M; Cipriani, R; Battista, T; Sponselli, G M; Caputi, G; Pesare, A

    2012-01-01

    In order to reach vaccination coverage in adults, the elderly and in high risk subjects, a tight network of collaboration between preventive medicine specialists and general practitioners must be created in the same way that they must be created with pediatricians. In fact, this strategy has brought about very high coverage rates in childhood vaccinations. The solution to propose once again would thus be to develop partnerships between the protagonists of the network (community health district, department of prevention, general practitioners, primary care physicians) so that synergies may be created which permit the realisation of common and specific training programs.

  11. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

    Directory of Open Access Journals (Sweden)

    Salmon Peter

    2008-08-01

    Full Text Available Abstract Background The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods A nested attitudinal survey and qualitative study in sixteen primary care teams in north-west England. All practitioners participating in the trial (n = 74 were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results Seventy (95% of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12 reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context. Conclusion Reattribution training increases practitioners' sense of competence in managing patients with medically unexplained symptoms. However, barriers to its implementation are

  12. Knowledge, Attitudes and Practices regarding Rabies among general practitioners of Belgaum City

    Directory of Open Access Journals (Sweden)

    R.K. Nayak

    2013-07-01

    Full Text Available Introduction: Rabies in humans is highly fatal and ends in an extremely painful and tortuous death. Unfortunately we still have highest number of deaths due to rabies, ironically a disease preventable by modern prophylactic measures. The post-exposure prophylaxis is a life saving treatment in a definite rabid animal bite. General Practitioners (GP’s act as first line care-givers for the treatment of dog bite and they are also easily approachable by the victim for the treatment to prevent rabies. Objective: To assess the knowledge, attitude and practices regarding rabies among general practitioners. Methodology: This cross sectional survey was carried out from July – August 2011 in Belgaum city among 100 general practitioners using a pre tested questionnaire. Data was entered and analyzed using SPSS 18 trial version. Frequencies were tabulated for demographic variables and association between variables was tested using Chi-square test. Results: Out of the total 100 general practitioners interviewed, 93 were males and 7 were females. The mean age of GP’s was 42.89 years. The mean duration of practice for MBBS doctors was 19 years and for other doctors (BAMS, BHMS, RMP’s was 11 years. Knowledge about various aspects of rabies was comparatively better among MBBS doctors. The knowledge regarding vaccine was very poor among the general practitioners. Conclusion: The major issue was lack of hands on training or updating the knowledge of general practitioners regarding the newer vaccines and their administration. We recommend continued medical education for general practitioners, both (MBBS and non MBBS on prevention of Rabies.

  13. The effectiveness of psychosocial interventions delivered by general practitioners.

    NARCIS (Netherlands)

    Huibers, M.J.H.; Beurskens, A.J.H.M.; Bleijenberg, G.; Schayck, C.P. van

    2003-01-01

    BACKGROUND: Many patients visit their general practitioner (GP) because of problems that are psychosocial in origin. However, for many of these problems there is no evidence-based treatment available in primary care, and these patients place time-consuming demands on their GP. Therefore, GPs could b

  14. General Practitioners' Knowledge and Concern about Electromagnetic Fields

    DEFF Research Database (Denmark)

    Berg-Beckhoff, Gabriele; Breckenkamp, Jürgen; Larsen, Pia Veldt

    2014-01-01

    Our aim is to explore general practitioners' (GPs') knowledge about EMF, and to assess whether different knowledge structures are related to the GPs' concern about EMF. Random samples were drawn from lists of GPs in Germany in 2008. Knowledge about EMF was assessed by seven items. A latent class ...

  15. How do general practitioners in Denmark promote physical activity?

    DEFF Research Database (Denmark)

    Jørgensen, Tanja K; Nordentoft, Merete; Krogh, Jesper

    2012-01-01

    The primary objective of this study was to quantify the frequency of advice given on type, frequency, duration, and intensity of exercise during physical activity (PA) promoting sessions by general practitioners. Second, to find GP characteristics associated with high quality of PA counselling....

  16. Role of Danish general practitioners in AIDS prevention

    DEFF Research Database (Denmark)

    Sandbæk, Annelli

    1996-01-01

    OBJECTIVE: To describe Danish general practitioners' perception of their own role and to register their actual behaviour in the prevention of HIV/AIDS. DESIGN: Data collection was carried out by a) questionnaire and b) prospective registration of consultations dealing with HIV/AIDS in a two...... are taken to strengthen the GPs' role in AIDS prevention. Udgivelsesdato: 1995-Dec...

  17. Acute bronchitis: general practitioners' views regarding diagnosis and treatment.

    NARCIS (Netherlands)

    Verheij, T.J.M.; Hermans, J.; Kaptein, A.A.; Wijkel, D.; Mulder, J.D.

    1990-01-01

    A survey was conducted among 800 Dutch general practitioners to establish their views on the diagnosis and treatment of bronchitis and related disorders with reference to 12 theoretical patients. The answers of the 467 respondents (response rate 60%) showed no clear relationship between signs and

  18. Helicobacter pylori in out-patients of a general practitioner

    DEFF Research Database (Denmark)

    Rothenbacher, D; Bode, G; Winz, T

    1997-01-01

    Data on prevalence and determinants of Helicobacter pylori infection in well-defined populations are scarce. We investigated the prevalence and determinants of active H. pylori infection in a population of out-patients attending a general practitioner in Southern Germany. Infection status...

  19. General practitioners' experiences as nursing home medical consultants.

    Science.gov (United States)

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  20. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up

    OpenAIRE

    Luijsterburg, Pim; Verhagen, Arianne; Ostelo, Raymond; Hoogen, Hans; Peul, Wilco; Avezaat, Cees; Koes, Bart

    2008-01-01

    textabstractA randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in pa...

  1. Does Training and Support of General Practitioners in Intensive Treatment of People with Screen-Detected Diabetes Improve Medication, Morbidity and Mortality in People with Clinically-Diagnosed Diabetes? Investigation of a Spill-Over Effect in a Cluster RCT

    Science.gov (United States)

    Skriver, Mette V.; Griffin, Simon J.; Simmons, Rebecca K.; Witte, Daniel R.; Dalsgaard, Else-Marie; Lauritzen, Torsten; Sandbæk, Annelli

    2017-01-01

    Introduction Very few studies have examined the potential spill-over effect of a trial intervention in general practice. We investigated whether training and support of general practitioners in the intensive treatment of people with screen-detected diabetes improved rates of redeemed medication, morbidity and mortality in people with clinically-diagnosed diabetes. Methods This is a secondary, post-hoc, register-based analysis linked to a cluster randomised trial. In the ADDITION-Denmark trial, 175 general practices were cluster randomised (i) to routine care, or (ii) to receive training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (2001 to 2009). Using national registers we identified all individuals who were diagnosed with clinically incident diabetes in the same practices over the same time period. (Patients participating in the ADDITION trial were excluded). We compared rates of redeemed medication, a cardiovascular composite endpoint, and all-cause mortality between the routine care and intensive treatment groups. Results In total, 4,107 individuals were diagnosed with clinically incident diabetes in ADDITION-Denmark practices between 2001 and 2009 (2,051 in the routine care group and 2,056 in the intensive treatment group). There were large and significant increases in the proportion of patients redeeming cardio-protective medication in both treatment groups during follow-up. After a median of seven years of follow-up, there was no difference in the incidence of a composite cardiovascular endpoint (HR 1.15, 95% CI 0.95 to 1.38) or all-cause mortality between the two groups (HR 1.08, 95% CI 0.94 to 1.23). Discussion There was no evidence of a spill-over effect from an intervention promoting intensive treatment of people with screen-detected diabetes to those with clinically-diagnosed diabetes. Overall, the proportion of patients redeeming cardio-protective medication during follow-up was similar in both groups

  2. An endodontic practice profile amongst general dental practitioners in Kathmandu: A questionnaire survey

    Directory of Open Access Journals (Sweden)

    D Shrestha

    2014-04-01

    Full Text Available Objective To investigate the endodontic practice profile of general dental practitioners. To explore the materials and methods employed by them in Kathmandu valley. To compare these findings with well acknowledged international academic standards. Methods Questionnaires with 18 closed-ended questions were distributed among randomly chosen 120 general dental practitioners of Kathmandu, working in various government or private hospital or clinics.The data were collected and descriptive statistical analysis was done. Results Out of 120 questionnaires, only 110 that were completely filled were included in the study .Most general dental practitioners (97% regularly did multi-rooted root canal treatments and followed multivisit root canal treatment.. Radiograph with instrument in canal was used by 80% of general dental practitioners to determine the working length while only 36% used electronic apex locator which is considered to be more reliable. Half of them (57% used nickel-titanium files for cleaning and shaping but only 23% used crown down technique. Sodium hypochlorite and calcium hydroxide was the most popular irrigation solution and intra-canal medicament respectively. Majority of general dental practitioners (91% used lateral compaction technique for root canal obturation. Sixty three percent used zinc oxide eugenol as root canal sealer and 46% used endomethasone. They seem to overuse antibiotics in cases requiring endodontic therapy. Only 48% used autoclave for sterilization of endodontic files while 86% never used rubber dam. Eight three percent of them felt the need of further endodontic training and 42% of them preferred post-graduate dental program. Conclusion This study shows that the standard guidelines and new technologies for endodontic treatments are not implemented by many general dental practitioners of Kathmandu and require further endodontic trainings. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 40-50 DOI

  3. Short-term training workshop of mini-clinical evaluation exercise for community general practitioner trainers%小型临床演练评量在社区全科师资培训中的效果评价

    Institute of Scientific and Technical Information of China (English)

    陈倩; 潘志刚; 祝墡珠; 顾杰

    2013-01-01

    目的 通过对社区全科师资进行短期小型临床演练评量(mini-CEX)应用培训,了解在社区带教中开展mini-CEX的需求与可行性,探索mini-CEX在临床教学中的应用与推广.方法 2012年9月对36名社区全科师资进行为期半天的集中培训,培训前后采用问卷调查了解对mini-CEX认知情况及培训需求;通过对观察示范录像后的评分进行分析,评价培训效果.结果 培训前47%(17/36)的社区师资曾听到过mini-CEX并了解评分表;42%(15/36)了解mini-CEX的实施步骤但没有师资曾用过mini-CEX;全部师资均希望了解“如何实施mini-CEX”.培训后绝大多数师资对mini-CEX的7项考核标准及实施反馈达到完全理解或基本理解.对示范录像的评分显示,7项标准中仅1项的9分制正确率接近50%,5项的等级评分正确率在50%以上;两者比较有4项标准的正确率差异存在统计学意义(均P<0.01).结论 社区师资认同mini-CEX在住院医师临床能力评估方面的优势,有较强的使用意愿.短期集中培训具有一定效果,在此基础上还应进行评分者培训,并在实际应用中加强经验交流与反馈.%Objective To assess the effect of short-term training workshop of mini clinical evaluation exercise (mini-CEX) for community general practitioner (GP) trainers.Methods Thirty six community GP trainers received half-day training workshop of mini-CEX on September 2012.The GP trainers were interviewed with questionnaire before and after the training program and their video scores were analyzed.Results 47% (17/36) of GP trainers knew of and briefly understood mini-CEX before the training.42% (15/36) of them had a rough idea of how to use it but nobody had used it before.All of these trainers hoped to know how to carry out mini-CEX.The vast majority of GP trainers completely or basically understood the standards of evaluation for 7 items of mini-CEX after the training.The accurate rate of 1 iten was

  4. 河北省全科医师规范化培训结业考核成绩分析%Analysis of graduation examination results in the standardized training of general practitioners in Hebei Province

    Institute of Scientific and Technical Information of China (English)

    支晓; 刘红超; 李峰; 王荣英; 赵静; 蒋蕊

    2015-01-01

    Objective To explore the influencing factors of graduation examination results in the standardized training of general practitioners in Hebei Province.Methods The graduation examination results including theory and skills of 182 general practitioners were collected in 2008-2011.The results were statistical description,the theory,performance and the influence factors of operation performance were analyzed.Results The theory results of female (149)and male (33)physicians were (71.8± 4.8)and(69.2± 4.4)scores,respectively,Female′s theory results were significantly higher than male′s (P = 0.009);The theory achievement of 26 - 27 years-old (46),28-29 years-old (93)and 30-32 years-old (43),physicians were (73.1±4.8), (71.2±4.4)and(70.5± 4.8)scores,respectively,26 - 27 years-old physicians′ theory results were significantly higher than other age groups (P = 0.021 );The theory achievement of the physician of first class/second class (21),third class (78),top-up (72)and adult education (11) were (73.3± 4.7),(71.4± 4.7),(70.4± 4.4)and (68.7± 4.6),respectively,first class/second class′s theory results were higher than other groups (P = 0.016 ).The achievement for performances of cardiopulmonary resuscitation,use of isolation gown,abdominocentesis and thoracocentesis were (95.9±4.0),(80.7±3.7),(94.7±3.7)and (86.0±3.5)scores,respectively in 26-27 years-old general practitioners,which were significantly higher than other age groups (P < 0.05 ).Conclusion Gender,age and education background of general practitioners are important factors affecting theory achievement.Meanwhile age and learning experience also directly influence the results of clinical skill trainings.%目的:通过对河北省全科医师规范化培训结业考核成绩的回顾性分析,探讨其影响因素。方法收集2008—2011年182名全科医师规范化培训结业考核的理论及技能操作成绩,对结果进行统计描述并对其理论及操作成绩的影响因素进

  5. Training and Exploration of Mental health Service Capacity of Rural General Practitioners%基层全科医生心理卫生服务能力的培训及探索

    Institute of Scientific and Technical Information of China (English)

    邱少娟(通讯作者); 李华

    2014-01-01

    Objective:Discuss the training path on the all -around doctor mental health service ability of teaching practice .Methods:On the base of general practitioners self -rating symptom scale (SCL-90 scale), chronic psychological guidance , psychological, mental health problems , clinical features , treatment and prevention and control principle of training .Results:Chronic psychological guidance , psychological , mental health problems , clinical characteristics , treatment and control principle of the project , the teacher evaluation and student evaluation results were 67.5%, 70.2%, self-rating symptom scale (SCL-90 scale) student self -assessment results for 25. 9%.Conclusion:(1)The all-around doctor mental health services and improve their ability;(2) The weak psychological measurement knowledge , strengthening medical psychology , psychological measurement knowledge training .%目的:探讨对基层全科医生心理卫生服务能力的教学实践培训路径。方法:对基层全科医生进行症状自评量表( SCL~90量表)、慢性病心理指导、常见心理、精神卫生问题临床特征、处理及防控原则的培训。结果:慢性病心理指导、常见心理、精神卫生问题临床特征、处理及防控原则项目,老师考核和学员自评结果分别为67.5%、70.2%,症状自评量表( SCL~90量表)学员自评结果为25.9%。结论:(1)基层全科医生心理卫生服务能力有所提高;(2)心理测量知识薄弱,应加强医学心理学、心理测量知识培训。

  6. Short-term training of direct observation procedural skills (DOPS) for community general practitioner trainers%临床操作技能评估在社区全科师资培训中的效果评价

    Institute of Scientific and Technical Information of China (English)

    顾杰; 潘志刚; 祝墡珠; 陈倩

    2013-01-01

    目的 通过对社区全科师资进行短期临床操作技能评估(DOPS)应用培训,了解在社区带教中开展DOPS的需求与可行性,探索如何推广DOPS在临床教学中的应用.方法 2012年9月对36名社区全科师资进行为期一天的集中培训,培训前后采用问卷调查了解DOPS认知情况及培训需求;通过对观察示范操作录像后的评分进行分析,评价培训效果.结果 培训前47.2% (17/36)的社区师资曾听说过DOPS、并了解评分表,41.7% (15/36)了解DOPS的实施步骤,仅2.8% (1/36)曾用过DOPS,36名师资均希望了解“如何实施DOPS”.培训后绝大多数师资对DOPS的11项考核标准及实施反馈达到完全理解或基本理解.示范录像的11项标准中,有4项的9分制正确率超过或接近50.0%,有7项的等级评分正确率在50.0%以上;共有6项标准的9分制正确率和等级正确率比较差异存在统计学意义(均P<0.01).结论 社区师资认同DOPS在操作技能评估方面的优势,有较强的使用意愿,短期集中培训具有一定效果,在此基础上还应进行评分者培训,并在实际应用中加强经验交流与反馈.%Objective To evaluate the efficacy of short-term training of direct observation procedural skills (DOPS) for community general practitioner (GP) trainers.Methods Thirty six GP trainers participated in one-day workshop of DOPS.The participants were interviewed with questionnaire before and after the training program and the training video was scored.Results 47.2% (17/36) of GP trainers knew and briefly understood DOPS before the training.41.7% (15/36)of them had a rough idea of how to use it and only 2.8% (1/36) had used it before.All of these trainers wanted to learn how to perform DOPS.The vast majority of GP trainers completely or basically understood the standards for evaluation of 11 items of DOPS after the training.The accuracy rates of 4 items were close to or more than 50.0% in 9-point scale and

  7. Why and when do Danish medical doctors choose to become a general practitioner?

    DEFF Research Database (Denmark)

    Lewandowska, Karolina; Kjær, Niels Kristian; Lillevang, Gunver

    -graduate training the structure of the postgraduate educational program, working conditions, respect for general practice, uncertainty about the future for general practice as a profession, when did I decide to choose family medicine. Out of these themes we identified factors, which influenced the choice...... of the junior doctors. Exposure to general practice as part the basic postgraduate training programme was important. Acceptance of the postgraduate training programme also has a positive impact. Factors with negative impact were limited awareness of family medicine during medical school and worrying......Background and Aim: Continued supply of qualified general practitioners is essential for the vitality of the primary health care sector. In Denmark however we have observed a decline in the number of applicants for our family medicine specialist training program, leaving some posts vacant. The aim...

  8. Revisiting reflexology: Concept, evidence, current practice, and practitioner training.

    Science.gov (United States)

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-10-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  9. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    Directory of Open Access Journals (Sweden)

    Nurul Haswani Embong

    2015-10-01

    Full Text Available Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided.

  10. Modelling Nonlinearities and Reference Dependence in General Practitioners' Income Preferences.

    Science.gov (United States)

    Holte, Jon Helgheim; Sivey, Peter; Abelsen, Birgit; Olsen, Jan Abel

    2016-08-01

    This paper tests for the existence of nonlinearity and reference dependence in income preferences for general practitioners. Confirming the theory of reference dependent utility within the context of a discrete choice experiment, we find that losses loom larger than gains in income for Norwegian general practitioners, i.e. they value losses from their current income level around three times higher than the equivalent gains. Our results are validated by comparison with equivalent contingent valuation values for marginal willingness to pay and marginal willingness to accept compensation for changes in job characteristics. Physicians' income preferences determine the effectiveness of 'pay for performance' and other incentive schemes. Our results may explain the relative ineffectiveness of financial incentive schemes that rely on increasing physicians' incomes. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Diagnostic competence of Swiss general practitioners in skin cancer

    OpenAIRE

    Badertscher, N; Braun, R P; Held, U; Kofmehl, R; Senn, O; Hofbauer, G.F.; Rossi, P O; Wensing, M.J.; Rosemann, T.; Tandjung, R

    2013-01-01

    QUESTIONS UNDER STUDY: In Switzerland, skin cancer is one of the most prevalent neoplasms. General practitioners (GPs) are often faced with suspicious skin lesions in their patients. The aim of our study was to assess GPs' competence to diagnose skin cancer and to examine whether this can be improved by a one-day dermatologic education programme. METHODS: Study design: Pre / post-intervention study. Study population: 78 GPs in the Canton of Zurich. Intervention: A one day dermatologic educ...

  12. Drawing on International Experiences to Build General Practitioner System

    Institute of Scientific and Technical Information of China (English)

    Liu; Chang

    2015-01-01

    stablished in 1849,the Royal Dutch Medical Association seeks to promote the academic research and development in medical care to provide high-quality service.At the invitation of the CPAFFC,a 25-member RDMA delegation visited Beijing from March 15 to 20 for in-depth discussions on the general practitioner system with China’s National Health and Family Planning Commission,Beijing Municipal Health and Family Planning Commission,Peking University Health E

  13. [Diagnostic rationalism. Views of general practitioners on fibromyalgia].

    Science.gov (United States)

    Daehli, B

    1993-09-20

    Clinical practice is characterized by having to make numerous important decisions, including the diagnosis. In this study, general practitioners were asked to agree or to disagree with statements of fibromyalgia. The main purpose was to test the usefulness of two well-known models for decision-making when studying diagnosis in cases of uncertainty and scepticism. The results show that the models are inadequate to explain the decisions.

  14. Trends in Practitioner Training for the Renewable Energy Trades

    Energy Technology Data Exchange (ETDEWEB)

    Weissman, Jane M. [Interstate Renewable Energy Council, Latham, NY (United States); Laflin, Kirk [Partnership for Environmental Technology Education, South Portland, ME (United States)

    2006-07-01

    As workforce development becomes more of a critical component for an expanding renewable energy economy, new training opportunities are on the increase for practitioners interested in either getting into the renewable energy trades or upgrading their professional skills. This paper will report on the new trends in training and show how the instruction has become more highly developed. In many cases, curricula are now designed to provide teaching that leads to defined workplace knowledge, skills, and abilities. Private and academic training programs are becoming accredited specifically to renewable energy standards. Community colleges and technical schools are responding to local jobs by offering more and more renewable energy trades courses. And classes are expanding from 3 to 5 day workshops to semester-long courses resulting in one-year certificate and two-year associate degree programs at Community Colleges.

  15. Establishment of assessment criteria for general practitioner trainers in clinical training base%上海市全科医师规范化培训临床教学基地师资评估标准的建立

    Institute of Scientific and Technical Information of China (English)

    江孙芳; 杨华; 寿涓; 张向杰; 彭明辉; 祝墡珠

    2015-01-01

    目的 建立全科医师规范化培训临床教学基地师资评估标准,以保证全科医师规范化培训质量.方法 在广泛文献研究和专家访谈的基础上,初步建立了由4个一级指标和45个二级指标构成的“上海市全科医师规范化培训临床教学基地师资评估标准”专家评议表,于2012年至2013年期间开展了2轮德尔菲专家咨询,以确定师资评估标准.结果 咨询专家来自于上海市全科医师规范化培训临床教学基地、医学院校和卫生行政机关的,从事全科临床、教学、管理的专家共37名.其中64.8%(24/37)从事全科医师培训5年以上,78.4%(29/37)曾作为师资直接带教过全科医师,70.2%(26/37)具有高级职称.两轮咨询中专家积极系数均分别为97.3%和100.0%;权威程度分别为0.817和0.855;指标重要性的专家协调系数分别为0.188和0.278(均P<0.01),且第二轮大于第一轮,专家意见趋于一致.最终确立了一套由4个一级指标和27个二级指标组成的全科医师规范化培训临床教学基地师资评估标准.4个一级指标为专业素养、临床医疗工作能力、教学资格与能力、全科医学基本概念,权重系数分别为0.253、0.253、0.251、0.243.结论 本全科医师规范化培训临床教学基地师资评估标准科学、内容全面,可用于全科医师规范化培训临床师资综合能力的评估.%Objective To develop an assessment criteria for general practitioner (GP) trainers in clinical training base.Methods Based on the extensive literature review and expert interview,a preliminary index system was established with 4 first-grade indicators and 45 second-grade indicators for GP trainers in clinical training base.During 2012 to 2013,a two-round Delphi consultation was conducted to establish the assessment criteria.Results Thirty seven experts engaged in clinical practice,training and managers of GP training program from clinical training bases

  16. Exploration on Network Self-learning Platform for General Practitioners Training in Research-oriented Hospital%网络自主学习平台在研究型医院全科医师培养中的探索

    Institute of Scientific and Technical Information of China (English)

    柯骏; 赵家义; 袁鹏群; 项耀钧; 姚文华; 韩一平

    2015-01-01

    随着全科医师培养改革的深化,研究型医院将网络自主学习平台引入到全科医师培养工作中。本文以长海医院为例,介绍研究型医院全科医师网络自主学习平台的优点和存在的问题,并探讨全科医师网络自主学习平台的构架设计、网络课程和平台功能的完善以及电子学档在网络自主学习平台中的运用。%With the advancement of general practitioners training reform, the research-oriented hospital applies the network self-learning platform to the working of general practitioners training.Taking Changhai hospi-tal as an example, the authors introduced some advantages and problems of the network self-learning platform in general practitioners training of research-oriented hospital.It also explored the design of the frame, the improve-ment of net courses and functions, and the application of E-learning Portfolio.

  17. Role of general practitioner, specialist and insurance practitioner in managing knee impairment

    Directory of Open Access Journals (Sweden)

    Olivera Masten-Cuznar

    2006-02-01

    Full Text Available Background: Proper treatment of the pacient with knee injury or disease, early diagnosis, therapy, rehabilitation which may include use of knee orthoses are most important for the best outcome. Communication between general practitioner, the specialists involved and even insurance practitioner on ZZZS (Health Insurance Institute of Slovenia and especially motivation of the patient are essential for the best cure in every case. World-wide studies showed opposite, positive and negative effects of active support of knee orthoses. The aim of the study was to find out if any differences could be detected in deciding about confirmation of knee orthoses and health resort rehabilitation between insurance practitioners in Slovenia.Methods: Retrospective review of number of confirmed orthoses and especially knee orthoses in connection with registrated active population of ten ZZZS areas on the ZZZS division for orthoses in 2001, 2002 in 2003 has been done. Retrospective review of number of all confirmed health resort rehabilitation and comparison for selected ten diagnosis of knee injuries and diseases in connection with registered active population of ten ZZZS areas from ZZZS computer basis data in 2001, 2002, 2003 in 2004 has been done.Results: Analysed data indicated a decrease in number of confirmed knee orthoses and number of health resort rehabilitation but moderate increase in number of health resort rehabilitation for selected ten diagnosis. Top number of confirmed orthoses in connection with registered active population was detected in Novo mesto and Maribor ZZZS area and the smallest number in Koper and Nova Gorica ZZZS area. Top number of health resort rehabilitation for selected ten diagnosis of knee dysfunction was confirmed in Krško and Ravne na Koroškem ZZZS area and the smallest number in Maribor and Koper ZZZS area.Conclusions: The research showed differences between decisions of insurance practitioners about knee orthoses and health

  18. A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases

    Directory of Open Access Journals (Sweden)

    Supreet Kaur

    2015-01-01

    Full Text Available Background: An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. Materials and Methods: A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Results: Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. Conclusion: General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

  19. Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sladden Michael

    2007-09-01

    Full Text Available Abstract Background Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice. Methods This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000, a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85% of these children in all 43 practices. Practices randomised to intervention (21 received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention. Results Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03. For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms. Conclusion Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting.

  20. An overview of patients' preference for, and satisfaction with, care provided by general practitioners and nurse practitioners.

    NARCIS (Netherlands)

    Laurant, M.G.H.; Hermens, R.P.M.G.; Braspenning, J.C.C.; Akkermans, R.P.; Sibbald, B.; Grol, R.P.T.M.

    2008-01-01

    AIM AND OBJECTIVES: To assess patients' views on the care provided by nurse practitioners compared with that provided by general practitioners and to determine factors influencing these views. BACKGROUND: Many countries have sought to shift aspects of primary care provision from doctors to nurses. I

  1. 49 CFR 1103.15 - The practitioner's duty to clients, generally.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false The practitioner's duty to clients, generally... TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS Canons of Ethics The Practitioner's Duties and Responsibilities Toward A Client § 1103.15 The practitioner's duty to clients...

  2. Dealing with uncertainty in general practice: an essential skill for the general practitioner

    NARCIS (Netherlands)

    O'Riordan, M.; Dahinden, A.; Akturk, Z.; Ortiz, J.M.; Dagdeviren, N.; Elwyn, G.; Micallef, A.; Murtonen, M.; Samuelson, M.; Struk, P.; Tayar, D.; Thesen, J.

    2011-01-01

    Many patients attending general practice do not have an obvious diagnosis at presentation. Skills to deal with uncertainty are particularly important in general practice as undifferentiated and unorganised problems are a common challenge for general practitioners (GPs). This paper describes the mana

  3. 上海市规范化培训全科医生社区卫生服务能力评估研究%Assessment of community health service ability of general practitioners after standardized training in Shanghai

    Institute of Scientific and Technical Information of China (English)

    李慧; 彭明辉; 傅士杰; 张向杰; 刘瑶; 江孙芳

    2016-01-01

    目的 评估上海市规范化培训后全科医生的社区卫生服务能力,并与未经规范化培训的全科医生进行比较,进而评价本市全科医生规范化培训效果.方法 2014年9-11月采用回顾性队列研究,建立经过规范化培训和未经规范化培训的社区全科医生队列(规培组和非规培组各102名),两组年龄、性别、教育背景、工作年限以及执业地点匹配,评估两组社区卫生服务(主要包括基本公共卫生服务和基本医疗服务)的能力.采用笔试评估全科医生基本公共卫生服务能力;采用客观结构化临床考核(OSCE)评估全科医生基本医疗服务能力,包括临床接诊和临床技能两部分.结果 规培组笔试成绩高于非规培组[(66±4)分比(62±7)分,P<0.01],OSCE总分高于非规培组[(494±78)分比(448 ±80)分,P<0.01],临床接诊和临床技能总分也均高于非规培组[分别为(245 ±44)分比(225 ±40)分;(252±59)分比(225 ±61)分,均P<0.01].OSCE评估中,规培组在病史采集、医患沟通、基本操作、心电图判读、心肺复苏5个站点的评分高于非规培组(均P <0.01);体格检查、病例分析和X线片判读站点评分两组比较差异无统计学意义(均P >0.05).结论 经过规范化培训的全科医生的基本医疗卫生服务和基本公共卫生服务的能力总体均优于未经规范化培训的全科医生,但在基本医疗能力的某些方面还需要在培训和实践中加强.%Objective To assess community health service ability of general practitioners (GPs) with the Standardized General Practitioner Training(SGPT) in Shanghai.Methods One hundred and four GPs receiving SGPT and matched 102 GPs without SGPT were enrolled in this retrospective cohort study from September to November in 2014.Community health service ability,including abilities in basic medical service and public health service were assessed and compared between two groups.Written examination was applied in

  4. Why and how do general practitioners teach? An exploration of the motivations and experiences of rural Australian general practitioner supervisors.

    Science.gov (United States)

    Ingham, Gerard; Fry, Jennifer; O'Meara, Peter; Tourle, Vianne

    2015-10-29

    In medical education, a learner-centred approach is recommended. There is also a trend towards workplace-based learning outside of the hospital setting. In Australia, this has resulted in an increased need for General Practitioner (GP) supervisors who are receptive to using adult learning principles in their teaching. Little is known about what motivates Australian GP supervisors and how they currently teach. A qualitative study involving semi-structured interviews with 20 rural GP supervisors who work within one Regional Training Provider region in Australia explored their reasons for being a supervisor and how they performed their role. Data was analysed using a thematic analysis approach. GP supervisors identified both personal and professional benefits in being a supervisor, as well as some benefits for their practice. Supervision fulfilled a perceived broader responsibility to the profession and community, though they felt it had little impact on rural retention of doctors. While financial issues did not provide significant motivation to teach, the increasing financial inequity compared with providing direct patient care might impact negatively on the decision to be or to remain a supervisor in the future. The principal challenge for supervisors was finding time for teaching. Despite this, there was little evidence of supervisors adopting strategies to reduce teaching load. Teaching methods were reported in the majority to be case-based with styles extending from didactic to coach/facilitator. The two-way collegiate relationship with a registrar was valued, with supervisors taking an interest in the registrars beyond their development as a clinician. Supervisors report positively on their teaching and mentoring roles. Recruitment strategies that highlight the personal and professional benefits that supervision offers are needed. Practices need assistance to adopt models of supervision and teaching that will help supervisors productively manage the increasing

  5. Research and Theory as Necessary Tools for Organizational Training and Performance Improvement Practitioners

    Science.gov (United States)

    Abaci, Serdar; Pershing, James A.

    2017-01-01

    Human Performance Technology (HPT) is the applied study and practice of improving organizational performance through training and non-training interventions. For practitioners working in this area that identify themselves as an HPT practitioner, organizational training and performance (OTP) specialist, or instructional designer--offering the right…

  6. [Pain experience and pain therapy of tumor patients in the view of general practitioners].

    Science.gov (United States)

    Janig, H; Pipam, W; Lastin, S; Sittl, R; Bernatzky, G; Likar, R

    2005-04-01

    The aim of the study presented in this paper is to find out how general practitioners evaluate their cancer patients' health, quality of life and type and extent of pain. In addition the study aims to get information about the training in pain therapy and palliative medicine. A representative sample of 440 of all Austrian general practitioners was interviewed via a standardized questionnaire. The consent for the questioning had been obtained by telephone. The state of health and quality of life of the treated cancer patients are described as little satisfying and most unfavourably affected by the disease. The physicians suppose that the patients experience pain more intense than could be expected of them as endurable. Nevertheless the cancer patients appreciate pain therapy. As a result the medical training in pain therapy and palliative medicine should be improved. At the same time the future general practitioners should gain psychological competences, which would consequently provide them with a broad spectrum of treatment needed when dealing with pain patients (suffering from cancer).

  7. [Malaria prevention: the general practitioners experience on the Reunion Island].

    Science.gov (United States)

    Di Bernardo, S; Guihard, B; Wartel, G; Sissoko, D

    2012-08-01

    Malaria has been officially eradicated from the Reunion Island since 1979. However, a potentially active vector of the disease - Anopheles arabiensis - persists on the island. The risk of resurgence is quite significant. More than 90%of the patients presenting a malarial infection in Reunion Island after a stay in Madagascar or in the Comoros had followed a chemoprophylaxis that was not in accordance with the guidelines. A survey, that included 100 general practitioners, wasconducted in the Reunion Island regarding their practices concerning the malaria prevention. The upshot of all this is that these doctors themselves do not follow the optimal malaria prevention practices during journeys, and neglect their protection against mosquito bites. Travelers' consultations with the doctors before a journey represent only a modest part of their activity. However, the general practitioner is considered to be the interlocutor of choice for these patients. During these consultations, they do not refer enough to the national references which, according to a number of practitioners, are difficult to obtain. On the contrary, they refer too much to the information delivered by the pharmaceutical industry. With regard to the prescriptions of prophylactic treatments, only 40% of the doctors respect the official recommendations. This gap in the recommendations is sometimes deliberate and justified by the very high cost of a number of treatments. However, a lack of up-to-date knowledge cannot be excluded. Finally, the promotion of the protection against mosquito bites remains very poor. According to these data, it seems important to promote networking between the doctors and the reference centers, which would enhance optimal practices concerning chemoprophylaxis and protection against mosquito bites, especially targeting the "at risk" patients.

  8. Five-year outcomes of western mental health training for Traditional Chinese Medicine practitioners

    Directory of Open Access Journals (Sweden)

    Tai Pong Lam

    2016-10-01

    Full Text Available Abstract Background There are increasing expectations for primary care practitioners to deal with mental health problems. In Hong Kong, 15 % of the general public consult Traditional Chinese Medicine (TCM practitioners regularly for their primary health care needs. This study investigated the 5-year outcomes of a western mental health training course for TCM practitioners in Hong Kong. Method Structured questionnaire surveys were conducted to compare the TCM practitioners’ confidence and engagement in mental health care before and after the Course. The data collected during 2011–2015 were analyzed. Results A total of 151 TCM practitioners returned both pre- and post-Course questionnaires, with a response rate of 95.6 %. After the course, there were significant increases in the proportions of participants being confident of recognizing patients with psychological problems (62.9 % before the course vs 89.4 % after, diagnosing common mental health problems (47.7 % vs 77.5 %, and managing them (31.2 % vs 64.3 %. Overall, 66.9 % of the participants reported some increase in their confidence in recognizing patients with psychological problems, diagnosing or/and managing patients with common mental health problems. Qualitative responses illustrated the major improvements were increased awareness of mental symptoms, better understanding of classification of mental disorders and management approaches. On the other hand, barriers included difficulties in understanding medical terms in English, consultation time constraints, and a lack of formal referral system to psychiatrists. Conclusions The Course has positive impact on TCM practitioners in handling mental health patients. The findings are useful for designing similar trainings on complementary and alternative medicine practitioners in other countries.

  9. Acceptance and commitment therapy - pathways for general practitioners.

    Science.gov (United States)

    Smout, Matthew

    2012-09-01

    Acceptance and commitment therapy (ACT) focuses on helping patients to behave more consistently with their own values and apply mindfulness and acceptance skills to their responses to uncontrollable experiences. This article presents an overview of ACT, its evidence base and how general practitioners can apply ACT consistent practice in the primary care setting. It describes pathways for general practitioners to develop further expertise in the approach. Acceptance and commitment therapy has been associated with improved outcomes in patients with chronic pain (comparable to cognitive behaviour therapy) and several studies suggest that it may be useful in patients with mild to moderate depression. Preliminary evidence of benefit has also been shown in the setting of obsessive-compulsive disorder, psychosis, smoking, tinnitus, epilepsy and emotionally disordered eating after gastric band surgery. Acceptance and commitment therapy starts with a discussion about what the patient wants and how they have tried to achieve these aims. Strategies previously used to avoid discomfort are discussed. Psychoeducation in ACT involves metaphors, stories and experiential exercises to demonstrate the uncontrollability and acceptability of much psychological experience. In its final phase, ACT resembles traditional behaviour therapy consisting of goal setting and graduated activity scheduling toward goals directed by values.

  10. Management of erectile dysfunction: barriers faced by general practitioners

    Institute of Scientific and Technical Information of China (English)

    Wah-YunLow; Chirk-JennNg; Ngiap-ChuanTan; Wan-YuenChoo; Hui-MengTan

    2004-01-01

    Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED). Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs. Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impoteneet drugs. Cardiovascular side effects and cost were two most important drug barriers. Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patientsand drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.

  11. The Doctor's Tale: Enacted Workspace and the General Practitioner

    Directory of Open Access Journals (Sweden)

    Frances Rapport

    2008-05-01

    Full Text Available The environments and landscapes in which we live and work say much about who we are and how we act, yet there is little in the literature that considers Primary Care professionals' reflections on workspace and its impact on practice. The paper addresses this lacuna by presenting the findings of Phase II of a novel, two-year, mixed-methods study of UK General Practitioner (GP workspace. Phase II employed photo-biographic-elicitation interviews supported by photo-biographic data from Phase I, to examine 8 GPs' understandings of their workspace in relation to professional practice and self-identity. Through distillation and summation of datasets, the paper establishes the pivotal role of workspace in Primary Care. Unlike many qualitative studies, the paper emphasizes ambiguity and difference rather than certainty and similarity as characteristics that prove to be of major significance in understanding the particularity of GP workspace. Like CHAUCER's Canterbury Tales, GPs' individual stories are set as a sequence of tales within what might be called a frame narrative—the overarching narrative of British general practice providing the frame for the particular stories of the practitioners. Although working environments may be similarly structured, how GPs perceive, perform within, and move through their own setting is unique to each. URN: urn:nbn:de:0114-fqs080227

  12. Video-assisted feedback in general practice internships using German general practitioner's guidelines

    NARCIS (Netherlands)

    Bolter, R.; Freund, T.; Ledig, T.; Boll, B.; Szecsenyi, J.; Roos, M.

    2012-01-01

    Introduction: The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the

  13. [The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Weel, C. van

    2008-01-01

    This article reviews the practice guideline from the Dutch College of General Practitioners on smoking cessation. General practitioners (GP) should strive after smoking cessation when patients consult and ask for support to stop smoking. Moreover, the practitioner should also show such initiative wh

  14. Validation of the diagnosis of autism in general practitioner records

    Directory of Open Access Journals (Sweden)

    Smith Peter G

    2004-03-01

    Full Text Available Abstract Background We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD. We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. Methods Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs. Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. Results For 294 subjects (92.5% the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2% fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6. Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa = .73, and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from .56 to 1.0. Conclusions This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high.

  15. General practitioners' opinions on the intake of painkillers among patients.

    Science.gov (United States)

    Latalski, Maciej; Skórzyńska, Hanna; Pacian, Anna

    2002-01-01

    The goal of this paper is to evaluate the consumption of painkillers among patients on the basis of the opinions of general practitioners. The most frequent ailments including pain symptoms were the cases of long-continued pain (64.3%); less frequent were acute pain syndromes in the course of a disease (35.7%). The phenomenon of the excessive use of painkillers among patients with long-continued pain syndromes is observed by the GPs. Uncontrolled self-treatment is possible owing to an easy access to this type of medicaments. The excessive use of analgesic medicines in therapy frequently results from the lack of simultaneous application of other methods of pain treatment e.g., in physiotherapy, psychotherapy. Long lasting use of various types of painkillers can lead to drug addiction. This problem is observed by over a half of the GPs (67.1%).

  16. Idiopathic Normal Pressure Hydrocephalus: A Review for General Practitioners.

    Science.gov (United States)

    Nassar, Basant R; Lippa, Carol F

    2016-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords "normal pressure hydrocephalus," "diagnosis," "shunt treatment," "biomarkers," "gait disturbances," "cognitive function," "neuropsychology," "imaging," and "pathogenesis," articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

  17. Preparedness of Lithuanian general practitioners to provide mental healthcare services

    DEFF Research Database (Denmark)

    Jaruseviciene, Lina; Sauliune, Skirmante; Jarusevicius, Gediminas

    2014-01-01

    BACKGROUND: A large unmet need for mental healthcare in Lithuania is partially attributable to a lack of primary care providers with skills in this area. The aim of this study was to assess general practitioners' (GPs) experience in mental healthcare and their perceptions about how to increase...... their involvement in the field. METHODS: In this cross-sectional study, a 41-item questionnaire was distributed to a random sample of 797 Lithuanian GPs in order to investigate current practices in their provision of mental healthcare as well as their suggestions for the improvement of mental healthcare services...... specialists with whom 32% of the respondents discuss the management of their patients with a mental disorder. Collaboration with psychologists and social workers was almost threefold lower (11.6% and 12.5%). Capacity-building of GPs was found to be among the most promising initiatives to improve mental health...

  18. Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

    DEFF Research Database (Denmark)

    Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

    2014-01-01

    Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. Results This study provides...... general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. Conclusions It is acceptable to inquire about IPV...... with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research...

  19. Inequitable distribution of general practitioners in Australia: estimating need through the Robin Hood Index.

    Science.gov (United States)

    Wilkinson, D; Symon, B

    2000-02-01

    From Census data, to document the distribution of general practitioners in Australia and to estimate the number of general practitioners needed to achieve an equitable distribution accounting for community health need. Data on location of general practitioners, population size and crude mortality by statistical division (SD) were obtained from the Australian Bureau of Statistics. The number of patients per general practitioner by SD was calculated and plotted. Using crude mortality to estimate community health need, a ratio of the number of general practitioners per person: mortality was calculated for all Australia and for each SD (the Robin Hood Index). From this, the number of general practitioners needed to achieve equity was calculated. In all, 26,290 general practitioners were identified in 57 SDs. The mean number of people per general practitioner is 707, ranging from 551 to 1887. Capital city SDs have most favourable ratios. The Robin Hood Index for Australia is 1, and ranges from 0.32 (relatively under-served) to 2.46 (relatively over-served). Twelve SDs (21%) including all capital cities and 65% of all Australians, have a Robin Hood Index > 1. To achieve equity per capita 2489 more general practitioners (10% of the current workforce) are needed. To achieve equity by the Robin Hood Index 3351 (13% of the current workforce) are needed. The distribution of general practitioners in Australia is skewed. Nonmetropolitan areas are relatively underserved. Census data and the Robin Hood Index could provide a simple means of identifying areas of need in Australia.

