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https://www.readbyqxmd.com/read/28444043/challenges-for-ensuring-availability-and-accessibility-toin-health-care-services-under-brazil-s-unified-health-system-sus
#1
Ana Paula Cavalcante de Oliveira, Mariana Gabriel, Mario Roberto Dal Poz, Gilles Dussault
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28442493/characteristics-and-outcomes-of-canadian-md-phd-program-graduates-a-cross-sectional-survey
#2
Michael A Skinnider, Jordan W Squair, David D W Twa, Jennifer X Ji, Alexandra Kuzyk, Xin Wang, Patrick E Steadman, Kirill Zaslavsky, Ayan K Dey, Mark J Eisenberg, Ève-Reine Gagné, Kent T HayGlass, James F Lewis, Peter J Margetts, D Alan Underhill, Norman D Rosenblum, Lynn A Raymond
BACKGROUND: Combined MD/PhD programs provide a structured path for physician-scientist training, but assessment of their success within Canada is limited by a lack of quantitative data. We collected outcomes data for graduates of Canadian MD/PhD programs. METHODS: We developed and implemented a Web-based survey consisting of 41 questions designed to collect outcomes data for Canadian MD/PhD program alumni from 8 Canadian universities who had graduated before September 2015...
April 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#3
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441129/medical-school-outreach-and-mentorship-for-rural-secondary-school-students-a-pilot-of-the-southwestern-ontario-medical-mentorship-program
#4
Maija A Robinson, Matt B Douglas-Vail, Jessica N Bryce, Theunis J van Zyl
INTRODUCTION: Rural communities in Canada face challenges with physician recruitment. Physicians from rural backgrounds are more likely to practise in rural areas; however, rural students are underrepresented in medical schools. To address this, the Southwestern Ontario Medical Mentorship Program (SWOMMP) was created to expose rural secondary school students to medical careers. METHODS: This pilot project involved a school-based interactive session run by rural medical students on paths to medicine, medical specialties and skills workshops of roughly 2...
2017: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/28439376/-back-to-bedside-residents-and-fellows-perspectives-on-finding-meaning-in-work
#5
Dustin M Hipp, Kristy L Rialon, Kathryn Nevel, Anai N Kothari, Lcdr Dinchen A Jardine
BACKGROUND: Physician burnout is common and associated with significant consequences for physicians and patients. One mechanism to combat burnout is to enhance meaning in work. OBJECTIVE: To provide a trainee perspective on how meaning in work can be enhanced in the clinical learning environment through individual, program, and institutional efforts. METHODS: "Back to Bedside" resulted from an appreciative inquiry exercise by 37 resident and fellow members of the ACGME's Council of Review Committee Residents (CRCR), which was guided by the memoir When Breath Becomes Air by Paul Kalanithi...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439357/resident-dyads-providing-transition-care-to-adolescents-and-young-adults-with-chronic-illnesses-and-neurodevelopmental-disabilities
#6
Richard J Chung, Joan Jasien, Gary R Maslow
BACKGROUND: Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. OBJECTIVE: This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28435755/comparison-of-primary-care-physician-reimbursement-rates-in-the-united-states
#7
Nathan Riley, Kelley Withy, Kevin Rogers, Ragan DuBose-Morris, Tiffany Kurozawa
With a growing shortage of physicians, particularly primary care physicians, the issue of adequate pay in Hawai'i is increasingly important. Anecdotal reports of low pay in Hawai'i have rarely been substantiated. Data from FAIR Health, a company that tracks private insurance reimbursement rates, is compared across the United States (US) for the CPT code 99213. In addition, FAIR Health and Medicare rates are compared for cities with both similar and disparate cost of living to Hawai'i. Hawai'i is in the second lowest quintile for payment in the US for private insurances, and providers are reimbursed significantly lower than in cities with similar cost of living by both Medicare and private insurances...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435320/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-in-patients-from-a-rural-area-in-south-carolina
#8
Jimmy Pruitt, Carolina Moracho-Vilrriales, Tiffaney Threatt, Sarah Wagner, Jun Wu, E Alfonso Romero-Sandoval
Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28435241/magnitude-of-exercise-capacity-and-quality-of-life-improvement-following-repeat-pulmonary-rehabilitation-in-patients-with-copd
#9
Jacqueline S Sandoz, Mary M Roberts, Jin-Gun Cho, John R Wheatley
