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Professionalism in the practice of medicine

Todd M Olszewski
This article examines the history and effect of the Consensus Development Program (CDP) at the National Institutes of Health (NIH). Introduced at a time when the relationship between the U.S. public and the medical profession was at a nadir, the CDP frequently placed the NIH in the middle of broader debates in medical practice and health policy during the last quarter of the 20th century. Drawing on published and archival sources, this paper sheds light on the challenges associated with collecting, assessing, and communicating evidence to medical professionals and convincing them to act on it in the name of improved health care...
March 20, 2018: Annals of Internal Medicine
Jeroen M van de Pol, Jurjen G Geljon, Svetlana V Belitser, Geert W J Frederix, Anke M Hövels, Marcel L Bouvy
INTRODUCTION: The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice. METHODS: Self-reporting work sampling was used to register the activities of community pharmacists...
March 9, 2018: Research in Social & Administrative Pharmacy: RSAP
James Rourke, Shabnam Asghari, Oliver Hurley, Mohamed Ravalia, Michael Jong, Wanda Parsons, Norah Duggan, Katherine Stringer, Danielle O'Keefe, Scott Moffatt, Wendy Graham, Carolyn Sturge Sparkes, Janelle Hippe, Kristin Harris Walsh, Donald McKay, Asoka Samarasena
CONTEXT: This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners...
March 2018: Rural and Remote Health
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
Florian Ferreri, Alexis Bourla, Stephane Mouchabac, Laurent Karila
Background: New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping , a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past...
2018: Frontiers in Psychiatry
Daniel Deimel
Clinical social work has established itself as a health-specific profession in Germany over the past 15 years. It refers to a bio-psycho-social health understanding and is particularly focused on hard-to-reach client groups. The concept of evidence-based practice is often criticized and rejected by parts of the profession and discipline of social work. The concepts of evidence-based medicine and clinical social work are associated with positive outcomes for clinical practice and professional development.
March 15, 2018: Das Gesundheitswesen
Renata C Gallagher, Laura Pollard, Anna I Scott, Suzette Huguenin, Stephen Goodman, Qin Sun
Disclaimer: These ACMG Standards are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these Standards is voluntary and does not necessarily assure a successful medical outcome. These Standards should not be considered inclusive of all proper procedures and tests, or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen...
March 15, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
G Ström, S Boqvist, A Albihn, L-L Fernström, A Andersson Djurfeldt, S Sokerya, T Sothyra, U Magnusson
Background: Administration of antimicrobials to food-producing animals is regarded as a major contributor to the overall emergence of resistance in bacteria worldwide. However, few data are available on global antimicrobial use and resistance (AMR) in livestock, especially from low- and middle-income countries. Methods: We conducted a structured survey of 91 small-scale pig farms in the urban and peri-urban areas of Phnom Penh, Cambodia, to assess the farmers' knowledge, attitudes and practices related to antimicrobial use in their pig production...
2018: Antimicrobial Resistance and Infection Control
Sanjay Kalra
Insulin is a life saving medicine. Yet, diabetes care professionals encounter many barriers to its use, especially at the patient level. This is even more true in primary care, where patients tend to resist injectable therapy. This article uses the mnemonic,InfoCRIne, to highlight four important barriers to insulin, and proposes bridges to overcome them. The bridges include information, confidence building, resource husbandry and individualization of strategy. These help overcome the barriers of hearsay, perceived inability to use insulin, perceived lack of resources and intrusion into lifestyle...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Anna Karla de Oliveira Tito Borba, Ana Paula de Oliveira Marques, Vânia Pinheiro Ramos, Márcia Carrera Campos Leal, Ilma Kruze Grande de Arruda, Roberta Souza Pereira da Silva Ramos
This study aimed to investigate factors associated with the treatment adherence of 150 elderly diabetics assisted in gerontogeriatric outpatient service in northeastern Brazil. Full adherence to therapy was self-reported by 27.3% of the elderly. In the bivariate analysis, adherence was associated with self-perceived health, beliefs in the use of medication, understanding explanations about diabetes and professional responsible for treatment guidance. After analysis adjustment, only beliefs in medicine were significant when comparing non-adherence with full adherence (OR = 9...
