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Primary care career

William R Phillips, Toby Keys
BACKGROUND AND OBJECTIVES: Primary care (PC) requires interprofessional teamwork and training. Although clinical training in PC settings is well developed in some professions, classroom teaching on the principles and practice of PC provides additional opportunities for interprofessional education. METHODS: We offered an elective one-credit classroom course on PC over 3 years, 2013 through 2015, enrolling students from dentistry, medicine, nursing, pharmacy, physician assistant, public health, social work, and other fields...
March 2018: Family Medicine
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
Hadeel Alkhaneen, Faisal Alhusain, Khalid Alshahri, Nawfal Al Jerian
BACKGROUND: Choosing a medical specialty is a poorly understood process. Although studies conducted around the world have attempted to identify the factors that affect medical students' choice of specialty, data is scarce on the factors that influence the choice of specialty of Saudi Arabian medical students, in particular those planning a career in emergency medicine (EM). In this study, we investigated whether Saudi medical students choosing EM are influenced by different factors to those choosing other specialties...
March 7, 2018: International Journal of Emergency Medicine
Howard Casey Cromwell
Presents an obituary for Jaak Panksepp, who died April 18, 2017. Panksepp reshaped the landscape of psychology by highlighting emotions and coincident feelings in basic and clinical research. Most of his career was spent convincing others that the key to understanding human mental illness was the understanding of primal emotional operating systems in conserved neural circuitry. His framework was carefully laid out in his book Affective Neuroscience: The Foundation of Human and Animal Emotions (1998). His controversial writings vigorously pushed for the acceptance of nonhuman animal feelings as primary states that link to motivated action and emotional expression...
February 2018: American Psychologist
Jeremey Walker, Brittany Payne, B Lee Clemans-Taylor, Erin Dunn Snyder
Background : Continuity between patients and physicians is a core principle of primary care and an accreditation requirement. Resident continuity clinics face challenges in nurturing continuity for their patients and trainees. Objective : We undertook a scoping review of the literature to better understand published benchmarks for resident continuity; the effectiveness of interventions to improve continuity; and the impact of continuity on resident and patient satisfaction, patient outcomes, and resident career choice...
February 2018: Journal of Graduate Medical Education
Matt Lechner, Liam Sutton, Jonathan M Fishman, David M Kaylie, Richard E Moon, Liam Masterson, Christoph Klingmann, Martin A Birchall, Valerie J Lund, John S Rubin
Importance: Scuba diving is becoming increasingly popular. However, scuba diving is associated with specific risks; 80% of adults and 85% of juvenile divers (aged 6-17 years) have been reputed to have an ear, nose, or throat complaint related to diving at some point during their diving career. Divers frequently seek advice from primary care physicians, diving physicians, and otorhinolaryngologists, not only in the acute setting, but also related to the long-term effects of diving. Observations: The principles underpinning diving-related injuries that may present to the otorhinolaryngologist rely on gas volume and gas saturation laws, and the prevention of these injuries requires both that the diver is skilled and that their anatomy allows for pressure equalization between the various anatomical compartments...
February 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Izet Masic, Zijo Begic, Nabil Naser, Edin Begic
Pediatrics is defined as the science of a healthy and sick child from birth to end of adolescence. Diseases of the cardiovascular system are the leading causes of mortality in adults, with frequent onset in childhood. The cardiologic examination starts with anamnesis in a pleasant atmosphere, refined space, enough time and patience, detailed measurements, and preferably a noncrying child. Anamnesis, regardless of the development of diagnostic procedures, still constitutes the basis of every clinical examination...
2018: International Journal of Preventive Medicine
Tong Wen, Yan Zhang, Xue Wang, Guo Tang
BACKGROUND: The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors' turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China. METHODS: A total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention...
February 13, 2018: Human Resources for Health
Christine Ashley, Kath Peters, Angela Brown, Elizabeth Halcomb
AIM: To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. BACKGROUND: Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. METHOD: A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care...
February 12, 2018: Journal of Nursing Management
Andrew G Boston, K Christopher McMains, Philip G Chen, Erik K Weitzel
Introduction: For some career military aviators, their ability to continue on flight status is limited by the pressure and pain of aerosinusitis, which is present only while in the flying environment. Failure to treat their disease process can mean the end of their flying careers and the loss of valuable assets trained with taxpayer dollars. Because some medications commonly used in treatment of sinus diseases are not allowed in aviation, this presents a unique problem for their medical management...
February 6, 2018: Military Medicine
Margrethe Foss Hansen
This PhD thesis is based on three original articles. The studies were performed at the Department of Obstetrics and Gynaecology, Herlev University Hospital and at the Center for Clinical Epidemiology, Odense University Hospital. 