BACKGROUND: Maintenance and repeated pulmonary rehabilitation programs (PRPs) for patients with COPD have attempted to prolong PRP benefits beyond 12-24 months. However, there is limited evidence as to the magnitude of benefit or the ideal interval between repeating the program under "real-world" conditions in which patients are referred based on clinical necessity. Therefore, we reviewed the effects of repeating PRP in a physician-referred cohort of patients with COPD. METHODS: A total of 141 individuals with COPD completed PRP twice and 35 completed PRP three times over a 12-year period...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28429976/reimbursement-changes-and-drug-switching-are-severe-patients-more-affected
#10
Shou-Hsia Cheng, Chi-Chen Chen, Hung-Chih Kuo, Chi-Chuan Wang
Objectives To examine the long-term effects of drug reimbursement adjustments on drug-switching decisions and to investigate whether patients with complicated or severe conditions are more affected. Methods A population-based, longitudinal study with a before-and-after design. Analysis of 141,703 patients with type 2 diabetes covered by the universal health insurance program in Taiwan. Observation of five 6-month phases before and after a drug reimbursement adjustment implemented in October 2009. Drug switching was defined as a brand change within the same anatomical therapeutic chemical group between two consecutive physician visits...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28428714/predictors-for-difficult-cecal-insertion-in-colonoscopy-the-impact-of-obesity-indices
#11
Soo Yun Moon, Byung Chang Kim, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Chang Won Hong, Bum Joon Park, Kum Hei Ryu, Ji Hyung Nam
AIM: To identify the factors influencing cecal insertion time (CIT) and to evaluate the effect of obesity indices on CIT. METHODS: We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography (CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index (BMI), waist-to-hip circumference ratio (WHR), waist circumference (WC), visceral adipose tissue (VAT) volume and subcutaneous adipose tissue (SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28423457/use-of-online-health-information-by-geriatric-and-adult-ed-patients-access-understanding-and-trust
#12
Grant Scott, Danielle M McCarthy, Amer Z Aldeen, Alyssa Czerniak, D Mark Courtney, Scott M Dresden
OBJECTIVE: The objective was to characterize geriatric patients' use of online health information (OHI) relative to younger adults and assess their comfort with OHI compared to health information (HI) from their physician. METHODS: This was a prospective cross-sectional survey study of adult ED patients. The survey assessed patients' self-reported use of OHI in the past year and immediately prior to ED visit and analyzed differences across 4 age groups: 18-39, 40-64, 65-74, and 75+...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28421176/distributed-learning-revitalizing-anesthesiology-training-in-resource-limited-ethiopia
#13
Krupa B Patel, Morgan Dooley, Ananya Abate, Vanessa Moll
BACKGROUND: Ethiopia has a significant paucity of available health-care workers. Despite the increasing number of medical schools, there are not enough physician instructors. Furthermore, availability and standardization of postgraduate training are lacking. Modalities of e-learning have been shown to be successful when used to impart medical education in other resource-limited countries. The Emory University and Addis Ababa University (AAU) Departments of Anesthesiology have formed a collaboration with the intent of improving the AAU Anesthesiology residency program, one of two postgraduate training programs for anesthesiology in Ethiopia...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28418455/the-development-and-performance-of-after-hours-primary-care-in-the-netherlands-a-narrative-review
#14
Marleen Smits, Martijn Rutten, Ellen Keizer, Michel Wensing, Gert Westert, Paul Giesen
In many Western countries, hospital emergency departments are overcrowded, leading to the desire to strengthen primary care, particularly after hours. To achieve this goal, an increasing number of Western nations are reorganizing their after-hours primary care systems into large-scale primary care physician (PCP) cooperatives. This article provides an overview of the organization, performance, and development of PCP cooperatives in the Netherlands. The Dutch after-hours primary care system might offer opportunities for other countries facing problems with after-hours care and inappropriate emergency department visits...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28414410/preparing-family-physicians-to-care-for-underserved-populations-a-historical-perspective