March 2018: Ciência & Saúde Coletiva
Vanessa A Thomas, Heather L Crouse, Kristy O Murray, Deborah C Hsu, Elizabeth A Camp, Andrea T Cruz
OBJECTIVE: The aim of this study was to perform a needs assessment of pediatric (PEM) and general emergency medicine (EM) provider knowledge, comfort, and current practice patterns in the evaluation of pediatric tropical infectious diseases. METHODS: An online survey was developed based on educational priorities identified by an expert panel via modified Delphi methodology. The survey included assessment of providers' typical evaluation, diagnosis, and treatment of tropical diseases and was distributed to PEM and EM providers in 2 large professional organizations...
March 12, 2018: Pediatric Emergency Care
Akhilesh S Pathipati, Christine K Cassel
Although they enter school with enthusiasm for a career in medicine, medical students in the United States subsequently report high levels of burnout and disillusionment. As medical school leaders consider how to address this problem, they can look to business schools as one source of inspiration. In this Commentary, the authors argue-based on their collective experience in both medical and business education-that medical schools can draw three lessons from business schools that can help reinvigorate students...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Dragana Milutinović, Robert Lovrić, Dragana Simin
BACKGROUND: There is an implicit expectation for medical sciences students to work together effectively as members of health-care team, and interprofessional education is therefore widely accepted. Students' attitudes, which are affected by various factors, have been recognized as the most important predictors of successful implementation of interprofessional education with the aim of developing collaborative practice. The Readiness for Interprofessional Learning Scale has often been used in studies to measure these perspectives...
March 8, 2018: Nurse Education Today
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Cary Cuncic, Glenn Regehr, Heather Frost, Joanna Bates
INTRODUCTION: The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs). METHODS: We drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution...
March 12, 2018: Perspectives on Medical Education
Riyad B Abu-Laban, Sharla Drebit, Ronald R Lindstrom, Chantel Archibald, Kim Eggers, Kendall Ho, Afshin Khazei, Adam Lund, Carolyn MacKinnon, Ray Markham, Julian Marsden, Ed Martin, Jim Christenson
As generalists, emergency practitioners face challenges in providing state-of-the-art care owing to the broad spectrum of practice and the rapid rate of new knowledge generation. Networks have become increasingly prevalent in health care, and it was in this backdrop, and the resulting opportunity to advance evidence-informed emergency care in the Canadian province of British Columbia (BC), that a new "Emergency Medicine Network" (EM Network) was launched in 2017. The EM Network consists of four programs, each led by a physician with expertise and a track record in the domain: (1) Clinical Resources; (2) Innovation; (3) Continuing Professional Development; and (4) Real-time Support...
January 4, 2018: Curēus
David B Reuben, Christine A Sinsky
Changes in health care delivery have affected the work that physicians are expected to perform and, in turn, their satisfaction. There is a gap between the professional mission-what physicians want to do (eg, caring relationships with patients, using intellectual and technical skills to help people, autonomy in their daily work) and what physicians spend a substantial portion of their time and energy doing (eg, data entry and forced function work). We believe that steps can be taken to align the current and future practice of medicine with the professional mission that motivates physicians and creates satisfaction...
March 2018: Annals of Family Medicine
Driss Berdaï, Florence Thomas-Delecourt, Karine Szwarcensztein
Early market access of health products is associated with a larger number of requests for information by the health authorities. Compared with these expectations, the growing expansion of health databases represents an opportunity for responding to questions raised by the authorities. The computerised nature of the health system provides numerous sources of data, and first and foremost medical/administrative databases such as the French National Inter-Scheme Health Insurance Information System (SNIIRAM) database...
December 30, 2017: Thérapie
Vivian E von Gruenigen, Beth Y Karlan
For the last few months, media and news outlets have exposed prominent professionals in many settings who have taken advantage of their status of power and influence to engage in sexual harassment and discrimination in the workplace. In medicine, harassment may include many types of health professionals including physicians, nurses, medical students, colleagues and even patients. Programs for sexual harassment prevention, education and training vary between industries, workplaces, medical schools and hospitals...
March 8, 2018: Gynecologic Oncology
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