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Family physician

Carla T Murray, Matthew Schmit
Introduction: We estimate the effect on health care spending of an option to change TRICARE. Under the option, which is based on a proposal made by the Military Compensation and Retirement Modernization Commission (MCRMC), most beneficiaries could choose from a range of commercial health networks instead of the current TRICARE plans. Military treatment facilities would become network providers under the commercial plans. Materials and Methods: We used data from the Department of Defense (DoD) to estimate the cost of providing the current health care benefit to working-age retirees and their dependents and survivors, and active duty family members...
March 14, 2018: Military Medicine
Emmett Harrison, Paul B A Dhillon
INTRODUCTION: Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. METHODS: We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision...
2018: Canadian Journal of Rural Medicine
Sarah Mousseau, Annie Lapointe, Jocelyn Gravel
BACKGROUND: The CellScope Oto® is a smartphone otoscope attachment allowing physicians to share diagnostic-quality images of the ears. Our primary objective was to evaluate the residents' accuracy in diagnosing acute otitis media in children using the CellScope Oto® attachment compared to traditional otoscope. METHODS: A randomized crossover controlled trial was performed at a single, tertiary care, pediatric emergency department. Participants were a convenience sample of preschool children, consulting for fever and respiratory symptoms...
January 31, 2018: American Journal of Emergency Medicine
Thomas Stephan Hiller, Antje Freytag, Jörg Breitbart, Tobias Teismann, Elisabeth Schöne, Wolfgang Blank, Mercedes Schelle, Horst Christian Vollmar, Jürgen Margraf, Jochen Gensichen
BACKGROUND: Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. METHODS: JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Peter A Nigrovic, Timothy Beukelman, George Tomlinson, Brian M Feldman, Laura E Schanberg, Yukiko Kimura
BACKGROUND: Systemic juvenile idiopathic arthritis is a rare febrile arthritis of childhood characterized by a potentially severe course, including prolonged glucocorticoid exposure, growth failure, destructive arthritis, and life-threatening macrophage activation syndrome. Early cytokine-blocking biologic therapy may improve long-term outcomes, although some systemic juvenile idiopathic arthritis patients respond well to non-biologic treatment, leaving optimal management undefined. Consequently, treatment of new-onset systemic juvenile idiopathic arthritis by expert clinicians varies widely...
March 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
Katie N Dainty, M Bianca Seaton, Ian R Drennan, Laurie J Morrison
OBJECTIVE: Community paramedicine (CP) is a model of community-based health care being used around the world. Our objective was to study the patient perspective and valuation of this type of program to understand its potential value for primary care innovation in the future. STUDY SETTING: The EPIC community paramedicine program is a partnership between primary care physicians and specially trained community paramedics, designed to provide in-home support for complex chronic disease patients in Ontario, Canada...
March 15, 2018: Health Services Research
James Rourke, Danielle O'Keefe, Mohamed Ravalia, Scott Moffatt, Wanda Parsons, Norah Duggan, Katherine Stringer, Michael Jong, Kristin Harris Walsh, Janelle Hippe
OBJECTIVE: To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. DESIGN: Analysis of anonymized secondary data. SETTING: Canada. PARTICIPANTS: Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091)...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Francine Lemire
No abstract text is available yet for this article.
March 2018: Canadian Family Physician Médecin de Famille Canadien
Eva Purkey, Rupa Patel, Tracey Beckett, Françoise Mathieu
OBJECTIVE: To understand the primary care experiences of women who have a history of childhood trauma and chronic disease. DESIGN: Qualitative study using in-depth interviews with directed content analysis. SETTING: Family health team in Kingston, Ont. PARTICIPANTS: Twenty-six women. METHODS: Letters of invitation were sent to eligible participants followed by a telephone survey. Women with an adverse childhood experience (ACE) score of 4 or higher and with 2 or more chronic conditions were invited to participate in a one-on-one interview...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Christopher Naugler, Irene Ma
No abstract text is available yet for this article.
March 2018: Canadian Family Physician Médecin de Famille Canadien
Sharone Bar-David
A recent study of patient violence toward hospital physicians and nurses offers a welcome perspective in its classifying of aggressive behaviors as workplace violence. While patients and families are widely recognized as sources of rude behaviors, we need to shed light on passive aggressive and other low-level rude behaviors that take place frequently amongst hospital personnel as well. Studied under the term "workplace incivility," these seemingly insignificant behaviors that show lack of regard for colleagues have far reaching negative consequences...