  20. National study of parental confidence in general practitioners.

    Science.gov (United States)

    Freed, Gary L; Spike, Neil; O'Hara, Jonathan; Hiscock, Harriet; Rhodes, Anthea L

    2017-09-03

    To assess a national sample of Australian parental confidence in general practitioner (GP) care for illness and injury for their children. Cross-sectional, internet-based survey of a national, representative sample of parents of children birth - 17 years in Australia was used. Purposeful recruitment was used to achieve a national, representative sample of 2100 Australian parents, reflective of demographic and geographic distribution based on census data. Parents were asked to indicate their degree of confidence in a GP to handle medical problems as well as their preference for, and use of, paediatric speciality care for their children. Fewer than half of parents (44%) reported that they were completely confident in a GP to provide general care as defined as 'can handle almost all general health issues for my child'. A slightly greater proportion of parents (56%) were completely confident in a GP to provide care for minor injuries, defined as injuries not requiring an X-ray. Greater confidence in general care was seen among parents >40 years of age and those whose GP is always bulk billed. Parental confidence in GPs is an important issue. Our findings that fewer than half of parents are completely confident in their GP to provide general care to their child may be an influencing factor on current health-care utilisation trends. The potential implications of low parental confidence in GPs are greater numbers of emergency department presentations for children with lower urgency conditions and increased referrals of children for specialty care. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  1. General practitioners' evaluation of community psychiatric services: responsiveness to change of the General Practitioner Experiences Questionnaire (GPEQ

    Directory of Open Access Journals (Sweden)

    Damerell Elisabeth

    2010-04-01

    Full Text Available Abstract Background Instruments have been developed to assess professional views of the quality of care but have rarely been tested for responsiveness to change. The objective of this study was to test the responsiveness of the General Practitioner Experiences Questionnaire (GPEQ for the measurement of Community Mental Health Centres in Norway. Methods National surveys were conducted in Norway in 2006 (n = 2,415 and 2008 (n = 2,209 to measure general practitioners' evaluation of community mental health centres. GPs evaluated the centres by means of a postal questionnaire, consisting of questions focused on centre quality and cooperation with GPs. As part of the national surveys 75 GPs in 2006 and 66 GPs in 2008 evaluated Hamar community mental health centre. Between the surveys, several quality improvement initiatives were implemented which were directed at cooperation with and guidance for GPs in Stange municipality, one of eight municipalities in Hamar centre catchment area. The main outcome measures were changes in GPEQ scores from 2006 to 2008 for GPs evaluating Hamar community mental health centre from Stange municipality, and changes in scores for GPs in the other seven municipalities and nationally which were assessed for statistical significance. Results GPs in Stange municipality rated Hamar community mental health centre significantly better on the guidance scale in 2008 than in 2006; on a 0-100 scale where 100 represents the best possible experiences the score was 26.5 in 2006 and 58.3 in 2008 (p Conclusions Following the implementation of an initiative designed to enhance service quality, the GPEQ identified expected changes in the guidance scale for the intervention group, indicating that the instrument is responsive to change. The worsening of services for GPs in the control group evaluating Hamar centre warrants further study.

  2. 全科住院医师规范化培训中“双导师制”的实施现况分析%A survey on double-preceptor system in standardized residency training of general practitioners

    Institute of Scientific and Technical Information of China (English)

    周容; 潘志刚; 陈倩; 张向杰; 张渊

    2014-01-01

    general practitioners (GPs).Methods A questionnaire survey was conducted among 48 residents,53 clinical and community preceptors during May and June 2013.Results The preceptors mostly agree with the necessity to carry out double-preceptor system.82.8% (24/29) clinical preceptors,95.8% (23/24) community preceptors and 89.6% (43/48) residents considered that it was very effective.Less than half of the clinical(13/29) and community (11/24) preceptors knew very clearly about their responsibilities and obligations ; 93.1% (27/29) clinical preceptors and 95.8 % (23/24) community preceptors hoped to receive corresponding training courses.72.4% (21/29) clinical preceptors and 75.0% (18/24) community preceptors communicated with residents frequently,75.9% (22/29) clinical preceptors thought "residents were not actively involved" was the main obstacle in the implementation of double-preceptor system.The guide contents were focused on clinical skills,scientific research and how to pass assessments.The main approaches were interviews,checking the quality of medical instruments and small lecture.Only 6.9% (2/29) clinical preceptors conducted outpatient teaching,83.3% (40/48)residents thought "tutors did not knew clearly about their responsibilities and obligations" was the main obstacle in the practice of doublepreceptor system.Regarding how to evaluate the double-preceptor system,clinical and community preceptors tended to use examination results and feedback of residents.Clinical preceptors,community preceptors and residents all gave low comments about the preceptor-resident contact handbook.87.5% (21/24) community preceptors thought "lack of corresponding incentive mechanisms" was the main obstacle in the practice of double-preceptor system.Conclusions Double-preceptor system has been widely recognized by both preceptors and students.In order to improve the system,we should conduct tutor training courses regularly and establish an effective mechanism to assess

  3. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study.

    Science.gov (United States)

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-03-01

    To explore general practitioners' (GPs) views on leadership roles and leadership challenges in general practice and primary health care. We conducted focus groups (FGs) with 17 GPs. Norwegian primary health care. 17 GPs who attended a 5 d course on leadership in primary health care. Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement. GPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance. KEY POINTS Little is known about doctors' experiences and views about leadership in general practice and primary health care. Our study suggests that: There is a lack of preparation and formal training for the leadership role. GPs experience tensions between the clinical and leadership role. GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

  4. The electronic locum record for general practitioners: Outcome of an evaluation study in the Netherlands

    NARCIS (Netherlands)

    Dumay, A.C.M.; Haaker, T.I.

    2010-01-01

    Background: A locum practitioner is an out-of-hours general practitioner who needs access to the electronic health record of visiting patients. The electronic locum record is a summary of the electronic health record available to the locum practitioner and includes the most significant health proble

  5. Novel anticoagulants: general overview and practical considerations for dental practitioners.

    Science.gov (United States)

    Elad, S; Marshall, J; Meyerowitz, C; Connolly, G

    2016-01-01

    Currently, 4 novel Direct Oral Anticoagulants (DOACs) were approved by the FDA. This review focuses on these agents and proposes a matrix for the general dentists to assess bleeding risk in dental management of patient on DOACs. The outline covers the pharmacology of DOACs (rivaroxaban, apixaban, edoxaban and dabigatran), bleeding complications, risk associated with discontinuation, monitoring/reversal, and implications for the dental practitioners. A total of 18 randomized controlled trials were identified with mixed results in regards to the risk for bleeding. Considering the pharmacology of DOACs and challenges in monitoring and reversing their effect, the dentist should consider carefully the management of patients on DOACs as it may differ from patients on conventional anticoagulants. Based on the type of dental procedure and the medical risk assessment, several general treatment approaches can be considered: continue DOACs, time dental treatment as late as possible after the last DOACs dose, discontinue DOACs for 24hrs, or discontinue DOACs for 48hrs. Based on the current reported dental literature, limited dental surgery may benefit from the first 2 conservative options. However, this needs to be proven in comparative clinical trials.

  6. How can a postgraduate professional education and development course benefit general practitioners?: a qualitative study

    Directory of Open Access Journals (Sweden)

    Steven Agius

    2015-06-01

    Full Text Available Purpose: The rationale for ‘professional education and development’ (PED courses is to support general practitioners, enabling them to access a range of theoretical and practical skills within a supportive schema. It aims to identify whether and how a regional PED course has had a beneficial impact upon participants. Methods: The study comprised a qualitative investigation of participants’ assessed coursework portfolios. The content of each portfolio gives individual accounts of the impact of the course on personal and practice development. Permission to access extant portfolios was obtained from 16 recent alumni of the course. The anonymous written material was analysed by the research team for recurring discourses and themes using a thematic framework analysis. Results: Seven major thematic categories were extrapolated from the data: leadership, resilience, quality improvement, change management, development of new services, educational expertise, and patient safety. In each category, we found evidence that the course enabled development of practitioners by enhancing knowledge and skills which had a positive impact upon their self-perceived effectiveness and motivation. Conclusion: Extended specialty training is on the horizon but such courses may still serve a valuable purpose for current trainees and the existing general practitioners workforce which will be responsible for leading the shift towards community-based service delivery.

  7. Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu

    Directory of Open Access Journals (Sweden)

    Sekharan Gopalakrishnan

    2013-01-01

    Full Text Available Background: Studying drug use pattern among medical practitioners is of vital importance in the present scenario where irrational drug use and development of drug resistance is becoming rampant. Objective: To assess, the pattern of prescribing practices among the general practitioners in a defined rural and urban area of Tamil Nadu. Materials and Methods: A community based descriptive study was conducted to collect 600 prescriptions from the catchment areas of rural and urban health training centers of a medical college using prescribing indicators as per the WHO "How to investigate drug use in health facilities" tool. Results: This prescription study revealed that multivitamins (19.5%, antibiotics (19.3%, drugs for gastro-intestinal tract (GIT (18%, analgesic non-steroidal anti-inflammatory drugs/ (NSAID′s (15.1%, and antihistaminic (12.5% were prescribed frequently. Among the antibiotics, amoxicillin (49.2% was the most commonly prescribed followed by gentamicin (31.7%. Percentage of prescriptions with an antibiotic was 55% and nearly 62% of the practitioners prescribed drugs by their generic names. As a practice of poly-pharmacy, it was observed that the average number of drugs prescribed in urban and rural area was nearly 5 and 4, respectively. Nearly 80% of the urban and rural practitioners were prescribing at least one injection. Study of the quality of prescriptions revealed that there was poor legibility, high usage of abbreviations, inadequate details of the drugs, and absence of signature by practitioners in the prescriptions. Conclusion: This study clearly highlights the practice of poly-pharmacy, low usage of generic drugs, injudicious usage of antibiotics and injections and low usage of drugs prescribed from essential drugs list.

  8. [The analysis of functioning of general practitioners offices in rural area].

    Science.gov (United States)

    2012-01-01

    The article deals with the analysis of functioning of general practitioners offices in rural municipal districts of Penzenskaya oblast. The particular forms of such practices (only adults, adults and children) are analyzed. The analysis of functional capacity of general practitioners offices depending on size of population assigned to the feldsher posts is presented. The measurement of work of general practitioner in pilot rural municipal district is carried out. The need in general practitioners offices and planned size of both adult and children population per one position of general practitioner is substantiated. The recommendations concerning the estimate of numbers of positions of general practitioners depending on size of population assigned to the feldsher posts are given.

  9. Developing cultural competence in general practitioners: an integrative review of the literature.

    Science.gov (United States)

    Watt, Kelly; Abbott, Penny; Reath, Jenny

    2016-11-15

    Cultural competence is a broad concept with multiple theoretical underpinnings and conflicting opinions on how it should be materialized. While it is recognized that cultural competence should be an integral part of General Practice, literature in the context of General Practice is limited. The aim of this article is to provide a comprehensive summary of the current literature with respect to the following: the elements of cultural competency that need to be fostered and developed in GPs and GP registrars; how is cultural competence being developed in General Practice currently; and who facilitates the development of cultural competence in General Practice. We conducted an integrative review comprising a systematic literature search followed by a synthesis of the results using a narrative synthesis technique. Fifty articles were included in the final analysis. Cultural competence was conceptualized as requiring elements of knowledge, awareness/attitudes and skills/behaviours by most articles. The ways in which elements of cultural competence were developed in General Practice appeared to be highly varied and rigorous evaluation was generally lacking, particularly with respect to improvement in patient outcomes. Formal cultural competence training in General Practice appeared to be underdeveloped despite GP registrars generally desiring more training. The development of most aspects of cultural competence relied on informal learning and in-practice exposure but this required proper guidance and facilitation by supervisors and educators. Levels of critical and cultural self-reflection amongst General Practitioners and GP registrars varied and were potentially underdeveloped. Most standalone training workshops were led by trained medical educators however the value of cultural mentors was recognised by patients, educators and GP registrars across many studies. Cultural competency development of GP registrars should receive more focus, particularly training in non

  10. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study.

    LENUS (Irish Health Repository)

    Montgomery, Anthony J

    2006-01-01

    BACKGROUND: To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. METHOD: Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. RESULTS: Referral levels varied widely with the full range of cases (0-32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 micromol\\/l (47% not referred) or 250 micromol\\/l (45%). While all patients were referred at higher levels (350 and 480 micromol\\/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 micromol\\/l creatinine; 28% at 250 micromol\\/l; 18% at 350 micromol\\/l and 14% at 480 micromol\\/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). CONCLUSION: The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

  11. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study

    Directory of Open Access Journals (Sweden)

    Shannon William

    2006-09-01

    Full Text Available Abstract Background To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. Method Randomly selected general practitioners (N = 51 were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians; influence of patient age, marital status and co-morbidity on referral. Results Referral levels varied widely with the full range of cases (0–32; median = 15 referred by different doctors after consideration of first laboratory results. Less than half (44% of cases were referred to a nephrologist. Patient age (40 vs 70 years, marital status, co-morbidity (none vs rheumatoid arthritis and general practitioner prior specialist renal training (yes or no did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 μmol/l (47% not referred or 250 μmol/l (45%. While all patients were referred at higher levels (350 and 480 μmol/l, referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 μmol/l creatinine; 28% at 250 μmol/l; 18% at 350 μmol/l and 14% at 480 μmol/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3. Conclusion The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

  12. Can organizational justice help the retention of general practitioners?

    Science.gov (United States)

    Heponiemi, Tarja; Manderbacka, Kristiina; Vänskä, Jukka; Elovainio, Marko

    2013-04-01

    In many countries, public sector has major difficulties in recruiting and retaining physicians to work as general practitioners (GPs). We examined the effects of taking up a public sector GP position and leaving public sector GP work on the changes of job satisfaction, job involvement and turnover intentions. In addition, we examined whether organizational justice in the new position would moderate these associations. This was a four-year prospective questionnaire study including two measurements among 1581 (948 women, 60%) Finnish physicians. A change to work as a public GP was associated with a substantial decrease in job satisfaction and job involvement when new GPs experienced that their primary care organization was unfair. However, high organizational justice was able to buffer against these negative effects. Those who changed to work as public GPs had 2.8 times and those who stayed as public GPs had 1.6 times higher likelihood of having turnover intentions compared to those who worked in other positions. Organizational justice was not able to buffer against this effect. Primary care organizations should pay more attention to their GPs - especially to newcomers - and to the fairness how management behaves towards employees, how processes are determined, and how rewards are distributed.

  13. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general

  14. [The practice guideline 'Anemia' from the Dutch College of General Practitioners; a response from the perspective of general practice medicine

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2003-01-01

    The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general practi

  15. General Practitioners Using Complementary and Alternative Medicine Differ From General Practitioners Using Conventional Medicine in Their View of the Risks of Electromagnetic Fields

    DEFF Research Database (Denmark)

    Kowall, Bernd; Breckenkamp, Jürgen; Berg-Beckhoff, Gabriele

    2015-01-01

    OBJECTIVE: General practitioners (GPs) play a key role in consulting patients worried about health effects of electromagnetic fields (EMF). We compared GPs using conventional medicine (COM) with GPs using complementary and alternative medicine (CAM) concerning their perception of EMF risks...

  16. Quitting patient care and career break intentions among general practitioners in South West England: findings of a census survey of general practitioners

    National Research Council Canada - National Science Library

    Emily Fletcher; Gary A Abel; Rob Anderson; Suzanne H Richards; Chris Salisbury; Sarah Gerard Dean; Anna Sansom; Fiona C Warren; John L Campbell

    2017-01-01

      Objective Given recent concerns regarding general practitioner (GP) workforce capacity, we aimed to describe GPs' career intentions, especially those which might impact on GP workforce availability over the next 5 years...

  17. Assessment of antibiotic prescribing in Latvian general practitioners

    Directory of Open Access Journals (Sweden)

    Dumpis Uga

    2013-01-01

    Full Text Available Abstract Background Though general antibiotic consumption data is available, information on the actual patterns of prescribing antibiotics locally is difficult to obtain. An easy to use methodology was designed to assess ambulatory management of infections by Latvian general practitioners (GPs. Methods GPs were asked to record data in a patient data collection form for every patient that received antibiotics. Study period – (7 days one week in November, 2008. Data recorded included the following details: an antibiotic, the prescribed dose, dosing interval, route of administration combined with the demographic factors of the patient and clinical diagnosis based on a pre-defined list. Results Two hundred forty eight forms out of the 600 (41% were returned by post. Antibiotics were prescribed in 6.4% (1711/26803 of outpatient consultations. In total, 1763 antibiotics were prescribed during the study period. Ninety seven percent of the patients received monotherapy and only 47 (2.7% patients were prescribed two antibiotics. The most commonly prescribed antibiotics were amoxicillin (33.9% of prescribed, amoxicillin/clavulanate (18,7% and clarithromycin (7.6%. The most commonly treated indications were pharyngitis (29.8%, acute bronchitis (25.3% and rhinosinusitis (10.2%. Pneumonia was mostly treated with amoxicillin/clavulanate (25,7%, amoxicillin (15.7% and clarithromycin (19.3%. Conclusions Methodology employed provided useful additional information on ambulatory practice of prescribing antibiotics and could be used in further assessment studies. Educational interventions should be focused on treatment of acute pharyngitis and bronchitis in children and unnecessary use of quinolones in adults for uncomplicated urinary tract infection.

  18. General practitioners' experience and benefits from patient evaluations

    Directory of Open Access Journals (Sweden)

    Olesen Frede

    2011-10-01

    Full Text Available Abstract Background It has now for many years been recognised that patient evaluations should be undertaken as an integral part of the complex task of improving the quality of general practice care. Yet little is known about the general practitioners' (GPs' benefit from patient evaluations. Aim 1 was to study the impact on the GPs of a patient evaluation and subsequent feedback of results presented at a plenary session comprising a study guide for the results and group discussions. Aim 2 was to study possible facilitators and barriers to the implementations of the results raised by the patient evaluation process. Methods A patient evaluation survey of 597 voluntarily participating GPs was performed by means of the EUROPEP questionnaire. Evaluation results were fed back to the GPs as written reports at a single feedback meeting with group discussions of the results. Between 3 and 17 months after the feedback, the 597 GPs received a questionnaire with items addressing their experience with and perceived benefit from the evaluations. Results 79.4% of the GPs responded. 33% of the responding GPs reported that the patient evaluation had raised their attention to the patient perspective on the quality of general practice care. Job satisfaction had improved among 26%, and 21% had developed a more positive attitude to patient evaluations. 77% of the GPs reported having learnt from the evaluation. 54% had made changes to improve practice, 82% would recommend a patient evaluation to a colleague and 75% would do another patient evaluation if invited. 14% of the GPs had become less positive towards patient evaluations, and job satisfaction had decreased among 3%. Conclusions We found a significant impact on the GPs regarding satisfaction with the process and attitude towards patient evaluations, GPs' attention to the patients' perspective on care quality and their job satisfaction. Being benchmarked against the average seemed to raise barriers to the

  19. Dissemination of information to General Practitioners: a questionnaire survey

    Directory of Open Access Journals (Sweden)

    Fortnum Heather

    2004-11-01

    Full Text Available Abstract Background Early identification of permanent hearing impairment in children enables appropriate intervention which reduces adverse developmental outcomes. The UK Government has introduced a universal hearing screening programme for neonates. All involved health professionals, including those in Primary Care, need to be aware of the service to enable them to offer appropriate support to their patients. A programme of information dissemination within Primary Care was therefore undertaken. The aim of the current study was to determine the extent to which the information had reached General Practitioners (GPs, the GPs' preferred mode of dissemination and the sources from which GPs accessed information Methods Postal questionnaire survey of a randomised sample of 1000 GPs in the Phase I pilot sites of the Neonatal Hearing Screening Programme (NHSP. Results Responses were received from 54.2% of the sample. Just under 50% of those responding had received information, 62.2% of respondents said they would like to receive more information and the preferred methods of dissemination were the written word and web-sites to allow access when needed. Few GPs perceive themselves to have a core role in the delivery of the NHSP and thence a need for knowledge in the subject. Many are keen to delegate detail to a third party, usually the health visitor, who has traditionally had responsibility for hearing screening. Conclusions Dissemination efforts for service developments of relevance to GPs should concentrate on advertising a website address via brief but memorable posted literature and/or articles in relevant journals and magazines. The website should be GP-friendly, and have a dedicated area for GPs including information of specific relevance and downloadable information sheets.

  20. Perception of drug teratogenicity among general practitioners and specialists in obstetrics/gynecology

    DEFF Research Database (Denmark)

    Gils, Charlotte; Pottegård, Anton; Ennis, Zandra Nymand

    2016-01-01

    the perception of the teratogenic risk of 9 commonly and 3 rarely prescribed drugs among general practitioners and specialists in obstetrics/gynecology. METHODS: All 811 general practitioners in the Region of Southern Denmark and all 502 specialist obstetricians/gynecologists in Denmark as a whole were invited...

  1. Educational needs of general practitioners in palliative care : Outcome of a focus group study

    NARCIS (Netherlands)

    Meijler, WJ; Van Heest, F; Otter, R; Sleijfer, DT

    2005-01-01

    Background. The objective of this study was to identify the general practitioner's perception of educational needs in palliative care. Method. A qualitative study with focus groups was performed. Results. General practitioners estimate palliative care as an important and valuable part of primary car

  2. Cost-effectiveness of physical therapy and general practitioner care for sciatica.

    NARCIS (Netherlands)

    Luijsterburg, P.A.; Lamers, L.M.; Verhagen, A.P.; Ostelo, R.W.J.G.; Hoogen, H.J.M. van den; Peul, W.C.; Avezaat, C.J.; Koes, B.W.

    2007-01-01

    STUDY DESIGN: An economic evaluation alongside a randomized clinical trial in primary care. A total of 135 patients were randomly allocated to physical therapy added to general practitioners' care (n = 67) or to general practitioners' care alone (n = 68). OBJECTIVE: To evaluate the cost-effectivenes

  3. Australian general practitioners' preferences for managing the care of people diagnosed with cancer.

    Science.gov (United States)

    Johnson, Claire E; Lizama, Natalia; Garg, Neeraj; Ghosh, Manonita; Emery, Jonathan; Saunders, Christobel

    2014-06-01

    To investigate general practitioners' (GPs) preferences for involvement in the management of people diagnosed with the seven most frequent cancers and any barriers to or concerns about an expanded role for GPs. A self-report survey was mailed to a random sample of 1969 Australian GPs. In all, 33% (648) of GPs participated. Participants were a median of 50 years and worked 38 h per week; 53% were male and 68% practiced in metropolitan areas. Most participants preferred to be involved in cancer prevention (86%) and initial diagnosis (85%). Fewer were interested in monitoring for recurrence (70%), follow up after treatment (68%), coordinating psychological support (70%) and palliative care (68%). Only 52% of GPs had a preference for providing supportive care to manage the symptoms of cancer treatment, 45% for managing postoperative care and 40% for coordinating treatment. On multivariate analysis, preference for involvement in more aspects of cancer management increased with age (P = 0.030), if the GP practiced in rural compared to metropolitan areas (P = 0.005), was a partner in a practice compared to a sole practitioner (P = 0.003), had previously received cancer-specific training (P management. While many GPs are currently involved in some aspects of cancer management, with training, good communication and support from specialists this role may be successfully expanded. © 2012 Wiley Publishing Asia Pty Ltd.

  4. Constitution and monitoring of an epidemiological surveillance network with sentinel general practitioners.

    Science.gov (United States)

    Chauvin, P

    1994-08-01

    The Réseau National Télé-informatique de surveillance et d'information sur les Maladies Transmissibles (RNTMT) (French communicable diseases computerised surveillance network) comprises a network of sentinel general practitioners (SGP). These benevolent volunteers are responsible for the weekly epidemiological surveillance. Since its creation, 1,700 SGPs have participated in the RNTMT, representing a total of more than 120,000 connections to the RNTMT telematic service center. The principal motivation of these benevolent SGPs was to 'actively participate in public health', although only a minority of them (17.6%) had any training in this field. Such a system, based on the benevolent and voluntary activity of SGPs, requires a good understanding of SGPs' attitudes towards epidemiological surveillance in general and the tool used, in order to quantitatively and qualitatively follow their participation and to provide regular and useful feedback to the surveillance actors.

  5. Leadership and management curriculum planning for Iranian general practitioners

    Directory of Open Access Journals (Sweden)

    SHAHLA KHOSRAVAN

    2015-10-01

    Full Text Available Introduction: Leadership and management are two expected features and competencies for general practitioners (GPs. The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern’s curriculum planning cycle. Methods: This study was conducted in 2011-2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern’s curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin’s method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14. Results: In the qualitatively stage of this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a

  6. Patients with urinary tract infection: proposed management strategies of general practitioners, microbiologists and urologists.

    Science.gov (United States)

    Olesen, F; Oestergaard, I

    1995-01-01

    BACKGROUND. It is difficult to implement change in general practice. It is not known how best to conduct effective continuing medical education in general practice. General practitioners' criteria for good clinical practice vary and it is unknown whether systematic education by hospital specialists could be expected to reduce variation between general practitioners. AIM. A study was undertaken to describe general practitioners', microbiologists' and urologists' strategies for diagnosis, treatment, and follow up of female patients with symptoms of urinary tract infection, a common reason for consultation in general practice. The findings of the study were to be used as a base upon which to discuss the advantages and disadvantages of using hospital specialists as a resource in general practitioners' peer group based continuing medical education. METHOD. Three vignettes together with several proposals for diagnosis, treatment and follow up were presented in a questionnaire to general practitioners, microbiologists and urologists in Denmark. The case histories concerned three female patients (aged 10, 30 and 60 years) who consulted their general practitioner for advice. The female patients were otherwise healthy and well known to the practice. General practitioners', microbiologists' and urologists' recommendations for good clinical practice were compared. RESULTS. A total of 154 general practitioners (77%), 45 microbiologists (51%) and 54 urologists (61%) who were eligible for the study responded to the questionnaire. There was considerable variation in the management strategies proposed by doctors within each specialty and between the specialties. Microbiologists and urologists were more likely to suggest treating the 30-year-old woman by giving advice and a prescription by telephone compared with their general practitioner colleagues. Conversely, the microbiologists and urologists were more likely to suggest asking the 10- and 60-year-old patients to attend the

  7. General practitioner workforce planning: assessment of four policy directions

    Directory of Open Access Journals (Sweden)

    O'Dowd Tom

    2010-06-01

    Full Text Available Abstract Background Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. Methods Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. Results Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. Conclusions A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment

  8. General practitioner workforce planning: assessment of four policy directions.

    LENUS (Irish Health Repository)

    Teljeur, Conor

    2010-01-01

    BACKGROUND: Estimating the supply of GPs into the future is important in forecasting shortages. The lengthy training process for medicine means that adjusting supply to meet demand in a timely fashion is problematic. This study uses Ireland as a case study to determine the future demand and supply of GPs and to assess the potential impact of several possible interventions to address future shortages. METHODS: Demand was estimated by applying GP visit rates by age and sex to national population projections. Supply was modelled using a range of parameters derived from two national surveys of GPs. A stochastic modelling approach was adopted to determine the probable future supply of GPs. Four policy interventions were tested: increasing vocational training places; recruiting GPs from abroad; incentivising later retirement; increasing nurse substitution to enable practice nurses to deliver more services. RESULTS: Relative to most other European countries, Ireland has few GPs per capita. Ireland has an ageing population and demand is estimated to increase by 19% by 2021. Without intervention, the supply of GPs will be 5.7% less than required in 2021. Increasing training places will enable supply to meet demand but only after 2019. Recruiting GPs from overseas will enable supply to meet demand continuously if the number recruited is approximately 0.8 per cent of the current workforce per annum. Later retirement has only a short-term impact. Nurse substitution can enable supply to meet demand but only if large numbers of practice nurses are recruited and allowed to deliver a wide range of GP services. CONCLUSIONS: A significant shortfall in GP supply is predicted for Ireland unless recruitment is increased. The shortfall will have numerous knock-on effects including price increases, longer waiting lists and an increased burden on hospitals. Increasing training places will not provide an adequate response to future shortages. Foreign recruitment has ethical considerations

  9. [Summary of the practice guideline 'Thyroid disorders' (first revision) from the Dutch College of General Practitioners

    NARCIS (Netherlands)

    Lieshout, J. van; Wessels, P.; Rijswijk, E. van; Boer, A.M; Wiersma, A.; Goudswaard, A.N.

    2007-01-01

    --The practice guideline 'Thyroid disorders' developed by the Dutch College of General Practitioners replaces the practice guideline 'Functional thyroid disorders' from 1996. Recommendations for palpable thyroid disorders have been added. --Hypothyroidism can often be treated by the general practiti

  10. Towards an optimal composition of general practitioners and nurse practitioners in out-of-hours primary care teams: a quasi-experimental study

    NARCIS (Netherlands)

    Biezen, M.G. van der; Wensing, M.; Burgt, R. Van Der; Laurant, M.G.

    2017-01-01

    OBJECTIVES: To gain insights into the ability of general practitioners (GPs) and nurse practitioners (NPs) to meet patient demands in out-of-hours primary care by comparing the outcomes of teams with different ratios of practitioners. DESIGN: Quasi-experimental study. SETTING: A GP cooperative (GPC)

  11. The general practitioner trainer exchange as an innovative approach to peer review.

    Science.gov (United States)

    van den Heuvel, H G J; Hood, M P

    2010-09-01

    There are various formal peer review schemes to assess the quality of primary care practices and several special approval and re-approval programmes exist for General Practitioner (GP) trainers and primary care training practices. The Defence Postgraduate Medical Deanery (DPMD) has its own General Practice Education Committee (GPEC) approval and re-approval programme. Part of this programme is related to the New Membership of the Royal College of Practitioners (nMRCGP). There is limited published information related to GP trainer exchanges as a means of peer review and as such as preparation for GPEC in the British Forces. This paper provides a review of a GP trainer exchange involving a visit of a GP trainer from British Forces Germany (BFG) to the practices of Dhekelia and Ay Nik on Cyprus in January 2010. It concludes that a GP trainer exchange is cost neutral and may be a valuable experience for both the host and visiting GP trainer, the local GP trainers' group, the practice teams and above all, for the GP trainee.

  12. 北京市社区卫生服务机构非中医全科医生和防保人员的中医素养及培训需求调查%Attainment of TCM and the Demand for TCM Training Among non - TCM General Practitioners and Prevention and Health Care Staff in Community Health Service Settings in Beijing

    Institute of Scientific and Technical Information of China (English)

    刘钢; 赵京

    2016-01-01

    Objective To investigate the attainment of TCM and the demand for TCM training among non - TCM general practitioners and prevention and health care staff in community health service settings in Beijing,in order to provide references for the formulation of relevant policies by governmental departments. Methods Using random number table method, we randomly selected 3 to 6 community health service centers from each of 16 districts/ counties of Beijing,and at last 62 community health service centers were selected. We randomly selected one community health service station from each of the 62 centers and selected all together 62 community health service stations. From the selected stations,all non - TCM general practitioners and prevention and health care staff were enrolled by cluster sampling method. From July 16 to August 16 in 2014, questionnaire survey was conducted. The questionnaire had two versions for general practitioners and prevention and health care staff,and the content covered basic information,the attainment of TCM and the demand for TCM training. Results The score of TCM attainment of non - TCM general practitioners was(67. 74 ± 13. 55),and the scores of four dimensions of TCM attainment, namely cognition of appropriate technology for TCM,cognition of policy for TCM,cognition of clinical knowledge of TCM and cognition of elementary theory of TCM,were(39. 09 ± 22. 61),(46. 18 ± 35. 31),(95. 92 ± 10. 80)and(72. 95 ± 27. 25) respectively. There were significant differences in the score of TCM attainment among general practitioners with different educational degrees and between general practitioners that had attended ″ the training on the rational use of Chinese patent medicine for general practitioners in Beijing″ and general practitioners who had not attended that(P < 0. 05). The score of TCM attainment of non - TCM prevention and health care staff was(50. 09 ± 23. 07),and the scores of three dimensions of TCM attainment,namely cognition of TCM

  13. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Luijsterburg, Pim A J; Verhagen, Arianne P; Ostelo, Raymond W J G; van den Hoogen, Hans J M M; Peul, Wilco C; Avezaat, Cees J J; Koes, Bart W

    2008-04-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2) the control group with general practitioners' care only. To assess the effectiveness of PT additional to general practitioners' care compared to general practitioners' care alone, in patients with acute sciatica. There is a lack of knowledge concerning the effectiveness of PT in patients with sciatica. The primary outcome was patients' global perceived effect (GPE). Secondary outcomes were severity of leg and back pain, severity of disability, general health and absence from work. The outcomes were measured at 3, 6, 12 and 52 weeks after randomisation. At 3 months follow-up, 70% of the intervention group and 62% of the control group reported improvement (RR 1.1; 95% CI 0.9-1.5). At 12 months follow-up, 79% of the intervention group and 56% of the control group reported improvement (RR 1.4; 95% CI 1.1; 1.8). No significant differences regarding leg pain, functional status, fear of movement and health status were found at short-term or long-term follow-up. At 12 months follow-up, evidence was found that PT added to general practitioners' care is only more effective regarding GPE, and not more cost-effective in the treatment of patients with acute sciatica than general practitioners' care alone. There are indications that PT is especially effective regarding GPE in patients reporting severe disability at presentation.

  14. Mastery Status of and Training Demands for General Practice Knowledge and Skills of General Practitioners in Hubei Province%湖北省全科医生对全科医学知识技能的掌握情况及培训需求分析

    Institute of Scientific and Technical Information of China (English)

    陈淑玲; 胡义瑛; 王波; 张光鹏; 张云

    2015-01-01

    "designed on the basis of the Delphi method was employed on the subjects. The content of the questionnaire included basic information,the mastery status of theories and skills related with general practice and training demands. A total of 90 questionnaires were sent out and 86 were recovered,among which 84 were qualified with an effective recovery rate of 93. 3%. Results Among the 84 subjects,54(64. 3%)were male,77(91. 7%)had associate degree or above,78(92. 9%)had primary or medium professional title. The mastery rates of the basic knowledge and skills of pre-hospital first aid, cardio pulmonary resuscitation, medical history collection, and medical record writing were 45. 2%(38/84),52. 4%(44/84)and 57. 1%(48/84) respectively,higher than the rest. The no mastery rates of individual -centered overall service method,children's hearing and vision abnormality screening technique and community mental patients management were 16. 7%(14/84),44. 0%(37/84)and 27. 4%(23/84),higher than the rest. The demanding rates for the training of the treatment of common emergency,acute cerebrovascular disease and shock were 63. 1%(53/84),61. 9%(52/84)and 58. 3%(49/84)respectively,higher than the rest. Conclusion GPs have a better mastery of emergent and common diseases and have more demand for the relevant training. While the mastery rates of general practice services,such as prevention,health care,rehabilitation and health management are lower. Therefore,it is necessary to promote the awareness of general practice, work out targeted training plans and programs and foster a general practitioner team which could meet the demands for grassroots'primary care.

  15. How General Practitioners and Their Patients Adhere to Osteoporosis Management: A Follow-Up Survey among Czech General Practitioners.

    Science.gov (United States)

    Vytrisalova, Magda; Touskova, Tereza; Fuksa, Leos; Karascak, Roman; Palicka, Vladimir; Byma, Svatopluk; Stepan, Jan

    2017-01-01

    Introduction: General practitioners (GPs) are key participants in osteoporosis (OP) management. The aim was to evaluate their adherence to lege artis management of the disease, potential barriers, and to discuss differences observed in comparison with the baseline survey carried out in 2007; the focus was on secondary prevention. Methods: On behalf of two professional associations, 2-round postal survey among randomly selected GPs (>1/4 of all Czech GPs) was performed in 2014. The questionnaire covered areas concerning GP's role in the fight against OP, knowledge about OP, management of OP-related fractures, barriers to the management of OP, system- and patient-related in particular, and availability and use of information sources. Results: The overall questionnaire return rate was 37% (551 respondents); mean age of the respondents was 53 year (37% men). The GP's role in the treatment of OP was rated as essential in 28 and 37% of men and women, respectively (P = 0.012). The guideline for diagnosis and treatment of OP for GPs was considered accessible by 92% of respondents. As much as 60% of the respondents were adherent to the guideline, i.e., used it repeatedly. The knowledge of several risk factors was very good, however, recommended daily intake of calcium was stated correctly by only 41% of respondents, and daily intake of vitamin D by only 40%. Three quarters reported active steps after a fracture: referral to a specialist, life-style recommendations, prescription of calcium/vitamin D supplements. Half of the respondents focus on fall prevention. System-related barriers, such as lack of possibility to prescribe selected drugs (61%) and financial limits set by health insurance company (44%) were most frequently reported. Patient-related barriers were also common, patient's non-adherence (reported by 29%) and patient's reluctance to go to a specialist (18%). Conclusion: GPs adhered to OP management more than in 2007. Knowledge of risk factors and involvement in

  16. Prevalence of burnout among Irish general practitioners: a cross-sectional study.

    Science.gov (United States)

    O'Dea, B; O'Connor, P; Lydon, S; Murphy, A W

    2017-05-01

    Burnout constitutes a significant problem among physicians which impacts negatively upon both the doctor and their patients. Previous research has indicated that burnout is prevalent among primary care physicians in other European countries and North America. However, there is a paucity of research assessing burnout among Irish general practitioners and examining predictive factors. To report the findings of a survey of burnout among Irish general practitioners, and assess variables related to burnout in this population. An online, anonymous questionnaire was distributed to general practitioners working in the Republic of Ireland. In total, 683 general practitioners (27.3 % of practising Irish general practitioners) completed the survey. Of these, 52.7 % reported high levels of emotional exhaustion, 31.6 % scored high on depersonalisation and 16.3 % presented with low levels of personal accomplishment. In total, 6.6 % presented with all three symptoms, fulfilling the criteria for burnout. Emotional exhaustion was higher among this sample than that reported in European and UK studies of burnout in general practitioners. Personal accomplishment was, however, higher in this sample than in other studies. Multiple regression analyses revealed that younger age, non-principal status role, and male gender were related to increased risk of burnout symptoms. The symptoms of burnout appear prevalent among Irish general practitioners. This is likely to have a detrimental impact both upon the individual general practitioners and the patients that they serve. Research investigating the factors contributing to burnout in this population, and evaluating interventions to improve general practitioner well-being, is, therefore, essential.

  17. Early palliative home care: Evaluation of an interprofessional educational intervention for district nurses and general practitioners about nutritional care.

    Science.gov (United States)

    Berggren, Erika; Ödlund Olin, Ann; Orrevall, Ylva; Strang, Peter; Johansson, Sven-Erik; Törnkvist, Lena

    2017-01-01

    Teamwork is important in early palliative home care, and interprofessional education is required to achieve teamwork. It is thus crucial to ensure that interprofessional education works well for the members of all participating professions because levels of knowledge and educational needs may vary. To evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase. A quasi-experimental study that used a computer-based, study-specific questionnaire to evaluate the effectiveness of the intervention. The continuing education in primary health care (ConPrim(®)) model was used to create the intervention. ConPrim includes a web-based program, a practical exercise and a case seminar, all with interprofessional training. Primary health care centers in Stockholm County, Sweden. Intervention group (n = 87; 48 district nurses, 39 general practitioners); control group (n = 53; 36 district nurses, 17 general practitioners). The total intervention effect was significant in all three areas, p = 0.000-0.004. The intervention effects were similar and significant for both professions in areas 1 and 2. In area 3, the intervention effects were significant for general practitioners but not for district nurses. The intervention seems promising, as it may create better prerequisites for teamwork and caring for patients living at home. However, it needs to be optimized to better increase district nurses' level of knowledge (area 3).

  18. 33 CFR 127.503 - Training: General.

    Science.gov (United States)

    2010-07-01

    ...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Personnel Training § 127.503 Training: General....

  19. Old persons' contact with general practitioners in relation to health: a Danish population study

    DEFF Research Database (Denmark)

    Almind, G; Holstein, B E; Holst, E;

    1991-01-01

    The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had...... no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless...

  20. Gender training for development practitioners: only a partial solution.

    Science.gov (United States)

    Porter, F; Smyth, I

    1998-07-01

    This article considers gender training for Oxfam staff working on a development program or project in a particular context where their experience of gender relations and ability to seek gender equality is informed by their hierarchial position, by their national culture, and by the fact that institutions are also gendered. Thus, the article focuses on contextualizing gender training and on the potential of such training to transform institutions. The first section looks at gender training in the Oxfam head office and notes that, although Oxfam identifies itself as a learning organization, the former Training Department has been devolved into separate divisions, so there is no longer any centrally available gender training. The next section describes gender training in the field context where hierarchial positions that may influence the effectiveness of training are created by the age and sex of the trainer and where it is important to distinguish between gender frameworks (what is taught) from pedagogy (how it is taught). Oxfam's present gender training is limited by a lack of documentation of gender training efforts, by trainees' personal resistance to concepts of gender, by language barriers, and by logistical problems. The article then explores Oxfam's use of gender training as a transformative tool and notes that Oxfam focuses on individual rather than internal organizational transformation. It is concluded that gender training is only a partial solution unless its potential for personal and political transformational is recognized and fostered.

  1. Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

    Directory of Open Access Journals (Sweden)

    Critchley Julia

    2005-06-01

    Full Text Available Abstract Background Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand. Methods Questionnaire survey of general practitioners in community hospitals, to estimate: i use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii views on the optimal duration of benzodiazepine use. Results Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%, panic disorder (n = 43, 78%, depression (n = 26, 43%, essential hypertension (n = 15, 27 % and uncomplicated low back pain (n = 10, 18%. Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%; or from 1 week to 1 month (47%; or 1 to 4 months (16%; or 4 to 6 months (5% or more than 6 months (2%. Twenty-five general practitioners (45% accepted that they used benzodiazepines excessively in the past year. Conclusion A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.

  2. Transfer of Training: 1988-2011 with the Practitioner in Mind

    Science.gov (United States)

    Lionetti, Patsy

    2012-01-01

    The purpose of this study was to provide a comprehensive, integrated review of transfer of training literature from 1988 to 2011 and to consolidate the findings to provide action oriented suggestions for practitioners. Research questions for this study were: (a) What characteristics in the transfer of training literature influence transfer of…

  3. Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study

    Science.gov (United States)

    2014-01-01

    Background Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV. Methods Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. Results This study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. Conclusions It is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study. PMID:24893567

  4. Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study.

    Science.gov (United States)

    Mørk, Trine; Andersen, Pernille Tanggaard; Taket, Ann

    2014-06-03

    Thirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women's views and attitudes are regarding being asked about IPV. Data were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data. This study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV. It is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.

  5. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Science.gov (United States)

    Rietveld, Remco P; ter Riet, Gerben; Bindels, Patrick JE; Schellevis, François G; van Weert, Henk CPM

    2007-01-01

    Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes) were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%). In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation. PMID:17868475

  6. Do general practitioners adhere to the guideline on infectious conjunctivitis? Results of the Second Dutch National Survey of General Practice

    Directory of Open Access Journals (Sweden)

    Schellevis François G

    2007-09-01

    Full Text Available Abstract Background In 1996 the guideline 'The Red Eye' was first published by the Dutch College of General Practitioners. The extent to which general practitioners adhere to this guideline is unclear. Recently, data on the management of infectious conjunctivitis by general practitioners became available from the Second Dutch National Survey of General Practice. We measured the age-specific incidence of infectious conjunctivitis, described its management by Dutch general practitioners, and then compared these findings with the recommendations made in the guideline. Methods In 2001, over a 12-month period, data from all patient contacts with 195 general practitioners were taken from electronic medical records. Registration was episode-oriented; all consultations dealing with the same health problem were grouped into disease episodes. Data concerning all episodes of infectious conjunctivitis (ICPC-code F70 and sub codes were analysed. Results Over one year, 5,213 new and recurrent episodes of infectious conjunctivitis were presented to general practitioners from a population of N = 375,899, resulting in an overall incidence rate of 13.9 per 1000 person-years, varying from more than 80/1000 py in children up to one-year old, to less than 12/1000 py in children over the age of 4. Topical ophthalmic ointments were prescribed in 87% of the episodes, of which 80% was antibiotic treatment. Fusidic acid gel was most frequently prescribed (69%. In most episodes general practitioners did not adhere to the guideline. Conclusion In 2001, the management of infectious conjunctivitis by Dutch general practitioners was not in accordance with the recommendations of the consensus-based guideline published five years previously, despite its wide distribution. In 2006 this guideline was revised. Its successful implementation requires more than distribution alone. Probably the most effective way to achieve this is by following a model for systemic implementation.