#15
Denise V Rodgers, Andrea L Wendling, George W Saba, Megan Ruth Mahoney, Joedrecka S Brown Speights
Family physicians have been involved in the care of rural and urban underserved populations since the founding of the specialty. In the early 1970s family medicine training programs specifically focused on training residents to work with the underserved were established in both urban and rural settings. Key to the success of these programs has been a specific focus on improving access to care, understanding and eliminating health disparities, cultural competency and behavioral science training that recognizes the challenges often faced by patients and families living in poor rural and urban areas of the country...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28414408/family-medicine-research-in-the-united-states-from-the-late-1960s-into-the-future
#16
Marjorie A Bowman, Sean C Lucan, Thomas C Rosenthal, Arch G Mainous, Paul A James
When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field's inception, there have been notable research successes for which family medicine organizations, researchers, and leaders-assisted by federal and state governments and private foundations-can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28414406/residency-training-in-family-medicine-a-history-of-innovation-and-program-support
#17
Peter J Carek, Tanya Anim, Colleen Conry, Sam Cullison, Stan Kozakowski, Dan Ostergaard, Stacy Potts, Perry A Pugno
Residency programs have been integral to the development, expansion and progression of family medicine as a discipline. Three reports formed the foundation for graduate medical education in family medicine: Meeting the Challenge of Family Practice, The Graduate Education of Physicians, and Health is a Community Affair. In addition, the original core concepts of comprehensiveness, coordination, continuity, and patient centeredness continue to serve as the foundation for residency training in family medicine...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28413842/-i-do-not-have-time-is-there-a-handout-i-can-use-combining-physicians-needs-and-behavior-change-theory-to-put-physical-activity-evidence-into-practice
#18
R E Clark, C McArthur, A Papaioannou, A M Cheung, J Laprade, L Lee, R Jain, L M Giangregorio
Guidelines for physical activity exist and following them would improve health. Physicians can advise patients on physical activity. We found barriers related to physicians' knowledge, a lack of tools and of physician incentives, and competing demands for limited time with a patient. We discuss interventions that could reduce these barriers. INTRODUCTION: Uptake of physical activity (PA) guidelines would improve health and reduce mortality in older adults. However, physicians face barriers in guideline implementation, particularly when faced with needing to tailor recommendations in the presence of chronic disease...
April 17, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28411933/wilderness-emergency-medical-services-systems
#19
REVIEW
Michael G Millin, Seth C Hawkins
Wilderness emergency medical services (WEMS) are designed to provide high quality health care in wilderness environments. A WEMS program should have oversight by a qualified physician responsible for protocol development, education, and quality improvement. The director is also ideally fully trained as a member of that wilderness rescue program, supporting the team with real-time patient care. WEMS providers function with scopes of practice approved by the local medical director and regulatory authority. With a focus on providing quality patient care, it is time for the evolution of WEMS as an integrated element of a local emergency response system...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410172/adolescent-and-young-adult-cancer-survivorship-educational-programming-a-qualitative-evaluation
#20
Deborah Vollmer Dahlke, Kayla Fair, Yan Alicia Hong, Debra Kellstedt, Marcia G Ory
BACKGROUND: This program evaluation considers the need for increased professional and patient education for adolescent and young adult (AYA) cancer survivorship. Due to the high incidence of late effects of cancer treatment among AYA cancer survivors, knowledge sharing and communications are needed throughout the transition from cancer care into community care. AYA survivors are likely to need developmentally appropriate psychosocial care as well as extensive follow-on surveillance by physicians who are educated and aware of the likely chronic conditions and late effects that may occur in these patients...
February 10, 2017: JMIR Cancer
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