Solo family practice

BACKGROUND: Lack of training among health care providers (HCPs) to safely prescribe opioids is a contributing factor to the opioid crisis. Training and other resources have been developed to educate providers about safe and appropriate opioid prescribing practices. METHOD: The national survey was conducted with 2000 HCPs representing primary care physicians (PCPs), including family practice, general practice, and internal medicine; specialists (SPs); physician assistants (PAs); and nurse practitioners (NPs), a mix of primary care and specialists...

Background: Telemedicine expansion during the coronavirus pandemic improved health care access for some. However, studies show disparate uptake among marginalized communities, where minority patients experience higher infection rates. We examined changes in pediatric telemedicine utilization as related to social determinants of health and characteristics of families accessing care. Materials and Methods: This IRB-approved study is a retrospective, cross-sectional comparison of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between January to May 2019 and January to May 2020...

PURPOSE: We undertook a study to identify conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care. METHODS: We purposively sampled and interviewed practice staff (eg, office managers, clinicians) from a subset of 104 practices participating in EvidenceNOW-a multisite cardiovascular disease prevention initiative. We calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening and, if relevant, counseling and in the proportion of hypertensive patients with adequately controlled BP...

Zeolitic octahedral metal oxides (ZOMOs) are fully inorganic crystalline materials, mostly containing transition metals, and possess a defined framework as well as regular hollow channels. Therefore, they have significant application potential in many fields, particularly catalysis. Herein, we report the synthesis and characterization of zeolitic octahedral niobium oxides (ZOMO-NbOx) and the framework was made of {NbOx} polyhedra ({NbO6} octahedron and {Nb6O27} pentagon units). Microchannels consisting of 7-membered rings with ∼0...

Although solo and small practices are a vital part of primary care, the proportion of family physicians reporting working in practices with 5 or fewer providers declined from 15% to 11% for solo and 37% to 34% for small (2 to 5 providers) practices from 2014 to 2018. These decreasing trends are concerning, mainly when a low proportion of family physicians have solo practices in rural locations given the access to care challenges in these underserved populations.

BACKGROUND: The image of outpatient medical care is physician-centered; little attention is paid to the (potential) influence of health organizations and their characteristics on medical care dimensions. AIM: Description of the structures of outpatient medical care stratified by legal forms, comparison with those of other decentralized health systems and discussion of the potential effect of legal form on different dimensions of medical care. METHODS: The frequencies of solo practice, group practice and Medical Care Centers for both primary and specialist medical care, the average team size of practices and the proportion of interdisciplinary health organizations are described over time based on secondary data sources (mainly provided by the National Association of Statutory Health Insurance Physicians)...

There are pressing issues that are plaguing healthcare systems across the world (especially in the lower-middle-income countries), which comprise low-quality care, affordability, accessibility, poor infrastructure, violence against healthcare personnel, deficiency of physicians and healthcare staff. COVID-19 has put an immense physical and mental strain on the young physicians who are at the forefront in fighting this pandemic. This has lead to an increase in incidences of burnout among young doctors, which adversely impacts the quality of healthcare, patient well-being and satisfaction...

Having seen the retired life of our professors both in general and plastic surgery and how lonely and isolated they were toward the end of their lives prompted me to discuss the retirement plans. The retirement from active surgical practice is indeed difficult and more so in plastic surgery. I feel that it needs meticulous planning for setting up a successful practice and when to say sayonara , just like treatment planning of any surgical procedure for perfect execution! At the end of M.Ch training, one should analyze oneself about the goal of the professional life and commit oneself to either a solo/group practice as an independent institutional practice or in a corporate set-up or choose a state/central government set-up with some academic position...

BACKGROUND: The COVID-19 pandemic affects the processes of routine care for chronic patients. A better understanding helps to increase resilience of the health system and prepare adequately for next waves of the pandemic. METHODS: A qualitative study was conducted in 16 primary care practices: 6 solo working, 4 monodisciplinary and 7 multidisciplinary. Twenty-one people (doctors, nurses, dieticians) were interviewed, using semi-structured video interviews. A thematic analysis was done using the domains of the Chronic Care Model (CCM)...

Music contests are a means of discovering talents and promoting musical abilities. Participation in a contest is usually preceded by many years of practice requiring a high level of motivation and a supportive environment, especially regarding family. Despite the importance participation in music contests may have for musical development, there is a considerable research deficit. The annual music contest "Jugend musiziert" (youth making music) is the most important musical competition for highly gifted young musicians in Germany...