  7. General practitioners' perspective on poverty: a qualitative study in Montreal, Canada.

    Science.gov (United States)

    Loignon, Christine; Gottin, Thomas; Dupéré, Sophie; Bedos, Christophe

    2017-08-24

    Social inequalities in healthcare systems persist worldwide. Physicians' prejudices and negative attitudes towards people living in poverty are one of the determinants of healthcare inequalities. We know very little about general practitioners' (GPs) perceptions of poverty, which shape their attitudes. To identify the perceptions of poverty of GPs who deal with it in everyday practice. A qualitative study based on interviews with GPs working in deprived urban neighbourhoods. In-depth semi-structured interviews were conducted with physicians working in disadvantaged neighbourhoods in Montreal, Canada. Interviews were audio-recorded and transcribed verbatim. Analysis consisted of interview debriefing, transcript coding, and thematic analysis using an inductive and iterative approach. Our study revealed two contrasting perceptions of poverty. The global conception of poverty referred to social determinants and was shared by the majority of physicians interviewed, while the moral conception, centring on individual responsibility, was shared by a minority of participants. The moral judgments and misunderstandings evidenced by GPs regarding poverty suggest avenues for improving general medical training. Understanding social determinants of health should be an important component of this training, to improve access to care for people living in poverty.

  8. The management of depressive symptoms in patients with COPD: a postal survey of general practitioners.

    NARCIS (Netherlands)

    Yohannes, A.M.; Hann, M.; Sibbald, B.S.

    2011-01-01

    AIMS: We examined the management of depression by general practitioners (GPs), through the use of case vignettes, in patients with chronic obstructive pulmonary disease (COPD), severe osteoarthritis and depressive symptoms alone. BACKGROUND: Depression is common in patients with COPD. Untreated

  9. [Elamed CP-01 capnographic hardware-software system for general practitioners].

    Science.gov (United States)

    Bialovskiĭ, Iu Iu; Konobeeva, T N; Solomakha, V N

    2007-01-01

    The diagnostic capabilities of the Elamed CP-01 capnographic hardware-software system are described. Original engineering solutions and software of the system make it highly useful for general practitioners.

  10. notification of occupational diseases by general practitioners in the ...

    African Journals Online (AJOL)

    miners have to be notified to the Medical Bureau for Occupa- tional Diseases in terms of the ... Factors influencing their reporting practice included lack of guidelines for ... notification system, adequate training and support of GPs, and timeous ...

  11. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: a randomised clinical trial with a 12-month follow-up.

    NARCIS (Netherlands)

    Luijsterburg, P.A.; Verhagen, A.P.; Ostelo, R.W.J.G.; Hoogen, H.J.M. van den; Peul, W.C.; Avezaat, C.J.; Koes, B.W.

    2008-01-01

    A randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' care, and (2)

  12. Physical therapy plus general practitioners' care versus general practitioners' care alone for sciatica: A randomised clinical trial with a 12-month follow-up

    NARCIS (Netherlands)

    P.A.J. Luijsterburg (Pim); A.P. Verhagen (Arianne); R.W.J.G. Ostelo (Raymond); H.J. van den Hoogen (Hans); W.C. Peul (Wilco); C.J.J. Avezaat (Cees); B.W. Koes (Bart)

    2008-01-01

    textabstractA randomised clinical trial in primary care with a 12-months follow-up period. About 135 patients with acute sciatica (recruited from May 2003 to November 2004) were randomised in two groups: (1) the intervention group received physical therapy (PT) added to the general practitioners' ca

  13. How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?

    DEFF Research Database (Denmark)

    Rubak, Sune; Andersen, Marie-Louise Elkjær; Mainz, Jan;

    2002-01-01

    Aim/Objectives: Evaluation of how the substitution system has been implemented, how it was assessed by the general practitioners (GPs), pharmacists (PHs) and patients, and clarification of benefits and problems related to the system. Methods: The study was based on specific question-naires to GPs....... How do general practitioners, pharmacists and patients evaluate the substitution system for prescription in Denmark?. Available from: http://www.researchgate.net/publication/243131968_How...

  14. Revisiting reflexology: Concept, evidence, current practice, and practitioner training

    OpenAIRE

    Embong, Nurul Haswani; Soh, Yee Chang; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and th...

  15. Exploring Professional Development Practices for Vocational Education and Training Practitioners

    Science.gov (United States)

    Williams, Kim

    2009-01-01

    This paper addresses the practice of professional development within the Vocational Education and Training (VET) arena. The study object was to gain the perceptions held by a selected group of VET educators in the tourism and hospitality sector of the professional teaching/training competencies required for effective practice. The study was…

  16. Patient Complaint Cases in Primary Health Care: What Are the Characteristics of General Practitioners Involved?

    Directory of Open Access Journals (Sweden)

    Søren Birkeland

    2013-01-01

    Full Text Available Background. Limited knowledge exists about factors increasing the risk of general practitioners becoming involved in a complaint case or getting disciplined in connection with a complaint case. Aim. The present study aimed to identify the general practitioner and practice characteristics associated with complaint cases and discipline. Methods. Information on general practitioners involved in complaint case decisions during one year (2007 was linked to Danish National register data on all general practitioners (. Logistic regression was used for statistical analysis. Results. With regard to complaints concerning daytime services (, the professional seniority of the general practitioner was positively associated with the odds of receiving a complaint decision (OR = 1.44 per 20 years of seniority; CI 95%, 1.04–1.98. Likewise, having more consultations per day was associated with increased odds (OR = 1.29 per 10 extra consultations per day; CI 95%, 1.07–1.54. No statistically significant association could be demonstrated between being disciplined and general practitioner or practice characteristics. Conclusion. The possible relationship between professional seniority, rate of consultations, and complaint cases merits further studies to clarify the impact of professional seniority and workload on professional performance and to furthermore consider the role of factors such as job content and communication styles.

  17. General practitioners trained in motivational interviewing can positively affect the attitude to behaviour change in people with type 2 diabetes. One year follow-up of an RCT, ADDITION Denmark

    DEFF Research Database (Denmark)

    Rubak, S.; Sandbaek, A.; Lauritzen, T.;

    2009-01-01

    OBJECTIVE: To examine whether training GPs in motivational interviewing (MI) can improve type 2 diabetic patients' (1) understanding of diabetes, (2) beliefs regarding prevention and treatment, and (3) motivation for behaviour change. METHODS: A randomized controlled trial including 65 GPs and 265...... type 2 diabetic patients. The GPs were randomized in two groups, one with and one without MI training. Both groups received training in target-driven intensive treatment of type 2 diabetic patients. The intervention was a 1(1/2)-day residential course in MI with (1/2)-day follow-up twice during......%. Patients in the intervention group were significantly more autonomous and motivated in their inclination to change behaviour after one year compared with the patients from the control group. Patients in the intervention group were also significantly more conscious of the importance of controlling...

  18. PDCA循环管理法在重庆市南川区人民医院全科医生转岗培训中的应用%Application of PDCA loop for job-transfer training of general practition-ers in Chongqing Nanchuan District People's Hospital

    Institute of Scientific and Technical Information of China (English)

    杨娟; 张艳; 邬开凤; 郝瑜

    2015-01-01

    目的:探讨计划、实施、检查、处理(PDCA)循环管理法在重庆市南川区人民医院全科医生转岗培训中的应用效果。方法将重庆市南川区人民医院30名全科医生转岗培训学员分为实验组(2013年4月~2014年12月)和对照组(2011年4月~2012年12月),对照组采用常规培训,实验组采用PDCA循环管理法,建立毕业后医学教育委员会专门监管、完善制度并培训、教学指标落实到具体科室、制订相应的带教措施、利用信息化软件协助管理等系列措施。先调查现状、找出存在的问题,然后分析原因并制订对策,最后检查、落实,反馈培训效果。比较两组学员实施PDCA循环前后的培训效果及满意度情况。结果与对照组比较,实验组的学员理论考试合格率从72.7豫上升至94.7豫;操作技能合格率从63.6豫上升至94.7豫;病历书写合格率从72.7豫上升至100.0豫;医护患投诉率、职业暴露发生率均从18.2豫下降至5.3豫;学员对各项指标的综合满意度从72.7豫上升至94.7豫;两组各指标差异均有统计学意义(均P<0.05)。结论PDCA循环管理法用于重庆市南川区人民医院全科医生转岗培训中的管理成效显著,值得在其他医院培训领Ⅱ推广应用。%Objective To explore application effects of job-transfer training of general practitioners by using Plan, Do, Check, Action (PDCA) loop in Chongqing Nanchuan District People's Hospital. Methods 30 general practitioner train-ing job-transfer were randomly divided into the experimental group (from April 2013 to December 2014) and control group (from April 2011 to December 2012) in Chongqing Nanchuan District People's Hospital. Regular training was used in the control group and PDCA loop was used in the experimental group. The system was supervised, improved and trained, the training index was concretely allotted to each department and the teaching measures were developed, the

  19. Analysis of specialty training on prevention and treatment capabilities for stroke in general practitioner in Shajing street%专科培训对沙井街道全科医生脑卒中防治管理能力的影响分析

    Institute of Scientific and Technical Information of China (English)

    董四五; 易梅珍; 张鞠蕾; 廖艳荣

    2015-01-01

    目的:考察专科培训对沙井街道全科医生对脑卒中管理能力水平的影响。方法随机选取沙井街道全科医生50人给予专科培训作为研究组,并选取未接受专科培训的全科医生作为对照组,通过自行设计的调查问卷对两组医生的脑卒中防治管理能力进行评定。结果共发放调查问卷100份,回收有效答卷95份,回收率为95.0%。研究组答卷总分显著高于对照组(P<0.01),研究组脑卒中的识别和处理得分显著高于对照组(P<0.01),研究组脑卒中二级预防得分显著高于对照组(P<0.01)。结论实施专科培训可以有效提高全科医生的脑卒中识别和处理能力以及脑卒中二级预防能力,有效改善社区全科医生的脑卒中防治管理能力。%Objective To investigate the efficacy of specialty training on prevention and treatment capabilities for stroke in general practitioner in Shajing street. Methods Self-designed questionnaire was carried out with a close-ex-am in 100 general practitioners working in Shajing street,50 doctors received specialty training were as study group and 50 doctors not received the training were as control group.The prevention and treatment capabilities was measured by questionnaire score. Results A total of 95 valid questionnaires were received and the valid returned rate was 95.0%. The total score in study group was higher than that in control group (P<0.01).The stroke recognition and precession a-bility and secondary prevention ability score in study group was higher than that in control group (P<0.01). Conclusion Specialty training has a great efficacy on prevention and treatment capabilities for stroke in general practitioner,which can improve the recognition and precession skill and secondary prevention knowledge.

  20. Open Access to General Practice Was Associated with Burnout among General Practitioners.

    Science.gov (United States)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without. In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach Burnout Inventory. Analyses using logistic regression were adjusted for gender, age, marital status, job satisfaction, minutes per consultation, practice organisation, working hours, number of listed patients per GP, number of contacts per GP, continuing medical education- (CME-) activities, and clusters of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot establish causality, it is recommended to closely monitor possible negative consequences of open access in general practice.

  1. Communication about work between general practitioners and patients consulting for musculoskeletal disorders.

    NARCIS (Netherlands)

    Weevers, H.A.; Beek, A.J. van der; Brink-Muinen, A. van den; Bensing, J.; Boot, C.R.L.; Mechelen, W. van

    2009-01-01

    BACKGROUND: Work-related musculoskeletal disorders (MSDs) are common in general practice. The communication between a general practitioner (GP) and patient is a key element of adequate general practice. No study has investigated the characteristics of communication about work-related matters during

  2. Non-medical triggers of patients' contacts to general practitioners

    DEFF Research Database (Denmark)

    Eriksson, Tina

    family practice, general practice, primary health care, health care services, health behaviour, mass media, reasons for encounter, case-crossover, time-selection bias, recall bias, bi-directional study......family practice, general practice, primary health care, health care services, health behaviour, mass media, reasons for encounter, case-crossover, time-selection bias, recall bias, bi-directional study...

  3. Dealing with uncertainty in general practice: an essential skill for the general practitioner.

    Science.gov (United States)

    O'Riordan, Margaret; Dahinden, André; Aktürk, Zekeriya; Ortiz, José Miguel Bueno; Dağdeviren, Nezih; Elwyn, Glyn; Micallef, Adrian; Murtonen, Mikko; Samuelson, Marianne; Struk, Per; Tayar, Danny; Thesen, Janecke

    2011-01-01

    Many patients attending general practice do not have an obvious diagnosis at presentation. Skills to deal with uncertainty are particularly important in general practice as undifferentiated and unorganised problems are a common challenge for general practitioners (GPs). This paper describes the management of uncertainty as an essential skill which should be included in educational programmes for both trainee and established GPs. Philosophers, psychologists and sociologists use different approaches to the conceptualisation of managing uncertainty. The literature on dealing with uncertainty focuses largely on identifying relevant evidence and decision making. Existing models of the consultation should be improved in order to understand consultations involving uncertainty. An alternative approach focusing on shared decision making and understanding the consultation from the patient's perspective is suggested. A good doctor-patient relationship is vital, creating trust and mutual respect, developed over time with good communication skills. Evidence-based medicine should be used, including discussion of probabilities where available. Trainers need to be aware of their own use of heuristics as they act as role models for trainees. Expression of feelings by trainees should be encouraged and acknowledged by trainers as a useful tool in dealing with uncertainty. Skills to deal with uncertainty should be regarded as quality improvement tools and included in educational programmes involving both trainee and established GPs.

  4. Open Access to General Practice Was Associated with Burnout among General Practitioners

    DEFF Research Database (Denmark)

    Vedsted, Peter; Sokolowski, Ineta; Olesen, Frede

    2013-01-01

    Walk-in open access in general practice may influence the general practitioner's (GP's) work, but very little research has been done on the consequences. In this study from Danish general practice, we compare the prevalence of burnout between GPs with a walk-in open access and those without....... In a questionnaire study (2004), we approached all 458 active GPs in the county of Aarhus, Denmark, and 376 (82.8%) GPs returned the questionnaire. Walk-in open access was defined as at least 30 minutes every weekday where patients could attend practice without an appointment. Burnout was measured by the Maslach...... of GPs. In all, 8% of GPs had open access and the prevalence of burnout was 24%. GPs with walk-in open access were more likely to suffer from burnout. Having open access was associated with a 3-fold increased likelihood of burnout (OR = 3.1 (95% CI: 1.1-8.8, P = 0.035)). Although the design cannot...

  5. Video-assisted feedback in general practice internships using German general practitioner's guidelines.

    Science.gov (United States)

    Bölter, Regine; Freund, Tobias; Ledig, Thomas; Boll, Bernhard; Szecsenyi, Joachim; Roos, Marco

    2012-01-01

    The planned modification of the Medical Licenses Act in Germany will strengthen the specialty of general practice. Therefore, medical students should get to know the daily routine of general practitioners during their academic studies. At least 10% of students should get the possibility to spend one quarter of the internship, in the last year of their academic studies, in a practice of family medicine. The demonstrated teaching method aims at giving feedback to the student based on video recordings of patient consultations (student-patient) with the help of a checklist. Video-feedback is already successful used in medical teaching in Germany and abroad. This feasibility study aims at assessing the practicability of video-assisted feedback as a teaching method during internship in general practice. First of all, the general practice chooses a guideline as the learning objective. Secondly, a subsequent patient - student - consultation is recorded on video. Afterwards, a video-assisted formative feedback is given by the physician. A checklist with learning objectives (communication, medical examination, a structured case report according to the guideline) is used to structure the feedback content. The feasibility was assessed by a semi structured interview in order to gain insight into barriers and challenges for future implementation. The teaching method was performed in one general practice. Afterwards the teaching physician and the trainee intern were interviewed. The Following four main categories were identified: feasibility, performance, implementation in daily routine, challenges of the teaching concept.The results of the feasibility study show general practicability of this approach. Installing a video camera in one examination room may solve technical problems. The trainee intern mentioned theoretical and practical benefits using the guideline. The teaching physician noted the challenge to reflect on his daily routines in the light of evidence

  6. Neil Edwin Carson. Academic general practitioner, leader and achiever.

    Science.gov (United States)

    1992-06-01

    Professor Neil Carson, who is to retire as Chairman of Monash University's Department of Community Medicine at the end of this year, has completed a significant and successful term marked by many achievements. His energy, vision and ability to acquire and channel resources have helped develop a vibrant and productive department. His wise counsel and negotiating skills have led to important achievements for the cause of general practice in both the political sphere and in academic institutions. He was the founder and first president of the Australian Association for Academic General Practice. His impact on medical education, especially for general practice in Australia, has been far reaching.

  7. The Direction of Web-based Training: A Practitioner's View.

    Science.gov (United States)

    Kilby, Tim

    2001-01-01

    Web-based training has had achievements and disappointments as online learning has matured. Best practices include user-centered design, knowledge object structures, usability engineering, and formal evaluation. Knowledge management, peer-to-peer learning, and personal learning appliances will continue to alter the online learning landscape. (SK)

  8. Targeting practitioners: A review of guidelines, training, and policy in pain management.

    Science.gov (United States)

    Barth, Kelly S; Guille, Constance; McCauley, Jenna; Brady, Kathleen T

    2017-04-01

    This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes. Although there is increasing attention to training in pain management in medical schools and medical residency programs, educational opportunities remain highly variable, and the need for additional clinician training in the recognition and treatment of pain as well as opioid use disorder has been recognized. Mandated use of private, federal and state educational and clinical initiatives such as Risk Evaluation and Mitigation Strategies (REMS) and Prescription Drug Monitoring Programs (PDMPs) generally increase utilization of these initiatives, but more research is needed to determine the impact of these initiatives on provider behaviors, treatment access, and patient outcomes. Finally, there is an acute need for more research on safe and effective treatments for chronic pain as well as an increased multi-level focus on improving training and access to evidence-based treatment for opioid use disorder as well as non-pharmacologic and non-interventional chronic pain treatments, so that these guideline-recommended interventions can become mainstream, accessible, first-line interventions for chronic pain and/or opioid use disorders. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  9. 哈尔滨市某三甲医院客观结构化临床考试在全科医师培养及考核中的应用%Application of the Objective Structured Clinical Examination in the General Practitioner Training and Assessment in a Tertiary Hospital, Harbin

    Institute of Scientific and Technical Information of China (English)

    张宇; 张东华; 薄红

    2015-01-01

    Objective:To investigate objective structured clinical examination ( OSCE) application feasibility and reliability in the general practitioners training and skills assessment. Methods:used the concept and method of OSCE, the establishment of general practitioner training and assessment scheme and Implementation, used Cronbach coefficient, difficulty coefficient and so on statistical indexes to evaluate the feasibility and reliability of the scheme. Results:The OSCE scores the lowest score was 47. 99 points, the highest score was 79. 23 points, the average score was (66.37 ±6.18) points, normality K-S test showed the examinee scores normally distributed (Z=0.582, P=0.887>0.05); The Cron⁃bach coefficient was 0. 783, shows that the OSCE with higher reliability;The 12 site test scores delete site the Cronbach coefficient, answer the questions delete site Cronbach coefficient was the smallest (0. 701), the operation of basic skills delete site Cronbach coefficient was the maximum (0. 735);12 test sites difficulty coefficient in the 0. 601-0. 714, difficulty coefficient mean value is 0. 660, the difficulty of OSCE is more appro⁃priate;ECG judgement was the most difficult, case analysis was the most easy. Conclusion:Application of OSCE has good feasibility and relia⁃bility in general practitioner training and assessment, is worth popularizing in clinical ability assessment.%目的:探讨客观结构化临床考试( OSCE)在全科医师培养和技能考核中应用的可行性和可靠性。方法:运用OSCE的理念和方法,建立并实施全科医师培养及考核方案,使用Cronbach系数、难度系数等统计指标对方案的可行性和可靠性进行评价。结果:本次OSCE考试成绩最低得分为47.99分,最高得分为79.23分,平均成绩为(66.37±6.18)分,正态性k-s检验显示考生成绩呈正态分布(Z=0.582,P=0.887>0.05);Cronbach系数=0.783,说明本次OSCE信度较高;12

  10. Primary health eye care knowledge among general practitioners ...

    African Journals Online (AJOL)

    2010-05-10

    May 10, 2010 ... knowledge of GPs and assessing whether there is a need to revise the undergraduate curriculum in .... For how long have you been in private general practice? 8. .... to recognise fundal disease on slide presentations rose on.

  11. The factors associated to psychosocial stress among general practitioners in Lithuania. Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vanagas Giedrius

    2005-06-01

    Full Text Available Abstract Background There are number of studies showing that general practice is one of the most stressful workplace among health care workers. Since Baltic States regained independence in 1990, the reform of the health care system took place in which new role and more responsibilities were allocated to general practitioners' in Lithuania. This study aimed to explore the psychosocial stress level among Lithuanian general practitioner's and examine the relationship between psychosocial stress and work characteristics. Methods The cross-sectional study of 300 Lithuanian General practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the R. Karasek scale. The analysis included descriptive statistics; interrelationship analysis between characteristics and multivariate logistic regression to estimate odds ratios for each of the independent variables in the model. Results Response rate 66% (N = 197. Our study highlighted highest prevalence of psychosocial stress among widowed, single and female general practitioners. Lowest prevalence of psychosocial stress was among males and older age general practitioners. Psychosocial stress occurs when job demands are high and job decision latitude is low (χ2 = 18,9; p Conclusion One half of respondents suffering from work related psychosocial stress. High psychological workload demands combined with low decision latitude has the greatest impact to stress caseness among GP's. High job demands, high patient load and young age of GP's can be assigned as significant predictors of psychosocial stress among GP's.

  12. [The practice guideline 'Anxiety disorders' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

    Science.gov (United States)

    van Weel-Baumgarten, E M; van Rijswijk, E

    2005-05-28

    The recommendations provided by the revised guideline 'Anxiety disorders' are well suited to every-day practice. The multidisciplinary approach reflects the increasing cooperation between primary and secondary care in the management of mental-health problems. The description of the various anxiety disorders and the questions that can be asked to elicit the symptoms will facilitate recognition. The indications for treatment with medication are clear: a limited number of antidepressants should be used. Although it is agreed that patient education is an important part of treatment, the guidelines could have described in more detail how this should be done. Cognitive-behavioural techniques may be used but this requires extra training; its effectiveness when used by general practitioners needs further study. This guideline will add to existing knowledge and improve the skills of general practitioners in dealing with anxiety.

  13. Two sides of the coin - general practitioners' experience of working in multidisciplinary teams.

    Science.gov (United States)

    Hansson, Anders; Friberg, Febe; Segesten, Kerstin; Gedda, Birgitta; Mattsson, Bengt

    2008-01-01

    Multidisciplinary teamwork, defined as the collaboration between different professional groups to achieve a common purpose, is commonly regarded as a means to meet the complex tasks that medicine has to deal with today. However, many attempts to introduce the method in primary care have failed and this is supposed to be partly due to the fact that general practitioners (GPs) did not participate in the implementation of the method. The aim of this investigation was to get a deeper understanding of their attitude to teamwork by interviewing nine GPs at four Swedish health care centres, where successful teamwork had been ongoing since 1997. Themes and categories in the interviews were identified according to content analysis. Although the attitude in general was in favour of teamwork, four major themes: time-consuming versus time-saving; shared responsibility versus main responsibility; medical expert versus generalist; shared knowledge versus all knowing, could be identified, which all revealed ambivalence towards teamwork among the interviewees. It was concluded that, if teamwork is to be successfully introduced into primary care, the GPs' self-perception has to be taken into consideration as has the prestige and status associated with their traditional role and the benefits of teamwork to the profession of medicine. Apart from time, teamwork requires, professional supervision and doctors need to be trained in this method as early as in medical school.

  14. [The general practitioner is amazed, the specialist is astonished - or put differently: unnecessary operations? - a fictive interview with a general practitioner].

    Science.gov (United States)

    Blunier, Hans-Ulrich

    2014-12-01

    From the sight of a General Practitioner time and again certain indications for some interventions on patients in hospitals are questionable. Enough evidence-based studies are of great importance, so that the individual evidence of the patient including the view of his General Practitioner can be put in first place when making decisions for interventions. In order to generate as much data with as little time and effort possible, structures for patient-centered care have to be created over the whole therapeutic chain (GPs, specialists, hospitals), where the necessary data can be gathered. In an interview GP Dr. med. H.U. Blunier speaks his mind, about how he is persistently pursuing his goal to develop patient paths across all institutions to finally close the therapy chain in terms of an integrated health care.

  15. Awareness of the Complications from Impacted Third Molar Surgeries among General Dental Practitioners

    Directory of Open Access Journals (Sweden)

    Farokh Farhadi

    2016-04-01

    Full Text Available Introduction: Surgery of impacted third molars and the resultant complications are common occurrences in dental offices. Therefore, the present study was undertaken to determine the awareness of general dental practitioners in Tabriz of complications of surgeries of impacted third molars. Materials and methods: In the present study a researcher-made questionnaire was completed by 186 randomly selected general dentists in Tabriz. After collecting the questionnaires and extractions of data, descriptive statistical methods and chi-squared test were used to evaluate the relationship between personal demographic variables (independent and the dependent variable of the study with SPSS 14. Statistical significance was set at P0.05. Conclusion: Based on the results, the awareness of general dental practitioners in Tabriz of the complications of impacted third molar surgeries was at a moderate level.   Key words: Awareness; general dental practitioner; impacted third molar; complications;

  16. What does it mean to be a General Practitioner?

    DEFF Research Database (Denmark)

    Olesen, Henning Salling

    2012-01-01

    Studying professional learning offers a particular contribution to learning research in general because professionals embody societal circumstances for learning in everyday life and work. This article refers to the medical profession. A general heuristic model is presented for organizing empirical...... of interpretation is elaborated. The article finally, on the one hand, draws perspectives for practice of professional continuing education, and on the other hand for the contribution of learning research in a rethinking of the relation between knowledge domains and occupational practices in the constitution...

  17. Practitioner Expectations and Experiences with the Certificate IV in Training and Assessment (TAA40104): Support Document

    Science.gov (United States)

    Clayton, Berwyn; Meyers, Dave; Bateman, Andrea; Bluer, Robert

    2010-01-01

    This document supports the report "Practitioner Expectations and Experiences with the Certificate IV in Training and Assessment (TAA40104)". The first section outlines the methodology used to undertake the research and covers the design of the research, sample details, data collection processes and the strategy for data analysis and…

  18. Understanding the Prcess of Differential Diagnosis: Prerequisite to the Training of Medical and Veterinary Medical Practitioners.

    Science.gov (United States)

    Wagner, Roy M. K.

    The paper describes an auto-tutorial methodology for training veterinary medical practitioners to perform differential diagnoses. It describes in detail the three phases of differential diagnosis: sensory pick-up, a combination of cognition and memory; categorization, the process by which diagnosticians group symptoms and signs prior to diagnosis;…

  19. An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario

    Science.gov (United States)

    Manassis, Katharina; Ickowicz, Abel; Picard, Erin; Antle, Beverley; McNeill, Ted; Chahauver, Anu; Mendlowitz, Sandra; Monga, Suneeta; Adler-Nevo, Gili

    2009-01-01

    Objective: Cognitive behavior therapy (CBT) for children has been shown efficacious, but community access to it is often limited by the lack of trained therapists. This study evaluated a child, CBT-focused, 20-session weekly group supervision seminar with a didactic component which was provided to community mental health practitioners by…

  20. Spatial Variation in General Medical Services Income in Dublin General Practitioners

    Directory of Open Access Journals (Sweden)

    Conor Teljeur

    2011-01-01

    Full Text Available The general medical services (GMS scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs. The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

  1. Assessment of the interest of the geriatric oncology consultation among French general practitioners.

    Science.gov (United States)

    Charbonnier, Claire; Marilier, Sophie; Dabakuyo, Sandrine; Cueff, Adèle; Quipourt, Valérie; Manckoundia, Patrick

    2016-01-01

    We assessed the interest of the geriatric oncology (GO) consultation (GOC) among general practitioners (GPs). We conducted a survey among GPs whose patients had had a GOC in 2012. A questionnaire was sent to GPs. The 1st part collected GPs' characteristics including medical education in geriatrics and GO, and knowledge of GOC. The following parts concerned the GOC and included the cancer type, GOC report and care plan. One-hundred twenty-six questionnaires corresponding to 94 GPs were collected. Concerning the GPs' characteristics, age range 50-59 (44.7%), men (62.8%) and urban practice (79.8%) were the most represented, 80.8% had no expertise in geriatrics, 60.6% knew of the existence of GOCs, and 14.9% had received medical education in GO. The most frequent cancer location was gynecological (40.7%) (82.6% were breast cancers). Of the GPs, 69.8% had received a GOC report and 92% were (very) satisfied with the delivery time. A care plan was proposed after the GOC in 83% of cases. It was satisfactory in 96.4% of cases, and applied by 74.7% of GPs. Sixteen percent of GPs were called by the GO team. The less the GP was satisfied with the GOC, the more he or she wanted phone contact (p=0.02); 94% of GPs considered the GOC (very) satisfactory. Sixty-seven percent of GPs wanted to be trained in GO. Very few GPs had been trained in geriatrics and/or GO. They were mostly satisfied with GOC and expressed a wish to be trained in GO. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. General practitioners' clinical expertise in managing suicidal young people: implications for continued education.

    Science.gov (United States)

    Michail, Maria; Tait, Lynda; Churchill, Dick

    2017-09-01

    Aim To examine general practitioners' (GPs) clinical expertise in assessing, communicating with, and managing suicidal young people aged 14-25 to inform the development of an educational intervention for GPs on youth suicide prevention. Suicide is the second leading cause of death for young people worldwide. GPs are ideally suited to facilitate early identification and assessment of suicide risk. However, GPs' levels of competence, knowledge, and attitudes towards suicidal young people have not yet been explored. A cross-sectional survey on GPs' levels of confidence in assessing and managing young people at risk of suicide; knowledge of risk factors and warning signs of suicide in young people; attitudes towards young suicidal people; and training preferences on managing suicide risk. Findings Seventy GPs completed the survey (30 males). The majority of GPs reported high levels of confidence in assessing and managing suicidality in young people. Experienced GPs demonstrated high levels of knowledge of suicide risk factors in young people but low levels of knowledge of warning signs that might indicate heightened risk. Although 48% of GPs disagreed that maintaining compassionate care is difficult with those who deliberately self-harm, GPs perceived communication with young people to be difficult, with one-third reporting frustration in managing those at risk of suicide. A total of 75% of GPs said they would be interested in receiving further training on assessing and managing young people at risk of suicide. The study has important implications for providing specialist training to support GPs in assessing and managing youth suicide risk and facilitating attitudinal change. GP education on youth suicide risk assessment and management should promote a holistic understanding and assessment of risk and its individual, social and contextual influences in line with clinical recommendations to facilitate therapeutic engagement and communication with young people.

  3. Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey

    Directory of Open Access Journals (Sweden)

    Beyhun Nazim E

    2007-06-01

    Full Text Available Abstract Background Commercial sources of information are known to have greater influence than scientific sources on general practitioners' (GPs prescribing behavior in under developed and developing countries. The study aimed to determine the self-reported impact of pharmaceutical promotion on the decision-making process of prescription of GPs in Eastern Turkey. Methods A cross-sectional, exploratory survey was performed among 152 GPs working in the primary health centers and hospitals in Erzurum province of Eastern Turkey in 2006. A self-administered structured questionnaire was used. The questionnaire included questions regarding sociodemographics, number of patients per day, time per patient, frequency of sales representative visits to GPs, participation of GPs in training courses on prescribing (in-service training, drug companies, factors affecting prescribing decision, reference sources concerning prescribing and self-reported and self-rated effect of the activities of sales representatives on GPs prescribing decisions. Results Of 152 subjects, 53.3% were male and 65.8% were working at primary health care centers, respectively. Mean patient per day was 58.3 ± 28.8 patients per GP. For majority of the GPs (73.7%, the most frequent resource used in case of any problems in prescribing process was drug guides of pharmaceutical companies. According to self-report of the GPs, their prescribing decisions were affected by participation in any training activity of drug companies, frequent visits by sales representatives, high number of patient examinations per day and low year of practice (p Conclusion The results of this study suggest that for the majority of the GPs, primary reference sources concerning prescribing was commercial information provided by sales representatives of pharmaceutical companies, which were reported to be highly influential on their decision-making process of prescribing by GPs. Since this study was based on self

  4. The incidence of sexual dysfunction in patients attending Dutch general practitioners.

    NARCIS (Netherlands)

    Kedde, H.; Donker, G.; Leusink, P.; Kruijer, H.

    2011-01-01

    Data on patients with a sexual dysfunction were collected in 45 Dutch general practices between 2003 and 2008. The aim of the study was to determine the incidence of patients with a sexual dysfunction, associated health problems, and related interventions performed by their general practitioners (GP

  5. Differences in treatment approach between Dutch paediatric dentists and general practitioners, a case control study

    NARCIS (Netherlands)

    Kuin, D.; Veerkamp, J.S.J.

    2012-01-01

    AIM: This case control study was to assess whether paediatric dentists perform significantly more diagnostic, preventive and curative care in a clinical setting then do general dental practitioners. METHODS: 16 paediatric dentists were approached and a matching control group of 16 general dental pra

  6. Is it econmically viable to employ the nurse practitioner in general practice?

    NARCIS (Netherlands)

    Dierick-van Daele, Angelique; Steuten, Lotte Maria Gertruda; Romeijn, Aria; Derckx, Emmy W.C.C.; Vrijhoef, Hubertus J.M.

    2011-01-01

    Background:  General practitioners face the challenging task of finding the most efficient and effective mix of professionals in general practice to accommodate future care demands within scarce health care budgets. To enable informed decision-making about skill mix issues, economic information is

  7. Correctional health care for general practitioners: working circumstances, work satisfaction and burnout.

    NARCIS (Netherlands)

    Brake, J.H.M. te; Bakker, D.H. de; Devillé, W.L.J.M.

    2007-01-01

    Aims: Working as a general practitioner (GP) within a correctional institution differs from working within a general population. Key characteristics such as direct accessibility, continuity of care and mutual trust between GP and patient are often absent. The current study aims to explore the ways i

  8. Is it economically viable to employ the nurse practitioner in general practice?

    NARCIS (Netherlands)

    Dierick-van Daele, Angelique; Steuten, Lotte M.G.; Romeijn, Aria; Derckx, Emmy W.C.C.; Vrijhoef, Hubertus J.M.

    2011-01-01

    Background:  General practitioners face the challenging task of finding the most efficient and effective mix of professionals in general practice to accommodate future care demands within scarce health care budgets. To enable informed decision-making about skill mix issues, economic information is n

  9. [Summary of the 'Stroke' guideline of the Dutch College of General Practitioners' (NHG)

    NARCIS (Netherlands)

    Verburg, A.F.; Tjon, A.T.M.R.; Verstappen, W.H.J.M.; Beusmans, G.H.M.I.; Wiersma, T.; Burgers, J.S.

    2014-01-01

    The Dutch College of General Practitioners (NHG) guideline 'Stroke' covers the diagnosis, management and long-term care of stroke in general practice. Patients with neurological symptoms suspected to be due to cerebral infarction or haemorrhage should be transferred directly to a stroke unit. The

  10. A Qualitative Study of Prescription Contraception Use: The Perspectives of Users, General Practitioners and Pharmacists.

    Directory of Open Access Journals (Sweden)

    Leigh-Ann Sweeney

    Full Text Available The oral contraceptive pill (OCP remains the most popular form of prescription contraception in many countries, despite adherence difficulties for many. Uptake of long acting reversible contraceptives (LARCs, which are less reliant on user adherence, remains low. The aim of this study was to explore the experiences of, and attitudes towards, prescription contraception amongst samples of contraception users, general practitioners (GPs and pharmacists.We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked.There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all

  11. The importance of gender of patients and general practitioners in relation to treatment practices for overweight.

    Directory of Open Access Journals (Sweden)

    Jeanett Friis Rohde

    Full Text Available BACKGROUND: Several studies suggest that men and women are treated differently for similar disease including diabetes and cardiovascular disease. Differences in attitudes and treatment practices towards men and women with obesity are not well recognized. OBJECTIVE: To investigate the attitudes and treatment practices among Danish general practitioners (GPs, in relation to treatment of overweight, while taking gender of both the patients and practitioners into account. DESIGN: Questionnaire inventory covertly examining attitudes and practices among Danish general practitioners towards treatment of overweight. All 3.637 general practitioners from the Danish Medical Association register were invited to participate in the survey. In total 1.136 participated. RESULTS: The GPs found weight loss to be more important for overweight male than overweight female patients. They also treated complications to overweight more rigorously among male than female patients, and recommended lipid lowering medicine more often to male than female overweight patients. In addition, the younger female GPs and older male GPs more often said that they would treat an overweight patient with lipid lowering medicine. CONCLUSION: Among general practitioners in Denmark, treatment for weight loss is more often practiced for overweight male than overweight female patients presenting with same symptoms. In addition, hyperlipidemia among overweight males is also more often treated with lipid lowering medicine than hyperlipidemia among overweight females.

  12. Variation in general practitioners' information-seeking behaviour

    DEFF Research Database (Denmark)

    Videbæk Le, Jette; Pedersen, Line Bjørnskov; Riisgaard, Helle

    2016-01-01

    . SETTING: Danish general practice. SUBJECTS: A population of 3440 GPs (corresponding to approximately 96% of all Danish GPs). MAIN OUTCOME MEASURES: GPs' use and perceived importance of information sources. Multilevel mixed-effects logit models were used to investigate associations with GP characteristics...... characteristics. Further insights could provide opportunities for targeting information dissemination strategies. Single-handed GPs seek information from colleagues less frequently than GPs in partnerships and do not use other sources more frequently. GPs aged above 44 years do not seek information as frequently...

  13. Experiences of a general practitioner in the daily practice about Digital Health Literacy. The real needs.

    Science.gov (United States)

    Traver, M; Basagoiti, I; Martinez-Millana, A; Fernandez-Llatas, C; Traver, V

    2016-08-01

    Digital Health Literacy (DHL) is a key element to promote patient empowerment. This position paper presents the lessons learnt from the daily activities of a General Practitioner interacting with patients. General Practitioners have a main role in each stage on individual digital health literacy process. They are the first meeting point between patients and the medical knowledge; in the search phase, they are who can prescribe and validate health information; in the comprehension phase, they lead to a full understanding; and in the adoption phase, they assist in the own personal application. Major conclusions are that General Practitioners need a set of tools, organizational resources and knowledge to acquire Digital Health Literacy skills to help patients on their way from the information to the empowerment. Some of these tools and knowledge are identified to draw the future roadmap to get people with Digital Health Literacy skills.

  14. General practitioners are bearing an increasing burden of the care of common mental disorders in France

    Directory of Open Access Journals (Sweden)

    Joanna Norton

    2007-03-01

    Full Text Available Introduction: In France, general practice is playing an increasing role in the management of common mental disorders. This is due to a variety of factors, among which the way general practice and specialised mental health services have evolved over time. Methods: A description of the status quo in France, with a comparison between France, the UK and the Netherlands. A review of reasons for the present position. Results: The general practitioner (GP is often the only medical carer to be contacted in cases of psychological distress and over 80% of psychotropic medications are prescribed in this setting. Although most common forms of mental disorder can be managed at the primary care level, GPs need to be able to refer patients rapidly to specialised mental health services. Yet there are delays for consultations with both private and public psychiatrists along with difficulties in finding beds for full-time hospitalisation. The situation is predicted to get worse with the reduction in the number of psychiatrists and GPs forecasted for the coming years. 'Psychiatric sectorisation' has led to a substantial development of community mental health care services, yet this has not compensated fully for the reduction in full-time hospital beds. Furthermore, community mental health care services remain relatively isolated from other community health services with very limited exchanges with general practice. Conclusion: GPs report an urgent need for training in mental health. Along with improving their ability to accurately detect and treat mental disorders, it is crucial also to improve communication between GPs and psychiatrists and increase shared case-management. Structural changes are also necessary to ensure a quicker and easier access to specialised mental health care services.

  15. Inequality in provider continuity for children by Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Reynolds Graham

    2011-09-01

    Full Text Available Abstract Background There is little published on provider continuity in Australian general practice and none on its effect on inequality of care for children. Method Questionnaire administered to parents of the ACT Kindergarten Health Screen asking the name of their child's usual GP and practice address between 2001 and 2008. Results Parents of 30,789 children named 433 GPs and 141 practices. In each year, an average of 77% of parents could name both the GP and the practice, an average of 11% of parents could name only the practice, and an average of 12% of parents could name neither. In each year, 25% of parents could not name a usual GP for children of Aboriginal or Torres Straight Islander descent, or children born outside of Australia, compared to 10% of all other children (p = Conclusions Many GPs (39% were reported to provide continuity of care for in the ACT region and some GPs (20% displayed transient care. Indigenous children or children born outside of Australia had less equity of access to a nominated GP than all other children. Such inequity might disappear if voluntary registration of children was adopted in Australian general practice.

  16. Measuring health inequalities in Albania: a focus on the distribution of general practitioners.

    Science.gov (United States)

    Theodorakis, Pavlos N; Mantzavinis, Georgios D; Rrumbullaku, Llukan; Lionis, Christos; Trell, Erik

    2006-02-21

    The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004. With census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates. The Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners), while after adjusting for consultation rates the number was 20.6% (315). These figures changed to 6.3% (100), 6.3% (115) and 19.8% (315) in 2004. There was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.

  17. Measuring health inequalities in Albania: a focus on the distribution of general practitioners

    Directory of Open Access Journals (Sweden)

    Mantzavinis Georgios D

    2006-02-01

    Full Text Available Abstract Background The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004. Methods With census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates. Results The Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners, while after adjusting for consultation rates the number was 20.6% (315. These figures changed to 6.3% (100, 6.3% (115 and 19.8% (315 in 2004. Conclusion There was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.

  18. Rheumatoid arthritis - an update for general dental practitioners.

    Science.gov (United States)

    de Souza, S; Bansal, R K; Galloway, J

    2016-11-18

    Rheumatoid arthritis (RA) is a common chronic inflammatory autoimmune disorder which significantly impacts patients' lives and can lead to permanent disability. Inflammation in RA not only affects joints; but can affect organs including the heart and lungs. Early diagnosis, initiation of intensive drug therapy, and a multidisciplinary care approach have vastly improved the long-term prognosis for those living with the condition. However, RA patients often present with co-morbidities which add to the complexity of clinical management. Orofacial conditions associated with RA which dental professionals need to be aware of include periodontal disease, temporomandibular dysfunction and salivary gland dysfunction. In this article, we provide information on RA, oral health in RA and guidance on how best to manage patients with RA in general dental practice.

