Medically underserved areas: are primary care teams efficient at attracting and retaining general practitioners?

2021 ◽  
Vol 287 ◽  
pp. 114358
Author(s):  
Guillaume Chevillard ◽  
Julien Mousquès
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Medically Underserved ◽  
Medically Underserved Areas ◽  
Primary Care Teams

scholarly journals What is the present role for general practitioners in dementia care? Experiences of general practitioners, patients and family carers in Portugal

Dementia ◽  
2020 ◽  
pp. 147130122097771
Author(s):  
Conceição Balsinha ◽  
Steve Iliffe ◽  
Sónia Dias ◽  
Alexandre Freitas ◽  
Joana Grave ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Social Contexts ◽  
Dementia Care ◽  
Family Carers ◽  
Primary Care Teams ◽  
Qualitative Interview Study ◽  
Framework Approach ◽  
Advanced Stages ◽  
Patient Relationships

Background Governments are being challenged to integrate at least part of dementia care into primary care. However, little is known about the current role of general practitioners (GPs) regarding dementia care, especially in countries that do not have dementia strategies in place. The aim of this study was to explore the experiences of GPs, persons with dementia and their family carers in Portuguese primary care settings, to better understand GPs’ contribution to dementia care. Methods A qualitative interview study of participants recruited from six practices in different social contexts within the Lisbon metropolitan area was carried out. Purposive sampling was used to recruit GPs, persons with dementia and carers. Interviews with GPs explored dementia care comprehensiveness, including satisfactory and challenging aspects. Interviews with patients and carers explored the experience of talking to GPs about cognitive impairments and related difficulties and the type of help received. Thematic analysis of interview transcripts was carried out using the framework approach. Results Five major themes were identified: GPs have a limited contribution to dementia care, the case of advanced dementia, doctor–patient relationships, doctor–carer relationships and management of chronic conditions other than dementia. Conclusion General practitioners seemed to contribute little to dementia care overall, particularly regarding symptom management. The exception was patients with advanced stages of dementia, given that specialists no longer followed them up. Remarkably, GPs seemed to be alone within primary care teams in providing dementia care. These findings strongly suggest that Portuguese primary care is not yet prepared to comply with policy expectations regarding the management of dementia.

scholarly journals Nurturing the Student, Sustaining the Mission: 20 Years of the International/Inner-City/Rural Preceptorship Program

2019 ◽  
Vol 51 (10) ◽  
pp. 823-829
Author(s):  
Yeri Park ◽  
Mark H. Ryan ◽  
Sally A. Santen ◽  
Roy Sabo ◽  
Courtney Blondino ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Inner City ◽  
Rural Areas ◽  
Self Determination Theory ◽  
Care Physician ◽  
Self Determination ◽  
Medically Underserved ◽  
Medically Underserved Areas ◽  
Virginia Commonwealth University

Background and Objectives: Specialized medical school educational tracks aim to increase the primary care workforce. The International/Inner-City/Rural Preceptorship (I2CRP) Program is unique in addressing multiple communities, a large cohort and applying the Self Determination Theory framework. This study examined program impact by analyzing the numbers of graduates matched into primary care and practicing in medically underserved communities. Methods: We compared the match list of I2CRP graduates between 2000 and 2017 (n=204) to non-I2CRP Virginia Commonwealth University School of Medicine (VCU SOM) graduates (n=3,037). We analyzed the matches into primary care, National Health Service Corps (NHSC) priority specialties, and NHSC priority plus general surgery. We searched a federal database to determine which graduates are practicing in workforce shortage areas. Results: Many more I2CRP graduates matched to primary care (71.1%), compared to non-I2CRP graduates (38.2%; P<.001). Within primary care, I2CRP graduates matched to family medicine more frequently than non-I2CRP graduates (36.3% vs 8.4%). Eighteen percent of posttraining I2CRP graduates work in rural areas and 41% work in medically underserved areas. Conclusions: I2CRP graduates are more likely to match to family medicine and primary care. I2CRP curriculum nurtures new medical students’ interest in primary care, and self-determination theory provides a framework to organize the program curriculum. The program’s impact endures as evidenced by participants’ continued work in underserved areas after residency. Increasing support for such programs may help address the primary care physician shortage in medically underserved areas.

scholarly journals Factors influencing primary care physiciansʼ choice to practice in medically underserved areas

1997 ◽  
Vol 72 (Supplement 1) ◽  
pp. S109-S111 ◽  
Author(s):  
G Xu ◽  
J Veloski ◽  
M Hojat ◽  
R M Politzer ◽  
H K Rabinowitz ◽  
...  
Keyword(s):  
Primary Care ◽  
Medically Underserved ◽  
Factors Influencing ◽  
Medically Underserved Areas

scholarly journals General Practitioners’ Perceptions of Whether Teleconsultations Reduce the Number of Face-to-face Visits in the Catalan Public Primary Care System: Retrospective Cross-Sectional Study