Urinary incontinence (UI) is a frequent disorder among women, which for the individual can have physical, psychological and social consequences. The current standard of surgical treatment is the synthetic midurethral sling (MUS), which is a minimal invasive procedure.
As the synthetic MUSs (TVT,TVT-O,TOT) were introduced in the late 1990s, there are only a few studies at the long-term follow-up based on nationwide populations; only a few have reported on the risk of reoperation and there is sparse evidence on which treatment should be used subsequently to failure of synthetic MUSs...
February 2018: Danish Medical Journal
Pieter Serneels, Tomas Lievens
BACKGROUND: Most developing countries face important challenges regarding the quality of health care, and there is a growing consensus that health workers play a key role in this process. Our understanding as to what are the key institutional challenges in human resources, and their underlying driving forces, is more limited. A conceptual framework that structures existing insights and provides concrete directions for policymaking is also missing. METHODS: To gain a bottom-up perspective, we gather qualitative data through semi-structured interviews with different levels of health workers and users of health services in rural and urban Rwanda...
January 26, 2018: Human Resources for Health
Maslah Amin, Shiv Chande, Sophie Park, Joe Rosenthal, Melvyn Jones
BACKGROUND: The NHS is struggling with GP recruitment. The Health Education England (HEE) Wass Report (By Choice not by Chance), among its recommendations to boost GP numbers, highlighted undergraduate (UG) GP placement experience as an important influence on future career choice. Aim To explore the UG influences on GP career choice. METHODS: Two junior doctors produced a pragmatic rapid appraisal of the literature on the UG influences on GP career choice for the Wass Report...
January 25, 2018: Education for Primary Care
Anna Sansom, Rohini Terry, Emily Fletcher, Chris Salisbury, Linda Long, Suzanne H Richards, Alex Aylward, Jo Welsman, Laura Sims, John L Campbell, Sarah G Dean
OBJECTIVE: To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. DESIGN: Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. SETTING: South West England, UK. PARTICIPANTS: 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break...
January 10, 2018: BMJ Open
Audiey C Kao, Andrew J Jager
With the US health care system facing a primary care physician shortage, we evaluated whether medical students who saw medicine as a calling were more likely to enter a family medicine, internal medicine, or pediatrics residency program. Of the 591 4th-year medical students who responded to a survey item on medicine as a calling, 237 strongly agreed that the "practice of medicine is a calling." Students who strongly agreed that medicine was a calling had higher odds ( P =.003) of selecting a primary care-related residency...
January 2018: Annals of Family Medicine
Patrick M Flanigan, Arman Jahangiri, Joshua L Golubovsky, Jaret M Karnuta, Francis J May, Mitchel S Berger, Manish K Aghi
OBJECTIVE The position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors' aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role...
January 5, 2018: Journal of Neurosurgery
Benjamin J Oldfield, Bennett W Clark, Monica C Mix, Katherine C Shaw, Janet R Serwint, Sanjay V Desai, Rachel M Kruzan, Rosalyn W Stewart, Sebastian Ruhs, Leonard S Feldman
BACKGROUND: Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. AIM: To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents. SETTING: Academic hospital, community health center, and community-based organizations...
January 3, 2018: Journal of General Internal Medicine
Doris Lin, Chirayu Shah, Steffanie Campbell, Jeffrey T Bates, Erica Lescinskas
OBJECTIVE: The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. METHODS: This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey...
January 2018: Southern Medical Journal
Zhonghui Xie, Jing Li, Yuhua Chen, Kaijun Cui
BACKGROUND: Patient initiated aggression is common among Chinese health-care workers, reaching over 10,000 incidents annually (Jinyang web. . 2013), and the tense doctor-patient relationship generates stress among medical students. Because of the paucity of data (few surveys pay attention to the effects of violence perpetrated by patients on medical students), this study aimed to characterize patient initiated aggression against medical students. METHODS: In this cross-sectional survey conducted at a medical school in West China in 2015, 157 medical students completed a self-administered questionnaire and the Short Form-36, which assesses quality of life...
December 28, 2017: BMC Health Services Research
Brent I Fox, David A Umphress, Joshua C Hollingsworth
BACKGROUND: Interdisciplinary practice is a primary focus within the United States health care system. Despite the existence of interdisciplinary educational efforts in pharmacy for many years, the practice only recently entered mainstream health care education. Informatics offers interdisciplinary educational opportunities. Mobile health (mHealth), an informatics sub-discipline, is the use of mobile devices for health and wellness activities. We used the mHealth domain as the context for an interdisciplinary learning experience for pharmacy and computer science and software engineering (CSSE) students...
July 2017: Currents in Pharmacy Teaching & Learning
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