  19. Perceived barriers to guideline adherence: A survey among general practitioners

    Directory of Open Access Journals (Sweden)

    Besters Casper F

    2011-09-01

    Full Text Available Abstract Background Despite considerable efforts to promote and support guideline use, adherence is often suboptimal. Barriers to adherence vary not only across guidelines but also across recommendations within guidelines. The aim of this study was to assess the perceived barriers to guideline adherence among GPs by focusing on key recommendations within guidelines. Methods We conducted a cross-sectional electronic survey among 703 GPs in the Netherlands. Sixteen key recommendations were derived from four national guidelines. Six statements were included to address the attitudes towards guidelines in general. In addition, GPs were asked to rate their perceived adherence (one statement and the perceived barriers (fourteen statements for each of the key recommendations, based on an existing framework. Results 264 GPs (38% completed the questionnaire. Although 35% of the GPs reported difficulties in changing routines and habits to follow guidelines, 89% believed that following guidelines leads to improved patient care. Perceived adherence varied between 52 and 95% across recommendations (mean: 77%. The most perceived barriers were related to external factors, in particular patient ability and behaviour (mean: 30% and patient preferences (mean: 23%. Lack of applicability of recommendations in general (mean: 22% and more specifically to individual patients (mean: 25% were also frequently perceived as barriers. The scores on perceived barriers differed largely between recommendations [minimum range 14%; maximum range 67%]. Conclusions Dutch GPs have a positive attitude towards the NHG guidelines, report high adherence rates and low levels of perceived barriers. However, the perceived adherence and perceived barriers varied largely across recommendations. The most perceived barriers across recommendations are patient related, suggesting that current guidelines do not always adequately incorporate patient preferences, needs and abilities. It may be

  20. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract.

    Science.gov (United States)

    Checkland, Kath; Harrison, Stephen; McDonald, Ruth; Grant, Suzanne; Campbell, Stephen; Guthrie, Bruce

    2008-07-01

    In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of 'pay-for-performance', including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, QOF) represent a move towards a more biomedical model of health and illness, which is contrary to the ideal of providing holistic (or biopsychosocial) care that has been traditionally espoused by GPs. This paper reports results from two linked studies (in England and Scotland) investigating the early stages of the new contract. We describe the way in which four practices with different organisational approaches and espoused identities have all changed their practice structures, consultations and clinical care in response to QOF in ways which will result in patients receiving a more biomedical type of care. In spite of these observed changes, respondents continued to maintain discursive claims to holism. We discuss how this disconnection between rhetoric and reality can be maintained, and consider its implications for the future development of GPs' claims to a professional identity.

  1. Role of general practitioner in the management of acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Beeleonie Beeleonie

    2005-12-01

    Full Text Available Acute myocardial infarction (AMI has been the leading cause of death in Western countries, as well as in Indonesia. Delay in diagnosis and incorrect early management often result in failure of thrombolytic reperfusion. General practitioner (GP as the primary care, needs to be equipped with the ability to diagnose and moreover to manage AMI. A case of fail thrombolytic management in a 47 years old man after seven hours of angina typical chest pain, after previously managed by GP, is being reported. (Med J Indones 2005; 14:249-52Keywords: acute myocardial infarction, reperfusion, general practitioner

  2. Does brief chronic pain management education change opioid prescribing rates? A pragmatic trial in Australian early-career general practitioners.

    Science.gov (United States)

    Holliday, Simon Mark; Hayes, Chris; Dunlop, Adrian J; Morgan, Simon; Tapley, Amanda; Henderson, Kim M; van Driel, Mieke L; Holliday, Elizabeth G; Ball, Jean I; Davey, Andrew; Spike, Neil Allan; McArthur, Lawrence Andrew; Magin, Parker John

    2017-02-01

    We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls. In ReCEnT, registrars record detailed data (including prescribing) during 60 consecutive consultations, on 3 occasions. Analysis was at the level of individual problem managed, with the primary outcome factor being prescription of an opioid analgesic and the secondary outcome being opioid initiation. Between 2010 and 2015, 168,528 problems were recorded by 849 registrars. Of these, 71% were recorded by registrars in the nontraining group. Eighty-two percentages were before training. Opioid analgesics were prescribed in 4382 (2.5%, 95% confidence interval [CI]: 2.40-2.63) problems, with 1665 of these (0.97%, 95% CI: 0.91-1.04) representing a new prescription. There was no relationship between the training and total prescribing after training (interaction odds ratio: 1.01; 95% CI: 0.75-1.35; P value 0.96). There was some evidence of a reduction in initial opioid prescriptions in the training group (interaction odds ratio: 0.74; 95% CI: 0.48-1.16; P value 0.19). This brief training package failed to increase overall opioid cessation. The inconsistency of these actual prescribing results with "hypothetical" prescribing behavior suggests that reducing opioid prescribing in chronic noncancer pain requires more than changing knowledge and attitudes.

  3. Telehealth and eHealth in nurse practitioner training: current perspectives

    Directory of Open Access Journals (Sweden)

    Rutledge CM

    2017-06-01

    Full Text Available Carolyn M Rutledge,1 Karen Kott,2 Patty A Schweickert,3 Rebecca Poston,1 Christianne Fowler,1 Tina S Haney1 1College of Health Sciences, School of Nursing, 2College of Health Sciences, School of Physical Therapy, Old Dominion University, Norfolk, 3Department of Neuroradiology, University of Virginia, Charlottesville, VA, USA Abstract: Telehealth is becoming a vital process for providing access to cost-effective quality care to patients at a distance. As such, it is important for nurse practitioners, often the primary providers for rural and disadvantaged populations, to develop the knowledge, skills, and attitudes needed to utilize telehealth technologies in practice. In reviewing the literature, very little information was found on programs that addressed nurse practitioner training in telehealth. This article provides an overview of both the topics and the techniques that have been utilized for training nurse practitioners and nurse practitioner students in the delivery of care utilizing telehealth. Specifically, this article focuses on topics including 1 defining telehealth, 2 telehealth etiquette, 3 interprofessional collaboration, 4 regulations, 5 reimbursement, 6 security/Health Insurance Portability and Accountability Act (HIPAA, 7 ethical practice in telehealth, and 8 satisfaction of patients and providers. A multimodal approach based on a review of the literature is presented for providing the training: 1 didactics, 2 simulations including standardized patient encounters, 3 practice immersions, and 4 telehealth projects. Studies found that training using the multimodal approach allowed the students to develop comfort, knowledge, and skills needed to embrace the utilization of telehealth in health care. Keywords: telehealth, nurse practitioner education, telemedicine, simulation, health care

  4. General practitioners role in the notification of communicable diseases - study in Malta.

    Science.gov (United States)

    Gauci, C; Gilles, H; O'Brien, S; Mamo, J; Calleja, N

    2007-11-01

    General practitioners (GPs) have an essential role in notification of communicable diseases. The main aim of the study described here was to assess the GPs' awareness of and attitudes towards the notification system in Malta, with special focus on infectious intestinal disease (IID). A questionnaire collecting demographic data, information on reporting practices, opinions on the existing notification system and suggestions for improvement was sent to 256 GPs working in either private or public health sector. In all, 150 GPs took part in the survey (response rate 58.6%). The responses revealed that Maltese GPs were aware of their obligations to notify communicable diseases but often did not report them, relying on the hospitals or laboratories to do so. The Disease Surveillance Unit (DSU) website and medical school training were the main sources of information on notification. Notification forms were obtained from health centres and usually kept at the place of work. Most GPs reported filling in the forms during the patients' visits. Private GPs tended to notify earlier than GPs working in public health centers. Among IID, food-borne illness was reported more frequently than person-to-person transmitted gastroenteritis and was considered to be of a higher priority with regard to public health importance (p<0.001). The survey highlighted also some areas for improvement, including need of feedback especially by direct communication or a newsletter.

  5. Disaster Management and General Dental Practitioners in India: An Overlooked Resource.

    Science.gov (United States)

    Chhabra, Kumar Gaurav; Rajesh, Gururaghavendran; Chhabra, Chaya; Binnal, Almas; Sharma, Ashish; Pachori, Yashpal

    2015-12-01

    To assess General Dental Practitioners' (GDPs) in India willingness to participate in disaster management and their previous training pertaining to disaster management, and to assess GDP objective knowledge, attitude, and behavior regarding disaster management. This study was a cross-sectional survey conducted on all GDPs of Jodhpur, Rajasthan, India. Willingness to participate, perceived knowledge, perceived effectiveness, objective knowledge, attitude, and behavior regarding disaster management were assessed through questionnaire method. Information also was collected regarding age, gender, religion, and residence. A total of 142 out of 180 GDPs participated in the study, representing a response rate of 79%. A majority (85%) of respondents were willing to participate in disaster management. Mean score for knowledge was 12.21%, for attitude was 33.56%, for behavior was 14.50%, and for perceived effectiveness was 9.08%. Significant correlations were observed between qualification and perceived effectiveness (P=.003), and between attitude and years of practice (P=.04). Willingness to participate in disaster management and age showed significant association (P=.000). High willingness and attitude to participate in disaster management was observed among respondents. Low knowledge and behavior scores were observed among GDPs.

  6. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    Science.gov (United States)

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  7. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

    Directory of Open Access Journals (Sweden)

    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  8. Knowledge, Attitudes, and Preventive Practice Towards Breast Cancer among General Practitioner Health Professionals in Morocco

    Science.gov (United States)

    Abda, Naima; Najdi, Adil; El Fakir, Samira; Tachfouti, Nabil; Berraho, Mohamed; Chami Khazraji, Youssef; Abousselham, Loubna; Belakhel, Latifa; Bekkali, Rachid; Nejjari, Chakib

    2017-04-01

    Background: Breast cancer is the most common cancer of women in Morocco and its diagnosis is usually made at advanced stages. The aim of this study was to describe the knowledge, practices and attitudes of general practitioners regarding early detection of breast cancer. Methods: A cross-sectional study was carried out during July 2011 on a sample of 140 general practitioners employed in basic health care facilities. Results: The majority (85.7%) of general practitioners were aware of the existence of a ministerial circular which aimed to generalize breast cancer screening. Systematic practice of clinical breast examination was reported by 18.0% of doctors for every woman between 45 and 70 years and a systematic breast self-examination check-up was reported by 59.4% of physicians. Mammography was requested by 54.1% of physicians in the presence of risk factors. Females and physicians practicing in urban areas were less likely to have a knowledge, attitudes and practices score higher than 8 as compared to male physicians and those practicing in rural areas. Discussion and conclusion: Our study showed that the knowledge, attitudes and practices of general practitioners regarding the early detection of breast cancer program were not satisfactory; hence the urgent need for improved implementation of the program in the affected regions. Creative Commons Attribution License

  9. The role of the general practitioner in cancer care: a survey of the patients' perspective.

    Science.gov (United States)

    Lang, V; Walter, S; Fessler, J; Koester, M J; Ruetters, D; Huebner, J

    2017-05-01

    Modern cancer care is provided in highly specialized structures as certificated centres and comprehensive cancer center, as well as specialized practices. In contrast, the position of the general practitioner (GP) is less well characterised and there is a lack of information about his importance in the care for cancer patients. The aim of our survey was to assess the role of GPs in German cancer care from patients' perspective. In several steps we developed a standardized anonymous questionnaire in cooperation with the German Association of General Practitioners and the Federal Association of German Self-Help Groups. This questionnaire was used in a print and an online version and distributed by the self-help organizations to their members. Seven hundred and forty participants took part in the survey, 66.5% women and 30.1% men. 71% had visited the GP during cancer therapy and 34.5% discussed decisions concerning diagnostics and therapy with him. The most relevant reasons to visit the GP during cancer therapy were to get a blood test (63.3%), comorbidities (42.7%) and complaints and side effects (38.3%). For the latter, most often a detailed discussion ensued (57%), fooled by a prescription (37.7%). In 63.4% the GP offered support when patients had some questions or worries concerning their cancer. Yet, 17% of the patients reported that the GP did not try to help. 85.5% of the participants thought that it is important that their GP is informed about the therapy on a regular basis. For 77.0%, a simultaneous care provided by the GP is important or very important. Our survey points to the importance of the GP during cancer therapy from the patient's point of view. Patients want their GP to take an active part in the cancer therapy. Furthermore, early integration of the GP may also enhance early integration of palliative care and also help family members and caregivers. A strategy to integrate GPs is the establishment of shared care models, in which GPs are supported by

  10. [EBM Service: evidence-based answers provided by general practitioners to questions asked by general practitioners--a project from South Tyrol/Italy].

    Science.gov (United States)

    Piccoliori, Giuliano; Kostner, Simon; Abholz, Heinz-Harald

    2010-01-01

    General practices also require more and more evidence-based decision-making. But knowledge is increasing rapidly and guidelines produced to help doctors to find answers to their problems seem to exclude a number of problems that are important in general practices. Here we report on the introduction and activities of an EbM Service provided by general practitioners to answer questions of their colleagues. The aim is to give EBM answers, but also, in doing so, to teach the application of EBM and--in the long run--to enable the users themselves to find EBM answers. The provision of EBM answers is fairly pragmatic: after using the service the inquiring physician should be better informed, i.e., have more evidence-based information, but sometimes this need not be the "ultimate truth" that experts might deliver. EBM answers are published both on the homepage of the College of General Practitioners and in their journal. It took quite a while to implement this service, and the number of those using it has increased slowly but constantly.

  11. Rewards, costs and challenges: the general practitioner's experience of teaching medical students.

    Science.gov (United States)

    Sturman, Nancy; Régo, Patricia; Dick, Marie-Louise

    2011-07-01

    Medical student attachments in general practices play an important role in undergraduate medical education internationally. The recruitment by universities of new teaching practices or an increase in the teaching commitment of existing practices will be necessary to address rising medical student numbers. General practitioners (GPs) are likely to weigh the perceived rewards of practice-based teaching against the perceived costs and challenges in deciding whether to accept a student placement and how to teach. These aspects of the 'lived experience' of the GP-teacher have not been adequately investigated. This study aims to enhance understanding of the GP clinical teacher experience in order to inform strategies for the recruitment, retention, training and support of teaching general practices. Sixty GP clinical teachers in Brisbane-based urban teaching general practices were interviewed individually face-to-face by the principal investigator, using a semi-structured interview plan. Representativeness was ensured through quota sampling. The interview data were analysed thematically by two of the investigators independently, following member checking of interview transcripts. The results demonstrate a number of key inter-related perceived rewards, costs and challenges of teaching, including intellectual stimulation, cognitive fatigue and student characteristics. The findings extend reports in the previous literature by offering a richer description of current GP-teacher experience. Participants identified teaching rewards in a manner largely consistent with previous research, with the exception of enhanced practice morale and teamwork. Findings confirm that reduced productivity and increased time pressures remain key perceived negative impacts of teaching, but also reveal a number of other important costs and challenges. They emphasise the diversity of GP experience and practice cultures, and the need for teaching to enhance both GP and patient perceptions of

  12. The existential dimension in general practice: identifying understandings and experiences of general practitioners in Denmark.

    Science.gov (United States)

    Assing Hvidt, Elisabeth; Søndergaard, Jens; Ammentorp, Jette; Bjerrum, Lars; Gilså Hansen, Dorte; Olesen, Frede; Pedersen, Susanne S; Timm, Helle; Timmermann, Connie; Hvidt, Niels Christian

    2016-12-01

    The objective of this study is to identify points of agreement and disagreements among general practitioners (GPs) in Denmark concerning how the existential dimension is understood, and when and how it is integrated in the GP-patient encounter. A qualitative methodology with semi-structured focus group interviews was employed. General practice setting in Denmark. Thirty-one GPs from two Danish regions between 38 and 68 years of age participated in seven focus group interviews. Although understood to involve broad life conditions such as present and future being and identity, connectedness to a society and to other people, the existential dimension was primarily reported integrated in connection with life-threatening diseases and death. Furthermore, integration of the existential dimension was characterized as unsystematic and intuitive. Communication about religious or spiritual questions was mostly avoided by GPs due to shyness and perceived lack of expertise. GPs also reported infrequent referrals of patients to chaplains. GPs integrate issues related to the existential dimension in implicit and non-standardized ways and are hindered by cultural barriers. As a way to enhance a practice culture in which GPs pay more explicit attention to the patients' multidimensional concerns, opportunities for professional development could be offered (courses or seminars) that focus on mutual sharing of existential reflections, ideas and communication competencies. Key points Although integration of the existential dimension is recommended for patient care in general practice, little is known about GPs' understanding and integration of this dimension in the GP-patient encounter. The existential dimension is understood to involve broad and universal life conditions having no explicit reference to spiritual or religious aspects. The integration of the existential dimension is delimited to patient cases where life-threatening diseases, life crises and unexplainable patient

  13. Building interdisciplinary leadership skills among health practitioners in the 21st century: an innovative training model

    Directory of Open Access Journals (Sweden)

    Preeti eNegandhi

    2015-10-01

    Full Text Available Transformational learning is the focus of 21st century global educational reforms. In India there is a need to amalgamate the skills and knowledge of medical, nursing and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners, and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing and public health institutions partnered in this endeavour. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in inter-professional health education and the key competencies required. The interdisciplinary leadership competencies identified were: self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team-building, innovation and being an effective change agent. Subsequently, a training program was developed and three training sessions were piloted with 66 participants. Each cohort comprised of a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

  14. General practitioners’ participation in a large, multicountry combined general practitioner-patient survey: recruitment procedures and participation rate.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Greß, S.; Schäfer, W.

    2016-01-01

    Background. Theparticipation of general practitioners (GPs) is essential in research on the performance of primary care.This paper describes the implementation of a large,multicountry study in primary care that combines a survey among GPs and a linked survey among patients that visited their practic

  15. [The Dutch College of General Practitioners practice guideline 'The menopause'; reaction of the field of general practice

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2002-01-01

    The Dutch College of General Practitioners' practice guideline on the menopause will not be any major cause for discussion. The hot issue of giving oestrogens to peri- and postmenopausal women to prevent osteoporosis or cardiovascular disease was already covered in the practice guideline on osteopor

  16. [Summary of the 'Thyroid disorders' guideline of the Dutch College of General Practitioners' (NHG)

    NARCIS (Netherlands)

    Sijbom, M.; Lieshout, J. van; Felix-Schollaart, B.; Burgers, J.S.; Bouma, M.

    2013-01-01

    - The 'Thyroid disorders' guideline of the Dutch College of General Practitioners (NHG) provides recommendations for the diagnosis and management of hypothyroidism, hyperthyroidism and changes in the size of the thyroid gland, such as goitre and thyroid nodules. - Hypothyroid patients younger than 6

  17. Availability of CYP2D6 genotyping results in general practitioner and community pharmacy medical records

    NARCIS (Netherlands)

    Simoons, Mirjam; Mulder, Hans; Schoevers, Robert A; Ruhé, Henricus G; van Roon, Eric N

    AIM: To investigate the availability of CYP450-2D6 (CYP2D6) genotyping results in general practitioner (GP) and/or community pharmacy records, and the influence thereof on psychotropic CYP2D6 substrate dosing. MATERIALS & METHODS: Primary outcome was the percentage of patients genotyped for CYP2D6

  18. Somali refugees' experiences with their general practitioners: frames of reference and critical episodes.

    NARCIS (Netherlands)

    Feldmann, C.T.; Bensing, J.M.; Ruijter, A. de; Boeije, H.R.

    2006-01-01

    The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The c

  19. Somali refugees’ experiences with their general practitioners: frames of reference and critical episodes

    NARCIS (Netherlands)

    Titia Feldmann, C.; Bensing, J.; Ruijter, Arie de; Boeije, H.R.

    2006-01-01

    The article presents the results of a qualitative study based on in-depth interviews with Somali refugees living in The Netherlands, on their experiences with general practitioners (GPs). The central question is: what are the frames of reference participants use to interpret their experiences? The c

  20. Alternative medicine and general practitioners in The Netherlands: towards acceptance and integration.

    NARCIS (Netherlands)

    Visser, G.J.; Peters, L.

    1990-01-01

    A questionnaire on alternative medicine was sent to 600 general practitioners in the Netherlands. Most of the 360 (60%) GPs who replied expressed on interest in alternative practice; and 47% revealed that they used one or more alternative methods themselves, most often homoeopathy. However, the

  1. Task profiles of district doctors in Estonia and general practitioners in Finland.

    NARCIS (Netherlands)

    Lember, M.; Kosunen, E.; Boerma, W.

    1998-01-01

    Objective: to compare the task profiles of primary care doctors in two societies: district doctors in Estonia and general practitioners in Finland. Design: a uniform questionnaire was developed and used in 30 European countries in 1993 (The European Study of GP Task Profiles). The questionnaire was

  2. Vulvovaginal candidiasis: Diagnostic and therapeutic approaches used by Dutch general practitioners

    NARCIS (Netherlands)

    Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

    2008-01-01

    Objective: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. Methods: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

  3. Vulvovaginal candidiasis: diagnostic and therapeutic approaches used by Dutch general practitioners.

    NARCIS (Netherlands)

    Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

    2008-01-01

    OBJECTIVE: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. METHODS: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

  4. Predictors of recall assignment decisions by general dental practitioners performing routine oral examinations.

    NARCIS (Netherlands)

    Mettes, Th.G.P.H.; Sanden, W.J.M. van der; Mulder, J.; Wensing, M.J.P.; Grol, R.P.T.M.; Plasschaert, A.J.M.

    2006-01-01

    The aim of this study was to explore the decision-making behavior of general dental practitioners (GDPs) in performing routine oral examinations (ROEs). Change over time was studied by comparing data from a cohort sample of participants in two surveys in 2000 and 2005. A written questionnaire was se

  5. Intention to Encourage Complementary and Alternative Medicine among General Practitioners and Medical Students

    Science.gov (United States)

    Godin, Gaston; Beaulieu, Dominique; Touchette, Jean-Sebastien; Lambert, Leo-Daniel; Dodin, Sylvie

    2007-01-01

    The authors' goal was to identify factors explaining intention to encourage a patient to follow complementary and alternative medicine (CAM) treatment among general practitioners (GPs), fourth-year medical students, and residents in family medicine. They surveyed 500 GPs and 904 medical students via a self-administered mailed questionnaire that…

  6. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

  7. Perceived barriers and facilitators for general practitioner-patient communication in palliative care: a systematic review

    NARCIS (Netherlands)

    Slort, W.; Schweitzer, B.P.M.; Blankenstein, A.H.; Abarshi, E.A.; Riphagen, I.I.; Echteld, M.A.; Aaronson, N.K.; van der Horst, H.E.; Deliens, L.

    2011-01-01

    While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic

  8. Alternative medicine and general practitioners in The Netherlands: towards acceptance and integration.

    NARCIS (Netherlands)

    Visser, G.J.; Peters, L.

    1990-01-01

    A questionnaire on alternative medicine was sent to 600 general practitioners in the Netherlands. Most of the 360 (60%) GPs who replied expressed on interest in alternative practice; and 47% revealed that they used one or more alternative methods themselves, most often homoeopathy. However, the numb

  9. A cost study of a general practitioner hospital in the Netherlands.

    NARCIS (Netherlands)

    Hakkart-van Roijen, L.; Moll van Charante, E.P.; Bindels, P.J.E.; Yzermans, C.J.; Rutten, F.F.H.

    2004-01-01

    To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hosptial were compared

  10. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    NARCIS (Netherlands)

    Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and pro

  11. Quality-Shaping Factors and Endodontic Treatment amongst General Dental Practitioners with a Focus on Denmark

    DEFF Research Database (Denmark)

    Demant, Sune; Markvart, Merete; Bjørndal, Lars

    2012-01-01

    There is a gap between the endodontic outcome that can be achieved and the outcome observed on the basis of worldwide general dental practitioner data. The quality of root canal treatment (RCT) is shaped by the dentist's knowledge, attitude, and skills, but it may also be influenced by the patient...

  12. Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?

    NARCIS (Netherlands)

    Giesen, P.H.J.; Ferwerda, R.; Tijssen, R.; Mokkink, H.G.A.; Drijver, R.; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: In recent years, there has been a growth in the use of triage nurses to decrease general practitioner (GP) workloads and increase the efficiency of telephone triage. The actual safety of decisions made by triage nurses has not yet been assessed. OBJECTIVES: To investigate whether triage

  13. The combined effect of cancer and chronic diseases on general practitioner consultation rates.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Donker, G.A.; Rijken, P.M.; Schellevis, F.G.

    2015-01-01

    Aim: More than two-thirds of cancer patients have one or more chronic diseases besides cancer. The purpose of this study was to get detailed insight into the combined effect of cancer and chronic diseases on general practitioner (GP) consultation rates. Methods: From the NIVEL Primary Care Database

  14. General dental practitioners' opinions on orthodontics in primary and secondary care.

    Science.gov (United States)

    McMichael, J A

    1997-01-01

    A survey of 232 general dental practitioners was undertaken by the purchasing authorities in Hereford and Worcester, England, in 1993, to establish local practitioners' views on primary and secondary care orthodontics. The response rate was 90.1%. The dentists overestimated their orthodontic case-load: 66.6% of contract holders submitted no claims for upper removable appliances (URA) treatment, but 70.8% claimed they undertook removable appliance therapy. Dentists believed orthodontics should be a feature of the General Dental Services (GDS) but did not seem inclined to commit themselves to providing it. A majority of GDPs (54.9%) felt orthodontics was uneconomic under the GDS. There was support for the treatment planning role of hospitals, but although this was available locally it did not appear to have stimulated primary care provision. Consultant outreach clinics were not generally supported but there was a desire for more opportunities for hospital clinical attachments in orthodontics. The implications for the policies of National Health Service (NHS) purchasers are considered: purchasing health authorities need to carry out systematic assessment of the views of their general dental practitioners and take account of their desired patterns of specialist provision. Policies encouraging the shift of orthodontics into primary care are called into question by this study. If demand for orthodontics is to be met, policy should concentrate on the development of hospital services and specialist practitioners.

  15. [Summary of the Dutch College of General Practitioners' practice guideline on food hypersensitivity

    NARCIS (Netherlands)

    Luning-Koster, M.N.; Lucassen, P.L.B.J.; Boukes, F.S.; Goudswaard, A.

    2011-01-01

    October 2010 the Dutch College of General Practitioners issued a revised version of their previous practice guideline of 1995 on food hypersensitivity in infants. If patients suspect either themselves or their child of having a food allergy, this is usually not demonstrated in subsequent investigati

  16. Vulvovaginal candidiasis: diagnostic and therapeutic approaches used by Dutch general practitioners.

    NARCIS (Netherlands)

    Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

    2008-01-01

    OBJECTIVE: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. METHODS: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

  17. Vulvovaginal candidiasis: Diagnostic and therapeutic approaches used by Dutch general practitioners

    NARCIS (Netherlands)

    Engberts, M.K.; Korporaal, H.; Vinkers, M.T.; Belkum, A. van; Binsbergen, J.J. van; Lagro-Janssen, A.L.M.; Helmerhorst, T.J.M.; Meijden, W.I. van der

    2008-01-01

    Objective: To establish how general practitioners (GPs) in the Netherlands diagnose and treat vaginal candidiasis. Methods: Questionnaires were sent to 1160 Dutch GPs. The GPs were asked to make an inventory of the annual number of consultations for vulvovaginal candidiasis. Furthermore, information

  18. Workload and job satisfaction among general practitioners: a review of the literature.

    NARCIS (Netherlands)

    Groenewegen, P.P.; Hutten, J.B.F.

    1991-01-01

    The workload of general practitioners (GPs) is an important issue in health care systems with capitation payment for GPs services. This article reviews the literature on determinants and consequences of workload and job satisfaction of GPs. Determinants of workload are located on the demand side

  19. Motives and preferences of general practitioners for new collaboration models with medical specialists : a qualitative study

    NARCIS (Netherlands)

    Berendsen, Annette J.; Benneker, Wim H. G. M.; Jong, Betty Meyboom-de; Klazinga, Niek S.; Schuling, Jan

    2007-01-01

    Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates GPs to initiate and continue participating w

  20. Collaboration with general practitioners : preferences of medical specialists - a qualitative study

    NARCIS (Netherlands)

    Berendsen, Annette J.; Benneker, Wim H. G. M.; Schuling, Jan; Rijkers-Koorn, Nienke; Slaets, Joris P. J.; Meyboom-de Jong, Betty

    2006-01-01

    Background: Collaboration between general practitioners (GPs) and specialists has been the focus of many collaborative care projects during the past decade. Unfortunately, quite a number of these projects failed. This raises the question of what motivates medical specialists to initiate and continue

  1. Gut feelings as a third track in general practitioners' diagnostic reasoning.

    NARCIS (Netherlands)

    Stolper, E.; Wiel, M. van de; Royen, P. Van; Bokhoven, M. Van; Weijden, G.D.E.M. van der; Dinant, G.J.

    2011-01-01

    BACKGROUND: General practitioners (GPs) are often faced with complicated, vague problems in situations of uncertainty that they have to solve at short notice. In such situations, gut feelings seem to play a substantial role in their diagnostic process. Qualitative research distinguished a sense of a

  2. The effect of pharmacotherapy audit meetings on early new drug prescribing by general practitioners.

    NARCIS (Netherlands)

    Florentinus, S.R.; Hulten, R. van; Kloth, M.E.M.; Heerdink, E.R.; Griens, A.M.G.F.; Leufkens, H.G.M.; Groenewegen, P.P.

    2007-01-01

    BACKGROUND: New drugs are cornerstones of clinical practice. However, when included in practice in an erratic fashion, there is valid concern about uncertain risk-benefit for patients and increased healthcare expenditures. In several countries, general practitioners (GPs) and pharmacists work closel

  3. General practitioners' needs for ongoing support for the interpretation of spirometry tests.

    NARCIS (Netherlands)

    Poels, P.J.P.; Schermer, T.R.J.; Akkermans, R.P.; Jacobs, A.; Bogart-Jansen, M.; Bottema, B.J.A.M.; Weel, C. van

    2007-01-01

    BACKGROUND: Although one out of three general practitioners (GPs) carries out spirometry, the diagnostic interpretation of spirometric test results appears to be a common barrier for GPs towards its routine application. METHODS: Multivariate cross-sectional analysis of a questionnaire survey among 1

  4. Diagnosis and interpretation of injuries: a study of Dutch general practitioners

    NARCIS (Netherlands)

    Reijnders, U.J.L.; Baasbank, van M.C.; Wal, van der G.

    2005-01-01

    This study explores the ability of Dutch general practitioners (GPs) in recognising types of injury. In the three sample cases, 48-91% classified the injury correctly. Only 9% of GPs recognised self-harm injury and in the 3rd case (child abuse) only 15% referred to the improbability of the account g

  5. General practitioners' continuing medical education: A prospective study from the County of Aarhus

    DEFF Research Database (Denmark)

    Nielsen, Jan E.; Lous, Jørgen; Adeler, H.F.;

    2002-01-01

    Participation of Danish general practitioners (GPs) in continuing medical education (CME) has often been the subject of debate, although very little is known about the extent and content of activities. One-hundred-and-sixty-one Danish GPs participated in this one-year prospective study...

  6. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient rel

  7. Skin tumour surgery in primary care: do general practitioners need to improve their surgical skills?

    NARCIS (Netherlands)

    Rijsingen, M.C.J. van; Vossen, R.; Huystee, B.E.W.L. van; Gorgels, W.J.; Gerritsen, M.J.P.

    2015-01-01

    BACKGROUND: Due to a rapid increase in the incidence of skin cancer, it seems inevitable that general practitioners (GPs) will play a larger role in skin cancer care. OBJECTIVES: To assess surgical procedures used by GPs in skin tumour management. METHODS: We performed a retrospective study of 1,898

  8. Attitudes of general practitioners and midwives towards ethnicity-based haemoglobinopathy-carrier screening

    NARCIS (Netherlands)

    Jans, S.M.P.J.; Jonge, A. de; Henneman, L.; Cornel, M.C.; Lagro-Janssen, A.L.M.

    2012-01-01

    Haemoglobinopathies (HbP) are severe autosomal recessive disorders with high prevalence among certain ethnic groups. World Health Organisation (WHO) advises implementing screening programmes for risk groups. Research in the Netherlands has shown that general practitioners and midwives do not perceiv

  9. [Summary of the Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'

    NARCIS (Netherlands)

    Weele, G.M. van der; Olde Rikkert, M.G.M.; Eizenga, W.H.; Assendelft, W.J.J.

    2003-01-01

    The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people' contains a number of key messages. These are: Consider the diagnosis of delirium in the case of changes in consciousness and attention, incoherent thinking or disorientation, if this picture developed over a

  10. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mazza Danielle

    2013-01-01

    Full Text Available Abstract Background Despite strong evidence of the benefits of preconception interventions for improving pregnancy outcomes, the delivery and uptake of preconception care and periconceptional folate supplementation remain low. General practitioners play a central role in the delivery of preconception care. Understanding general practitioners’ perceptions of the barriers and enablers to implementing preconception care allows for more appropriate targeting of quality improvement interventions. Consequently, the aim of this study was to examine the barriers and enablers to the delivery and uptake of preconception care guidelines from general practitioners’ perspective using theoretical domains related to behaviour change. Methods We conducted a qualitative study using focus groups consisting of 22 general practitioners who were recruited from three regional general practice support organisations. Questions were based on the theoretical domain framework, which describes 12 domains related to behaviour change. General practitioners’ responses were classified into predefined themes using a deductive process of thematic analysis. Results Beliefs about capabilities, motivations and goals, environmental context and resources, and memory, attention and decision making were the key domains identified in the barrier analysis. Some of the perceived barriers identified by general practitioners were time constraints, the lack of women presenting at the preconception stage, the numerous competing preventive priorities within the general practice setting, issues relating to the cost of and access to preconception care, and the lack of resources for assisting in the delivery of preconception care guidelines. Perceived enablers identified by general practitioners included the availability of preconception care checklists and patient brochures, handouts, and waiting room posters outlining the benefits and availability of preconception care consultations

  11. General Practitioners' perceptions of their role in cancer care and factors which influence this role.

    Science.gov (United States)

    Mitchell, Geoffrey K; Burridge, Letitia H; Colquist, Shoni P; Love, Alison

    2012-11-01

    Effective cancer care depends on inter-sectoral and inter-professional communication. General Practitioners (GPs) play a pivotal role in managing the health of most Australians, but their role in cancer care is unclear. This qualitative study explored GPs' views of this role and factors influencing their engagement with cancer care. Twelve metropolitan and non-metropolitan GPs in Queensland, Australia, were recruited between April and May 2008, and three focus groups and one interview were conducted using open-ended questions. The transcripts were analysed thematically. The first theme, GPs' perceptions of their role, comprised subthemes corresponding to four phases of the trajectory. The second theme, Enhancing GPs' involvement in ongoing cancer care, comprised subthemes regarding enhanced communication and clarification of roles and expectations. GPs' role in cancer care fluctuates between active advocacy during diagnosis and palliation, and ambivalent redundancy in between. The role is influenced by socioeconomic, clinical and geographical factors, patients' expectations and GPs' motivation. Not all participants wanted an enhanced role in cancer care, but all valued better specialist-GP communication. Role clarification is needed, together with greater mutual trust between GPs and specialists. Key needs included accessible competency training and mentoring for doctors unfamiliar with the system. Existing system barriers and workforce pressures in general practice must be addressed to improve the sharing of cancer care. Only one metropolitan focus group was conducted, so saturation of themes may not have been reached. The challenges of providing cancer care in busy metropolitan practices are multiplied in non-metropolitan settings with less accessible resources and where distance affects specialist communication. Non-metropolitan GPs learn from experience how to overcome referral and communication challenges. While the GPs identified solutions to their concerns

  12. Attitudes of general practitioners and midwives towards ethnicity-based haemoglobinopathy-carrier screening

    Science.gov (United States)

    Jans, Suze MPJ; de Jonge, Ank; Henneman, Lidewij; Cornel, Martina C; Lagro-Janssen, Antoinette LM

    2012-01-01

    Haemoglobinopathies (HbP) are severe autosomal recessive disorders with high prevalence among certain ethnic groups. World Health Organisation (WHO) advises implementing screening programmes for risk groups. Research in the Netherlands has shown that general practitioners and midwives do not perceive ethnicity as a risk factor for HbP. Moreover, registration of ethnicity is a controversial societal issue, which may complicate the introduction of a national preconception or antenatal carrier screening programme. This study investigates attitudes, intention and behaviour of general practitioners and midwives towards ethnicity-based HbP-carrier screening in general. A structured questionnaire based on the Theory of Planned Behaviour was sent by mail to a random selection of 2100 general practitioners and 1800 primary care midwives. Response was 35% (midwives 44.2% GPs 27.6%). Although 45% of respondents thought that offering a carrier test on the basis of ethnicity alone should become national policy, it is currently not carried out. The main factor explaining lack of intention towards ethnicity-based HbP-carrier screening was subjective norm, the perception that their peers do not think they should offer screening (52.2% variance explained). If ethnicity-based HbP-carrier screening would become national policy, most professionals report that they would carry this out. Most respondents favoured ethnicity registration for health purposes. As most practitioners look for role models among peers, debate among general practitioners and midwives should be encouraged when new policy is to be developed, articulating the voices of colleagues who already actively offer HbP-carrier screening. Moreover, primary care professionals and professional organisations need support of policy at national level. PMID:22549405

  13. General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study

    Directory of Open Access Journals (Sweden)

    Bring Johan

    2005-01-01

    Full Text Available Abstract Background Diagnosing chronic heart failure is difficult, especially in mild cases or early in the course of the disease, and guidelines are not easily implemented in everyday practice. The aim of this study was to investigate general practitioners' diagnostic reasoning about patients with suspected chronic heart failure in comparison with recommendations in European guidelines. Methods Think-aloud technique was used. Fifteen general practitioners reasoned about six case vignettes, representing authentic patients with suspected chronic heart failure. Information about each case was added successively in five steps. The general practitioners said their thoughts aloud while reasoning about the probability of the patient having chronic heart failure, and tried to decide about the diagnosis. Arguments for and against chronic heart failure were analysed and compared to recommendations in guidelines. Results Information about ejection fraction was the most frequent diagnostic argument, followed by information about cardiac enlargement or pulmonary congestion on chest X-ray. However, in a third of the judgement situations, no information about echocardiography was utilized in the general practitioners' diagnostic reasoning. Only three of the 15 doctors used information about a normal electrocardiography as an argument against chronic heart failure. Information about other cardio-vascular diseases was frequently used as a diagnostic argument. Conclusions The clinical information was not utilized to the extent recommended in guidelines. Some implications of our study are that 1 general practitioners need more information about how to utilize echocardiography when diagnosing chronic heart failure, 2 guidelines ought to give more importance to information about other cardio-vascular diseases in the diagnostic reasoning, and 3 guidelines ought to treat the topic of diastolic heart failure in a clearer way.

  14. Knowledge of managing avulsed tooth among general dental practitioners in Malaysia.

    Science.gov (United States)

    Abdullah, Dalia; Soo, Suet Yeo; Kanagasingam, Shalini

    2016-12-01

    Dental and maxillofacial injuries are one of the areas of concern highlighted in the Malaysian National Oral Health Plan 2011-2020. General dental practitioners (GDPs) have the responsibility of diagnosing and assessing dental trauma and determining the prognosis and outcomes of trauma along with its management. The purpose of this study was to evaluate the knowledge base and preferred methods of general dental practitioners regarding the management of avulsed tooth. A random convenient sampling methodology was employed for sample selection. A pre-tested 11-item questionnaire was validated on the dental officers. The survey was distributed to 182 GDPs attending the annual Malaysian Dental Association conference in January 2010. The data obtained was statistically analyzed using descriptive analysis and logistic regression was employed to predict the probability of achieving high scores. A total of 182 general dental practitioners participated in the study, with the majority being female (n=153, 75%). The place of practice significantly affected the knowledge score. In the group that scored more than 80 points (n=84, 46%), 76% of them worked with government hospitals. Age, work duration and number of traumatised teeth previously treated had no significant effect. The odds ratio for place of practice indicates that respondents who work in government hospitals are 3.6 times more likely to score more than 80 points compared to those who worked in private clinics (OR=3.615, P=0.001). The knowledge level on the management of avulsed tooth among general dental practitioners in Malaysia needs to be improved. Strategies in improvement of the Malaysian dental educational system, continuous dental educational activities and utilisation of guidelines on trauma management should be recommended to increase the knowledge level of avulsed tooth management to ensure good treatment outcomes. Trauma prevention and further education regarding the management of avulsed tooth is an

  15. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

    DEFF Research Database (Denmark)

    Bergholdt, Stinne Holm; Gilså Hansen, Dorte; Larsen, Pia Veldt

    2013-01-01

    OBJECTIVE: To test whether a complex intervention facilitating early cancer rehabilitation by involvement of the general practitioner (GP) soon after diagnosis improves patients' satisfaction with their GPs. DESIGN: A cluster randomised controlled trial. All general practices in Denmark were...... hospital (Vejle Hospital, Denmark) were included between May 2008 and February 2009. A total of 955 patients registered with 323 practices were included, of which 486 patients were allocated to the intervention group and 469 to the control group. INTERVENTION: The intervention included a patient interview...... assessing the need for rehabilitation, improved information from the hospital to GPs including information on the patients' current needs along with information about needs of patients with cancer in general. Further, GPs were encouraged to proactively contact the patients and facilitate the patients...

  16. General dental practitioners' perceptions of removable prosthodontics in the undergraduate curriculum.

    Science.gov (United States)

    Ong, C T; Pan, N; Tiang, R; Payne, A G; Thomson, W M

    1999-09-01

    The undergraduate dental curriculum is undergoing rapid change and revision in dental schools worldwide. Decreasing edentulism, the advent of the clinical dental technician, and advances in technology (such as dental implantology) have led to changes in patient management and treatment options for general dental practitioners in New Zealand. The current undergraduate removable prosthodontic curriculum has seen very little change in past years at the School of Dentistry, University of Otago, and is under review to facilitate the teaching of general dental practice in the Final Year. A questionnaire-based survey of 150 general dental practitioners (response rate 74.6 percent) supported modification of the existing removable prosthodontics curriculum to improve its relevance to modern general dental practice. Integration of fixed and removable prosthodontic teaching was recommended.

  17. Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners.

    OpenAIRE

    Cockburn, J.; Ruth, D.; Silagy, C.; Dobbin, M.; Reid, Y.; SCOLLO, M.; Naccarella, L

    1992-01-01

    OBJECTIVE--To compare three approaches for marketing a quit smoking intervention kit to general practitioners. DESIGN--Randomised trial of (a) personal delivery and presentation by an educational facilitator with a follow up visit six weeks later; (b) delivery to the receptionist by a friendly volunteer courier with a follow up phone call six weeks later, or (c) postal delivery with a follow up letter six weeks later. SETTING--Melbourne, Australia. SUBJECTS--264 randomly selected general prac...

  18. Attitudes Toward Collaboration Among Practitioners in Newly Established Medical Homes: A Survey of Nurses, General Practitioners, and Specialists.

    Science.gov (United States)

    Alcusky, Matthew; Ferrari, Luciano; Rossi, Giuseppina; Liu, Mengdan; Hojat, Mohammadreza; Maio, Vittorio

    2016-11-01

    The objective was to evaluate the attitudes toward collaboration of nurses, general practitioners (GPs), and specialists practicing in newly established Medical Homes (MHs) in Parma Local Health Authority (LHA), Emilia-Romagna region, Italy. The 15-item Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was administered electronically to 172 physicians (66 GPs, 106 specialists) and 113 nurses practicing in 12 MHs. In all, 191 surveys (45 GPs, 59 specialists, 87 nurses) were completed (67% response rate). The mean total score among nurses (51.5, standard deviation [SD] = 3.7) reflected a significantly (P < .01) more positive attitude toward collaboration compared with GPs (47.8, SD = 4.6) and specialists (45.3, SD = 7.7). Discrepancies in attitudes are concerning because conflicting perceptions of professional roles may impede a successful transition to integrated care within MHs in Parma LHA. Internationally, further research into understanding interprofessional relationships within MHs is needed to inform policy and build a necessary culture of team-based care. © The Author(s) 2015.