10.2196/14478 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e14478 ◽  
Author(s):  
Francesc López Seguí ◽  
Josep Vidal-Alaball ◽  
Marta Sagarra Castro ◽  
Anna García-Altés ◽  
Francesc García Cuyàs
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Care Service ◽  
Cross Sectional Study ◽  
Clinical Value ◽  
Cross Sectional ◽  
Face To Face ◽  
Primary Care Teams ◽  
Ease Of Access ◽  
Demand For Health

Background eConsulta is a teleconsultation service involving general practitioners (GPs) and patients. It is part of the information system belonging to Catalonia’s primary care service. It has been in operation since the end of 2015 in conjunction with face-to-face consultations with Primary Care Teams as one of the services offered in the patient’s Personal Health Folder. Objective This study aimed to assess the ability of using eConsulta to reduce the number of face-to-face visits to Primary Care Teams. Methods Using 13 categories proposed by the researchers, 18 GPs from the Central Catalonia Health Region retrospectively classified 2268 cases managed with eConsulta and indicated whether, in their opinion, the teleconsultations reduced the number of face-to-face visits. Results There was broad consensus among the GPs that eConsulta has the potential to resolve patient queries for every type of consultation. eConsulta avoided the need for a face-to-face visit in 87.9% of cases. In addition, the GPs reported that the ease of access increased the demand for health care support in 27.7% of cases; otherwise, the patient would not have initiated the queries. Therefore, based on the equation (88% x [1-28%]), eConsulta could replace 63%-88% of conventional appointments. The most frequent uses of the teleconsultation service were for management of test results (35.2%), medical enquiries (16.0%), and the management of repeat prescriptions (12.2%). On average, the teleconsultations consisted of a mean 1.57 messages (SD 0.54 messages); 45.9% (1040/2268) of the teleconsultations consisted of 1 message, and the majority of the remaining teleconsultations consisted of 2-5 interactions. The patient initiated 60.0% (1361/2268) of the teleconsultations. Conclusions Based on the GPs’ perceptions, eConsulta could replace 63%-88% of conventional appointments. Therefore, asynchronous teleconsultations between practitioners and patients in primary care could avoid interactions that have limited added clinical value.

Has the diffusion of primary care teams in France improved attraction and retention of general practitioners in rural areas?

Health Policy ◽  
2019 ◽  
Vol 123 (5) ◽  
pp. 508-515 ◽  
Author(s):  
Guillaume Chevillard ◽  
Julien Mousquès ◽  
Véronique Lucas-Gabrielli ◽  
Stéphane Rican
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Rural Areas ◽  
Primary Care Teams ◽  
Attraction And Retention

scholarly journals General Practitioners’ Perceptions of Whether Teleconsultations Reduce the Number of Face-to-face Visits in the Catalan Public Primary Care System: Retrospective Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Francesc López Seguí ◽  
Josep Vidal-Alaball ◽  
Marta Sagarra Castro ◽  
Anna García-Altés ◽  
Francesc García Cuyàs
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Care Service ◽  
Cross Sectional Study ◽  
Clinical Value ◽  
Cross Sectional ◽  
Face To Face ◽  
Primary Care Teams ◽  
Ease Of Access ◽  
Demand For Health

BACKGROUND eConsulta is a teleconsultation service involving general practitioners (GPs) and patients. It is part of the information system belonging to Catalonia’s primary care service. It has been in operation since the end of 2015 in conjunction with face-to-face consultations with Primary Care Teams as one of the services offered in the patient’s Personal Health Folder. OBJECTIVE This study aimed to assess the ability of using eConsulta to reduce the number of face-to-face visits to Primary Care Teams. METHODS Using 13 categories proposed by the researchers, 18 GPs from the Central Catalonia Health Region retrospectively classified 2268 cases managed with eConsulta and indicated whether, in their opinion, the teleconsultations reduced the number of face-to-face visits. RESULTS There was broad consensus among the GPs that eConsulta has the potential to resolve patient queries for every type of consultation. eConsulta avoided the need for a face-to-face visit in 87.9% of cases. In addition, the GPs reported that the ease of access increased the demand for health care support in 27.7% of cases; otherwise, the patient would not have initiated the queries. Therefore, based on the equation (88% x [1-28%]), eConsulta could replace 63%-88% of conventional appointments. The most frequent uses of the teleconsultation service were for management of test results (35.2%), medical enquiries (16.0%), and the management of repeat prescriptions (12.2%). On average, the teleconsultations consisted of a mean 1.57 messages (SD 0.54 messages); 45.9% (1040/2268) of the teleconsultations consisted of 1 message, and the majority of the remaining teleconsultations consisted of 2-5 interactions. The patient initiated 60.0% (1361/2268) of the teleconsultations. CONCLUSIONS Based on the GPs’ perceptions, eConsulta could replace 63%-88% of conventional appointments. Therefore, asynchronous teleconsultations between practitioners and patients in primary care could avoid interactions that have limited added clinical value.

Factors influencing primary care physicians?? choice to practice in medically underserved areas

1997 ◽  
Vol 72 (10) ◽  
pp. S109???11
Author(s):  
G Xu ◽  
J Veloski ◽  
M Hojat ◽  
R M Politzer ◽  
H K Rabinowitz ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Medically Underserved ◽  
Factors Influencing ◽  
Medically Underserved Areas
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