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physician practice

Michael Argenyi
Applicants to medical schools who are deaf and hard of hearing (DHoH) or who have other disabilities face significant barriers to medical school admission. One commonly cited barrier to admission is medical schools' technical standards (TS) for admission, advancement, and graduation. Ethical values of diversity and equity support altering the technical standards to be more inclusive of people with disabilities. Incorporating these values into admissions, advancement, and graduation considerations for DHoH and other students with disabilities can contribute to the physician workforce being more representative of the diverse patients it serves and better able to care for them...
October 1, 2016: AMA Journal of Ethics
Lisa I Iezzoni
Erroneous assumptions among health care professionals about the daily lives, preferences, values, and expectations of persons with disability can contribute to documented health care disparities, faulty communication, and substandard quality of care affecting this heterogeneous population. Efforts to reduce racial and ethnic disparities have focused on expanding diversity in the physician workforce. Would expanding the numbers of physicians with disability benefit patients with disability? Increasing the number of physicians who identify as "disabled" is one strategy for proactively confronting disability-related barriers affecting patients, but such efforts will likely face substantial challenges...
October 1, 2016: AMA Journal of Ethics
Krista L Kaups
Consideration of the effects of aging on physicians' practice is crucial to addressing aging clinicians' competence, that is, their ability to practice with reasonable skill and safety. Given physician workforce shortages even in resource abundant countries, the establishment of a compulsory retirement age in the US is impractical and unlikely. Several US hospitals and institutions have sought to address concerns about competence by establishing mandatory age-linked testing and evaluation for physicians. However, these procedures have raised questions regarding age discrimination and test validity...
October 1, 2016: AMA Journal of Ethics
Joel A DeLisa, Jacob Jay Lindenthal
Although progress has been made in diversifying medical school admissions and faculty, this has not extended to physicians with physical disabilities. To improve our understanding of medical students and physicians with physical and sensory disabilities, the authors propose systematically gathering information on the needs and experiences of four groups: physicians who had disabilities before beginning practice, physicians whose disabilities were incurred during their medical careers, physicians drawn from those two groups, and patients of physicians with disabilities...
October 1, 2016: AMA Journal of Ethics
Inger Hagqvist, Stig Rödjer, Anna Aggeryd, Ebba Holmberg, Göran Bondjers
Experiences from PLUS - program for learning and development in Swedish health care In Sweden, more than half of newly registered physicians have been trained outside of the country. Thus, they are not familiar with Swedish culture and the Swedish healthcare system. To support their introduction to a professional carrier in Sweden, in line with the WHO ethical code for recruitment of health personnel, the health care region of Western Sweden established PLUS - program for learning and development in Swedish Health care...
October 24, 2016: Läkartidningen
Hasan M Al-Dorzi, Abdulaziz S Aldawood, Raymond Khan, Salim Baharoon, John D Alchin, Amal A Matroud, Sameera M Al Johany, Hanan H Balkhy, Yaseen M Arabi
BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak. METHODS: This observational study was conducted at the Intensive Care Department which covered 5 ICUs with 60 single-bedded rooms. We described qualitatively and, as applicable, quantitatively the response of intensive care services to the outbreak...
December 2016: Annals of Intensive Care
Oni J Blackstock, Brent A Moore, Gail V Berkenblit, Sarah K Calabrese, Chinazo O Cunningham, David A Fiellin, Viraj V Patel, Karran A Phillips, Jeanette M Tetrault, Minesh Shah, E Jennifer Edelman
BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015...
October 24, 2016: Journal of General Internal Medicine
Amber R Atwater, Mariah Rudd, Audrey Brown, John S Wiener, Robert Benjamin, W Robert Lee, Jullia A Rosdahl
BACKGROUND : There is limited information on the impact of widespread adoption of the electronic health record (EHR) on graduate medical education (GME). OBJECTIVE : To identify areas of consensus by education experts, where the use of EHR impacts GME, with the goal of developing strategies and tools to enhance GME teaching and learning in the EHR environment. METHODS : Information was solicited from experienced US physician educators who use EPIC EHR following 3 steps: 2 rounds of online surveys using the Delphi technique, followed by telephone interviews...
October 2016: Journal of Graduate Medical Education
Karsten A van Loon, Pim W Teunissen, Erik W Driessen, Fedde Scheele
BACKGROUND : Entrustable professional activities (EPAs) seek to translate essential physician competencies into clinical practice. Until now, it is not known whether EPA-based curricula offer enhanced assessment and feedback to trainees. OBJECTIVE : This study examined program directors' and senior residents' justifications for entrustment decisions and what role generic, cross-specialty competencies (such as communication skills, collaboration, and understanding health care systems) play in these decisions...
October 2016: Journal of Graduate Medical Education
Tracy J Koehler, Jaclyn Goodfellow, Alan T Davis, John E vanSchagen, Lori Schuh
BACKGROUND : In a time of threats to the funding for graduate medical education (GME) and projected physician shortages, drawing attention to the value of physician training programs may be useful. One approach is to study the number and percentage of physicians who enter practice in the state in which they trained. OBJECTIVE : We sought to examine the percentage of graduates from a single Michigan-based GME institution over a 15-year period, who practiced medicine in Michigan during their career...