  19. Current sedation practice among general dental practitioners and dental specialists in Jordan: an example of a developing country

    Directory of Open Access Journals (Sweden)

    Al-Shayyab MH

    2013-05-01

    Full Text Available Mohammad H Al-Shayyab,1 Soukaina Ryalat,1 Najla Dar-odeh,1 Firas Alsoleihat21Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, Faculty of Dentistry, 2Department of Conservative Dentistry and Fixed Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, JordanPurpose: The study reported here aimed to identify current sedation practice among general dental practitioners (GDPs and specialist dental practitioners (SDPs in Jordan in 2010.Methods: Questionnaires were sent by email to 1683 GDPs and SDPs who were working in Jordan at the time of the study. The contact details of these dental practitioners were obtained from a Jordan Dental Association list. Details on personal status, use of, and training in, conscious sedation techniques were sought by the questionnaires.Results: A total of 1003 (60% questionnaires were returned, with 748 (86.9% GDPs and 113 (13.1% SDPs responding. Only ten (1.3% GDPs and 63 (55.8% SDPs provided information on the different types of treatments related to their specialties undertaken under some form of sedation performed by specialist and/or assistant anesthetists. Approximately 0.075% of the Jordanian population received some form of sedation during the year 2010, with approximately 0.054% having been treated by oral and maxillofacial surgeons. The main reason for the majority of GDPs (55.0% and many SDPs (40% not to perform sedation was lack of training in this field. While some SDPs (26.0% indicated they did not use sedation because of the inadequacy of sedative facilities.Conclusion: Within the limitations of the present study, it can be concluded that the provision of conscious sedation services in general and specialist dental practices in Jordan is inconsistent and inadequate. This stresses the great need to train practitioners and dental assistants in Jordan to enable them to safely and effectively perform all forms of sedation.Keywords: Jordan Dental

  20. Pain, power and patience - A narrative study of general practitioners' relations with chronic pain patients

    Directory of Open Access Journals (Sweden)

    Troein Margareta

    2011-05-01

    Full Text Available Abstract Background Chronic pain patients are common in general practice. In this study "chronic pain" is defined as diffuse musculoskeletal pain not due to inflammatory diseases or cancer. Effective patient-physician relations improve treatment results. The relationship between doctors and chronic pain patients is often dysfunctional. Consultation training for physicians and medical students can improve the professional ability to build effective relations, but this demands a thorough understanding of the problems in the relation. Several studies have defined the issues that frequently cause problems, but few have described the process. The aim of this study was to understand and illustrate what GPs' experience in contact with chronic pain patients and what works and does not work in these consultations. Methods Our theoretical perspective is constructivist, based upon the relativist view that individuals construct realities to understand and navigate the world. Five Swedish General Practitioners (GPs, two male and three female, were interviewed and asked to tell a story about a difficult encounter with a chronic pain patient. Tapes of the interviews were transcribed and analysed using narrative analysis. Three GPs told narratives suited for our analytic tools and these were included in the final results. Results Each narrative highlights a certain dilemma and a strategy. The dilemmas were: power game; good intentions that fail when a patient is persuaded against her own conviction; persuasion of the unwilling; transferred tiredness; distrust and dissociation from the patient. Professional strategies of listening, encouraging and teamwork were central to handling difficult situations. Conclusions The narratives show that GP's consultations with chronic pain patients sometimes are characterized by conflicts and difficult situations. They are facilitated by methods such as active listening and teamwork, but still may remain hard to handle. This

  1. "Tossing out the baby with the bath water": New Zealand general practitioners on maternity care.

    Science.gov (United States)

    Jaye, Chrystal; Mason, Zara; Miller, Dawn

    2013-01-01

    A rapid decline in the number of general practitioners practicing obstetrics followed legislative changes in New Zealand during the early 1990s that changed the maternity care landscape. The resulting repositioning of maternity care professions has seen medical dominance give way to midwifery dominance in the maternity marketplace. Drawing on our research, we suggest that current and former general practitioner obstetricians harbor grievances relating to (1) the loss of obstetrics from the 'cradle to grave' philosophy of general practice, and (2) policies encouraging competition between maternity care providers. We argue that these perspectives represent truth games that are generated by the disciplinary blocks of the maternity care professions, and reveal the moral nature of the political economy of maternity care.

  2. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

    DEFF Research Database (Denmark)

    Bergholdt, Stinne Holm; Gilså Hansen, Dorte; Larsen, Pia Veldt

    2013-01-01

    OBJECTIVE: To test whether a complex intervention facilitating early cancer rehabilitation by involvement of the general practitioner (GP) soon after diagnosis improves patients' satisfaction with their GPs. DESIGN: A cluster randomised controlled trial. All general practices in Denmark were...... randomised to an intervention or a control group before the start of the study. Patients included those with cancer who were subsequently allocated to either group based on the randomisation status of their GP. PARTICIPANTS: Adult patients with cancer treated for incident cancer at the public regional...... hospital (Vejle Hospital, Denmark) were included between May 2008 and February 2009. A total of 955 patients registered with 323 practices were included, of which 486 patients were allocated to the intervention group and 469 to the control group. INTERVENTION: The intervention included a patient interview...

  3. Routines for interocclusal appliance therapy among general dental practitioners in a Swedish county.

    Science.gov (United States)

    Gnauck, Maja; Helkimo, Martti; Magnusson, Tomas

    2012-01-01

    The aims of this study were to investigate what kind of interocclusal appliances that were chosen among Swedish dentists when treating temporomandibular disorders (TMD), the clinical rationale for the treatment, the diagnoses that warranted the appliance treatment, the use of adjunct TMD treatments and prognostic considerations, and possible differences in these respects between children/adolescents and adults with TMD, and, finally, possible differences between private practitioners and general practitioners in the public dental service. During the 12-months-period April 2009-March 2010 all general dental practitioners in the county of Jönköping, Sweden, were asked to fill in a questionnaire when performing a TMD treatment with an interocclusal appliance. A total of 394 questionnaires were filled in and returned, 216 (55%) from dentists in public dental service and 178 (45%) from private practitioners. It was found that in 40% of the cases, no pre-treatment recording of the functional status in the masticatory system had been made. The commonest reasons for the treatment were bruxism, headache, and replacement of a previous appliance. Less than half of the appliances made were hard acrylic appliances. Some kind of adjunct therapy had been made in 22% of the cases treated in public dental service. The corresponding figure for those treated by private practitioners was 25%. Therapeutic jaw exercises was the commonest adjunct therapy followed by selective occlusal adjustment. In the vast majority of cases, the dentists judged the prognosis of the treatment to be good. It is concluded that a large number of appliances made to treat TMD were soft appliances, especially in public dental service. This reflects a possible overuse of soft appliances at the expense of hard acrylic appliances. Furthermore, in a large number of cases, the treatment was performed without any pre-treatment registrations, and adjunct therapies were rarely used. In all these respects,there is

  4. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  5. Psychiatric services in primary care settings: a survey of general practitioners in Thailand

    Directory of Open Access Journals (Sweden)

    Saipanish Ratana

    2006-07-01

    Full Text Available Abstract Background General Practitioners (GPs in Thailand play an important role in treating psychiatric disorders since there is a shortage of psychiatrists in the country. Our aim was to examine GP's perception of psychiatric problems, drug treatment and service problems encountered in primary care settings. Methods We distributed 1,193 postal questionnaires inquiring about psychiatric practices and service problems to doctors in primary care settings throughout Thailand. Results Four hundred and thirty-four questionnaires (36.4% were returned. Sixty-seven of the respondents (15.4% who had taken further special training in various fields were excluded from the analysis, giving a total of 367 GPs in this study. Fifty-six per cent of respondents were males and they had worked for 4.6 years on average (median = 3 years. 65.6% (SD = 19.3 of the total patients examined had physical problems, 10.7% (SD = 7.9 had psychiatric problems and 23.9% (SD = 16.0 had both problems. The most common psychiatric diagnoses were anxiety disorders (37.5%, alcohol and drugs abuse (28.1%, and depressive disorders (29.2%. Commonly prescribed psychotropic drugs were anxiolytics and antidepressants. The psychotropic drugs most frequently prescribed were diazepam among anti-anxiety drugs, amitriptyline among antidepressant drugs, and haloperidol among antipsychotic drugs. Conclusion Most drugs available through primary care were the same as what existed 3 decades ago. There should be adequate supply of new and appropriate psychotropic drugs in primary care. Case-finding instruments for common mental disorders might be helpful for GPs whose quality of practice was limited by large numbers of patients. However, the service delivery system should be modified in order to maintain successful care for a large number of psychiatric patients.

  6. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

    Science.gov (United States)

    2013-01-01

    Background A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. Conclusions The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself. PMID:23945286

  7. Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania.

    Science.gov (United States)

    Jaruseviciene, Lina; Liseckiene, Ida; Valius, Leonas; Kontrimiene, Ausrine; Jarusevicius, Gediminas; Lapão, Luís Velez

    2013-08-15

    A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself.

  8. Content Development for 72,000 Learners: An Online Learning Environment for General Practitioners: A Case Study

    Science.gov (United States)

    Pilat, Dirk

    2016-01-01

    Increasing workload due to reduced numbers of general practitioners, a population boom and an aging population has increased the need for accessible distance learning for the UK's primary care doctors. The Royal College of General Practitioners is now in its eighth year of delivering high quality e-learning to 72,000 registered users via its…

  9. The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'; response from a geriatric perspective

    NARCIS (Netherlands)

    Izaks, GJ

    2003-01-01

    Delirium in elderly people is a severe condition that requires vigorous medical attention. Therefore, the Dutch College of General Practitioners has duly chosen to develop a practice guideline 'Delirium in elderly people'. It is likely that many general practitioners are only partly familiar with

  10. The Dutch College of General Practitioners' practice guideline 'Delirium in elderly people'; response from a geriatric perspective

    NARCIS (Netherlands)

    Izaks, GJ

    2003-01-01

    Delirium in elderly people is a severe condition that requires vigorous medical attention. Therefore, the Dutch College of General Practitioners has duly chosen to develop a practice guideline 'Delirium in elderly people'. It is likely that many general practitioners are only partly familiar with de

  11. General Military Training: Standardization and Reduction Options

    Science.gov (United States)

    2012-01-01

    Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 This product is part of the RAND Corporation technical report series. Reports may include...and suicide pre- Table 4.1 Service Estimates of the Cost of Preparing Computer-Based General Military Training Product Cost ($) Ten one-hour training...allow members to telecommute to complete training, and then it is left up to the unit commander to decide whether to allow telecommuting . ANG officials

  12. Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners.

    Science.gov (United States)

    Catzikiris, Nigel; Tapley, Amanda; Morgan, Simon; Holliday, Elizabeth G; Ball, Jean; Henderson, Kim; Elliott, Taryn; Spike, Neil; Regan, Cathy; Magin, Parker

    2017-08-10

    Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs.Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences.Results In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (Pcareer GPs in practice-based apprenticeship-like teaching or training should inform strategies to maintain workforce training capacity.What is known about the topic? Projected changes in the demand for and supply of clinical teaching and supervision within Australian general practice will require greater uptake of teaching and supervision by recently qualified GPs to ensure sustainability of this teaching model. Although interest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking.What does this paper add? This paper is the first to document the prevalence of teaching and

  13. Care for patients with severe mental illness: the general practitioner's role perspective

    Directory of Open Access Journals (Sweden)

    Groenier Klaas H

    2009-05-01

    Full Text Available Abstract Background Patients with severe mental illness (SMI experience distress and disabilities in several aspects of life, and they have a higher risk of somatic co-morbidity. Both patients and their family members need the support of an easily accessible primary care system. The willingness of general practitioners and the impeding factors for them to participate in providing care for patients with severe mental illness in the acute and the chronic or residual phase were explored. Methods A questionnaire survey of a sample of Dutch general practitioners spread over the Netherlands was carried out. This comprised 20 questions on the GP's 'Opinion and Task Perspective', 19 questions on 'Treatment and Experiences', and 27 questions on 'Characteristics of the General Practitioner and the Practice Organisation'. Results 186 general practitioners distributed over urban areas (49%, urbanised rural areas (38% and rural areas (15% of the Netherlands participated. The findings were as follows: GPs currently considered themselves as the first contact in the acute psychotic phase. In the chronic or residual phase GPs saw their core task as to diagnose and treat somatic co-morbidity. A majority would be willing to monitor the general health of these patients as well. It appeared that GP trainers and GPs with a smaller practice setting made follow-up appointments and were willing to monitor the self-care of patients with SMI more often than GPs with larger practices. GPs also saw their role as giving support and information to the patient's family. However, they felt a need for recognition of their competencies when working with mental health care specialists. Conclusion GPs were willing to participate in providing care for patients with SMI. They considered themselves responsible for psychotic emergency cases, for monitoring physical health in the chronic phase, and for supporting the relatives of psychotic patients.

  14. Getting a visit: how district nurses and general practitioners 'organise' each other in primary care.

    Science.gov (United States)

    Speed, Shaun; Luker, Karen A

    2006-11-01

    This paper examines the ways in which district nurses and general practitioners interacted and influenced each other's work within primary care services. The data presented here examine how the developments in the organisation of primary care affected the work of district nurses during a time of turbulent change. Qualitative data from 300 hours of participant observation and 40 semi-structured interviews with 33 district nurses were analysed using grounded theory, after which a literature review was undertaken. The findings from this study were interpreted using a Foucauldian notion of power and Fox's (1995) analysis of 'organisation'. The shift in power to general practitioners (GPs) has meant that they can exercise ever-increasing authority over nurses in their employ. Strict rules governed the process of inter-professional work and nurses and doctors used creative strategies to overcome the problems that existed between them. The data show that nurses could and did resist the power of GPs but this resistance generally elicited other more punishing forms of authority. Direct and indirect threats were commonplace. The data suggest that district nurses were moving into a closer, more business-like and tightly-controlled working relationship with general practitioners, through which competing discourses interplayed and circulated between GPs and district nurses in the organisation of primary care services.

  15. General Employee Training Live, Course 15503

    Energy Technology Data Exchange (ETDEWEB)

    Gabel, Daniel Glen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hughes, Heather [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-08-25

    This training at Los Alamos National Laboratory contains the following sections: Introduction to the Laboratory, Institutional Quality Assurance, Facilities, Policies, Procedures, and Other Requirements, Safety Expectations, Worker Protection: Occupational Safety and Health, Industrial Hygiene and Safety, Lockout/Tagout, General Employee Radiological Training, Fire Protection, Security, Emergency Operations, Occupational Health, and Environment.

  16. Preferred Materials and Methods Employed for Endodontic Treatment by Iranian General Practitioners

    Science.gov (United States)

    Raoof, Maryam; Zeini, Negar; Haghani, Jahangir; Sadr, Saeedeh; Mohammadalizadeh, Sakineh

    2015-01-01

    Introduction: The aim of this study was to gather information on the materials and methods employed in root canal treatment (RCT) by general dental practitioners (GDPs) in Iran. Methods and Materials: A questionnaire was distributed among 450 dentists who attended the 53th Iranian Dental Association congress. Participants were asked to consider demographic variables and answer the questions regarding the materials and methods commonly used in RCT. Descriptive statistics were given as absolute frequencies and valid percentages. The chi-square test was used to investigate the influence of gender and the years of professional activity for the employed materials and techniques. Results: The response rate was 84.88%. The results showed that 61.5% of the participants did not perform pulp sensitivity tests prior to RCT. Less than half of the general dental practitioners (47.4%) said that they would trace a sinus tract before starting the treatment. Nearly 16% of practitioners preferred the rubber dam isolation method. Over 36% of the practitioners reported using formocresol for pulpotomy. The combined approach of working length (WL) radiographs and electronic apex locators was used by 35.2% of the practitioners. Most of the respondents used K-file hand instruments for canal preparation and the technique of choice was step-back (43.5%), while 40.1% of respondents used NiTi rotary files, mostly ProTaper and RaCe. The most widely used irrigant was normal saline (61.8%). Calcium hydroxide was the most commonly used inter appointment medicament (84.6%). The most popular obturation technique was cold lateral condensation (81.7%) with 51% using zinc oxide-eugenol-based sealers. Conclusions: The majority of Iranian GDPs who participated in the present survey do not comply with quality guidelines of endodontic treatment. PMID:25834595

  17. Awareness of the association between periodontal disease and pre-term births among general dentists, general medical practitioners and gynecologists

    Directory of Open Access Journals (Sweden)

    Fouzia Tarannum

    2013-01-01

    Full Text Available In the recent decades, periodontal disease has been identified as a risk factor for pre-term deliveries. Hence, it is important to evaluate the awareness of health-care providers of the association between periodontal diseases and pre-term birth. A self-administered questionnaire was distributed to random samples representing general medical practitioners (GMPs, general dental practitioners (GDPs and Gynecologists for this study. A knowledge score was calculated for correct answers to 11 survey questions related to oral health effects during pregnancy and compared among the three groups. In this study, 133 physicians, 135 dentists and 100 Gynecologists completed the questionnaire. More GDPs (67.4% than GMPs (56.4% and Gynecologists (63% reported there was an association between periodontal disease and pre-term low birth weight. Efforts to increase this awareness may prove valuable in improving preventive care during pregnancy.

  18. [Dutch College of General Practitioners' practice guideline 'Peripheral facial paralysis': a summary].

    Science.gov (United States)

    Klomp, M A Rien; Verdaasdonk, Aard L; Striekwold, Manuela P; Teunissen, H Eric; Opstelten, Wim; Goudswaard, A N Lex

    2010-01-01

    The practice guideline 'Peripheral facial paralysis' of the Dutch College of General Practitioners provides the general practitioner with guidelines for diagnosis and management of patients with a peripheral facial paralysis. In about two-thirds of cases of peripheral facial paralysis no cause can be found. The diagnosis of this so-called idiopathic peripheral facial paralysis is based on the patient's history and physical examination; additional investigations are not indicated. The natural course is usually good: without treatment 65-85% of patients will regain normal function of the facial muscles. Treatment with corticosteroids is recommended for all patients with an idiopathic peripheral facial paralysis, irrespective of the degree of the paralysis. This increases the chance of complete recovery by approximately 10%. Antiviral treatment is not recommended.

  19. "We need to get you focused": general practitioners' representations of chronic low back pain patients.

    Science.gov (United States)

    Macneela, Pádraig; Gibbons, Andrea; McGuire, Brian; Murphy, Andrew

    2010-07-01

    Although subject to considerable research from perspectives including general practitioners, patients, and perspective guidelines, chronic low back pain (CLBP) continues to be a common but contentious condition in primary care. We used medical consultation records, critical incident interviews, and a think-aloud problem-solving task to examine how general practitioners applied professional knowledge of the condition, especially in relation to psychosocial care. Using qualitative content analysis and thematic analysis, we identified a pragmatic, goal-focused approach to patients, a schema based on biomedical knowledge and tacit theories of motivation. The doctors' expectations for CLBP included uncertainty over symptoms and doubts over patient credibility, which helped to explain an autonomous rather than collaborative approach to managing back pain patients. The findings are discussed in light of social representations theory, self-determination, and research on the therapeutic relationship.

  20. The electronic patient record as a meaningful audit tool - Accountability and autonomy in general practitioner work

    DEFF Research Database (Denmark)

    Winthereik, Brit Ross; van der Ploeg, I.; Berg, Marc

    2007-01-01

    Health authorities increasingly request that general practitioners (GPs) use information and communication technologies such as electronic patient records (EPR) for accountability purposes. This article deals with the use of EPRs among general practitioners in Britain. It examines two ways in which...... GPs use the EPR for accountability purposes. One way is to generate audit reports on the basis of the information that has been entered into the record. The other is to let the computer intervene in the clinical process through prompts. The article argues that GPs' ambivalence toward using the EPR...... requests to document one's work. Instead, new forms of autonomy are produced in the sociotechnical network that is made up by health policy and local engagements with patients and technology....

  1. [Summary of the Dutch College of General Practitioners (NHG) practice guideline on 'Diverticulitis'].

    Science.gov (United States)

    de Wit, Niek J; Berger, Marjolein Y; Vogelenzang, Rogier; Wetzels, Raymond V; van Rijn-van Kortenhof, Nathalie M M; Opstelten, Wim; Goudswaard, A N Lex

    2012-01-01

    The NHG practice guideline on 'Diverticulitis' provides general practitioners with directions on the diagnosis and treatment of uncomplicated and complicated diverticulitis. Diverticulitis is primarily a clinical diagnosis which can be supported by assessment of CRP. Uncomplicated diverticulitis is strongly suspected if the patient reports the development of persistent sharp, stabbing pain in the lower left abdomen within a couple of days; if there is pressure or rebound tenderness only in the lower left abdomen; and if there are no alarm signals. Alarm signals of complicated diverticulitis are: guarded muscle response, signs of intestinal obstruction, locally palpable resistance, rectal loss of blood, hypotension, and high fever. The policy for uncomplicated diverticulitis is waiting without specific measures, provided that the general practitioner monitors the course actively. There is no indication for antibiotics in patients with uncomplicated diverticulitis. Patients with signs of complicated diverticulitis or with persisting symptoms should be referred.

  2. Nine-year follow-up of children with atopic dermatitis by general practitioners.

    Science.gov (United States)

    Misery, Laurent; Ansolabehere, Xavier; Grandfils, Nathalie; Georgescu, Victor; Taieb, Charles

    2014-01-01

    The frequency of associated comorbidity and the cost of treatments in patients with atopic dermatitis (AD) followed up in primary care settings are poorly known. We carried out a retrospective cohort study on a longitudinal electronic medical records database of patients consulting a panel of general practitioners in France. All subjects with AD diagnosed during the first year of life were selected and matched with infants without the disease according to sex (1,163 vs. 1,163). Subjects were followed up for 9 years. Associated diseases, drug consumptions and available medical costs were detailed. Comparisons between subjects and controls were carried out. Subjects with AD had more comorbidities than others, especially in respiratory and ophthalmic system organs. The number of prescribed treatments in the field of skin diseases as well as overall medical costs (general practitioner consultations and prescribed drugs) were higher among atopic subjects, but differences were attenuated with age.

  3. Screening for depression in patients with myocardial infarction by general practitioners

    DEFF Research Database (Denmark)

    Larsen, K. K.; Vestergaard, M.; Sondergaard, J.;

    2013-01-01

    Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners' practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...... information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders' general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information...

  4. Analysis of the bureaucratic unsolicited mountainous paper heap (BUMPH) that general practitioners received in 1994.

    Science.gov (United States)

    Kenny, D.

    1995-01-01

    OBJECTIVES--To record and analyse the bureaucratic unsolicited mountainous paper heap (BUMPH) received by general practitioners; to make some suggestions for coping with the ensuing workload. DESIGN--Daily record of all BUMPH landing on the desk of a general practitioner in one year. SETTING--Mixed practice with one full time and two job sharing principals. RESULTS--5100 pages of BUMPH arrived during the year. The most prolific source of origin was health authorities (1549 pages). Fridays, Mondays, and the day after a holiday were the days BUMPH was most frequently seen. CONCLUSIONS--BUMPH is a major source of workload. One way of avoiding it is not to work on the day after a day off. Images p1706-a PMID:8541768

  5. Role of the chosen general practitioner in educating women on the importance of regular gynecological examinations

    Directory of Open Access Journals (Sweden)

    Markov Zlatka

    2011-01-01

    Full Text Available Introduction. Since regular screening is the best way of preventing the development of cervical cancer, the objective has been set to assess the motivation of women to have regular gynecological examinations and to estimate the role of the chosen general practitioner. Material and Methods. The survey was performed on the basis of the prospective study done at the Health Centre ”Novi Sad” in 2009 during the systematic regular examinations carried out by general practitioners. Results. It was found that 60.8% of the examined women had regular checkups; 21.5% visited their doctor once in the period of two to five years and 4.9% had undergone the examination in a period > 10 years, whereas 1.9 women had never had an examination. Other examinees had occasional check-ups with various time laps between them. Discussion. The reasons for not visiting a gynecologist were fear of the examination, absence of discomforts and lack of time. However, 87.2% of the examinees visited a gynecologist after they had been advised to do so by their general practitioner. Gynecological finding was good in 87.6% of the women, 3.4% were found to have carcinoma and 8.9% had some other abnormal finding. Conclusion. According to the obtained results, it has been concluded that the chosen general practitioner has a very important role in motivating women to have regular gynecological examinations and in educating them on the risk factors for developing malignant diseases and on the possible prevention.

  6. The meaning of quality work from the general practitioner's perspective: an interview study

    Directory of Open Access Journals (Sweden)

    Håkansson Anders

    2006-10-01

    Full Text Available Abstract Background The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. Methods Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of the statements. Results Two fundamentally different ways to view quality work emerged from the statements: A pronounced top-down perspective with elements of control, and an intra-profession or bottom-up perspective. From the top-down perspective, quality work was described as something that infringes professional freedom. From the bottom-up perspective the statements described quality work as a self-evident duty and as a professional attitude to the medical vocation, guided by the principles of medical ethics. Follow-up with a bottom-up approach is best done in internal processes, with the profession itself designing structures and methods based on its own needs. Conclusions The study indicates that general practitioners view internal follow-up as a professional obligation but external control as an imposition. This opposition entails a difficulty in achieving systematism in follow-up and quality work in health care. If the statutory standards for systematic quality work are to gain a real foothold, they must be packaged in such a way that general practitioners feel that both perspectives can be reconciled.

  7. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    OpenAIRE

    Schene, A.H.; Baas, K.D.; Koeter, M; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K. F.; van Weert, H.C.; Huyser, J.

    2014-01-01

    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and protocolised according to current evidence based guidelines for depression. So far this has not been the case. We studied whether a protocolised 8 session CBT is more effective than optimised and prot...

  8. Bridging the Gap – Electronic Messaging between Home Health Care and General Practitioners

    OpenAIRE

    2015-01-01

    Communication between health care providers is essential for the safe delivery of care to patients. The health care service is fragmented and the tools designed to support communication between health care providers has been unsatisfactory, in particular between home health care nurses and general practitioners (GPs). Three sub-studies were conducted to; 1) describe the experiences of home health care nurses with an e-messaging system and to determine how e-messaging influenced their communic...

  9. Could measuring of perceived risk among general practitioners have helped anticipate the French BSE crisis?

    Science.gov (United States)

    Setbon, Michel; Fischler, Claude; Lukasiewicz, Esther; Raude, Jocelyn; Flahault, Antoine

    2004-01-01

    In October of 2000, a second BSE crisis caught French public authorities unprepared and caused a collapse in beef consumption as well as considerable political turmoil. Data collected between May and July, 2000, among a group of general practitioners (GPs), while national consumption of beef was back to pre-BSE levels, paradoxically showed high latent risk perception, suggesting a new crisis was possible or likely.

  10. Management of adult attention deficit hyperactivity disorder in UK primary care: a survey of general practitioners

    OpenAIRE

    McCarthy, Suzanne; Wilton, Lynda; Murray, Macey; Hodgkins, Paul; Asherson, Philip; Wong, Ian CK

    2013-01-01

    Background: Compared to existing literature on childhood attention deficit hyperactivity disorder (ADHD), little published adult data are available, particularly outside of the United States. Using General Practitioner (GP) questionnaires from the United Kingdom, this study aimed to examine a number of issues related to ADHD in adults, across three cohorts of patients, adults who received ADHD drug treatment in childhood/adolescence but stopped prior to adulthood; adults who received ADHD dru...

  11. Voluntary euthanasia in Northern Ireland: general practitioners' beliefs, experiences, and actions.

    OpenAIRE

    McGlade, K. J.; Slaney, L; Bunting, B. P.; Gallagher, A G

    2000-01-01

    BACKGROUND: There has been much recent interest in the press and among the profession on the subject of euthanasia and physician-assisted suicide. The BMA recently conducted a 'consensus conference' over the internet to collect views on physician-assisted suicide. Any surveys to date have addressed a variety of specialties; however, no recent surveys have looked at general practitioner (GP) attitudes and experiences. AIM: To explore the attitudes of GPs in Northern Ireland towards the issue o...

  12. Determining the Frequency of Defensive Medicine Among General Practitioners in Southeast Iran

    Directory of Open Access Journals (Sweden)

    Mahmood Moosazadeh

    2014-04-01

    Full Text Available Background Defensive medicine prompts physicians not to admit high-risk patients who need intensive care. This phenomenon not only decreases the quality of healthcare services, but also wastes scarce health resources. Defensive medicine occurs in negative and positive forms. Hence, the present study aimed to determine frequency of positive and negative defensive medicine behaviors and their underlying factors among general practitioners in Southeast Iran. Methods The present cross-sectional study was performed among general practitioners in Southeast Iran. 423 subjects participated in the study on a census basis and a questionnaire was used for data collection. Data analysis was carried out using descriptive and analytical statistics through SPSS 20. Results The majority of participants were male (58.2%. The mean age of physicians was 40 ± 8.5. The frequency of positive and negative defensive medicine among general practitioners in Southeast Iran was 99.8% and 79.2% respectively. A significant relationship was observed between working experience, being informed of law suits against their colleagues, and committing defensive medicine behavior (P< 0.001. Conclusion The present study indicated high frequency of defensive medicine behavior in the Southeast Iran. So, it calls policy-makers special attention to improve the status quo.

  13. French general practitioners vary in their attitudes toward treating terminally ill patients.

    Science.gov (United States)

    Mas, Céline; Albaret, Marie-Claire; Sorum, Paul C; Mullet, Etienne

    2010-01-01

    The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scenarios of terminal cancer patients with different levels of age, gender, stated pain, request for painkillers, and signs of depression; 103 of them also indicated the acceptability of making frequent home visits in the same 48 scenarios. The responses were analyzed using analysis of variance and cluster analysis. For prescribing opiates, four clusters of physicians were found: 13 prescribed primarily in response to stated pain; 43 to request for painkillers; 43 to the combination of pain, request, and depression; and 16 in virtually all cases. Using the same clusters to analyze visiting gave results that were very consistent with those for prescribing. We conclude that French general practitioners have differing and consistent styles in prescribing painkillers and making home visits to dying cancer patients.

  14. The general practitioner and mental health problems: challenges and strategies for medical education

    Directory of Open Access Journals (Sweden)

    Dinarte Alexandre Ballester

    Full Text Available CONTEXT AND OBJECTIVE: Within the context of primary health care and mental disorders, our aim was to study the opinions of general practitioners regarding attendance of people with mental health problems. DESIGN AND SETTING: Qualitative focal group study among primary care services in the cities of Porto Alegre and Parobé, State of Rio Grande do Sul. METHODS: A deliberately selected sample of 41 general practitioners who were working in basic health services met in focal groups. Two videos were presented, which simulated consultations for patients with depression and psychoses. The discussions about the identification and handling of mental health problems were recorded and assessed via content analysis. RESULTS: The opinions related to the difficulties of diagnosing and treating mental problems, the involvement of relatives in caring for patients, the difficulty of compliance with the treatment, the uncertainty experienced by physicians and the difficulty of referring patients to specialized services. CONCLUSIONS: The general practitioners indicated that they perceived the mental health problems among their clientele, but the diagnosis and treatment of these problems are still seen as a task for specialists. The challenge of continuing education on mental health requires methods of interactive and critical teaching, such as the problem-based approach.

  15. The payment for performance model and its influence on British general practitioners' principles and practice

    Directory of Open Access Journals (Sweden)

    Armando Henrique Norman

    2014-01-01

    Full Text Available This article explores some effects of the British payment for performance model on general practitioners’ principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

  16. A randomised controlled trial to improve general practitioners' services in cancer rehabilitation: Effects on general practitioners' proactivity and on patients' participation in rehabilitation activities

    DEFF Research Database (Denmark)

    Bergholdt, SH; Søndergaard, J; Larsen, PV

    2013-01-01

    Abstract Few studies have evaluated initiatives targeting implementation of cancer rehabilitation. In this study we aim to test the effects of a complex intervention designed to improve general practitioners' (GPs) involvement in cancer rehabilitation. Outcomes were proactive contacts to patients...... to an intervention and 469 to a control group. The intervention included a patient interview about rehabilitation with a rehabilitation coordinator at the hospital, comprehensive information to the GP about individual needs for rehabilitation, and an encouragement to the GP to contact the patient proactively......- or GP-reported extent of GP proactivity. Further, no effect was observed on patient participation in rehabilitation activities during the 14-month follow-up period. Discussion. The intervention had no effect on GP proactivity or on patient participation in rehabilitation activities. However, analyses...

  17. Are age and gender associated to tobacco use and knowledge among general practitioners?: Results of a survey in Italy

    Directory of Open Access Journals (Sweden)

    Brigid Unim

    2013-09-01

    Full Text Available OBJECTIVES: The aim of this study was to assess knowledge and opinions of Italian general practitioners about the effectiveness of smoking cessation interventions and physicians' attitudes in addressing tobacco-related issues. METHODS: The survey was carried out through a questionnaire administered to general practitioners (GPs attending a medical refresher course. 133 Italian GPs participated in the study with a mean age of 51.4 years (SD = 6.2. RESULTS: The GPs had good knowledge about the predictors of smoking onset, pharmacotherapies for tobacco cessation and the clinical guidelines recommendations. Wrong answers were encountered for the prevalence of smokers in Italy, the Fagerstrom Test for nicotine dependence and minimal advice. Females were more subjected to higher knowledge about tobacco, and at lower risk to be a smoker/ex smoker. Furthermore, physicians > 50 years old living in northern Italy had higher knowledge score. CONCLUSIONS: Physician education on tobacco counseling is associated to increased comfort and practice in advising patients who smoke. Tobacco cessation training might increase the success rate of helping patients to quit smoking.

  18. An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice.

    Science.gov (United States)

    McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

    2015-09-01

    To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse's role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. Integrative literature review. CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention. © 2015 John Wiley & Sons Ltd.

  19. Short-term effect of different teaching methods on nasopharyngeal carcinoma for general practitioners in Jakarta, Indonesia.

    Directory of Open Access Journals (Sweden)

    Maarten A Wildeman

    Full Text Available UNLABELLED: In Indonesia, Nasopharyngeal Carcinoma (NPC is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period. METHODS: Two Indonesian GPs visited 31 Primary Health Care Centres (PHCCs and provided a lecture on NPC. The alternative format consisted of a symposium at the Universitas Indonesia, Jakarta, presented by local head and neck surgeons, with all GPs in the region being invited. To evaluate the effect of both formats a questionnaire was conducted before and after. RESULTS: The lecture in the PHCCs was attended by 130 GPs. Sixty-six GPs attended the training in the university hospital and 40 GPs attended both. Pre training the NPC knowledge level was poor with an average of 1.6 symptoms being correctly identified out of a potential maximum of 12, this was increased to 4.9 post training (p<0.0001. GPs attending the PHCC course recorded a greater increase in correct symptoms than those attending the symposium (3.8 vs. 2.8; p = 0.01. After a two week period the knowledge levels had declined slightly from 5.5 correctly identified symptoms to 4.2 (p = 0.25. CONCLUSION: These results confirm our findings regarding GPs insufficient knowledge of NPC. Lectures in the PHCC and a symposium have both been proven to be effective training tools in the education of GPs.

  20. Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

    Science.gov (United States)

    Wildeman, Maarten A.; Fles, Renske; Adham, Marlinda; Mayangsari, Ika D.; Luirink, Ilse; Sandberg, Mara; Vincent, Andrew D.; Fardizza, Faiziah; Musa, Zanil; Armiyanto; Middeldorp, Jaap M.; Gerritsen, Geerten; Suwanto, Ronny; Tan, I. Bing

    2012-01-01

    In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period. Methods Two Indonesian GPs visited 31 Primary Health Care Centres (PHCCs) and provided a lecture on NPC. The alternative format consisted of a symposium at the Universitas Indonesia, Jakarta, presented by local head and neck surgeons, with all GPs in the region being invited. To evaluate the effect of both formats a questionnaire was conducted before and after. Results The lecture in the PHCCs was attended by 130 GPs. Sixty-six GPs attended the training in the university hospital and 40 GPs attended both. Pre training the NPC knowledge level was poor with an average of 1.6 symptoms being correctly identified out of a potential maximum of 12, this was increased to 4.9 post training (p<0.0001). GPs attending the PHCC course recorded a greater increase in correct symptoms than those attending the symposium (3.8 vs. 2.8; p = 0.01). After a two week period the knowledge levels had declined slightly from 5.5 correctly identified symptoms to 4.2 (p = 0.25). Conclusion These results confirm our findings regarding GPs insufficient knowledge of NPC. Lectures in the PHCC and a symposium have both been proven to be effective training tools in the education of GPs. PMID:22431981

  1. [The practice guideline 'Problematic alcohol consumption' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Bosch, W.J.H.M. van den

    2006-01-01

    The recently revised version of the practice guideline 'Problematic alcohol consumption' from the Dutch College of General Practitioners offers realistic advice to general practitioners on how to manage problem drinkers. The number of patients with alcohol problems tends to increase among women of m

  2. Collaboration between general practitioners and mental health care professionals: a qualitative study

    Directory of Open Access Journals (Sweden)

    Haavet Ole R

    2011-05-01

    Full Text Available Abstract Background Collaboration between general practice and mental health care has been recognised as necessary to provide good quality healthcare services to people with mental health problems. Several studies indicate that collaboration often is poor, with the result that patient' needs for coordinated services are not sufficiently met, and that resources are inefficiently used. An increasing number of mental health care workers should improve mental health services, but may complicate collaboration and coordination between mental health workers and other professionals in the treatment chain. The aim of this qualitative study is to investigate strengths and weaknesses in today's collaboration, and to suggest improvements in the interaction between General Practitioners (GPs and specialised mental health service. Methods This paper presents a qualitative focus group study with data drawn from six groups and eight group sessions with 28 health professionals (10 GPs, 12 nurses, and 6 physicians doing post-doctoral training in psychiatry, all working in the same region and assumed to make professional contact with each other. Results GPs and mental health professionals shared each others expressions of strengths, weaknesses and suggestions for improvement in today's collaboration. Strengths in today's collaboration were related to common consultations between GPs and mental health professionals, and when GPs were able to receive advice about diagnostic treatment dilemmas. Weaknesses were related to the GPs' possibility to meet mental health professionals, and lack of mutual knowledge in mental health services. The results describe experiences and importance of interpersonal knowledge, mutual accessibility and familiarity with existing systems and resources. There is an agreement between GPs and mental health professionals that services will improve with shared knowledge about patients through systematic collaborative services, direct cell

  3. General practitioners' management of mental disorders: A rewarding practice with considerable obstacles

    Directory of Open Access Journals (Sweden)

    Fleury Marie-Josée

    2012-03-01

    Full Text Available Abstract Background Primary care improvement is the cornerstone of current reforms. Mental disorders (MDs are a leading cause of morbidity worldwide and widespread in industrialised countries. MDs are treated mainly in primary care by general practitioners (GPs, even though the latter ability to detect, diagnose, and treat patients with MDs is often considered unsatisfactory. This article examines GPs' management of MDs in an effort to acquire more information regarding means by which GPs deal with MD cases, impact of such cases on their practices, factors that enable or hinder MD management, and patient-management strategies. Methods This study employs a mixed-method approach with emphasis on qualitative investigation. Based on a previous survey of 398 GPs in Quebec, Canada, 60 GPs representing a variety of practice settings were selected for further study. A 10-minute-long questionnaire comprising 27 items was administered, and 70-minute-long interviews were conducted. Quantitative (SPSS and qualitative (NVivo analyses were performed. Results At least 20% of GP visits were MD-related. GPs were comfortable managing common MDs, but not serious MDs. GPs' based their treatment of MDs on pharmacotherapy, support therapy, and psycho-education. They used clinical intuition with few clinical tools, and closely followed their patients with MDs. Practice features (salary or hourly fees payment; psycho-social teams on-site; strong informal networks, and GPs' individual characteristics (continuing medical education; exposure and interest in MDs; traits like empathy favoured MD management. Collaboration with psychologists and psychiatrists was considered key to good MD management. Limited access to specialists, system fragmentation, and underdeveloped group practice and shared-care models were impediments. MD management was seen as burdensome because it required more time, flexibility, and emotional investment. Strategies exist to reduce the burden (one

  4. [Factors influencing general practitioners and specialists of general practice to declare in favor of accepting the role of family doctors].

    Science.gov (United States)

    Lapcević, Mirjana; Dimitrijević, Ivan; Ristić, Jelena; Vuković, Mira; Nikolić, Radivoje; Stanojević, Petar

    2006-10-01

    Protection and promotion of health of an individual, family and society as the whole depends on the organization and efficiency of the public health service. Modern health service is focused on the health prevention and improvement of the family which is the basic unit of society. The life cycle of the family indicates crisis related to development and underdevelopment as well as some expected and unexpected life situations and this is very important when discussing about many somatic and mental diseases. The objective of our project which included 473 specialists of general practice and 355 general practitioners was to determine the factors which influence the positive attitude of the general practitioners about becoming a family doctor. A total of 828 doctors in Serbia were required to answer the set of eight questions. Statistical analysis included Pearson chi square test with contingency tables and logistic regression, while dependent variable was doctor's attitude about becoming a family doctor in a certain situation. The answer 'no' or 'I don't know' was scored 1 point and the 'yes' answer was graded 2 points. Eight questions mentioned above were independent variables. Logistic model accounting for 79.3% of dependent variable was obtained. Positive attitude of doctors was very much affected by family problems and great majority of these doctors were specialists of general practice. Other questions were not so important for our results. Specialists of general practice, regardless of their working experience and years of practice, gave significantly more positive answers, and the situation was quite opposite with general practitioners. Family medicine supported by modern information systems provides ideal model of comprehensive and complete health prevention with high level of rationalism, quality, efficiency and cost-effectiveness.

  5. Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

    Science.gov (United States)

    Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

    2015-08-01

    Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. The role of the general practitioner and the orthodontist in the provision of orthodontic care.

    Science.gov (United States)

    Linge, L

    1987-06-01

    Orthodontics is a small branch of dentistry but one of the oldest and most widespread of dental specialties. It is characterized by long-term treatment objectives which are related to dentofacial morphology and function, growth, facial balance and maturation. Owing to the lack of baseline data it has not been included in the recommendations of the FDI for a stepwise procedure towards 'Health for All by the Year 2000'. Serious efforts should be made to allow inclusion of orthodontics by overcoming this data problem. It is strongly recommended that an internationally acceptable index for orthodontic purposes at the community level be developed. Problems of integration of orthodontic services within oral health care programmes are most significant at medium resource levels when priorities have to be established among many highly desirable dental services. In upper resource levels with less caries and periodontal disease than before the general practitioner should be aware of the rapidly increasing needs for service among elderly people due to improved oral health in adults. For the sake of efficiency, control and quality orthodontic treatment should preferably be carried out by appropriately educated orthodontists, even if the case appears simple in the beginning. Simple cases treated by specialists consume fewer resources than are needed for a system of effective communication and delegation to the general practitioner. Continuing education of all practitioners and other members of the dental team should be carried out in personnel categories and across the boundaries between them.

  7. Employment law: A guidance note for general practitioners on providing patient information to employers.

    Science.gov (United States)

    Garnett, Adele; Tobin, Andrew

    2017-01-01

    Medical practitioners are often caught between a patient who is reluctant to provide their employer with personal health information and an employer who is requesting more detailed health information. This article outlines the rights and responsibilities of employees and employers with regards to the provision of personal health information within employment, and how medical practitioners can assist in advocating for their patient. Topics covered include legal requirements for medical certificates; when certificates can be questioned by an employer; and whether employers can request additional health information from a general practitioner (GP) or independent specialist. In many cases, employers have the right to seek further health information from their employees (eg for health and safety obligations), and employees can face disciplinary action and even dismissal if they are uncooperative. As GPs are necessarily involved in the pro-vision of this information, it is important that they have a general understanding of employment law as it relates to the provision of a patient's personal health information to employers.