PURPOSE: We sought to determine the financial impact to primary care practices of alternative strategies for offering buprenorphine-based treatment for opioid use disorder. METHODS: We interviewed 20 practice managers and identified 4 approaches to delivering buprenorphine-based treatment via primary care practice that differed in physician and nurse responsibilities. We used a microsimulation model to estimate how practice variations in patient type, payer, revenue, and cost across primary care practices nationwide would affect cost and revenue implications for each approach for the following types of practices: federally qualified health centers (FQHCs), non-FQHCs in urban high-poverty areas, non-FQHCs in rural high-poverty areas, and practices outside of high-poverty areas...

INTRODUCTION: Both opioid use disorder and mortality for opioid overdoses are increasing. Family physicians (FPs) can treat opioid use disorder if they are waivered to prescribe buprenorphine. Our objective was to determine personal, practice, and community characteristics associated with FPs prescribing buprenorphine. METHODS: We used data from the 2017 and 2018 American Board of Family Medicine examination registration questionnaire. The questionnaire asked about current prescribing of buprenorphine, as well as about practice size, organization, and location...

OBJECTIVE: To examine patients' perceptions of care outcomes following the introduction of collaborative teams into community family practices. DESIGN: Cross-sectional, longitudinal study comprising 4 patient telephone surveys between 2007 and 2016, using random sampling of telephone records based on postal codes. SETTING: Ten WestView Primary Care Network (WPCN) clinics in Alberta, serving a suburban-rural population of approximately 89 000 and an aggregate clinic panel of 61 611 (in 2016)...

Background Clinical practices and testing strategies in patients with ovarian cancer differ worldwide. We therefor wanted to give an overview over the current data to advise best clinical practice. Materials and methods A systematic review of the literature was performed with the aim to define which ovarian cancer patients to refer for genetic counseling and how to perform genetic testing. We also discuss the timing of genetic testing and clinical relevance of the BRCA mutation status. Results The germline mutation rate in patients with ovarian cancer is high, independent of family history, age at diagnosis and histology...

OBJECTIVE: The objective was to assess the number of new clients accepted by licensed mental health clinicians in Massachusetts and clinician characteristics associated with new clients accepted. METHODS: Surveys about client access to outpatient mental health care were sent to a stratified random sample of 2,250 licensed mental health clinicians (psychiatrists, psychologists, licensed certified social workers, licensed independent clinical social workers, licensed mental health counselors, and licensed marriage and family therapists) practicing in Massachusetts...

BACKGROUND: Family medicine residents choose among a range of practice options as they enter the physician workforce. We describe the demographic and personal characteristics of Canadian family medicine residents and examine differences in the intentions of residents from Ontario, Quebec, Western Canada and Atlantic Canada at the completion of their training, in terms of practice comprehensiveness, organizational model, clinical domains, practice settings and populations served. METHODS: We analyzed national survey data collected by the College of Family Physicians of Canada and 16 university-based family medicine residency programs...

It is an oft-repeated trope that the recent medical advances in the field of assisted reproduction have radically transformed the ways in which we can achieve, practice and imagine parenthood. This development has enabled new forms of non-heterosexual family constellations, including same-sex nuclear families and solo-parents by choice, and as a result an increasing number of groups are mobilising politically for access to fertility treatments. Swedish transgender patients are one of these groups; after many years of political mobilisation, they are no longer required by law to go through sterilisation as a compulsory part of gender corrective surgery, and instead today, all transgender patients are offered fertility preservation through gamete freezing...

Numerous studies have observed a persistent and most often negative association between pornography use and romantic relationship quality. While various theories have been suggested to explain this association, studies have yet to empirically examine whether the observed link between pornography consumption and relationship outcomes has more to do with solo masturbation than actually watching pornography. The current study drew on two nationally representative data sets with nearly identical measures to test whether taking masturbation practice into account reduces or nullifies the association between pornography use and relational happiness...

In light of calls for improving people's skill in collaboration, this paper examines strengths in processes of collaboration of Mexican immigrant children. Sibling pairs (6-10 years old) in California were asked to collaborate in planning the shortest route through a model grocery store. On average, 14 sibling pairs with Mexican Indigenous-heritage backgrounds engaged together collaboratively as an ensemble, making decisions in common and fluidly building on each other's ideas, more often than 16 middle-class European American sibling pairs, who on average more often divided decision making into a solo activity (often ignoring the other or simply bossing the other)...

INTRODUCTION: Well-Child Care (WCC) is the provision of preventive health care services for children and their families. Prior research has highlighted that several barriers exist for the provision of WCC services. OBJECTIVES: To study "real life" visits of parents and children with health professionals in order to enhance the theoretical understanding of factors affecting WCC. METHODS: Participant observations of a cross-sectional sample of 71 visits at three general practices were analysed using a mixed-methods approach...