March 14, 2018: Israel Journal of Health Policy Research
Hein Heidbuchel, Nikolaos Dagres, Matthias Antz, Karl-Heinz Kuck, Patrice Lazure, Suzanne Murray, Céline Carrera, Gerhard Hindricks, Alec Vahanian
Aims: Guideline-adherent treatment is associated with improved prognosis in atrial fibrillation (AF) patients but is insufficiently implemented in clinical practice. The European Society of Cardiology (ESC) performed a multinational educational needs assessment study among cardiologists, general practitioners/family physicians (GPs/FPs), and neurologists in order to evaluate knowledge and skills of physicians and system factors related to AF care delivery. Methods and results: A total of 561 physicians (294 cardiologists, 131 neurologists, and 136 GPs/FPs) from six European countries participated...
March 12, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Lucas Wan Der Maas
The aim of this study was to analyze the changes in the 2000s in the social base of the medical and nursing professions in Brazil, as a result of the expansion of higher education in the country beginning in the late 1990s. The article begins with a descriptive analysis of the social base of recruitment, drawing on data from the socioeconomic questionnaire of the National Student Performance Exam in 2004 and 2010, for incoming and graduating students in medicine and nursing. Next, it analyzes the social base of certified physicians and nurses, using data from the 2000 and 2010 Population Censuses...
March 8, 2018: Cadernos de Saúde Pública
Sebastian T Tong, Camille J Hochheimer, Wendy B Barr, Matteo Leveroni-Calvi, Nicholas M Lefevre, Jordyn T Wallenborn, Lars E Peterson
BACKGROUND AND OBJECTIVES: Prior research found that 24% of graduating family medicine residents intend to provide obstetrical deliveries, but only 9% of family physicians 1 to 10 years into practice are doing so. Our study aims to describe the individual and residency program characteristics associated with intention to provide obstetrical deliveries and prenatal care. METHODS: Cross-sectional data on 2014-2016 graduating residents were obtained from the American Board of Family Medicine certification examination demographic questionnaire that asked about intended provision of specific clinical activities...
March 8, 2018: Family Medicine
Michael R Kolber, Shelley Ross
BACKGROUND AND OBJECTIVES: In Canada, few family physicians (FPs) perform endoscopy. Conflicting evidence exists on the quality of endoscopy performed by Canadian FPs, which may be explained by differing skillsets of these endoscopists. The objective of this study was to perform the first exploration of the practice, skills, and knowledge of Canadian FP endoscopists. METHODS: A cross-sectional survey, including direct knowledge test, was used. RESULTS: Twenty Canadian FP endoscopists completed the survey...
March 2018: Family Medicine
Nancy Elder
The author, a family physician, reflects on raising a daughter with a rare eye disease, aniridia, and learning and memory disabilities as the daughter heads off to college.
March 2018: Journal of the American Board of Family Medicine: JABFM
Christy J W Ledford, Carla L Fisher, David A Moss, Paul F Crawford
INTRODUCTION: Although an increasing number of physicians are completing medical acupuncture training, only half of those physicians are able to successfully incorporate acupuncture into practice. We conducted a qualitative study to identify the factors and barriers that can enhance and impede physicians' delivery of and patients' engagement in medical acupuncture within the family medicine clinic. METHODS: We conducted interviews with 15 family physicians and 17 patients in a US family medicine clinic that has integrated medical acupuncture into its practice...
March 2018: Journal of the American Board of Family Medicine: JABFM
Ellen M McCreedy, Robert L Kane, Sarah E Gollust, Nathan D Shippee, Kirby D Clark
BACKGROUND: Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explores how patient characteristics associated with an high risk-to-benefit ratio with hypoglycemia medications affect decision making by primary care clinicians. METHODS: Using a vignette-based survey, we queried primary care clinicians on their intended management of geriatric patients with diabetes. The patients' ages, disease durations, and comorbidities were systematically varied...
March 2018: Journal of the American Board of Family Medicine: JABFM
Lars E Peterson, Bo Fang, James C Puffer, Andrew W Bazemore
We found substantial gaps between preparation for, and practice of, early career family physicians in nearly all clinical practice areas. With reported intentions of graduates for a broad scope of practice, gaps between practice and preparation suggest family physicians early in their careers may not be finding opportunities to provide comprehensive care.
March 2018: Journal of the American Board of Family Medicine: JABFM
Peter J Carek
No abstract text is available yet for this article.
March 2018: Journal of the American Board of Family Medicine: JABFM
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