  8. Social relations and loneliness among older patients consulting their general practitioner

    DEFF Research Database (Denmark)

    Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

    2017-01-01

    INTRODUCTION: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients' social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. METHODS: This survey counted the participation of 12 general practices in the Capital Region of Denmark...

  9. Social relations and loneliness among older patients consulting their general practitioner

    DEFF Research Database (Denmark)

    Due, Tina Drud; Sandholdt, Håkon; Waldorff, Frans Boch

    2017-01-01

    Introduction: Social relations are important for people and affect their quality of life, morbidity and mortality. This holds true especially for older persons. General practitioners (GPs) are in a unique position to address social relations and loneliness; however, no GP population-based studies...... have assessed older patients’ social relations and loneliness. The aim of this study was to analyse the social relations and loneliness of patients aged 65 years and above consulting their GP. Methods: This survey counted the participation of 12 general practices in the Capital Region of Denmark...

  10. [Diagnosis and classification of orofacial pain by dental and general practitioners].

    Science.gov (United States)

    Stegenga, B; de Bont, L G M

    2006-11-01

    Dental practitioners as well as general practitioners are frequently confronted with patients complaining of pain in the orofacial region. Diagnosing these pains often poses a challenge to the clinician. Currently, the diagnosis of orofacial pains is biaxial. In determining a diagnosis, it is important to consider, in addition to the condition which is causing the pain (axis I-diagnosis), the impact of the pain on the patient's ability to function (axis II-diagnosis). The compilation of a thorough medical history represents the most important diagnostic tool and basis for clinical examination. Based on the axis I-diagnosis several treatment options are suggested; the strategy for managing the pain is, however, largely determined by the axis II-diagnosis.

  11. General practitioners' knowledge, practices, and obstacles in the diagnosis and management of dementia.

    Science.gov (United States)

    Pathak, Krishna P; Montgomery, Anthony

    2015-01-01

    To identify general practitioners' (GPs) knowledge, practices, and obstacles with regard to the diagnosis and management of dementia. Standardized questionnaires covering knowledge, practices, and obstacles were distributed among a purposive sample of GPs in Kathmandu, Nepal. Three hundred and eighty GPs responded (response rate = 89%). Knowledge of practitioners' with regard to the diagnosis and management of dementia was unsatisfactory (management barriers are presented with regard to GP, patient, and carer factors. Specifically, the results address the following issues: communicating the diagnosis, negative views of dementia, difficulty diagnosing early-stage dementia, acceptability of specialists, responsibility for extra issues, knowledge of dementia and aging, less awareness of declining abilities, diminished resources to handle care, lack of specific guidelines, and poor awareness of epidemiology. Demographic changes mean that dementia will represent a significant problem in the future. The following paper outlines the problems and solutions that the Nepalese medical community needs to adopt to deal effectively with diagnosis, care, and management of dementia.

  12. Preliminary studies on establishment of indicator system to evaluate basic capacities of trainers of training for community general practitioners in Shanghai%上海市社区全科师资基本能力评估指标体系的建立

    Institute of Scientific and Technical Information of China (English)

    张渊; 杨华; 王天浩; 祝墡珠

    2011-01-01

    目的 探讨建立上海市社区全科师资基本能力的评估指标体系,以规范社区全科师资队伍的建设和管理.方法 对190名上海市12个区县从事全科临床医疗、社区卫生服务行政管理及全科医师规范化在培学员行问卷调查,了解社区全科师资应该具备的基本能力;根据问卷调查结果拟定"社区全科师资基本能力评估指标体系"评议表,选择从事全科医疗、全科教学、公共卫生事业及卫生行政管理等28位专家,进行两轮德尔菲法咨询,经数据统计分析咨询结果、意见汇总确立评估指标体系.结果 建立的社区全科师资基本能力评估指标体系,包括5个一级指标(综合素质、能力和个人愿望,教育和工作背景,个人职业发展能力,全科医疗工作能力,全科医学教学能力)和57个二级指标.两轮咨询的专家积极系数均为100%,专家权威程度均为0.85,指标重要性协调系数分别为0.190和0.225(均P<0.01).结论 采用德尔菲专家咨询法初步建立了上海市社区全科师资基本能力评估指标体系,多方位、多角度评价社区全科师资应当具备的基本能力,可作为将来设立社区全科师资准入标准的基础.%Objective To explore establishment of indicator system to evaluate basic capacities of trainers of training for community general practitioners (GPs) to standardize their capacity building and management.Methods Questionnaire survey was conducted among 190 trainers of training for community health managers and GPs who were involved in community health-care and health-care service management in 12 districts of Shanghai to investigate what basic capacities the trainers should have.Delphi expert consultation method was used to construct an evaluation indicator system.Firstly, an evaluation form was formulated based on the preceding questionnaire.Then, two rounds of expert consultation were carried out with 28 experts specialized in general practice

  13. Changing guidelines of cardiopulmonary resuscitation and basic life support for general dental practitioners and oral and maxillofacial surgeons.

    Science.gov (United States)

    Gadipelly, Srinivas; Neshangi, Srisha

    2015-06-01

    Every general dental practitioner and oral and maxillofacial surgeon needs a thorough knowledge of the diagnosis and management of medical emergencies. Cardiopulmonary arrest is the most urgent of emergencies and diagnosis must be done as soon as possible. This paper discusses the importance of the International Liaison Committee on Resuscitation which forms the guidelines for cardiopulmonary resuscitation (CPR), highlighting the important changes in the guidelines of CPR from the year 2000 to 2010, the basic sequence of performing CPR and also the role of defibrillation and the use of automated external defibrillators. Finally the five part chain of survival which is of utmost importance to dental health care professionals and oral and maxillofacial surgeons. All dental health care personnel and oral & maxillofacial surgeons should recognize the importance of the changes in the guidelines of CPR, be trained and allowed to use a properly maintained defibrillator, to respond to cardiac arrest victims.

  14. General practitioners' attitudes towards research in primary care: qualitative results of a cross sectional study

    Science.gov (United States)

    Rosemann, Thomas; Szecsenyi, Joachim

    2004-01-01

    Background Research in General Practice requires the participation of General practitioners (GPs). In Germany there is little tradition of research in this field, and GPs are not used to be participants in research. Little is known about German GPs attitudes towards research. Therefore the aim of our study was to assess the willingness of German General Practitioners to participate in primary care research and their attitude towards research in general practice. The results should enable a more successful approach to GPs in further studies. Methods Cross sectional study using semi-structured interviews with a random sample of 76 General Practitioners who participate in the teaching of medical students at the University of Heidelberg. Results Despite little experience, over 85 % of GPs appreciated research in their field. Important reasons for scepticism about research were the gap between theoretical research and practical work of GPs and the domination of research by specialists. Main barriers for participation are clinical workload, administrative overload and the newly introduced Disease Management Programs. The highest motivation for GPs to participate in research emanates from the will to substantiate their quality of care with solid research data. Conclusions Financial incentives and personal support e.g. with study nurses are certainly necessary to establish a research culture and to overcome main barriers against participation. The most successful approach to motivate GPs to participate is to convince them that research documents their quality of care. This data may reflect the facts on which the financial resources are provided in the future health care system. PMID:15613246

  15. Variations in chemoprophylaxis for meningococcal disease: a retrospective case note review, analysis of routine prescribing data and questionnaire of general practitioners

    Directory of Open Access Journals (Sweden)

    Neal Keith R

    2001-12-01

    Full Text Available Abstract Background Invasive meningococcal disease is a significant cause of mortality and morbidity in the UK. Administration of chemoprophylaxis to close contacts reduces the risk of a secondary case. However, unnecessary chemoprophylaxis may be associated with adverse reactions, increased antibiotic resistance and removal of organisms, such as Neisseria lactamica, which help to protect against meningococcal disease. Limited evidence exists to suggest that overuse of chemoprophylaxis may occur. This study aimed to evaluate prescribing of chemoprophylaxis for contacts of meningococcal disease by general practitioners and hospital staff. Methods Retrospective case note review of cases of meningococcal disease was conducted in one health district from 1st September 1997 to 31st August 1999. Routine hospital and general practitioner prescribing data was searched for chemoprophylactic prescriptions of rifampicin and ciprofloxacin. A questionnaire of general practitioners was undertaken to obtain more detailed information. Results Prescribing by hospital doctors was in line with recommendations by the Consultant for Communicable Disease Control. General practitioners prescribed 118% more chemoprophylaxis than was recommended. Size of practice and training status did not affect the level of additional prescribing, but there were significant differences by geographical area. The highest levels of prescribing occurred in areas with high disease rates and associated publicity. However, some true close contacts did not appear to receive prophylaxis. Conclusions Receipt of chemoprophylaxis is affected by a series of patient, doctor and community interactions. High publicity appears to increase demand for prophylaxis. Some true contacts do not receive appropriate chemoprophylaxis and are left at an unnecessarily increased risk.

  16. Practitioner review: When parent training doesn't work: theory-driven clinical strategies.

    Science.gov (United States)

    Scott, Stephen; Dadds, Mark R

    2009-12-01

    Improving the parent-child relationship by using strategies based on social learning theory has become the cornerstone for the treatment of conduct problems in children. Over the past 40 years, interventions have expanded greatly from small, experimental procedures to substantial, systematic programmes that provide clear guidelines in detailed manuals on how practitioners should implement the standardised treatments. They are now widely disseminated and there is a great deal of empirical support that they are very effective for the majority of cases. However, evaluations of even the best of these evidence-based programmes show that a quarter to a third of families and their children do not benefit. What does the practitioner then do, when a standard social learning approach, diligently applied, doesn't work? We argue that under these circumstances, some of the major theories of child development, family functioning and individual psychology can help the skilled practitioner think his or her way through complex clinical situations. This paper describes a set of practical strategies that can then be flexibly applied, based on a systematic theoretical analysis. We hold that social learning theory remains the core of effective parent training interventions, but that ideas from attachment theory, structural family systems theory, cognitive-attribution theory, and shared empowerment/motivational interviewing can each, according to the nature of the difficulty, greatly enrich the practitioner's ability to help bring about change in families who are stuck. We summarise each of these models and present practical examples of when and how they may help the clinician plan treatment.

  17. [What factors aid in the recruitment of general practice as a career? An enquiry by interview of general practitioners].

    Science.gov (United States)

    Natanzon, Iris; Ose, D; Szecsenyi, J; Joos, S

    2010-05-01

    In some parts of Germany there is already a lack of general practitioners (GPs). The reasons for this lack are complex. On the one hand there is an increasing demand for GPs as a result to demographic changes and an increase in the number of chronic diseases. On the other hand fewer medical students decide to become a general practitioner. The aim of this study was to explore, from the perspective of GPs, factors influencing the choice of general practice as a career. Also analysed is the extent to which those factors influence medical students in their carrier choice. 16 GPs were interviewed. Qualitative content analysis according to Mayring has been assisted by the Atlas.ti software program. GPs thought that the occupational orientation of medical students would be strongly dependent on the attractiveness of their future profession. Factors affecting the day-to-day work of general practice and may deterring the carrier choice of students were: poor working and general conditions leading to an increasing dissatisfaction among GPs; decreasing prestige of GPs caused by changed personal and occupational values and attitudes within the society; as well as poor representation and image of general practice as a discipline within the medical curriculum. Various approaches aimed at different target groups can be derived from these identified factors: the government providing general and occupational conditions that would relieve GPs of excessive bureaucracy; universities and medical associations meeting the challenge by improving undergraduate and postgraduate education in general practice; and GPs themselves giving a more self-confident presentation of general practice. Georg Thieme Verlag KG Stuttgart * New York.

  18. Business ethics of private general practitioners in KwaDuKuza, Kwazulu-Natal

    Directory of Open Access Journals (Sweden)

    Indiran Govendor

    2010-03-01

    Full Text Available Background: Private general practitioners (GPs have been criticised by the lay press citing unethical practice and the acceptance of kickbacks. In 2003, the Ethics Institute of South Africa conducted a national study of all doctors and also accused private GPs of unethical practice. In countries such as South Africa, with a practice of fee-for-service payments, there may be a temptation to put material interests above the best interests of patients. Private GPs, on the other hand, are of the opinion that the press and the Ethics Institute publication have unfairly singled them out.Objective: To detect whether private GPs in KwaDukuza perceive their colleagues to be practising ethically.Method: The study entailed a cross-sectional descriptive study design, in which all 30 private GPs based in KwaDukuza, KwaZulu-Natal, were asked to complete a self-administered questionnaire during 2003. The survey was done on a voluntary basis and anonymity and confidentiality was maintained.Results: Twenty-five doctors returned completed questionnaires (an 83.3% response rate. Seventy per cent perceived their peers to be practicing ethically, while 48% (12/25 reported that they did not observe any medical misconduct by their colleagues. The majority of the respondents (76% reported that they did not know of any colleague who supplemented his or her income through the over-servicing of patients. The majority of the respondents (84% also reported that their colleagues never accepted cash payments that were not declared for income tax purposes. Medically unnecessary tests are a form of unethical behaviour pertaining to over-servicing, and 64% of the respondents reported that medically unnecessary tests to satisfy patient requests were not an important reason for performing these tests. The doctors expressed high stress levels from multiple stressors in their occupation.Conclusion: GPs in KwaDukuza indicated that they were under stress, but still practised ethically

  19. Business ethics of private general practitioners in KwaDuKuza, Kwazulu-Natal

    Directory of Open Access Journals (Sweden)

    Indiran Govendor

    2010-03-01

    Full Text Available Background: Private general practitioners (GPs have been criticised by the lay press citing unethical practice and the acceptance of kickbacks. In 2003, the Ethics Institute of South Africa conducted a national study of all doctors and also accused private GPs of unethical practice. In countries such as South Africa, with a practice of fee-for-service payments, there may be a temptation to put material interests above the best interests of patients. Private GPs, on the other hand, are of the opinion that the press and the Ethics Institute publication have unfairly singled them out.Objective: To detect whether private GPs in KwaDukuza perceive their colleagues to be practising ethically.Method: The study entailed a cross-sectional descriptive study design, in which all 30 private GPs based in KwaDukuza, KwaZulu-Natal, were asked to complete a self-administered questionnaire during 2003. The survey was done on a voluntary basis and anonymity and confidentiality was maintained.Results: Twenty-five doctors returned completed questionnaires (an 83.3% response rate. Seventy per cent perceived their peers to be practicing ethically, while 48% (12/25 reported that they did not observe any medical misconduct by their colleagues. The majority of the respondents (76% reported that they did not know of any colleague who supplemented his or her income through the over-servicing of patients. The majority of the respondents (84% also reported that their colleagues never accepted cash payments that were not declared for income tax purposes. Medically unnecessary tests are a form of unethical behaviour pertaining to over-servicing, and 64% of the respondents reported that medically unnecessary tests to satisfy patient requests were not an important reason for performing these tests. The doctors expressed high stress levels from multiple stressors in their occupation.Conclusion: GPs in KwaDukuza indicated that they were under stress, but still practised ethically

  20. The United Kingdom 2009 Swine Flu Outbreak As Recorded in Real Time by General Practitioners

    Directory of Open Access Journals (Sweden)

    Hershel Jick

    2011-01-01

    Full Text Available Background. Initially the course of the 2009 swine flu pandemic was uncertain and impossible to predict with any confidence. An effective prospective data resource exists in the United Kingdom (UK that could have been utilized to describe the scope and extent of the swine flu outbreak as it unfolded. We describe the 2009 swine flu outbreak in the UK as recorded daily by general practitioners and the potential use of this database for real-time tracking of flu outbreaks. Methods. Using the General Practice Research Database, a real-time general practice, electronic database, we estimated influenza incidence from July 1998 to September 2009 according to age, region, and calendar time. Results. From 1998 to2008, influenza outbreaks regularly occurred yearly from October to March, but did not typically occur from April to September until the swine flu outbreak began in April 2009. The weekly incidence rose gradually, peaking at the end of July, and the outbreak had largely dissipated by early September. Conclusions. The UK swine flu outbreak, recorded in real time by a large group of general practitioners, was mild and limited in time. Simultaneous online access seemed feasible and could have provided additional clinical-based evidence at an early planning stage of the outbreak.

  1. Stress among general practitioners of Kwa-Dukuza, Kwa-Zulu Natal

    Directory of Open Access Journals (Sweden)

    Indiran Govender

    2009-04-01

    Full Text Available Background: Stress and burnout are prevalent among the caring professionals, including doctors and nurses. The work-related stress rate among the general working population is 18% whilst among doctors it is around 28%. Stress in general practitioners (GPs can result in multiple negative consequences. Detecting stress early may have positive outcomes for doctors, their families and the people they care for at their practice.Method: A cross-sectional, descriptive study using a self-administered, standardised questionnaire (12-item General Health Questionnaire [GHC] was performed on the 30 general practitioners in Kwa-Dukuza. Confidentiality and anonymity were maintained.Results: 26 of the 30 GPs (87% responded to the survey. 10 GPs (38% were stressed as per the GHQ, six of whom were severely stressed. 22 reported that they felt stressed at work (subjectively.Conclusion: The results indicated that stress among Kwa-Dukuza GPs is slightly higher (38% than found in other studies that indicate a prevalence of 28% among doctors.

  2. Dental Implants and General Dental Practitioners of Nepal: A study of existing knowledge and need for further education

    Directory of Open Access Journals (Sweden)

    Bhageshwar Dhami

    2017-03-01

    Full Text Available Background & Objectives: The use of dental implants in partially or completely edentulous patients has proved effective and an accepted treatment modality with predictable long-term success. Dental implants are becoming a popular choice for replacing the missing teeth because of increased awareness about implants both in dentists and patients. The objective of the study was to assess the basic knowledge and education about dental implants among general dental practitioners (GDPs of Nepal.Materials & Methods:  A cross sectional questionnaire was carried out among 110 GDPs which consist of twenty questions that were divided into three categories; first with some basic knowledge in implant dentistry, second with clinical knowledge of dental implants and third with dental implant education and training.Results: Out of 110 GDPs, 72.7% had basic knowledge about implant dentistry and 65.5% were not aware about advance surgical procedures like sinus lift and guided bone regeneration. All the GDPs were positive regarding more training and education in dental implants and 95.5% of them would like to incorporate dental implant treatment in their practice in future. Conclusion: GDPs should have adequate knowledge and training of dental implants which can be incorporated at undergraduate or post doctoral level so that they are skilled to provide quality dental implant therapy to their patients confidently.

  3. Antibiotic prescription patterns of South African general medical practitioners for treatment of acute bronchitis.

    Science.gov (United States)

    Ncube, N B Q; Solanki, G C; Kredo, T; Lalloo, R

    2017-01-30

    Antibiotic resistance is a significant public health problem. Prudent use of antibiotics is crucial in reducing this resistance. Acute bronchitis is a common reason for consultations with general medical practitioners, and antibiotics are often prescribed even though guidelines recommend not prescribing them for uncomplicated acute bronchitis. To analyse the antibiotic prescription patterns of South African (SA) general medical practitioners in the treatment of acute bronchitis. The 2013 claims for members of 11 health insurance schemes were analysed to assess antibiotic prescription patterns for patients diagnosed with acute bronchitis. The patterns were assessed by type of bronchitis, chronic health status of the patients, sex and age group. The types of antibiotic prescribed were also analysed. Of 166 821 events analysed, an antibiotic was prescribed in more than half (52.9%). There were significant differences by type of bronchitis and chronic health status. Patients with viral bronchitis were more likely to be prescribed an antibiotic than those with bacterial bronchitis (odds ratio (OR) 1.17, 95% confidence interval (CI) 1.08 - 1.26). Patients with a chronic illness were less likely to be prescribed an antibiotic than those without (OR 0.58, 95% CI 0.57 - 0.60). More than 70% of the antibiotics prescribed were cephalosporins, penicillins and other beta-lactams. Prescription rates of antibiotics for acute bronchitis by SA general medical practitioners are high. There is an urgent need to follow the guidelines for antibiotic use for acute bronchitis to reduce the likelihood of increasing resistance to available antibiotics.

  4. Management of asthma in pregnant women by general practitioners: A cross sectional survey

    Directory of Open Access Journals (Sweden)

    Abramson Michael J

    2011-11-01

    Full Text Available Abstract Background Poorly controlled asthma can lead to maternal and fetal complications. Despite the known risks of poorly controlled asthma during pregnancy and the need for stepping up therapy when appropriate, there are concerns that management is suboptimal in primary care. Our objective was to investigate the management of asthma during pregnancy by general practitioners providing shared maternity care. Methods A pre-piloted, anonymous mail survey was sent to all general practitioners (n = 842 involved in shared maternity care at six maternity hospitals in Victoria, Australia. Respondents were asked about their perceived safety of individual asthma medications during pregnancy. Approach to asthma management during pregnancy was further explored using scenarios of pregnant women with stable and deteriorating asthma and poor medication adherence. Results Inhaled corticosteroids (ICS were perceived to be the safest and were the preferred preventive medication in first trimester (74.1%, whilst leukotriene receptor antagonists were the least preferred (2.9%. A quarter (25.8% of respondents would stop or decrease patients' ICS doses during pregnancy, even when their asthma was well controlled by current therapy. In addition, 12.1% of respondents were not sure how to manage deteriorating asthma during pregnancy and opted to refer to another health professional. Almost half the respondents (48.9% reported encountering medication nonadherence during pregnancy. Conclusion A lack of confidence and/or knowledge among general practitioners in managing deteriorating asthma in pregnancy was observed despite a good understanding of the safety of asthma medications during pregnancy, compliance with evidence-based guidelines in the selection of preventive medications, and self reported good asthma knowledge.

  5. Manual therapy, physical therapy, or continued care by a general practitioner for patients with neck pain: a randomized, controlled trial.

    NARCIS (Netherlands)

    Hoving, J.L.; Koes, B.W.; Vet, H.C.W. de; Windt, D.A.W.M. van der; Assendelft, W.J.J.; Mameren, H. van; Devillé, W.L.J.M.; Pool, J.J.M.; Scholten, R.J.P.M.; Bouter, L.M.

    2002-01-01

    BACKGROUND: Neck pain is a common problem, but the effectiveness of frequently applied conservative therapies has never been directly compared. OBJECTIVE: To determine the effectiveness of manual therapy, physical therapy, and continued care by a general practitioner. DESIGN: Randomized, controlled

  6. Preparing general practitioners to receive cancer patients following treatment in secondary care

    DEFF Research Database (Denmark)

    Guassora, Ann Dorrit Kristiane; Jarlbæk, Lene; Thorsen, Thorkil

    2015-01-01

    for professionals in both primary and secondary healthcare. Participants discussed solutions to problems which had previously been identified in patient interviews and in focus groups with general practitioners (GPs), hospital doctors, and nursing staff. The data were analyzed using framework analysis. Results......Background: Many patients consider the interface between secondary and primary care difficult, and in particular, the transition of care between these different parts of the healthcare system presents problems. This interface has long been recognized as a critical point for quality of care...

  7. [Present and future ambulatory nursing care in Switzerland: what general practitioners should know].

    Science.gov (United States)

    Weber-Yaskevich, Olga; Reber, Alexandra; Gillabert, Cédric

    2011-09-28

    In response to the ambulatorization of medical care, the panel of ambulatory nursing medical care is operating important changes. Since 2011, "acute and transitional medical care" is being prescribed by hospital practitioners, implying a new definition of the nurse's profession. The consequence is more complex and more autonomous nursing care: an academic formation has been created for nurses (bachelor and master) and their assistants (healthcare and community assistants). The futur will probably be made of ambulatory case management by nurses (advanced nurse practictioner). General practictioners will not only collaborate with the nurses but also assign them with tasks handled until then by themselves, prescribing, among other things, domiciliary "long-term" medical care.

  8. High diagnostic value of general practitioners' presumptive diagnosis for pyelonephritis, meningitis and pancreatitis

    DEFF Research Database (Denmark)

    Sriskandarajah, Srishamanthi; Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik

    2016-01-01

    INTRODUCTION: In Denmark, patients referred from the general practitioner (GP) to the emergency department (ED) can be referred with either specific symptoms or with a presumptive diagnosis. The aim of the present study was to evaluate the diagnostic accuracy for various presumptive diagnoses made...... by the GP in a population acutely referred to an ED. METHODS: This was a retrospective cohort study of all registered acute referrals for admission to Kolding ED in 2010. Eight presumptive diagnoses were selected for further studies: meningitis, acute coronary syndrome (ACS), pulmonary embolism, pneumonia...

  9. [Insomnia in the general practitioner's office: from diagnosis to initial interventions].

    Science.gov (United States)

    Sommer, Isabelle; Brühl, Annette; Delsignore, Aba; Weidt, Steffi

    2014-05-21

    Insomnia is the most frequent type of sleeping disorder and - following pain - the second most common symptom reported in the general practitioner's office. The prevalence of insomnia increases with age. Untreated, insomnia is regarded as risk factor for other comorbid somatic and mental disorders. Therefore, it is important to make a thorough diagnostic and differential diagnostic assessment. Particularly interventions aiming at improving sleep hygiene and therapy using sleep restriction can help alleviate insomnia. Pharmacologically, herbal drugs and antidepressants with sleep inducing effects can be used, for short-term treatment also benzodiazepine/gaba-ergic agonists.

  10. Danish general practitioners only play a minor role in the coordination of cancer treatment

    DEFF Research Database (Denmark)

    Dalsted, Rikke Juul; Guassora, Ann Dorrit; Thorsen, Thorkil

    2011-01-01

    of coordination. The aim of the article is to discuss whether general practitioners (GPs) may play a coordinating role for individual patients in Danish cancer treatment? MATERIAL AND METHODS: This study is based on individual interviews and focus groups analyzed by meaning condensation. RESULTS: The GP....... In the majority of cases, GPs had no access to information or were not informed about hospital decisions affecting the patients’ trajectories, and they were therefore unable to perform a coordinating role. CONCLUSION: GPs only played a minor or no role at all as coordinators of individual cancer patient...

  11. What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners

    Directory of Open Access Journals (Sweden)

    Fairley Christopher K

    2008-12-01

    Full Text Available Abstract Background Australia is considering implementing a chlamydia screening program in general practice. The views of general practitioners (GPs are necessary to inform the design of the program. This paper aimed to investigate Australian GPs' views on how chlamydia screening could work in the Australian context. Methods This project used both qualitative interviews and a quantitative questionnaire. GPs were randomly selected from a national database of medical practitioners for both the qualitative and quantitative components. Semi-structured interviews were conducted with GPs and a thematic analysis conducted. The results of the interviews were used to design a quantitative postal questionnaire for completion by a larger sample of GPs. Up to three reminders were sent to non-responders. Results Twenty one GPs completed an interview and 255 completed the postal questionnaire. The results of the postal survey were in strong concordance with those of the interview. GPs identified a number of barriers to increased screening including lack of time, knowledge of GPs and the public about chlamydia, patient embarrassment and support for partner notification. GPs felt strongly that screening would be easier if there was a national program and if the public and GPs had a greater knowledge about chlamydia. Incentive payments and mechanisms for recall and reminders would facilitate screening. Greater support for contact tracing would be important if screening is to increase. Conclusion Chlamydia screening in general practice is acceptable to Australian GPs. If screening is to succeed, policy makers must consider the facilitators identified by GPs.

  12. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    OpenAIRE

    Jensen Natasja Koitzsch; Norredam Marie; Priebe Stefan; Krasnik Allan

    2013-01-01

    Abstract Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health prob...

  13. [The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners; a response from the perspective of pulmonary medicine].

    Science.gov (United States)

    van Spiegel, P I

    2008-06-28

    The practice guideline 'Smoking cessation' from the Dutch College of General Practitioners has been published. If general practitioners are going to use the standard, this can have a great impact on smoking in the Dutch population. A decrease in smokers among the population will also have an impact on several smoking-related chronic diseases from a preventive point of view. The guideline emphasizes that smoking cessation is not a one-stop shop but that it requires a long-term effort.

  14. [Halitosis management by the general dental practitioner- results of an International Consensus Workshop*].

    Science.gov (United States)

    Seemann, Rainer; Duarte da Conceicao, Mauricio; Filippi, Andreas; Greenman, John; Lenton, Patricia; Nachnani, Sushma; Quirynen, Marc; Roldán, Silvia; Schulze, Hendrik; Sterer, Nir; Tangerman, Albert; Winkel, Edwin G; Yaegaki, Ken; Rosenberg, Mel

    2014-01-01

    Clinical investigations on patients suffering from halitosis clearly reveal that in the vast majority of cases the source for an offensive breath odor can be found within the oral cavity (90%). Based on these studies, the main sources for intra-oral halitosis where tongue coating, gingivitis/periodontitis and a combination of the two. Thus, it is perfectly logical that general dental practitioners (GDPs) should be able to manage intra-oral halitosis under the conditions found in a normal dental practice. However, GDPs who are interested in diagnosing and treating halitosis are challenged to incorporate scientifically based strategies for use in their clinics. Therefore, the present paper summarizes the results of a consensus workshop of international authorities held with the aim to reach a consensus on general guidelines on how to assess and diagnose patients’ breath odor concerns and general guidelines on regimens for the treatment of halitosis.

  15. Halitosis management by the general dental practitioner--results of an international consensus workshop.

    Science.gov (United States)

    Seemann, R; Conceicao, M D; Filippi, A; Greenman, J; Lenton, P; Nachnani, S; Quirynen, M; Roldan, S; Schulze, H; Sterer, N; Tangerman, A; Winkel, E G; Yaegaki, K; Rosenberg, M

    2014-03-01

    Clinical investigations on patients suffering from halitosis clearly reveal that in the vast majority of cases the source for an offensive breath odor can be found within the oral cavity (90%). Based on these studies, the main sources for intra-oral halitosis where tongue coating, gingivitis/periodontitis or a combination of the two. Thus, it is perfectly logical that general dental practitioners (GDPs) should be able to manage intra-oral halitosis under the conditions found in a normal dental practice. However, GDPs who are interested in diagnosing and treating halitosis are challenged to incorporate scientifically based strategies for use in their clinics. Therefore, the present paper summarizes the results of a consensus workshop of international authorities held with the aim to reach a consensus on general guidelines on how to assess and diagnose patients' breath odor concerns and general guidelines on regimens for the treatment of halitosis.

  16. Development of the EMAP tool facilitating existential communication between general practitioners and cancer patients

    DEFF Research Database (Denmark)

    Assing Hvidt, Elisabeth; Hansen, Dorte Gilså; Ammentorp, Jette

    2017-01-01

    BACKGROUND: General practice recognizes the existential dimension as an integral part of multidimensional patient care alongside the physical, psychological and social dimensions. However, general practitioners (GPs) report substantial barriers related to communication with patients about...... existential concerns. OBJECTIVES: To describe the development of the EMAP tool facilitating communication about existential problems and resources between GPs and patients with cancer. METHODS: A mixed-methods design was chosen comprising a literature search, focus group interviews with GPs and patients (n...... dimension. The tool utilized the acronym and mnemonic EMAP (existential communication in general practice) indicating the intention of the tool: to provide a map of possible existential problems and resources that the GP and the patient can discuss to find points of reorientation in the patient's situation...

  17. New general radiation protection training course

    CERN Multimedia

    2008-01-01

    Some members of CERN personnel, users included, may have to work in supervised or controlled radiation areas, or may be concerned with activities involving the use of radioactive sources. According to CERN Safety rules all persons whose work may encounter ionising radiation risk must be adequately trained. This training must ensure that workers are informed about the potential health risks which could result from radiation exposure, about the basic principles of radiation protection and of the relevant radiation protection regulations as well as about safe working methods and techniques in radiation zones. Therefore the Organization organises mandatory general and work-specific radiation protection (RP) courses addressed to its personnel. These courses are also open to contractors’ personnel, in addition to the RP training they must receive from their employers. Based on the results of a pilot project, an improved general radiation protection course has been prepared. This...

  18. New general radiation protection training course

    CERN Multimedia

    2008-01-01

    Some members of CERN personnel, including users, may have to work in supervised or controlled radiation areas, or may be involved in activities involving the use of radioactive sources. According to CERN Safety Rules all persons whose work may be associated with ionising radiation risk must be adequately trained. This training must ensure that workers are informed about the potential health risks which could result from radiation exposure, the basic principles of radiation protection and the relevant radiation protection regulations as well as safe working methods and techniques in radiation zones. Therefore the Organization organises mandatory general and work-specific radiation protection (RP) courses for its personnel. These courses are also open to contractors’ personnel, in addition to the RP training they must receive from their employers. Based on the results of a pilot project, an improved general radiation protection course has been prepared. This new ½ day cours...

  19. Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners.

    LENUS (Irish Health Repository)

    MacFarlane, Anne

    2008-01-01

    BACKGROUND: Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients\\' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. METHODS: Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. RESULTS: There was a 70% (n = 56\\/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. CONCLUSION: The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners\\' choices are responsive to the needs of patients with limited English.

  20. Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners

    Directory of Open Access Journals (Sweden)

    Mosinkie Phillip I

    2008-12-01

    Full Text Available Abstract Background Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients' relatives or friends. However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. Methods Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. Results There was a 70% (n = 56/80 response rate to the telephone survey. The majority of respondents (77% said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. Conclusion The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners' choices are responsive to the needs of patients with limited English.

  1. General practitioners' preferences with regard to colorectal cancer screening organisation Colon cancer screening medico-legal aspects.

    Science.gov (United States)

    Papin-Lefebvre, Frédérique; Guillaume, Elodie; Moutel, Grégoire; Launoy, Guy; Berchi, Célia

    2017-09-06

    French health authorities put general practitioners at the heart of the colorectal cancer screening. This position raises organisational issues and poses medico-legal problems for the professionals and institutions involved in these campaigns, related to the key concepts of medical decisions and suitability of standards. The objective of our study is to reveal the preferences of general practitioners related to colorectal cancer screening organisation with regard to the medico-legal risk METHODS: A discrete choice questionnaire presenting hypothetical screening scenarios was mailed to 2114 physicians from 20 French different areas. The preferences of 358 general practitioners were analysed using logistic regression models. The factors that have significant impact on the preferences of general practitioners are the capacity of the primary care professional in the procedure, the manner in which pre-screening information is given to patients, the manner in which screening results are given to patients, the number of reminders sent to patients who test positive and who do not undergo a colonoscopy and the remuneration of the attending physician. Our results reveals that current colorectal cancer screening organisation is not adapted to general practitioners preferences. This work offers the public authorities avenues for reflection on possible developments in order to optimize the involvement of general practitioners in the promotion of cancer screening programme. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Malaysian private general practitioners' views and experiences on continuous professional development: A qualitative study.

    Science.gov (United States)

    Abdul Samad, N; Md Zain, A; Osman, R; Lee, P Y; Ng, C J

    2014-01-01

    Continuous professional development (CPD) is an important aspect of a medical practitioner's career. AIMing to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors. The aim of the study was to explore the private general practitioners' (GPs) views, experiences and needs regarding CPD programme in the primary care service. This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers' discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach. GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients' expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring. Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.

  3. Practitioner Expectations and Experiences with the Certificate IV in Training and Assessment (TAA40104). A National Vocational Education and Training Research and Evaluation Program Report

    Science.gov (United States)

    Clayton, Berwyn; Meyers, Dave; Bateman, Andrea; Bluer, Robert

    2010-01-01

    The Certificate IV in Training and Assessment (TAA40104) is seen as the standard entry-level teaching qualification in the vocational education and training (VET) sector. The qualification is widely accepted and well supported as an essential requirement for VET practitioners. However, it has been criticised in relation to its ability to provide…

  4. Training for the Future? A Case Study of Emerging Education, Training and Development Practitioners in the South African Clothing Manufacturing Industry

    Science.gov (United States)

    Jones, Barbara; Cooper, Linda; McMillan, Janice

    2006-01-01

    This article investigates how training instructors in the South African clothing industry were prepared for their roles as Education, Training and Development Practitioners (ETDPs) by a university adult education programme. The key focus is on how these emerging ETDPs experienced their changing roles, identities and approaches to teaching and the…

  5. COMMITMENT OF GENERAL PRACTITIONERS ON PROPHYLAXIS ACCORDING TO THE PATIENT’S OPINION

    Directory of Open Access Journals (Sweden)

    Kalina Peycheva

    2017-06-01

    Full Text Available The vicious cycle of underestimating promotion and prevention of health care by all involved – patients, medical and dental general practitioners (GP continues. According to the health regulation, GPs should inform their patients about the mandatory annual check-ups. GPs are obliged to put in a visible place in their medical office information about all mandatory check-ups for patients under 18 years old – when they are and what they should include. The aim is to study patients’ opinion regarding the role of medical and dental general practitioners in prophylaxis. Material and Methods: A questionnaire was prepared, for the purposes of the study. The methods utilised were a direct individual anonymous questionnaire, statistical – descriptive, analytical (hi – square. The answers were examined and statistically processed according to age, gender and education level of the participants. Results: 1. According to the questionnaires, almost 90 % of patients do not receive equate information about their oral and medical condition. 2. Only 1/5 of GPs inform their patients about the mandatory annual check –ups, immunisations and procedures related to the patient's age. Conclusion: Strict control of the activities of GPs and sanctions for non- regular patients are needed.

  6. General Medical Practitioners Need to Be Aware of the Theories on Which Our Work Depend

    Science.gov (United States)

    Thomas, Paul

    2006-01-01

    When general practitioners and family physicians listen, reflect, and diagnose, we use 3 different theories of knowledge. This essay explores these theories to highlight an approach to clinical practice, inquiry, and learning that can do justice to the complex and uncertain world we experience. The following points are made: (1) A variety of approaches to research and audit are needed to illuminate the richness of experience witnessed by general medical practitioners. (2) Evidence about the past cannot predict the future except in simple, short-term, or slowly changing situations. (3) We consciously or unconsciously weave together evidence generated through 3 fundamental theories of knowledge, termed postpositivism, critical theory, and constructivism, to make sense of everyday experience. We call it listening, reflecting, and diagnosing. (4) These 3 fundamental theories of knowledge highlight different aspects within a world that is more complex, integrated, and changing than any single theory can reveal on its own; they frame what we see and how we act in everyday situations. (5) Moving appropriately between these different theories helps us to see a fuller picture and provides a framework for improving our skills as clinicians, researchers, and learners. (6) Narrative unity offers a way to bring together different kinds of evidence to understand the overall health of patients and of communities; evidence of all kinds provides discrete snapshots of more complex stories in evolution. (7) We need to understand these issues so we can create an agenda for clinical practice, inquiry, and learning appropriate to our discipline. PMID:17003147

  7. Knowledge, attitude and practice of General Practitioners towards adverse drug reaction reporting in South of Iran, Shiraz (Pharmacoepidemiology report).

    Science.gov (United States)

    Peymani, Payam; Tabrizi, Reza; Afifi, Saba; Namazi, Soha; Heydari, Seyed Taghi; Shirazi, Mohammad Khabaz; Nouraei, Hasti; Sadeghi, Elham; Lankarani, Kamran B; Maharlouei, Najmeh

    2016-03-16

    Pharmacovigilance center should play a more active role in improving physicians' adherence to the ADRs reporting systems and the comprehensive educational pack can be used in local and national meetings. The main factor for low ADR reporting rates is lack of information about ADRs and how to report an ADR. Otherwise, obligatory education and training courses should be designed for general practitioners on reporting ADRs during and after graduation.

  8. Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Bowden Francis J

    2010-09-01

    Full Text Available Abstract Background Genital chlamydia is the most commonly notified sexually transmissible infection (STI in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. Methods In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT. Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. Results Perceived barriers to patients telling partners (patient referral included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not

  9. Are videogame training gains specific or general?

    Science.gov (United States)

    Oei, Adam C; Patterson, Michael D

    2014-01-01

    Many recent studies using healthy adults document enhancements in perception and cognition from playing commercial action videogames (AVGs). Playing action games (e.g., Call of Duty, Medal of Honor) is associated with improved bottom-up lower-level information processing skills like visual-perceptual and attentional processes. One proposal states a general improvement in the ability to interpret and gather statistical information to predict future actions which then leads to better performance across different perceptual/attentional tasks. Another proposal claims all the tasks are separately trained in the AVGs because the AVGs and laboratory tasks contain similar demands. We review studies of action and non-AVGs to show support for the latter proposal. To explain transfer in AVGs, we argue that the perceptual and attention tasks share common demands with the trained videogames (e.g., multiple object tracking (MOT), rapid attentional switches, and peripheral vision). In non-AVGs, several studies also demonstrate specific, limited transfer. One instance of specific transfer is the specific enhancement to mental rotation after training in games with a spatial emphasis (e.g., Tetris). In contrast, the evidence for transfer is equivocal where the game and task do not share common demands (e.g., executive functioning). Thus, the "common demands" hypothesis of transfer not only characterizes transfer effects in AVGs, but also non-action games. Furthermore, such a theory provides specific predictions, which can help in the selection of games to train human cognition as well as in the design of videogames purposed for human cognitive and perceptual enhancement. Finally this hypothesis is consistent with the cognitive training literature where most post-training gains are for tasks similar to the training rather than general, non-specific improvements.

  10. Are videogame training gains specific or general?

    Directory of Open Access Journals (Sweden)

    Adam C. Oei

    2014-04-01

    Full Text Available Many recent studies using healthy adults document enhancements in perception and cognition from playing commercial action videogames. Playing action games (e.g., Call of Duty, Medal of Honor is associated with improved bottom-up lower-level information processing skills like visual-perceptual and attentional processes. One proposal states a general improvement in the ability to interpret and gather statistical information to predict future actions which then leads to better performance across different perceptual/attentional tasks. Another proposal claims all the tasks are separately trained in the action videogames because the action videogames and laboratory tasks contain similar demands. We review studies of action and non-action videogames to show support for the latter proposal. To explain transfer in action videogames, we argue that the perceptual and attention tasks share common demands with the trained videogames (e.g., multiple object tracking, rapid attentional switches, and peripheral vision. In non-action videogames, several studies also demonstrate specific, limited transfer. One instance of specific transfer is the specific enhancement to mental rotation after training in games with a spatial emphasis (e.g, Tetris. In contrast, the evidence for transfer is equivocal where the game and task do not share common demands (e.g., executive functioning. Thus, the common demands hypothesis of transfer not only characterizes transfer effects in action videogames, but also non-action games. Furthermore, such a theory provides specific predictions, which can help in the selection of games to train human cognition as well as in the design of videogames purposed for human cognitive and perceptual enhancement. Finally this hypothesis is consistent with the cognitive training literature where most post-training gains are for tasks similar to the training rather than general, non-specific improvements.

  11. General practitioners' views of pharmacists' current and potential contributions to medication review and prescribing in New Zealand

    Directory of Open Access Journals (Sweden)

    Hatah E

    2013-09-01

    Full Text Available INTRODUCTION: Internationally, non-medical practitioners are increasingly involved in tasks traditionally undertaken by general practitioners (GPs, such as medication review and prescribing. This study aims to evaluate GPs' perceptions of pharmacists' contributions to those services. METHODS: Semi-structured interviews were carried out in two localities with GPs whose patients had and had not undergone a pharmacist-led adherence support Medication Use Review (MUR. GPs were asked their opinions of pharmacists' provision of MUR, clinical medication review and prescribing. Data were analysed thematically using NVivo 8 and grouped by strengths, weaknesses, opportunities and threats (SWOT category. FINDINGS: Eighteen GPs were interviewed. GPs mentioned their own skills, training and knowledge of clinical conditions. These were considered GPs' major strengths. GPs' perceived weaknesses were their time constraints and heavy workloads. GPs thought pharmacists' strengths were their knowledge of pharmacology and having more time for in-depth medication review than GPs. Nevertheless, GPs felt pharmacist-led medication reviews might confuse patients, and increase GP workloads. GPs were concerned that pharmacist prescribing might include pharmacists making a diagnosis. This is not the proposed model for New Zealand. In general, GPs were more accepting of pharmacists providing medication reviews than of pharmacist prescribing, unless appropriate controls, close collaboration and co-location of services took place. CONCLUSION: GPs perceived their own skills were well suited to reviewing medication and prescribing, but thought pharmacists might also have strengths and skills in these areas. In future, GPs thought that working together with pharmacists in these services might be possible in a collaborative setting.