October 2016: Journal of Graduate Medical Education
Marek L Kowalski, Ignacio Ansotegui, Werner Aberer, Mona Al-Ahmad, Mubeccel Akdis, Barbara K Ballmer-Weber, Kirsten Beyer, Miguel Blanca, Simon Brown, Chaweewan Bunnag, Arnaldo Capriles Hulett, Mariana Castells, Hiok Hee Chng, Frederic De Blay, Motohiro Ebisawa, Stanley Fineman, David B K Golden, Tari Haahtela, Michael Kaliner, Connie Katelaris, Bee Wah Lee, Joanna Makowska, Ulrich Muller, Joaquim Mullol, John Oppenheimer, Hae-Sim Park, James Parkerson, Giovanni Passalacqua, Ruby Pawankar, Harald Renz, Franziska Rueff, Mario Sanchez-Borges, Joaquin Sastre, Glenis Scadding, Scott Sicherer, Pongsakorn Tantilipikorn, James Tracy, Vera van Kempen, Barbara Bohle, G Walter Canonica, Luis Caraballo, Maximiliano Gomez, Komei Ito, Erika Jensen-Jarolim, Mark Larche, Giovanni Melioli, Lars K Poulsen, Rudolf Valenta, Torsten Zuberbier
One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing), deliberate induction in the office of allergic symptoms to offending compounds (provocation tests) or intentional application of potentially dangerous substances (allergy vaccine) to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided...
2016: World Allergy Organization Journal
Eric Ehieli, Suraj Yalamuri, Charles S Brudney, Srinivas Pyati
Critically ill patients are a heterogeneous group with diverse comorbidities and physiological derangements. The management of pain in the critically ill population is emerging as a standard of care in the intensive care unit (ICU). Pain control of critically ill patients in the ICU presents numerous challenges to intensivists. Inconsistencies in pain assessment, analgesic prescription and variation in monitoring sedation and analgesia result in suboptimal pain management. Inadequate pain control can have deleterious effects on several organ systems in critically ill patients...
October 24, 2016: Postgraduate Medical Journal
Bobby Yanagawa, Gosta B Pettersson, Gilbert Habib, Marc Ruel, Gustavo Saposnik, David A Latter, Subodh Verma
There has been an overall improvement in surgical mortality for patients with infective endocarditis (IE), presumably because of improved diagnosis and management, centered around a more aggressive early surgical approach. Surgery is currently performed in approximately half of all cases of IE. Improved survival in surgery-treated patients is correlated with a reduction in heart failure and the prevention of embolic sequelae. It is reported that between 20% and 40% of patients with IE present with stroke or other neurological conditions...
October 25, 2016: Circulation
R Aubry
On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition...
October 21, 2016: Revue Neurologique
Karen D Hidalgo, Grégore I Mielke, Diana C Parra, Felipe Lobelo, Eduardo J Simões, Grace O Gomes, Alex A Florindo, Mário Bracco, Lenildo Moura, Ross C Brownson, Michael Pratt, Luiz R Ramos, Pedro C Hallal
BACKGROUND: This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. METHODS: A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals...
October 24, 2016: BMC Public Health
R Barrois, Th Gregory, L Oudre, Th Moreau, Ch Truong, A Aram Pulini, A Vienne, Ch Labourdette, N Vayatis, S Buffat, A Yelnik, C de Waele, S Laporte, P P Vidal, D Ricard
For diagnosis and follow up, it is important to be able to quantify limp in an objective, and precise way adapted to daily clinical consultation. The purpose of this exploratory study was to determine if an inertial sensor-based method could provide simple features that correlate with the severity of lower limb osteoarthritis evaluated by the WOMAC index without the use of step detection in the signal processing. Forty-eight patients with lower limb osteoarthritis formed two severity groups separated by the median of the WOMAC index (G1, G2)...
2016: PloS One
Katherine Hallock, Natalie H Vaughn, Paul Juliano, James G Marks
BACKGROUND: There is no clear consensus among orthopedic surgeons concerning metal hypersensitivity screening and orthopedic implants. OBJECTIVE: This study investigated practices and opinions about metal hypersensitivity and orthopedic implants via a survey administered to practicing orthopedists. METHODS: A questionnaire was sent to members of the Pennsylvania Orthopaedic Society electronically. Respondents were asked about preoperative and postoperative screening habits concerning metal hypersensitivity and implants...
October 21, 2016: Dermatitis
Audrey Tilly-Gratton, Alexandrine Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
BACKGROUND: Asthma control remains suboptimal in Canada. Expansion of pharmacist's professional activities offers the opportunity to improve the interdisciplinary management of patients with asthma. OBJECTIVE: The aim of this study was to determine the level of agreement of physicians regarding the expansion of pharmacists' professional activities in the management of asthma patients. METHODS: We conducted a survey of randomly selected Quebec physicians in family medicine, paediatrics and emergency medicine...
October 24, 2016: International Journal of Pharmacy Practice
L A Louwé, A M Stiggelbout, A Overbeek, C G J M Hilders, M H van den Berg, E Wendel, E van Dulmen-den Broeder, M M Ter Kuile
Current practices in counselling of female cancer patients with respect to fertility issues need considerable improvement, particularly given the general underuse of fertility preservation options and the negative impact that infertility can have on quality of life. We investigated the relationship between physicians' and physician-related factors and the frequency of physicians discussing fertility issues and referring to a reproductive specialist. We invited 1,832 physicians in the Netherlands who had treated at least five reproductive-age female cancer patients within the past year to complete a questionnaire...
October 24, 2016: European Journal of Cancer Care
Joan H Krause
Fueled by massive settlements and concerns about pharmaceutical company influence over medical practice, the fight over off-label promotion has become a rancorous one with little middle ground. For some, off-label restrictions are both bad law and bad medicine, violating the First Amendment while denying physicians access to crucial information. For others, the battle pits the very soul of the FDA against the excesses of a profit-driven marketplace. Far from ameliorating concerns over manufacturer influence, the New Model proposed by Bennett et al...
November 2015: Journal of Law and the Biosciences
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