  12. Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Bjerrum, Lars; Gahrn-Hansen, Bente

    2013-01-01

    Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT. Objectives: To investigate Danish general practitioners' (GPs') assessment...... of a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern. Methods: A total of 102 Danish GPs were invited to assess the 41 quality...... indicators. The GPs were categorized into two groups according to their assessment of indicators. Data concerning practice characteristics and antibiotic treatment were obtained during a three-week registration of patients with RTIs and were linked to the GPs' assessments of the indicators. Results: A total...

  13. [Summary of the Dutch College of General Practitioners' practice guideline on food hypersensitivity].

    Science.gov (United States)

    Luning-Koster, Marleen N; Lucassen, Peter L B J; Boukes, Froukje S; Goudswaard, A N Lex

    2011-01-01

    October 2010 the Dutch College of General Practitioners issued a revised version of their previous practice guideline of 1995 on food hypersensitivity in infants. If patients suspect either themselves or their child of having a food allergy, this is usually not demonstrated in subsequent investigation. Wrongly prescribed elimination diets may have adverse effects. Examination of serum specific IgE levels has no place in the diagnosis of food allergy in general practice. An open elimination challenge is especially suitable in order to exclude a food allergy. A sure diagnosis of food allergy can only be made by a double-blind placebo-controlled food challenge. There are no proven effective measures that can prevent food allergy.

  14. Screening for depression in patients with myocardial infarction by general practitioners

    DEFF Research Database (Denmark)

    Larsen, Karen Kjær; Vestergaard, Mogens; Christensen, Bo;

    2013-01-01

    Background: Depression in patients with myocardial infarction (MI) is highly prevalent and associated with increased morbidity and mortality. Routine screening for post-MI depression is recommended. We studied general practitioners’ practice of screening for post-MI depression and analysed whether...... the screening rate varied among subgroups of MI patients with a particular high risk of depression. Design: Population-based cohort study in the Central Denmark Region. Methods: All patients with a first-time MI in 2009 received a questionnaire 3 months after discharge from hospital. The questionnaire included...... information on anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS), severity of the disease, and smoking habits. The responders’ general practitioners received a questionnaire 1 year after the patient had been discharged from hospital. This questionnaire provided information...

  15. Learning a novel technique to identify possible melanomas: are Australian general practitioners better than their U.K. colleagues?

    Directory of Open Access Journals (Sweden)

    Watson Tony

    2009-04-01

    Full Text Available Abstract Background Spectrophotometric intracutaneous analysis (SIAscopy™ is a multispectral imaging technique that is used to identify 'suspicious' (i.e. potentially malignant pigmented skin lesions for further investigation. The MoleMate™ system is a hand-held scanner that captures SIAscopy™ images that are then classified by the clinician using a computerized diagnostic algorithm designed for the primary health care setting. The objectives of this study were to test the effectiveness of a computer program designed to train health care workers to identify the diagnostic features of SIAscopy™ images and compare the results of a group of Australian and a group of English general practitioners (GPs. Methods Thirty GPs recruited from the Perth (Western Australia metropolitan area completed the training program at a workshop held in March 2008. The accuracy and speed of their pre- and post-test scores were then compared with those of a group of 18 GPs (including 10 GP registrars who completed a similar program at two workshops held in Cambridge (U.K. in March and April, 2007. Results The median test score of the Australian GPs improved from 79.5% to 86.5% (median increase 5.5%; p Conclusion Most of the SIAscopy™ features can be learnt to a reasonable degree of accuracy with this brief computer training program. Although the Australian GPs scored higher in the pre-test, both groups had similar levels of accuracy and speed in interpreting the SIAscopy™ features after completing the program. Scores were not affected by previous dermoscopy experience or dermatology training, which suggests that the MoleMate™ system is relatively easy to learn.

  16. General practitioners using complementary and alternative medicine differ from general practitioners using conventional medicine in their view of the risks of electromagnetic fields: a postal survey from Germany.

    Science.gov (United States)

    Kowall, Bernd; Breckenkamp, Jürgen; Berg-Beckhoff, Gabriele

    2015-01-01

    General practitioners (GPs) play a key role in consulting patients worried about health effects of electromagnetic fields (EMF). We compared GPs using conventional medicine (COM) with GPs using complementary and alternative medicine (CAM) concerning their perception of EMF risks. Moreover, we assessed whether the kind of alternative medicine has an influence on the results. A total of 2795 GPs drawn randomly from lists of German GPs were sent an either long or short self-administered postal questionnaire on EMF-related topics. Adjusted logistic regression models were fitted to assess the association of an education in alternative medicine with various aspects of perceiving EMF risks. Concern about EMF, misconceptions about EMF, and distrust toward scientific organizations are more prevalent in CAM-GPs. CAM-GPs more often falsely believed that mobile phone use can lead to head warming of more than 1°C (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.5-3.3), more often distrusted the Federal Office for Radiation Protection (OR = 2.2, 95% CI = 1.4-3.6), were more often concerned about mobile phone base stations (OR = 2.4, 95% CI = 1.6-3.6), more often attributed own health complaints to EMF (OR = 3.2, 95% CI = 1.8-5.6), and more often reported at least 1 EMF consultation (OR = 2.5, 95% CI = 1.6-3.9). GPs using homeopathy perceived EMF as more risky than GPs using acupuncture or naturopathic treatment. Concern about common EMF sources is highly prevalent among German GPs. CAM-GPs perceive stronger associations between EMF and health problems than COM-GPs. There is a need for evidence-based information about EMF risks for GPs and particularly for CAM-GPs. This is the precondition that GPs can inform patients about EMF and health in line with current scientific knowledge. © The Author(s) 2014.

  17. Communication about euthanasia in general practice: opinions and experiences of patients and their general practitioners.

    Science.gov (United States)

    Borgsteede, Sander D; Deliens, Luc; Graafland-Riedstra, Corrie; Francke, Anneke L; van der Wal, Gerrit; Willems, Dick L

    2007-05-01

    Public opinion and professional organisations dominate the euthanasia debate, and there is a need to understand the opinions of people confronted with euthanasia. The aim of this study was to investigate whether patients and their GPs talk about euthanasia, and if so, how they communicate about this. Qualitative, semi-structured interviews were held with 20 GPs and 30 of their patients in primary care in the Netherlands, where euthanasia is legalised. The patients had a life expectancy of less than 6 months, and cancer, heart failure or chronic obstructive pulmonary disease as underlying disease. Many patients did not communicate about euthanasia with their GP. Neither the patient nor the GP were clear in formulating their expectations concerning future decision making. The initial patient-GP communication consisted of an exchange of opinions about situations in which euthanasia would be desirable. GPs had different opinions about who should initiate communication, and found it difficult to judge the right moment to talk. It is essential to pay attention to education in communication about dying and euthanasia and to train the GPs to gain insight in the patient's end-of-life preferences, and to direct care at the best possible quality of life.

  18. Building Interdisciplinary Leadership Skills among Health Practitioners in the Twenty-First Century: An Innovative Training Model.

    Science.gov (United States)

    Negandhi, Preeti; Negandhi, Himanshu; Tiwari, Ritika; Sharma, Kavya; Zodpey, Sanjay P; Quazi, Zahiruddin; Gaidhane, Abhay; Jayalakshmi N; Gijare, Meenakshi; Yeravdekar, Rajiv

    2015-01-01

    Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.

  19. Consultations in primary care for symptoms attributed to electromagnetic fields – a survey among general practitioners

    Directory of Open Access Journals (Sweden)

    Röösli Martin

    2006-10-01

    Full Text Available Abstract Background Five percent of the Swiss population attribute symptoms to electromagnetic fields (EMF. General practitioners (GPs might play a key role in recognising an emerging health risk, since they are the first to observe and follow up persons who attribute symptoms to EMF. It is unclear to what extent EMFs have become an issue in general practice and which experiences GPs report from the consultations. Methods We conducted telephone interviews in a random sample of GPs in Switzerland in order to assess the frequency of consultations in primary care due to EMF and the GPs' experience with these patients. Results 342 general practitioners were interviewed, corresponding to a response rate of 28.2%. 69% of the GPs reported at least one consultation due to EMF, but GPs with a certificate in complementary medicine were much more likely to report EMF consultations. The median of EMF consultation numbers within one year was three. An overview of the most recent EMF-related consultation per GP yielded sleep disorders, headaches and fatigue as the most often reported symptoms and mobile phone base stations, power lines and the own use of mobile phones as the main EMF sources suspected to be associated to symptoms. GPs judged the association between EMF and the symptoms to be plausible in 54% of the cases. There was no combination of symptoms and EMF sources that was remarkably and consistently judged to be a plausible cause of the symptoms. Conclusion In our survey, GPs often judged the association between the health problems and the suspected exposure to be plausible. This plausibility assessment seems to be based on grounds of preventive positions in a situation of scientific uncertainty. More research effort is needed to obtain more insight on a potential association between long term EMF exposure and unspecific symptoms.

  20. Varicella and Herpes Zoster in Madrid, based on the Sentinel General Practitioner Network: 1997–2004

    Directory of Open Access Journals (Sweden)

    Gutiérrez-Rodríguez Ángeles

    2007-06-01

    Full Text Available Abstract Background Varicella (chickenpox is the primary disease caused by varicella-zoster virus. It is extremely contagious and is frequent in children. Indeed, in the absence of vaccination, a high proportion of the population is liable to contract it. Herpes zoster -more frequent among adults- is caused by reactivation of the latent virus. The objective of this study is to describe the status of and time trend for varicella and herpes zoster in the Madrid Autonomous Region prior to the introduction of the vaccine to the general population. Methods Data source: individualised varicella and herpes zoster case records kept by the Madrid Autonomous Region Sentinel General Practitioner Network for the period 1997–2004. Cumulative incidences, crude and standardised incidence rates, and age-specific rates of varicella and herpes zoster were calculated for each year. Kendall's Tau-b correlation coefficient was calculated to evaluate whether incidence displayed a time trend. Spectral density in the time series of weekly incidences was estimated using a periodogram. Results Standardised annual varicella incidence rates ranged from 742.5 (95% CI: 687.2 – 797.7 to 1239.6 (95% CI: 1164.5 – 1313.4 cases per 100 000 person-years. Most cases affected children, though complications were more frequent in adults. Varicella incidence displayed an annual periodicity but no trend over time. Most herpes zoster cases occurred at advanced ages, with incidence registering a rising annual trend but no seasonality factor. Conclusion In the absence of vaccination, no significant changes in varicella incidence were in evidence recent years, though these were observed in the incidence of herpes zoster. Sentinel general practitioner networks are a valid instrument for surveillance of diseases such as varicella. Further varicella vaccination-coverage and vaccine-efficacy studies are called for.

  1. [Burnout of general practitioners in Belgium: societal consequences and paths to solutions].

    Science.gov (United States)

    Kacenelenbogen, N; Offermans, A M; Roland, M

    2011-09-01

    The definition of burn-out the most often cited and proposed by Maslach and Jackson, clarifies the three cardinal symptoms affecting doctors, namely, emotional exhaustion, with depersonalization of their patients and reduction of the feeling of personal accomplishment. The causes of this phenomenon are relatively well-known: individual psychological factors, stressful factors intrinsic to the medical practice and finally extrinsic factors related to the professional environment and its organization. The purpose of this review is to estimate the prevalence of burnout within the population of Belgian family physicians and to understand both individual and societal consequences. About the method. This is a literature review using databases Medline, Cochrane Library, and the American Psychological Association from 2000 to 2011 with the keywords: primary health care, family practice, burnout, emotional exhaustion, psychological stressors, distress, fatigue, depersonalization, substance and alcohol abuse, depression, well-being, quality of life, job satisfaction, professional efficiency, patient care, physician-patient relations, medical errors, quality of health care, pharmaceutical/health expenditure/statistics-numerical data, obstacles to prevention, health system assessment, medical demography. Selecting of the most relevant articles through the reading of abstracts and then full text reading of 49 selected articles. In conclusion, the exact prevalence of burn-out amongst Belgian general practitioners is not known. From some works, it is estimated that about half of them would be achieved at least in terms of emotional exhaustion. The symptoms related to burn-out are potentially serious: ea depression, alcohol and tobacco abuse and cardiovascular complications. There are also arguments demonstrating the fact that this disorder amongst general practitioners influences negatively the quality of care, their cost, but also medical demography of primary care with as a

  2. The application of foraging theory to the information searching behaviour of general practitioners.

    Science.gov (United States)

    Dwairy, Mai; Dowell, Anthony C; Stahl, Jean-Claude

    2011-08-23

    General Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context.Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources) and books (22%). These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases). GPs nearly always accessed another source when unsuccessful (95% after 1st source), and frequently when successful (43% after 2nd source). Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. By consulting in foraging terms the most 'profitable' sources of information (colleagues, books), rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and minimizing searching time. As predicted by foraging theory, GPs

  3. The application of foraging theory to the information searching behaviour of general practitioners

    Directory of Open Access Journals (Sweden)

    Dowell Anthony C

    2011-08-01

    Full Text Available Abstract Background General Practitioners (GPs employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context. Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. Methods GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. Results A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources and books (22%. These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases. GPs nearly always accessed another source when unsuccessful (95% after 1st source, and frequently when successful (43% after 2nd source. Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. Conclusions By consulting in foraging terms the most 'profitable' sources of information (colleagues, books, rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and

  4. 上海市全科医学规范化培训学员选择社区卫生中心就业的影响因素分析%Factors related to choice of community health service centers in standardized training general practitioners in Shanghai

    Institute of Scientific and Technical Information of China (English)

    李曼; 潘志刚; 祝墡珠; 邵黎兵; 冯燕

    2015-01-01

    目的 了解上海市全科住院医师规范化培训学员选择社区卫生服务中心就业的影响因素.方法 采用自行设计的调查表对上海市2013年住院医师规范化培训全科医学科(含中医全科)结业并在上海市社区卫生服务中心就业的152名学员进行横断面调查.结果 152名学员中,113人(74.3%)表示最重视薪资水平,58人(38.2%)工作后前3年期待年薪大于12万元.学员更倾向选择“市中心”(61人,40.1%)和“离家近”(58人,38.2%)的社区卫生服务中心就业,主要因为“交通的便利性”(91人,59.9%).考虑到个人发展,综合医疗水平高(78人,51.3%)、辖区面积大服务人口数多(77人,50.0%)的社区卫生服务中心更具有吸引力.学员关注较多的其他因素是“全国示范性社区卫生服务中心”(87人,57.2%)和“进入上海优秀青年医师培养计划人数多的社区卫生服务中心”(77人,51.7%).户籍是影响选择社区卫生服务中心的最主要因素,相对于非沪籍学员,沪籍学员较多考虑社区地理位置(61.8%比34.2%),更倾向于选择离家近的社区卫生服务中心(55.3%比21.1%);非沪籍学员更重视编制问题(51.3%比28.9%).西医类全科医师期待年薪较中医类高(x2=13.648,P<0.05),男性较女性高(x2=7.799,P<0.05).结论 全科住院医师规范化培训学员选择社区卫生服务中心就业时最重视薪资水平,倾向选择位于市中心、实力强、规模大的社区卫生服务中心,户籍、全科医师类别、性别是影响学员选择的因素.%Objective To investigate the factors related to choice of community health service centers (CHSCs) in standardized training general practitioners (GPs) in Shanghai.Methods Totally 152 GPs,(including those of Traditional Chinese Medicine) who completed the residency training in 2013 and signed employment contract with community in Shanghai were surveyed with a self-designed questionnaire

  5. Experimenting clinical pathways in general practice: a focus group investigation with Italian general practitioners

    Directory of Open Access Journals (Sweden)

    Lucia Zannini

    2012-07-01

    Full Text Available Background. Clinical governance is considered crucial in primary care. Since 2005, clinical pathways have been experimentally implemented at the Local Health Authority of Monza Brianza (ASLMB, Italy, to develop general practitioners’ (GPs care of patients affected by some chronic diseases. The experimentation was aimed at introducing clinical governance in primary care, increasing GPs’ involvement in the care of their patients, and improving both patients’ and professionals’ satisfaction. In the period 2005-2006, 12% of the 763 employed GPs in the ASLMB were involved in the experiment, while this percentage increased to 15-20% in 2007-2008. Design and Methods. Twenty-four GPs were purposively sampled, randomly divided into two groups and asked to participate in focus groups (FGs held in 2008, aimed at evaluating their perception of the experiment. The FGs were audio-recorded, dialogues were typed out and undergone to a thematic analysis, according to the Interpretative Phenomenological Approach. Results. Four major themes emerged: i clinical pathways can result in GPs working in a more efficient and effective fashion; ii they can assure higher levels of both patient and professional satisfaction, since they sustain a caring approach and strengthen the GPs’ role; iii nevertheless, clinical pathways increase the bureaucratic workload and problems can arise in relationships among GPs and the LHA; iv the implementation of clinical pathways can be improved, especially by reducing bureaucracy and by assuring their continuity. Conclusions. Managerial aspects should be considered with care in order to experimentally introduce clinical pathways in general practice, and continuity of the experimentation should be guaranteed to improve GPs’ adherence and commitment.

  6. 'Making every contact count': Evaluation of the impact of an intervention to train health and social care practitioners in skills to support health behaviour change.

    Science.gov (United States)

    Lawrence, Wendy; Black, Christina; Tinati, Tannaze; Cradock, Sue; Begum, Rufia; Jarman, Megan; Pease, Anna; Margetts, Barrie; Davies, Jenny; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary

    2016-02-01

    A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to 1 year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost.

  7. General practitioners’ hypertension knowledge and training needs: a survey in Xuhui district, Shanghai

    Directory of Open Access Journals (Sweden)

    Chen Qian

    2013-01-01

    Full Text Available Abstract Background Hypertension prevalence is high in China, while patients’ levels of hypertension awareness, treatment and control are low. General practitioners’ knowledge and training relating to hypertension prevention may be an important related factor. We aimed to investigate general practitioners’ knowledge of hypertension prevention and potential training needs. Methods A questionnaire survey was conducted among all general practitioners at five community health service centers selected by convenience sampling. A total of 160 questionnaires were distributed and 147 were returned (response rate 91.9% The questionnaire included general information; 12 subjective questions on health promotion, education and training needs; and 19 objective questions in 5 domains (epidemiology, diagnosis, treatment, referral and community management measuring knowledge of hypertension prevention and treatment. Results The major difficulties in health education practice for general practitioners were poor patient compliance (77.6% and lack of medical consultation time (49.0%. The average accuracy rate of hypertension prevention knowledge was 49.2%, ranging from 10.5% to 94.7%. The factors associated with accuracy rate were physician’s education level (medical university vs. professional school, β = 13.3, P = 0.003, and type of center (training base vs. community healthcare center, β = 12.3, P  Conclusions The knowledge level of hypertension prevention is low among general practitioners in urban settings. Physicians working in community clinics where they participate in a series of teaching, assessing and evaluating systems for hypertension prevention perform better than those in general healthcare centers who lack specific training. Continuing hypertension education is urgently needed to ensure that physicians in general practice are aware of and adhere to the national hypertension prevention guidelines.

  8. General practitioners and carers: a questionnaire survey of attitudes, awareness of issues, barriers and enablers to provision of services

    Directory of Open Access Journals (Sweden)

    Atkins Christine

    2010-12-01

    Full Text Available Abstract Background Approximately one in ten of the UK population are unpaid carers supporting a family member or friend who could not manage without their help, saving the UK economy an estimated £87 billion. This role is known to sometimes have a negative impact on carers and to require support both informally and from statutory services. General practice is a first point of contact for carers but research investigating general practitioners' (GPs' attitudes towards carers and awareness of issues facing carers is rare. This study therefore aimed to identify GPs' attitudes, awareness of issues, and perceptions of the barriers and enablers to provision of services. Methods Using a self-completion questionnaire distributed at a series of workshops, this study investigates GPs' attitudes to carers; awareness and knowledge of carers' issues; services offered in general practice and barriers to supporting carers. Results Seventy eight out of a total of 95 GPs (82% response rate from a variety of areas in England completed the questionnaires. The GPs identified time, resources and lack of knowledge as barriers, but only 9% agreed with the statement that there is little support they can offer carers. However, nine in ten GPs (89% feel they have insufficient training here and approximately half of them (47% lack confidence that they are meeting carers' needs. Confidence in identifying carers is also low (45%. Issues that GPs would look out for amongst carers include emotional and physical health problems and financial and isolation difficulties. GPs specifically highlighted educational and isolation issues for young carers. Few services were described that targeted carers. Conclusions GPs recognise that they have an important role to play in supporting carers but would like training and support. Further investigation is needed both to determine how best to train and facilitate GPs and general practice teams in their role in supporting carers and to

  9. Danish general practitioners only play a minor role in the coordination of cancer treatment

    DEFF Research Database (Denmark)

    Dalsted, R.J.; Guassora, A.D.; Thorsen, T.

    2011-01-01

    of coordination. The aim of the article is to discuss whether general practitioners (GPs) may play a coordinating role for individual patients in Danish cancer treatment. MATERIAL AND METHODS: This study is based on individual interviews and focus groups analyzed by meaning condensation. RESULTS: The GP....... In the majority of cases, GPs had no access to information or were not informed about hospital decisions affecting the patients' trajectories, and they were therefore unable to perform a coordinating role. CONCLUSION: GPs only played a minor or no role at all as coordinators of individual cancer patient...... trajectories. The findings of the present study question the idea that coordination throughout the entire health-care system may be assigned to a single individual as the involved parties belong to different organizations with different goals, managements and economic resources...

  10. Danish general practitioners only play a minor role in the coordination of cancer treatment

    DEFF Research Database (Denmark)

    Dalsted, Rikke Juul; Guassora, Ann Dorrit; Thorsen, Thorkil

    2011-01-01

    of coordination. The aim of the article is to discuss whether general practitioners (GPs) may play a coordinating role for individual patients in Danish cancer treatment? MATERIAL AND METHODS: This study is based on individual interviews and focus groups analyzed by meaning condensation. RESULTS: The GP......INTRODUCTION: Despite initiatives to integrate treatment and care across organisations, patient trajectories in Danish health-care are not well coordinated. Coordination among many health-care professionals is essential, and it is frequently suggested that a single person should perform the task......’s potential to coordinate patient trajectories was limited by lack of involvement of the GPs by other health-care professionals and lack of needed information. Furthermore, many patients do not regard their GP as a coordinator. Patients who contacted their GP during treatment typically had a close...

  11. Assisted admissions? A national survey of general practitioner experience of involuntary admissions.

    LENUS (Irish Health Repository)

    Kelly, M

    2011-10-01

    The 2001 Mental Health Act introduced in 2006, changed how a patient is admitted involuntarily to a psychiatric unit. This paper reports on a national survey of general practitioners\\' experience implementing the Act. Five hundred and sixty eight (568) GPs completed the survey. Twenty five percent (25%) of respondants had not used it. When used, twenty four percent (24%) report that it takes seven hours or more to complete an admission. Fifty percent (50%) of respondents are confident to complete the necessary paperwork. Overall GPs are dissatisfied with arrangements for transport of patients (mean Likert score 3.5), primarily due to the time delay. GPs believe this places risk on the patient, family and GP. Only thirty-three percent (33%) of respondents feel that the Mental Health Act has improved the patient, GP and family experience of involuntary admission.

  12. Bedside rationing by general practitioners: a postal survey in the Danish public healthcare system

    DEFF Research Database (Denmark)

    Lauridsen, Sigurd; Norup, Michael; Rossel, Peter

    2008-01-01

    ABSTRACT: BACKGROUND: It is ethically controversial whether medical doctors are morally permitted to ration the care of their patients at the bedside. To explore whether general practitioners in fact do ration in this manner we conducted a study within primary care in the Danish public healthcare...... of the study were twofold: an assessment of the proportion of GPs who, in a mainly hypothetical setting, would consider cost-quality trade-offs relevant to their clinical decision-making given their economic impact on the healthcare system; and a measure of the extent to which they would disclose...... this information to patients. RESULTS: In the hypothetical setting 95% of GPs considered cost-quality trade-offs relevant to their clinical decision-making given the economic impact of such trade-offs on the healthcare system. In all 90% stated that this consideration had been relevant in clinical decision...

  13. Can general practitioners create a successful palliative pathway for cancer patients?

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Vedsted, Peter

    to 599 GPs of deceased cancer patients to obtain data on the GPs' involvement. Register data were collected on diagnosis, place of death and number of GP home visits. Questionnaires were sent to the closest relatives asking them to evaluate the palliative pathway. 153 cases were included and associations......  Background: Most terminal cancer patients and their relatives wish that the patient should be allowed to die at home. Palliative home care often involves general practitioners (GPs) and community nurses who become frontline workers in the patients' homes. GP home visits have been shown...... to be positively associated with home death, but this does not necessarily mean that the palliative pathway was successful since many factors and professionals are involved. GP-related factors may be important for a successful palliative course, but there is a lack of knowledge of the importance of these factors...

  14. Can general practitioners create a successful palliative pathway for cancer patients?

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Vedsted, Peter

      Background: Most terminal cancer patients and their relatives wish that the patient should be allowed to die at home. Palliative home care often involves general practitioners (GPs) and community nurses who become frontline workers in the patients' homes. GP home visits have been shown...... with a successful pathway were analysed (multivariate regression model) using prevalence ratios (PR) as measure of association. Results:, Home death was positively associated with a successful palliative pathway in terms of relatives' evaluations (PR: 1.5 (95%CI: 1.0;2.1)), but no GP-related variables had...... significant importance. Conclusion: Our study indicates that home death is positively associated with a higher likelihood of a positive evaluation of the palliative course among the bereaved relatives. There is a need for studies examining in more detail which primary care efforts are associated with a "good...

  15. Non-participation in preventive child health examinations at the general practitioner in Denmark

    DEFF Research Database (Denmark)

    Søndergaard, Grethe; Biering-Sørensen, Sofie; Michelsen, Susan Ishøy

    2008-01-01

    , and older siblings) and parental characteristics (age, educational level, attachment to labour market, ethnicity, household income, and number of adults in the household). Results. Children of young and single parents were less likely to receive a preventive child health examination. Increased odds ratios......Objective. To examine demographic and socioeconomic characteristics of parents and children in families not participating in preventive child health examinations at the general practitioner in a society with free and easy access to healthcare. Design. Population-covering register linkage study...... for non-participation were found for children of parents outside the labour market, with low educational level, and especially for the combination of these. Non-participation increased with decreasing household income and with the number of older siblings. Conclusion. Despite the fact that Denmark has...

  16. General practitioners' knowledge of ageing and attitudes towards older people in China.

    Science.gov (United States)

    Yang, Yanni; Xiao, Lily Dongxia; Ullah, Shahid; Deng, Lanlan

    2015-06-01

    To explore general practitioners (GPs)knowledge of ageing, attitudes towards older people and factors affecting their knowledge and attitudes in a Chinese context. Four hundred GPs were surveyed using the Chinese version of the Aging Semantic Differential (CASD) and the Chinese version of the Facts on Aging Quiz (CFAQ1) scale. The CASD scores indicated that GPs had a neutral attitude towards older people. The CFAQ1 scores indicated a low level of knowledge about ageing. GPs' awareness of the mental and social facts of ageing was poorer compared to that of physical facts. Male GPs had a significantly higher negative bias score than female GPs. No other variables had a statistically significant influence on knowledge and attitudes. The findings suggest the need for education interventions for GPs regarding knowledge of ageing and also provide evidence to guide future development of continuing medical programs for this group of medical doctors. © 2013 ACOTA.

  17. General practitioners learning qualitative research: A case study of postgraduate education.

    Science.gov (United States)

    Hepworth, Julie; Kay, Margaret

    2015-10-01

    Qualitative research is increasingly being recognised as a vital aspect of primary healthcare research. Teaching and learning how to conduct qualitative research is especially important for general practitioners and other clinicians in the professional educational setting. This article examines a case study of postgraduate professional education in qualitative research for clinicians, for the purpose of enabling a robust discussion around teaching and learning in medicine and the health sciences. A series of three workshops was delivered for primary healthcare academics. The workshops were evaluated using a quantitative survey and qualitative free-text responses to enable descriptive analyses. Participants found qualitative philosophy and theory the most difficult areas to engage with, and learning qualitative coding and analysis was considered the easiest to learn. Key elements for successful teaching were identified, including the use of adult learning principles, the value of an experienced facilitator and an awareness of the impact of clinical subcultures on learning.

  18. Assessment of agreement between general practitioners and radiologists as to whether a radiation exposure is justified.

    Science.gov (United States)

    Dhingsa, R; Finlay, D B L; Robinson, G D; Liddicoat, A J

    2002-02-01

    The objective of this study was to assess agreement between General Practitioners (GPs) and Consultant Radiologists as to whether a radiation exposure is justified and whether a request conforms to the Royal College of Radiologists (RCR) guidelines. Three GPs and three Consultant Radiologists were asked to review 100 requests for plain film imaging from GPs and to state whether the request justified a radiation exposure and whether the request conformed to RCR guidelines. It was discovered that there is greater agreement between radiologists than between GPs; this is a consistent pattern. The best agreement was between two Consultant Radiologists using the RCR guidelines. The poorest was between GPs using the request form details. It is suggested that the guidelines should be symptom-based to improve efficacy.

  19. Coping with disaster: general practitioners' perspectives on the impact of the canterbury earthquakes.

    Science.gov (United States)

    Johal, Sarb; Mounsey, Zoe; Tuohy, Robyn; Johnston, David

    2014-04-02

    Aim - To explore the challenges for general practitioners (GPs) following the 2010/2011 Canterbury earthquakes and describe how these were met. Methods - Qualitative study using semi-structured interviews with eight GPs from the Christchurch area exploring their experiences. Results - The interviews revealed that the GPs faced a range of challenges both in the immediate aftermath of the earthquakes and in the following months. These included dealing with an increased and changed workload, and managing personal concerns. The GPs reflected on their coping behaviour and how their professional practice had changed as a result. Conclusions - All GPs reported significant increases in workload raising questions about the need for coordination of locum support. GPs often found themselves working outside their area of accustomed expertise especially in relation to patients needing financial aid. GPs identified a number of coping behaviours though some only in hindsight. Greater awareness of self-care strategies would benefit GPs responding to disasters.

  20. Interaction between participants in focus groups with older patients and general practitioners.

    Science.gov (United States)

    Moen, Janne; Antonov, Karolina; Nilsson, J Lars G; Ring, Lena

    2010-05-01

    Group interaction is put forward as the principal advantage for focus group research, although rarely reported on. The aim of the article is to contribute to the methodological knowledge regarding focus group research by providing an empirical example of the application of the Lehoux, Poland, and Daudelin template suggested for analysis of the interaction in focus groups. The data source was 18 focus groups' performance in Sweden: 12 with older patients and 6 with general practitioners (GPs). GPs found common ground in belonging to the same profession, whereas the older patients, instead of constituting a group in the word's real sense, started just sharing a common focus. We found the template easy to understand and use, except for identifying participants' explicit and implicit purposes for participating. Furthermore, adding an interaction analysis to the content analysis helped us appreciate and clarify the contexts from which these data were created.

  1. A survey of root canal treatment of molar teeth by general dental practitioners in private practice in Saudi Arabia

    Science.gov (United States)

    Al-Fouzan, Khalid S.

    2010-01-01

    The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment. PMID:23960485

  2. A survey of root canal treatment of molar teeth by general dental practitioners in private practice in Saudi Arabia.

    Science.gov (United States)

    Al-Fouzan, Khalid S

    2010-07-01

    The purpose of this study was to evaluate the practice and depth of knowledge of root canal treatment by general dental practitioners working in private dental centers in different cities within the Kingdom of Saudi Arabia. A questionnaire was distributed to 400 general dental practitioners. Completed questionnaires were analyzed in term of simple summary statistics. A total of 252 (63%) practitioners responded. The majority of the respondents were Syrians (59%) and Egyptians (32%). Ninety-one per cent of the respondents indicated that they performed root canal treatment. Amongst those who carried out root canal treatment, only seven practitioners (3%) used rubber dam for isolation. More than half of the respondents (55%) used saline to irrigate canals during treatment. Forty-six per cent of practitioners used formocresol as an inter appointment medicament. The standardized and step-back preparation techniques were the method of choice for the majority of the respondents (91%). Ninety-seven per cent of the practitioners used stainless steel hand instruments to prepare root canals and the majority (92%) used gutta-percha for obturation. Seventy-four per cent of the respondent used cold lateral condensation. The average number of radiographs routinely taken for root canal treatment was four. Ninety-three per cent indicated that they usually completed a root canal treatment of molar teeth in three or more visits. Eighty-eight per cent of the practitioners preferred waiting for 1 or 2 weeks to restore the teeth permanently. Results of this study confirm that many general dental practitioners are not following quality guidelines for endodontic treatment.

  3. The estimation of patients' views on organizational aspects of a general dental practice by general dental practitioners: a survey study

    Directory of Open Access Journals (Sweden)

    Truin Gert-Jan

    2011-10-01

    Full Text Available Abstract Background Considering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs take patients' views into account. The aim of the study was to compare patients' views on organizational aspects of general dental practices with those of GDPs and with GDPs' estimation of patients' views. Methods In a survey study, patients and GDPs provided their views on organizational aspects of a general dental practice. In a second, separate survey, GDPs were invited to estimate patients' views on 22 organizational aspects of a general dental practice. Results For 4 of the 22 aspects, patients and GDPs had the same views, and GDPs estimated patients' views reasonably well: 'Dutch-speaking GDP', 'guarantee on treatment', 'treatment by the same GDP', and 'reminder of routine oral examination'. For 2 aspects ('quality assessment' and 'accessibility for disabled patients' patients and GDPs had the same standards, although the GDPs underestimated the patients' standards. Patients had higher standards than GDPs for 7 aspects and lower standards than GDPs for 8 aspects. Conclusion On most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDP's estimated only half of the patients' views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients.

  4. Distributing questionnaires about smoking to patients: impact on general practitioners' recording of smoking advice

    Directory of Open Access Journals (Sweden)

    Wynne Alison

    2007-09-01

    Full Text Available Abstract Background Little is known about the impact of questionnaire-based data collection methods on the consulting behaviour of general practitioners (family physicians who participate in research. Here data collected during a research project which involved questionnaires on smoking being distributed to patients before and after appointments with general practitioners (GPs is analyzed to investigate the impact of this data collection method on doctors' documenting of smoking advice in medical records. Methods Researchers distributed questionnaires on smoking behaviour to 6775 patients who attended consultations during surgery sessions with 32 GPs based in Leicestershire, UK. We obtained the medical records for patients who had attended these surgery sessions and also for a comparator group, during which no researcher had been present. We compared the documenting of advice against smoking in patient's medical records for consultations within GPs' surgery sessions where questionnaires had been distributed with those which occurred when no questionnaires had been given out. Results We obtained records for 77.9% (5276/6775 of all adult patients who attended GPs' surgery sessions, with 51.9% (2739 being from sessions during which researchers distributed questionnaires. Discussion of smoking was recorded in 8.0% (220/2739 of medical records when questionnaires were distributed versus 4.6% (116/2537 where these were not. After controlling for relevant potential confounders including patients' age, gender, the odds ratio for recording of information in the presence of questionnaire distribution (versus none was 1.78 (95% CI, 1.36 to 2.34. Conclusion Distributing questionnaires about smoking to patients before and after they consult with doctors significantly increases GPs' recording of discussions about smoking medical records. This has implications for the design of some types of research into addictive behaviours and further research into how data

  5. Are general practitioners prepared to end life on request in a country where euthanasia is legalised?

    Science.gov (United States)

    Sercu, M; Pype, P; Christiaens, T; Grypdonck, M; Derese, A; Deveugele, M

    2012-05-01

    In 2002, Belgium set a legal framework for euthanasia, whereby granting and performing euthanasia is entrusted entirely to physicians, and-as advised by Belgian Medical Deontology--in the context of a trusted patient--physician relationship. Euthanasia is, however, rarely practiced, so the average physician will not attain routine in this matter. To explore how general practitioners in Flanders (Belgium) deal with euthanasia. This was performed via qualitative analysis of semistructured interviews with 52 general practitioners (GPs). Although GPs can understand a patient's request for euthanasia, their own willingness to perform it is limited, based on their assumption that legal euthanasia equates to an injection that ends life abruptly. Their willingness to perform euthanasia is affected by the demanding nature of a patient's request, by their views on what circumstances render euthanasia legitimate and by their own ability to inject a lethal dose. Several GPs prefer increasing opioid dosages and palliative sedation to a lethal injection, which they consider to fall outside the scope of euthanasia legislation. Four attitudes can be identified: (1) willing to perform euthanasia; (2) only willing to perform as a last resort; (3) feeling incapable of performing; (4) refusing on principle. The situation where GPs have to consider the request and-if they grant it-to perform the act may result in arbitrary access to euthanasia for the patient. The possibility of installing transparent referral and support strategies for the GPs should be further examined. Further discussion is needed in the medical profession about the exact content of the euthanasia law.

  6. Role of general practitioners in prevention and treatment of hepatitis B in China

    Institute of Scientific and Technical Information of China (English)

    Jing-Jing Ren; Lan-Juan Li; Ying Liu; Wen Ren; Yan Qiu; Bing Wang; Ping Chen; Kai-Jin Xu; Shi-Gui Yang; Jun Yao

    2014-01-01

    BACKGROUND: Hepatitis B virus (HBV) infection may impose an economic burden to patients or their families. The prevention and control of HBV could effectively reduce the burden. However, the management of HBV-related patients has not been well controlled in China. With the development of general practitioner (GP) system in this country, GPs may greatly improve the management of the patients with HBV infection. However, the role of GPs in controlling HBV infection has been rarely studied. DATA SOURCES: A literature search of PubMed, CNKI, Wanfang data and VIP was performed with the following key words: "general practitioner", "family physician", "community management", "community health care workers", "family practice", "hepatitis B virus", "HBV", "HBV vaccination", "HBV prevention", "HBV management", "HBV treatment", "antiviral therapy" and "chronic hepatitis B (CHB)". The information about the GPs-involved prevention, diagnosis and treatment of CHB was reviewed. RESULTS: The reports on the role of GPs in the prevention, diagnosis and treatment of HBV infection are few. But the experiences from Western countries demonstrated that GPs could play a significant role in the management of patients with CHB. The importance of GPs is obvious although there are some difficulties in China. GPs and health officials at different levels should work together in the management of patients with CHB. CONCLUSIONS: The involvement of GPs in the management of patients with HBV infection is effective in China. But GPs' knowledge and skills for the control of HBV infection have to be improved currently. GPs' involvement will enforce the management of CHB in China in the near future.

  7. Antibiotics dispensing for URTIs by community pharmacists and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients

    OpenAIRE

    Alabid, Alamin Hassan M. A.; Ibrahim, Mohamed Izham Mohamed; Hassali,Mohamed Azmi

    2014-01-01

    Background: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular. Aim: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics...

  8. Survey on job satisfaction of general practitioners who completed residency training in Zhongshan Hospital%复旦大学附属中山医院全科规范化培训毕业学员工作满意度调查

    Institute of Scientific and Technical Information of China (English)

    王健; 潘志刚; 赵琦

    2016-01-01

    Objective To survey job satisfaction of general practitioners ( GP ) who completed residency training program in Zhongshan Hospital , Fudan University .Methods One hundred and fifty two GPs who completed residency training program in Zhongshan Hospital and were currently working in community health service centers in Shanghai participated in the study .Job satisfaction was surveyed with Minnesota job satisfaction questionnaire and self-designed job satisfaction questionnaire .Results Total 152 questionnaires were distributed and 152 effective questionnaires were recovered with a response rate of 100%.The overall score of job satisfaction was 60.26 ±16.47, the mean score of internal satisfaction was 60.13 ±15.13 and the mean score of external satisfaction was 60.08 ±15.07.Linear regression analysis showed that there were no significant differences in overall , internal and external job satisfaction scores among participants with different gender , age, education level , job title, work duration and work location . Besides pay , participants valued the opportunities of upgrading working capability , job achievement , harmonious interpersonal relationships and good working environment .21.1%(32/152) of the participants were satisfied with their job and 26.3%(40/152) were not satisfied or even wanted to leave their job .The main reason for dissatisfaction was low income ( 100.0%); other reasons included lacking opportunity of upgrading clinical skills(72.5%,29/40)and poor working conditions (35.0%,14/40).Only 11.8%(18/152)of the participants thought that their work was recognized by their chief and peers .52.6%(80/152) thought that their abilities had not been fully developed and 7.2%(11/152) did not have any chance to display their abilities.61.8%(94/152) thought that they were over burdened .Only 9.3%(14/152) thought that medical work is respectable by the society .Conclusion The job satisfaction of GPs who completed residency training in Zhongshan Hospital seems

  9. Engaging general practitioners in public-private mix tuberculosis DOTS program in an urban area in Pakistan: need for context-specific approach.

    Science.gov (United States)

    Pethani, Amin; Zafar, Mubashir; Khan, Adeel Ahmed; Rabbani Sana, Unaib; Ahmed, Sana; Fatmi, Zafar

    2015-03-01

    A public-private mix tuberculosis (TB) DOTS project was implemented to enhance coverage and collaboration between the public and private sectors, with an objective to increase case detection and to improve TB case management in a large urban area. General practitioners (GPs) were trained to provide DOTS services. Patients were diagnosed and treated as per national guidelines and outcomes were reported to national TB control program. Treatment and sputum microscopy were provided free of cost. A total of 94 GPs were trained. In all, 57.4% of trained GPs remained actively involved in the project. Overall treatment success rate of the patients enrolled with the project was 86.3% with 8.7% default patients. Experience suggests that a more stringent selection criteria need to be followed for inclusion of GPs in the program to improve the success of the program. A multifaceted context specific approach is needed while working with private health care providers.

  10. A survey of French general practitioners on the epidemiology of wounds in family practice

    Directory of Open Access Journals (Sweden)

    Sarazin M

    2015-06-01

    Full Text Available Marianne Sarazin,1–3 Florence Roberton,4 Rodolphe Charles,4 Alessandra Falchi,1,2,5 Solange Gonzales Chiappe,1–3 Thierry Blanchon,1,2 Frédéric Lucht,6 Thomas Hanslik1,2,7,8 1INSERM, UMR_S 1136, F-75012, Paris, France; 2Sorbonne Universités, UPMC University Paris 06, UMR_S 1136, F-75012, Paris, France; 3DIM, Centre Hospitalier, 42 700 Firminy, France; 4Département de médecine générale, Faculté de médecine Jacques Lisfranc, F-42023 Saint Etienne, CE France; 5EA 7310, Laboratoire de Virologie, Université de Corse, F-20250 Corte, France; 6CIC-EC3, CHU Saint Etienne, F-42277 Saint-Priest en Jarez, CE France; 7UVSQ, Université de Versailles Saint Quentin, F-78000 Versailles, France; 8Assistance Publique Hôpitaux de Paris, service de Médecine Interne, Hôpital Ambroise Paré, F-92100 Boulogne Billancourt, France Background: To measure the frequency and nature of wounds in patients treated in general practice and to describe the patients' tetanus vaccination status and the sources providing information about this status. Methods: A descriptive, prospective, week-long, national electronic survey was conducted among general practitioners within the Sentinelles network. Results: The participation rate was 12.6% (95% confidence interval [CI], 10.6%–14.6%; 130 general practitioners: 197 patients with wounds were reported, and 175 of them were described. Wound frequency was 1.4 (95% CI, 1.2–1.6 per 100 consultations. These wounds had an acute character in 76 (95% CI, 69.7–82.3 of cases, were mostly of traumatic origin (54.8% of cases; 95% CI, 47.5%–62.1%, were more than 24 hours old (67.1%; 95% CI, 59.1%–75.1%, and were clean, without bone and/or muscle decay (94%; 95% CI, 90.5%–97.5%. Vaccination status was known for 71 (95% CI, 64–78 patients. According to the 2013 immunization schedule, 21% (95% CI, 13.9%–28.1% of the patients had not updated their vaccinations, mostly among the patients older than 75 years. Conclusion

  11. Prioritization of future genetics education for general practitioners: a Delphi study

    Science.gov (United States)

    Houwink, Elisa J.F.; Henneman, Lidewij; Westerneng, Myrte; van Luijk, Scheltus J.; Cornel, Martina C.; Dinant, Jan Geert; Vleuten, Cees van der

    2012-01-01

    Purpose: General practitioners (GPs) are increasingly expected to deliver genetics services in daily patient care. Education in primary care genetics is considered suboptimal and in urgent need of revision and innovation. The aim of this study was to prioritize topics for genetics education for general practice. Methods: A Delphi consensus procedure consisting of three rounds was conducted. A purposively selected heterogeneous panel (n = 18) of experts, comprising six practicing GPs who were also engaged in research, five GP trainers, four clinical genetics professionals, and three representatives of patient organizations, participated. Educational needs regarding genetics in general practice in terms of knowledge, skills, and attitudes were rated and ranked in a top-10 list. Results: The entire panel completed all three rounds. Kendall's coefficient of concordance indicated significant agreement regarding the top 10 genetic education needs (P < 0.001). “Recognizing signals that are potentially indicative of a hereditary component of a disease” was rated highest, followed by “Evaluating indications for referral to a clinical genetics centre” and “Knowledge of the possibilities and limitations of genetic tests.” Conclusions: The priorities resulting from this study can inform the development of educational modules, including input for case-based education, to improve GP performance in genetic patient care. PMID:22241093

  12. On attitudes about colorectal cancer screening among gastrointestinal specialists and general practitioners in the Netherlands

    Institute of Scientific and Technical Information of China (English)

    JS Terhaar sive Droste; GDN Heine; ME Craanen; H Boot; CJJ Mulder

    2006-01-01

    AIM: To find out whether there are differences in attitudes about colorectal cancer (CRC) screening among gastrointestinal (GI) specialists and general practitioners (GPs) and which method is preferred in a national screening programMETHODS: Four hundred and twenty Dutch GI specialists in the Netherlands and 400 GPs in Amsterdam were questioned in 2004. Questions included demographics, affiliation, attitude towards screening both for the general population and themselves, methods of screening, family history and individual risk.RESULTS: Eighty-four percent of the GI specialists returned the questionnaire in comparison to 32% of the GPs (P < 0.001). Among the GI specialists, 92% favoured population screening whereas 51% of GPs supported population screening (P < 0.001). Of the GI specialists 95% planned to be screened themselves, while 30%of GPs intended to do so (P < 0.001). Regarding the general population, 72% of the GI specialists preferred colonoscopy as the screening method compared to 27% of the GPs (P < 0.001). The method preferred for personal screening was colonoscopy in 97% of the GI specialists, while 29% of the GPs favoured colonoscopy (P < 0.001).CONCLUSION: Screening for CRC is strongly supported by Dutch GI specialists and less by GPs. The major health issue is possibly misjudged by GPs. Since GPs play a crucial role in a successful national screening program, CRC awareness should be realized by increasing knowledge about the incidence and mortality, thus increasing awareness of the need for screening among GPs.

  13. Knowledge and Practice of Pulp Therapy in Deciduous Teeth among General Dental Practitioners in Saudi Arabia.

    Science.gov (United States)

    Togoo, Ra; Nasim, Vs; Zakirulla, M; Yaseen, Sm

    2012-07-01

    It has been observed that the general dentists and pedodontists differ in their treatment recommendations for pulp therapy in deciduous teeth. To determine the knowledge and practice of pulp therapy in deciduous teeth by general dental practitioners (GDP) in two cities of southern Saudi Arabia. Fifty GDP selected at random from government and private dental clinics were questioned about pulp therapy in deciduous teeth in Abha and Najran cities using a 10-item questionnaire. The data were analyzed using IBM SPSS software version 11.0 and descriptive statistics were obtained. All 50 participants responded to the survey. Pulpotomy was suggested as the first line of treatment for pulp-exposed primary tooth by 32 respondents with 44 using Buckley's formocresol and 32 applying it on the pulp for 5 minutes. 43 respondents squeeze dried the cotton pellet before application on the pulp. In pulpectomy procedure 44 respondents preferred zinc oxide eugenol as obturation material with 22 using handheld reamers and 15 using slow-speed lentilospirals for obturation. 12 respondents used obturation techniques which had no scientific relevance. In order of preference Glass ionomer cement (GIC), silver amalgam, and stainless steel crowns were the materials of choice for final restoration of endodontically treated deciduous teeth. All 50 answered in the affirmative when asked if they would like to have additional information about pulp therapy in deciduous teeth. The study concluded that general dentists were regularly performing pulp therapy in decidous teeth and therefore need to be frequently updated about these procedures.

  14. [Care networks, mobile palliative and supportive teams. What benefits are there for patients, natural caregivers and general practitioners in patient homes?].

    Science.gov (United States)

    Hubault, Philippe; Chataigner, Bernard; Diquero, Vincent; Cesbron, Jean-Yves; Pommateau, Romuald; Cotinat, Jean-Paul; Guitard, Véronique; Mathien, Laurence; Thetas, Elisabeth

    2009-06-20

    Civil society at large and all caregivers, whether at home or within institutions, are involved in palliative care However, procedures may vary considerably, excluding a single approach. So as to best adapt their responses, the authors recorded everyone's expectations. Such a participatory methodology is, sine 1990, behind the establishment of local networks providing assistance, support and training to physicians non-specialized in palliative care (general practitioners, specialists, students or residents facing specific aspects of this medical management, as well as other health and social workers).

  15. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

    Directory of Open Access Journals (Sweden)

    Jensen Natasja Koitzsch

    2013-01-01

    Full Text Available Abstract Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE. Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy

  16. Advising vaccinations for the elderly: a cross-sectional survey on differences between general practitioners and physician assistants in Germany.

    Science.gov (United States)

    Klett-Tammen, Carolina Judith; Krause, Gérard; von Lengerke, Thomas; Castell, Stefanie

    2016-07-29

    In Germany, the coverage of officially recommended vaccinations for the elderly is below a desirable level. It is known that advice provided by General Practitioners and Physician Assistants influences the uptake in patients ≥60 years. Therefore, the predictors of advice-giving behavior by these professions should be investigated to develop recommendations for possible actions for improvement. We conducted a postal cross-sectional survey on knowledge, attitudes and advice - giving behavior regarding vaccinations in the elderly among General Practitioners and Physician Assistants in 4995 practices in Germany. To find specific predictors, we performed logistic regressions with non-advising on any officially recommended vaccination or on three specific vaccinations as four separate outcomes, first using all participants, then only General Practitioners and lastly only Physician Assistants as our study population. Participants consisted of 774 General Practitioners and 563 Physician Assistants, of whom overall 21 % stated to have not advised an officially recommended vaccination in elderly patients. The most frequent explanation was having forgotten about it. The habit of not counselling on vaccinations at regular intervals was associated with not advising any vaccination (OR: 2.8), influenza vaccination (OR: 2.3), and pneumococcal vaccination (OR: 3.1). While more General Practitioners than Physician Assistants felt sufficiently informed (90 % vs. 79 %, p vaccinations (ORs: 1.8-2.8). To reduce the high risk of forgetting to advice on vaccinations, we recommend improving and promoting standing recall-systems, encouraging General Practitioners and Physician Assistants to counsel routinely at regular intervals regarding vaccinations, and providing Physician Assistants with better, tailor-made information on official recommendations and their changes.

  17. Is personality the missing link in understanding recruitment and retention of rural general practitioners?

    Science.gov (United States)

    Jones, Michael P; Humphreys, John S; Nicholson, Tahnee

    2012-04-01

    Little is known about the role of personality and related constructs in general practitioners' (GPs) choices of geographic location of medical practice. There is however some theory suggesting a role for personality in career decision making and some limited empirical evidence that this applies in medical career decisions. The aim of this study is to gain insight into whether personality plays a role in GPs' decisions to work in rural areas and the length of time that they intend to remain as a rural practitioner. Samples of rural (n=372) and urban (n=100) GPs from New South Wales (Australia) completed the Neuroticism, Extraversion, Openness--Five Factor Inventory (NEO-FFI) and Adjective Checklist personality instruments and answered questions about demographics and rural upbringing. Rural GPs scored, on average, more highly than urban GPs with respect to conscientiousness and agreeableness but lower on openness, which can also be taken to mean a more 'down-to-earth' personality. Personality together with age, gender, experience as a GP, time in current location and rural childhood yield an area under the receiver operating characteristic curve of 0.81 in discriminating rural from urban GPs. Among rural GPs openness (P=0.007) was positively correlated with intended longevity as a rural doctor as was nurturing (P=0.06). Personality appears to play some role both in discriminating rural from urban GPs and in how long existing rural GPs intend to remain as rural GPs. Consideration of personality might assist in selection of individuals who will better fit the professional and social environment of rural life. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  18. Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioners' perspectives

    Directory of Open Access Journals (Sweden)

    van der Pligt Paige

    2011-11-01

    Full Text Available Abstract Background The impact of excess gestational weight gain (GWG on maternal and child health outcomes is well documented. Understanding how health care providers view and manage GWG may assist with influencing healthy gestational weight outcomes. This study aimed to assess General Practitioner's (GPs perspectives regarding the management and assessment of GWG and to understand how GPs can be best supported to provide healthy GWG advice to pregnant women. Methods Descriptive qualitative research methods utilising semi - structured interview questions to assess GPs perspectives and management of GWG. GPs participating in shared antenatal care in Geelong, Victoria and Sydney, New South Wales were invited to participate in semi - structured, individual interviews via telephone or in person. Interviews were digitally recorded and transcribed verbatim. Data was analysed utilising thematic analysis for common emerging themes. Results Twenty eight GPs participated, 14 from each state. Common themes emerged relating to awareness of the implications of excess GWG, advice regarding weight gain, regularity of gestational weighing by GPs, options for GPs to seek support to provide healthy lifestyle behaviour advice and barriers to engaging pregnant women about their weight. GPs perspectives concerning excess GWG were varied. They frequently acknowledged maternal and child health complications resulting from excess GWG yet weighing practices and GWG advice appeared to be inconsistent. The preferred support option to promote healthy weight was referral to allied health practitioners yet GPs noted that cost and limited access were barriers to achieving this. Conclusions GPs were aware of the importance of healthy GWG yet routine weighing was not standard practice for diverse reasons. Management of GWG and perspectives of the issue varied widely. Time efficient and cost effective interventions may assist GPs in ensuring women are supported in achieving

  19. Becoming a general practitioner--which factors have most impact on career choice of medical students?

    Science.gov (United States)

    Kiolbassa, Kathrin; Miksch, Antje; Hermann, Katja; Loh, Andreas; Szecsenyi, Joachim; Joos, Stefanie; Goetz, Katja

    2011-05-09

    In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase

  20. Increasing general practitioners' confidence and self-efficacy in managing obesity: a mixed methods study

    Science.gov (United States)

    Haesler, Emily; Elmitt, Nicholas; van Weel, Chris; Douglas, Kirsty

    2017-01-01

    Objectives Internationally, general practitioners (GPs) are being encouraged to take an active role in the care of their patients with obesity, but as yet there are few tools for them to implement within their clinics. This study assessed the self-efficacy and confidence of GPs before and after implementing a weight management programme in their practice. Design Nested mixed methods study within a 6-month feasibility trial. Setting 4 urban general practices and 1 rural general practice in Australia. Participants All vocationally registered GPs in the local region were eligible and invited to participate; 12 GPs were recruited and 11 completed the study. Interventions The Change Programme is a structured GP-delivered weight management programme that uses the therapeutic relationship between the patient and their GP to provide holistic and person-centred care. It is an evidence-based programme founded on Australian guidelines for the management of obesity in primary care. Primary outcome measures Self-efficacy and confidence of the GPs when managing obesity was measured using a quantitative survey consisting of Likert scales in conjunction with pro forma interviews. Results In line with social cognitive theory, GPs who experienced performance mastery during the pilot intervention had an increase in their confidence and self-efficacy. In particular, confidence in assisting and arranging care for patients was improved as demonstrated in the survey and supported by the qualitative data. Most importantly from the qualitative data, GPs described changing their usual practice and felt more confident to discuss obesity with all of their patients. Conclusions A structured management tool for obesity care in general practice can improve GP confidence and self-efficacy in managing obesity. Enhancing GP ‘professional self-efficacy’ is the first step to improving obesity management within general practice. Trial registration number ACTRN12614001192673; Results. PMID:28132016

  1. Becoming a general practitioner - Which factors have most impact on career choice of medical students?

    Directory of Open Access Journals (Sweden)

    Loh Andreas

    2011-05-01

    Full Text Available Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance' were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition' for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should

  2. Diffusion of an e-learning programme among Danish General Practitioners: a nation-wide prospective survey

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Steenstrup, Annette Plesner; Nielsen, Bente

    2008-01-01

    BACKGROUND: We were unable to identify studies that have considered the diffusion of an e-learning programme among a large population of general practitioners. The aim of this study was to investigate the uptake of an e-learning programme introduced to General Practitioners as part of a nation......-wide disseminated dementia guideline. METHODS: A prospective study among all 3632 Danish GPs. The GPs were followed from the launching of the e-learning programme in November 2006 and 6 months forward. Main outcome measures: Use of the e-learning programme. A logistic regression model (GEE) was used to identify...

  3. General George Crook’s development as a practitioner of irregular warfare during the Indian wars.

    Science.gov (United States)

    2017-06-09

    continue to prepare, train, and equip for large-scale peer or near-peer conventional warfare, the breadth of the republic’s history teaches that Irregular...considered many of the officers he encountered to be selfish, self- important, and worse yet, out of touch with the realities facing them. They limited...of Cottonwood generally, thereby virtually acknowledging himself whipped by a small party of Indians and leaving our citizens and their property

  4. Perioperative role development: evaluating a fast-track approach to advanced scrub and/or dual role practitioner training.

    Science.gov (United States)

    Timpany, Michaela D; McAleavy, Janet

    2010-01-01

    This report describes the service evaluation of a newly developed fast-track advanced scrub practitioner (ASP)/dual role training programme. The evaluation examines whether the introduction of new policies and training based on risk assessment have strengthened quality assurance measures and controls which aim to ensure that staff work safely within their scope of practice. A further aim is to establish if the fast-track route is adequately meeting the training and development needs of staff within the organisation and supporting service requirements.

  5. [Prescription of Benzodiazepines and Z-Drugs by German General Practitioners: A Cross-Sectional Study].

    Science.gov (United States)

    Moßhammer, Dirk; Haumann, Hannah; Muche, Rainer; Scheub, David; Joos, Stefanie; Laux, Gunter

    2017-07-03

    Background Due to their addictive potential, benzodiazepine (BZ) and non-benzodiazepine-agonists (NBZ, so-called Z-drugs) should be taken no longer than 6 weeks. BZ and NBZ are primarily prescribed by general practitioners (GPs). Therefore, we aimed to analyze GPs' data on the patients collective, the amount of BZ/NBZ prescribed and the rate of private prescriptions. Methods We analyzed person years of 2-year intervals from 2009 to 2014 of the primary care CONTENT register that contains routine data from 31 general practitioners' practices. We classified BZ/NBZ prescriptions according to risk groups. The association of BZ/NBZ prescription and potential influencing factors was analyzed by calculating the odds ratio with 95% confidence interval (and corresponding p-value) on the basis of a multiple logistic regression model (adjusted by age, sex and type of health insurance). All patients with drug prescription with and without BZ/NBZ-prescription were compared. Results Almost 5% of patients with drug prescriptions received at least one prescription of BZ/NBZ during 1 year of observation. On average these patients were older (67.5 vs. 48 years respectively) and the proportion of women was higher than in the comparison group (69 vs. 58%). About one-third of these patients received more than 600 mg diazepam equivalent dose per person year (according to a 2-month daily intake of more than 10 mg diazepam). About one-third of the prescriptions were private prescriptions. A number of variables were significantly associated with the prescription of BZ/NBZ (e. g. age, gender, diagnosis codes, practices). Conclusion The results provide valuable information about BZ/NBZ prescription routines in general practice. For continuous medical education as well as the development of interventions to reduce the use of BZ/NBZ, patient characteristics (e. g. sex, age, comorbidities, type of insurance) as well as different prescription routines (e. g. private prescriptions

  6. The general practitioner's role in promoting physical activity to older adults: a review based on program theory.

    Science.gov (United States)

    Hinrichs, Timo; Brach, Michael

    2012-02-01

    Positive influences of physical activity both on many chronic diseases and on preservation of mobility are well documented. But chronically ill or mobility restricted elderly living in their own homes are difficult to reach for interventions. The general practitioner's (GP) surgery offers one of the few opportunities to give advice for physical activity to those people. We used program theory to sound out knowledge on GP-centered physical activity counseling. The "conceptual theory" (evidence for training effects in old age) and the "implementation theory" (unique position of the GP) were reviewed narratively. The "action theory" (effects of GP counseling) was reviewed systematically. According to program theory, appropriate MeSH (Medical subject headings) concepts were Aged OR Aged, 80 and over (Target group), Physicians, Family OR Primary Health Care (Implementation/Setting), Counseling OR Patient Education as Topic OR Disease Management OR Health promotion (Intervention), Exercise OR Motor Activity OR Physical Fitness OR Sports (Determinants). The resulting six review papers (Pubmed, 2000-2009) were presented using the STARLITE mnemonic. Authors agree, that the GP plays a central role in the promotion of physical activity to elderly people, but there is conflicting evidence concerning counseling effectiveness. Utilizing behavioral change strategies and the collaboration between GPs and specialised professions are recommended and currently under research.

  7. Comparison of German and Japanese general practitioners' awareness of suicide and attitudes toward patients with suicidal ideation.

    Directory of Open Access Journals (Sweden)

    Redsch,Oliver

    2006-06-01

    Full Text Available The authors designed a questionnaire to investigate the differences in German and Japanese general practitioners? (GP awareness of suicide and attitudes toward patients with suicidal ideation in their respective societies. The purpose of this study was to obtain insights leading to a better means of suicide prevention in primary care in Japan. The background for conducting the study was declining suicides in the past 20 years and the lower suicide rate in Germany compared with the present situation in Japan, where the number of suicides has in recent years continued to exceed 30,000, resulting in a suicide rate approximately 2 times higher than that in Germany. The questionnaire was randomly mailed to GPs in Okayama-Prefecture (western Japan and Hamburg-State (northern Germany and was collected in the same way. The patterns of answers were compared between the 2 countries, and the differences were statistically analyzed. Japanese GPs seem to have a lower will to prevent suicide in daily practice compared to German GPs and a great lack of knowledge about treatment of suicidal patients. These observations suggest that improving GPs? interest in the problem of suicide and providing training programs for the treatment of patients with suicidal intentions might be a means of achieving better suicide prevention in Japan.

  8. Cow’s Milk Protein Allergy from Diagnosis to Management: A Very Different Journey for General Practitioners and Parents

    Science.gov (United States)

    Lozinsky, Adriana C.; Meyer, Rosan; Anagnostou, Katherine; Dziubak, Robert; Reeve, Kate; Godwin, Heather; Fox, Adam T.; Shah, Neil

    2015-01-01

    Cow’s milk protein allergy (CMPA) is the most common food allergy in infants and can affect a family’s quality of life. The purpose of this paper is to evaluate the knowledge and experience of general practitioners (GPs) in terms of CMPA diagnosis and management and to explore the views of parents on the current diagnostic process. Two surveys were conducted in June 2014, which collected data from GPs and parents of infants diagnosed with CMPA in the United Kingdom. The questionnaires included quantitative and qualitative questions, which measured self-reported knowledge, management and perceived treatment progression, and the educational needs of GPs. We also explored parents’ experiences of local healthcare support in relation to CMPA. A total of 403 GPs and 300 parents completed the surveys. The main symptoms of CMPA and diagnosis period differed between GPs and parents. Other key points include different perceptions on symptom presentation and improvement, lack of awareness from GPs about current guidelines, and the significant burden on both families and GPs. This is the first study attempting to establish GP and parental experience in diagnosing CMPA. It isnotable that the difference can be improved through training, appropriate diagnostic tools and improved communication between physicians and parents. PMID:27417366

  9. Childhood obesity: parents fail to recognise, general practitioners fail to act.

    LENUS (Irish Health Repository)

    White, A

    2012-01-01

    General Practitioners (GPs) have an important role to play in recognition of and intervention against childhood obesity in Ireland. Data were collected prospectively on a cohort of children aged 4-14 and their parents (n = 101 pairs) who attended consecutively to a semi-rural group general practice. Parents estimated their child\\'s weight status. Actual weight status was determined for both parent and child using the United States Centres\\' for Disease Control\\'s BMI-for-age references. 15 (14.9%) of the children and 49 (51.6%) of the parents were overweight or obese. While 71 (95.5%) of normal weight status children were correctly identified, parents showed poor concordance in identifying their children as overweight 2 (18.2%) or obese 0 (0%). BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified. With parents failing to recognise childhood obesity, GPs have a responsibility in tackling this problem at a family level.

  10. Challenges in the care for consanguineous couples: an exploratory interview study among general practitioners and midwives

    Directory of Open Access Journals (Sweden)

    Teeuw Marieke E

    2012-10-01

    Full Text Available Abstract Background It is often suggested that an effort must be made to increase awareness among consanguineous couples of their reproductive risk, and to refer them for genetic counseling if needed. Primary care professionals are considered most appropriate for addressing the subject and identifying couples at risk during consultations in their practice. This Dutch study aims to explore the experiences, attitudes and beliefs of such professionals regarding their care for consanguineous couples. Methods Sixteen semi-structured interviews were conducted with midwives and general practitioners. Results Although most primary care professionals considered it their task to inform couples about the risks of consanguinity, during consultations the topic was generally only briefly touched upon and quickly abandoned. Important reasons for this were professionals’ beliefs about religious and social values of couples, their low perception of the couples’ reproductive risk and expected limited feasibility of referral. Feelings of embarrassment regarding addressing consanguinity did not seem to play a significant role. Conclusions Primary care professional beliefs about their clients’ religious and social values, their attitudes toward the risk, and perceived limited options for referral seem to conflict with the professional norm to address the topic of consanguinity.

  11. Referral patterns of general dental practitioners for bone grafting and implant placement.

    Science.gov (United States)

    Gupta, B; Shadbolt, B; Hyam, D

    2017-09-01

    Dental implant rehabilitation is a well-established procedure often conducted in the general dental practise setting. The outcomes for implant placement are reliable when the recipient site is favourable. The goal of this study was to assess the accuracy with which general dental practitioners (GDP) assess the bone volume available for implant placement and their referral patterns for implant sites, which may require bone grafting. Fifty-three GDP were surveyed and asked to assess five different scenarios and cone-beam scans for difficulty (0, 'no difficulty'; 5, 'the most difficult'), and bone grafting requirements ('yes'/'no' and 'who to perform'), prior to implant placement. The GDP assessment of difficulty for the cases was: no graft required, 1.88; aesthetic zone involvement, 3.25; vertical deficiency, 2.8; sinus lift required, 3.68; and horizontal deficiency, 4.4. GDP seemed to have some difficulty identifying which cases required a bone graft, occasionally grafting a site with sufficient bone (12.5%), or not grafting a site with insufficient bone (45-75%). These results show that GDP are accurate in assessing the difficulty of an implant case and conservative when it comes to attempting these complex cases. GDP are less confident when it comes to recognizing cases that require bone grafting, and what options are available. © 2017 Australian Dental Association.

  12. Difficulties encountered by general practitioners during acute behavioral disturbances of their dementia patients.

    Science.gov (United States)

    Campana, Marion; Bonin-Guillaume, Sylvie; Yagoubi, Ramzi; Berbis, Julie; Franqui, Caroline

    2016-06-01

    Alzheimer diseases and related disorders (ADRD) remain a major public health issue. The progression of the disease is dominated by behavioral and psychological symptoms of dementia (BPSD) which are frequent and burdensome for caregivers. The aim of our survey was to study how the general practionner managed these behavioral disturbances (particularly agitation and aggressiveness) in community living patients with ADRD and support of their main caregivers. We based our study on a medical survey sent to all general practitioners (GP) practicing in four districts in Marseille near from a secure unit. Ninety five out of 260 answered to the survey and 57 had already been exposed to patients' behavioral decompensation. For these BPSD management, atypical neuroleptics and benzodiazepines were mostly prescribed, and according to the literature and guidelines. Half of the GP's recognized the weak effectiveness of this strategy. Almost all of them are interested in having a document summarizing the main strategy to be set up or a possibility to call a specialized mobile team with doctors and professionals caregivers. A few dedicated consultations were devoted to informal caregivers whereas GP were aware of negative effects of these decompensations on them. This study point out difficulties for GP to provide appropriate management for their patients with ADRD living at home and for their informal caregivers, particularly during acute behavioral disturbance, despite their practical knowledges.

  13. General practitioner-led commissioning in the NHS: progress, prospects and pitfalls.

    Science.gov (United States)

    Mannion, Russell

    2011-01-01

    The latest NHS reforms in England will require all general practices to become members of general practitioner (GP) consortia. These organisations will have responsibility for commissioning the majority of health care for their local populations. This article reviews the history and evidence on impact of the previous models of GP commissioning that have been introduced in the NHS with the aim of distilling key lessons for the design, implementation and evaluation of the latest reforms. GP commissioning has the potential to generate a variety of benefits for the NHS and patients, including lowering elective and non-elective referrals, reducing waiting times, improved coordination of primary and community support services and better financial risk management. GP commissioning has also the potential to reduce patient satisfaction, increase inequalities between geographical areas and may generate substantial management and transaction costs. The GP community will need to display strong directive leadership as well as nurture a culture of collaboration and group camaraderie among practices if the GP consortia model of commissioning is to deliver the desired improvements in quality and performance. The implementation of the new GP consortia model of commissioning needs to be monitored and evaluated to ensure that the benefits are maximized and any unintended and dysfunctional effects mitigated.

  14. Childhood obesity: parents fail to recognise, general practitioners fail to act.

    Science.gov (United States)

    White, A; O'Brien, B; Houlihan, T; Darker, C; O'Shea, B

    2012-01-01

    General Practitioners (GPs) have an important role to play in recognition of and intervention against childhood obesity in Ireland. Data were collected prospectively on a cohort of children aged 4-14 and their parents (n = 101 pairs) who attended consecutively to a semi-rural group general practice. Parents estimated their child's weight status. Actual weight status was determined for both parent and child using the United States Centres' for Disease Control's BMI-for-age references. 15 (14.9%) of the children and 49 (51.6%) of the parents were overweight or obese. While 71 (95.5%) of normal weight status children were correctly identified, parents showed poor concordance in identifying their children as overweight 2 (18.2%) or obese 0 (0%). BMI was only evidently recorded in the clinical records of 1 out of 15 cases of overweight children identified. With parents failing to recognise childhood obesity, GPs have a responsibility in tackling this problem at a family level.

  15. A study on concept of P- drug selection among rural general practitioners

    Directory of Open Access Journals (Sweden)

    Priyadarshini Bai G.

    2016-12-01

    Full Text Available Background: The objective of the study was to assess the awareness of P- drug selection among rural general practitioners’s (GP for common medical conditions. Methods: Fifty general practitioners in Tumakuru district were provided with proformas for selection of P- drugs for mild to moderate hypertension, diabetes, upper respiratory tract infections and acid peptic disease based on safety, affordability, need, and efficacy (SANE criteria. Results: Forty one GP’s responded by completing the proformas. Seventeen of them were aware of the concept of P- drug selection. In hypertension, beta blockers followed by Angiotensin Converting Enzyme (ACE inhibitors were most commonly preferred. In diabetes, biguanides followed by sulfonylureas were preferred as oral hypoglycemic agents. Ampicillin, Ciprofloxacin and Cotrimoxazole were the commonly used antibiotics for upper respiratory tract infections. Ranitidine and antacids were preferred for acid peptic disease. Affordability followed by efficacy was the deciding criteria for P- drug selection. Conclusions: There is lack of awareness of P- drug selection among many rural GP’s. Therefore, there is necessity to create awareness about P- drug selection through continued medical education for rational use of drugs.

  16. [The practice guideline 'Bacterial skin infections' (first revision) from the Dutch College of General Practitioners; a response from the perspective of general practice

    NARCIS (Netherlands)

    Olde Hartman, T.C.; Uijen, A.A.

    2008-01-01

    The revised guideline 'Bacterial skin infections' from the Dutch College ofGeneral Practitioners offers a clear and extensive overview of the most prevalent superficial and deep bacterial infections in general practice. Given the lack of evidence, it is no longer recommended to keep children with im

  17. Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

    NARCIS (Netherlands)

    Feijen-de Jong, Esther I.; Baarveld, Frank; Jansen, Danielle E. M. C.; Ursum, Jennie; Reijneveld, Sijmen A.; Schellevis, Francois G.

    2013-01-01

    Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of

  18. Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice

    NARCIS (Netherlands)

    Feijen-de Jong, Esther I.; Baarveld, Frank; Jansen, Danielle E. M. C.; Ursum, Jennie; Reijneveld, Sijmen A.; Schellevis, Francois G.

    2013-01-01

    Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of p

  19. Do pregnant women contact their general practitioner? A register-based comparison of healthcare utilisation of pregnant and non-pregnant women in general practice.

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Baarveld, F.; Jansen, D.E.M.C.; Ursum, J.; Reijneveld, S.A.; Schellevis, F.G.

    2013-01-01

    Background: Midwives and obstetricians are the key providers of care during pregnancy and postpartum. Information about the consultations with a general practitioner (GP) during this period is generally lacking. The aim of this study is to compare consultation rates, diagnoses and GP management of p

  20. Brief cognitive behavioral therapy compared to general practitioners care for depression in primary care: a randomized trial

    Directory of Open Access Journals (Sweden)

    Bockting Claudi LH

    2010-10-01

    Full Text Available Abstract Background Depressive disorders are highly prevalent in primary care (PC and are associated with considerable functional impairment and increased health care use. Research has shown that many patients prefer psychological treatments to pharmacotherapy, however, it remains unclear which treatment is most optimal for depressive patients in primary care. Methods/Design A randomized, multi-centre trial involving two intervention groups: one receiving brief cognitive behavioral therapy and the other receiving general practitioner care. General practitioners from 109 General Practices in Nijmegen and Amsterdam (The Netherlands will be asked to include patients aged between 18-70 years presenting with depressive symptomatology, who do not receive an active treatment for their depressive complaints. Patients will be telephonically assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I to ascertain study eligibility. Eligible patients will be randomized to one of two treatment conditions: either 8 sessions of cognitive behavioral therapy by a first line psychologist or general practitioner's care according to The Dutch College of General Practitioners Practice Guideline (NHG- standaard. Baseline and follow-up assessments are scheduled at 0, 6, 12 and 52 weeks following the start of the intervention. Primary outcome will be measured with the Hamilton Depression Rating Scale-17 (HDRS-17 and the Patient Health Questionnaire-9 (PHQ-9. Outcomes will be analyzed on an intention to treat basis. Trial Registration ISRCTN65811640

  1. Depression during pregnancy: views on antidepressant use and information sources of general practitioners and pharmacists

    Directory of Open Access Journals (Sweden)

    Schobben Fred

    2009-07-01

    Full Text Available Abstract Background The use of antidepressants during pregnancy has increased in recent years. In the Netherlands, almost 2% of all pregnant women are exposed to antidepressants. Although guidelines have been developed on considerations that should be taken into account, prescribing antidepressants during pregnancy is still a subject of debate. Physicians and pharmacists may have opposing views on using medication during pregnancy and may give contradictory advice on whether or not to take medication for depression and anxiety disorders during pregnancy. In this study, we investigated information sources used by general practitioners (GPs and pharmacists and their common practices. Methods A questionnaire on the use of information sources and the general approach when managing depression during pregnancy was sent out to 1400 health care professionals to assess information sources on drug safety during pregnancy and also the factors that influence decision-making. The questionnaires consisted predominantly of closed multiple-choice questions. Results A total of 130 GPs (19% and 144 pharmacists (21% responded. The most popular source of information on the safety of drug use during pregnancy is the Dutch National Health Insurance System Formulary, while a minority of respondents contacts the Dutch national Teratology Information Service (TIS. The majority of GPs contact the pharmacy with questions concerning drug use during pregnancy. There is no clear line with regard to treatment or consensus between GPs on the best therapeutic strategy, nor do practitioners agree upon the drug of first choice. GPs have different views on stopping or continuing antidepressants during pregnancy or applying alternative treatment options. The debate appears to be ongoing as to whether or not specialised care for mother and child is indicated in cases of gestational antidepressant use. Conclusion Primary health care workers are not univocal concerning therapy for

  2. A survey of doctorates by thesis among general practitioners in the British Isles from 1973 to 1988.

    Science.gov (United States)

    Williams, W O

    1990-12-01

    Doctors who were general practitioners in the period 1973-88 and had written a successful MD or PhD thesis were identified. Of 96 doctorates, 64 were MDs and 32 PhDs. Fourteen doctors had obtained their MD before becoming general practitioners and the remaining 50 after becoming general practitioners. Twenty of the 64 doctors were full time or part time members of a university department of general practice; six of these were professors. In this 16 year study the mean annual number of MDs written by doctors while in general practice was three, compared with five in the previous 15 years. Of the PhDs, 11 were obtained before starting a medical course, six during the pre-clinical period, three after qualifying but before entry into general practice and 12 after entry into general practice. Ninety two per cent of the 50 doctors who obtained their MDs while in general practice and 84% of all the doctors with MDs continued to do research afterwards. Further research was carried out by 81% of doctors with a PhD. The best way of producing good researchers in general practice is to encourage doctors to accept the challenge of writing a PhD or an MD thesis. This study has shown that writing such a thesis encourages rather than discourages a doctor to undertake further research.

  3. General practitioners' satisfaction with and attitudes to out-of-hours services

    Directory of Open Access Journals (Sweden)

    Wesseling Geertjan

    2005-03-01

    Full Text Available Abstract Background In recent years, Dutch general practitioner (GP out-of-hours service has been reorganised into large-scale GP cooperatives. Until now little is known about GPs' experiences with working at these cooperatives for out-of-hours care. The purpose of this study is to gain insight into GPs' satisfaction with working at GP cooperatives for out-of-hours care in separated and integrated cooperatives. Methods A GP cooperative separate from the hospital Accident and Emergency (A&E department, and a GP cooperative integrated within the A&E department of another hospital. Both cooperatives are situated in adjacent geographic regions in the South of the Netherlands. One hundred GPs were interviewed by telephone; fifty GPs working at the separated GP cooperative and fifty GPs from the integrated GP cooperative. Opinions on different aspects of GP cooperatives for out-of-hours care were measured, and regression analysis was performed to investigate if these could be related to GP satisfaction with out-of-hours care organisation. Results GPs from the separated model were more satisfied with the organisation of out-of-hours care than GPs from the integrated model (70 vs. 60 on a scale score from 0 to 100; P = 0.020. Satisfaction about out-of-hours care organisation was related to opinions on workload, guarantee of gatekeeper function, and attitude towards out-of-hours care as being an essential part of general practice. Cooperation with medical specialists was much more appreciated at the integrated model (77 vs. 48; P Conclusion GPs in this study appear to be generally satisfied with the organisation of GP cooperatives for out-of-hours care. Furthermore, GPs working at the separated cooperative seem to be more satisfied compared to GPs working at the integrated cooperative.

  4. Professional stress in general practitioners and psychiatrists: The level of psycologic distress and burnout risk

    Directory of Open Access Journals (Sweden)

    Vićentić Sreten

    2010-01-01

    Full Text Available Background/Aim. So far, studies of stress have shown that physicians are at a high risk of sickness from psychic and somatic disorders related to professional stress, that can lead to important disturbance of personal, familiar and professional functionating. The aim of this study was to investigate the doctors exposition level to professional stress, to compare stress level in general practitioners (GP group with that in the group of psychiatrists and risk level for the apperance of burnout syndrome. Methods. This cross-section study included subjects recruited by a random sample method. Thirty General Practice doctors and 30 psychiatrists (totally 60 doctors filled the set of 3 questionnaires: Sociodemographics features, General Health Questionnaire (GHQ; Goldberg D, 1991, and Maslach Burnout Inventory (MBI; Maslach C, 1996. Appropriate statistical procedures (Pearson test, t-test, variance analysis in interpretation of the results were used. Results. A total level of psychic distress measured with the GHQ test in both groups of physicians was very low implying their good mental health. A difference in Burnout risk based on MBI test between the groups was statistically significant (χ2 = 4,286; p < 0.05 only at subscale Personal Accomplishment (MBI-PA; it was a consequence of a higher number of GPs with medium burnout risk (13.3 : 0.0%. However, even 35 physicians from the sample were affected with a high burnout risk measured with subscales Emotional Ehausation (MBI-EE and MBI-DP, showing that both groups of physicians had risk for the appearance of burnout syndrome. Conclusion. The obtained results showed a high burnout risk level in both, GPs and psychiatrists, groups. In both groups there was no presence of psychic disorders (anxiety, depression, insomnia, while there was a high level of emotional ehausation and overtension by job, and also a lower total personal accomplishment. Level of exposition to professional stress is higher in GPs

  5. Direct observation of the nutrition care practices of Australian general practitioners

    Directory of Open Access Journals (Sweden)

    Ball LE

    2014-06-01

    Full Text Available INTRODUCTION: Nutrition care refers to nutrition-related advice or counselling provided by health professionals in an attempt to improve the nutrition behaviour of patients. AIM: The aim of this study was to describe the practices of a sample of Australian general practitioners (GPs when providing nutrition care to adult patients. METHODS: Eighteen GPs (13 male, 5 female were observed by fourth-year medical students during their general practice rotation. Each GP was observed for five consultations that included nutrition care, totalling 90 observed consultations. In each consultation, students completed a 31-item nutrition care checklist of nutrition care practices that could feasibly occur in a standard consultation. Each practice was marked with either a ‘yes’ (completed, ‘no’ (did not complete or ‘completed by practice nurse prior to or after the consultation’. RESULTS: Twenty-eight nutrition care practices were observed at least once. The most frequently observed practices were measuring and discussing blood pressure (76.7%; n=69, followed by general questions about current diet (74.4%; n=67. Approximately half of the consultations included a statement of a nutrition-related problem (52.2%; n=47, and the provision of nutrition advice that focused on a nutrient (45.6%; n=41 or food group (52.2%; n=47. Consultations with male GPs, as well as GPs with more than 25 years of experience, were associated with an increased number of nutrition care practices per consultation. DISCUSSION: The GPs performed nutrition care practices in varying frequencies. Further research is required to identify the most effective GP nutrition care practices to improve the nutrition behaviour of patients.

  6. Knowledge and Practice of Pulp Therapy in Deciduous Teeth among General Dental Practitioners in Saudi Arabia

    Science.gov (United States)

    Togoo, RA; Nasim, VS; Zakirulla, M; Yaseen, SM

    2012-01-01

    Background: It has been observed that the general dentists and pedodontists differ in their treatment recommendations for pulp therapy in deciduous teeth. Aim: To determine the knowledge and practice of pulp therapy in deciduous teeth by general dental practitioners (GDP) in two cities of southern Saudi Arabia. Subjects and Methods: Fifty GDP selected at random from government and private dental clinics were questioned about pulp therapy in deciduous teeth in Abha and Najran cities using a 10-item questionnaire. The data were analyzed using IBM SPSS software version 11.0 and descriptive statistics were obtained. Results: All 50 participants responded to the survey. Pulpotomy was suggested as the first line of treatment for pulp-exposed primary tooth by 32 respondents with 44 using Buckley's formocresol and 32 applying it on the pulp for 5 minutes. 43 respondents squeeze dried the cotton pellet before application on the pulp. In pulpectomy procedure 44 respondents preferred zinc oxide eugenol as obturation material with 22 using handheld reamers and 15 using slow-speed lentilospirals for obturation. 12 respondents used obturation techniques which had no scientific relevance. In order of preference Glass ionomer cement (GIC), silver amalgam, and stainless steel crowns were the materials of choice for final restoration of endodontically treated deciduous teeth. All 50 answered in the affirmative when asked if they would like to have additional information about pulp therapy in deciduous teeth. Conclusion: The study concluded that general dentists were regularly performing pulp therapy in decidous teeth and therefore need to be frequently updated about these procedures. PMID:23440030

  7. Associations between degrees of task delegation and job satisfaction of general practitioners and their staff: a cross-sectional study

    DEFF Research Database (Denmark)

    Riisgaard, Helle; Søndergaard, Jens; Munch, Maria

    2017-01-01

    to rethink the working structure without compromising the quality of care. However, there is a substantial variation in the degree to which general practitioners delegate tasks to their staff, and it is not known how these various degrees of task delegation influence the job satisfaction of general...... obstructive pulmonary disease in general practice and a part concerning the general job satisfaction and motivation to work. Results We found a significant association between perceived “maximal degree” of task delegation in management of patients with chronic obstructive pulmonary disease and the staff......’s overall job satisfaction. The odds ratio of the staff’s satisfaction with the working environment displayed a tendency that there is also an association with “maximal degree” of task delegation. In the analysis of the general practitioners, the odds ratios of the results indicate that there is a tendency...

  8. The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China

    Directory of Open Access Journals (Sweden)

    Fei Chen

    2015-08-01

    Full Text Available Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6% of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty

  9. Effectiveness of exercise therapy added to general practitioner care in patients with hip osteoarthritis: A pragmatic randomized controlled trial

    NARCIS (Netherlands)

    C.H. Teirlinck (Carolien H.); P.A.J. Luijsterburg (Pim); J.H.M. Dekker (Joost); A.M. Bohnen (Arthur); J.A.N. Verhaar (Jan); M.A. Koopmanschap (Marc); P. van Es (Pauline); B.W. Koes (Bart); S.M. Bierma-Zeinstra (Sita)

    2016-01-01

    textabstractObjective: To assess the effectiveness of exercise therapy added to general practitioner (GP) care compared with GP care alone, in patients with hip osteoarthritis (OA) during 12 months follow-up. Methods: We performed a multi-center parallel pragmatic randomized controlled trial in 120

  10. German wide cross sectional survey on health impacts of electromagnetic fields in the view of general practitioners

    DEFF Research Database (Denmark)

    Kowall, Bernd; Breckenkamp, Jürgen; Heyer, Kristina

    2010-01-01

    OBJECTIVES: The proportion of general practitioners (GPs) in Germany who assume health impacts of electromagnetic fields (EMF) is assessed. Moreover, factors associated with this risk perception are examined. METHODS: A 7% random sample was drawn from online lists of all the GPs working in Germany...

  11. Worries are the mother of many diseases: General practitioners and refugees in the Netherlands on stress, being ill and prejudice

    NARCIS (Netherlands)

    Titia Feldmann, C.; Bensing, J.; Ruijter, Arie de

    Objective: To confront the views of refugee patients and general practitioners in the Netherlands, focusing on medically unexplained physical symptoms (MUPS). Methods: The study is based on in depth interviews with refugees from Afghanistan (n = 36) and Somalia (n = 30). Additionally,

  12. The general practitioner as the first contacted health professional by patients with psychosocial problems: a European study.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Verhaak, P.F.M.

    1999-01-01

    Background: there are considerable differences between and within countries in the involvement of general practitioners (GPs) in psychosocial care. This study aimed to describe the self-perceived role of GPs in 30 European countries as the fir