Time Constraints Limit Full-Body Exams in Primary Care

2011 ◽  
Vol 44 (2) ◽  
pp. 28
Author(s):  
MARY ANN MOON
2011 ◽  
Vol 41 (2) ◽  
pp. 35
Author(s):  
MARY ANN MOON
Keyword(s):  

Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman

Depression treatment that is coordinated with care for comorbid chronic conditions improves control of both the depression and the chronic medical disease. Interpersonal counseling (IPC) and briefer forms of IPT for depression have been introduced in medical practice and primary care to accommodate providers’ time constraints and different levels of training of mental health care providers. IPC is best used with patients who have low levels of depressive symptoms, or distress, and where more highly trained therapists are not available but health personnel are interested in providing counseling. There is high interest in developing briefer approaches for depression treatment in medical patients, a wealth of evidence-based choices, and much work to be done. A case example is given of a college student with comorbid depression and diabetes.


2020 ◽  
Vol 13 (6) ◽  
pp. 336-343
Author(s):  
Tajvinder Kaur Grewal ◽  
Aravindhan Baheerathan

Migraine and other severe recurrent headache disorders are highly prevalent disabling conditions, and are a common reason for presentation to primary care. Headaches can have a significant impact on an individual’s quality of life, resulting in huge costs to healthcare and the economy. This highlights the importance of being able to assess, diagnose and manage this symptom appropriately within the time constraints of a 10-minute consultation. This article will focus on an approach to the assessment of patients presenting with headache and a framework for managing the headache disorders commonly encountered in primary care.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Olaf von dem Knesebeck ◽  
Sarah Koens ◽  
Gabriella Marx ◽  
Martin Scherer

Abstract Background Time constraints during patient visits play a major role for the work stress of primary care physicians. Several studies suggest that there is a critical situation in terms of time constraints in primary care in Germany. Therefore, the following research questions are addressed: (1) What is the time allocated and needed for different types of consultations among primary care physicians in an urban area in Germany? (2) What is the extent of time stress? (3) Are there differences in time stress according to physician characteristics (gender and length of experience) and practice type (single vs. group/shared practice)? Methods Data stem from a face-to-face survey of primary care doctors in Hamburg and adjacent regions. A sample of 128 physicians stratified by a combination of physicians’ gender and length of experience (≤15 years or > 15 years) was used. Physicians were asked about the time needed (in minutes) to provide high quality of care for patients regarding six types of consultations: (1) new patient appointment, (2) routine consultation, (3) complete physical examination, (4) symptom-oriented examination, (5) check-up, and (6) home visit (without drive). Afterwards, they were asked about the average minutes allocated for the six consultations. Time stress was measured by calculating minutes needed minus minutes available. Results Average perceived time needed was higher than time allocated for all six types of consultation. However, there were differences in the magnitude of time stress between the consultation types. Time stress was most pronounced and most prevalent in case of a new patient visit. No significant differences in time stress between male and female primary care physicians were found, while less experienced physicians reported more time stress than those with more experience (> 15 years). Physicians working in a single practice had less time stress than those working in a group or shared practice in case of a check-up visit. Conclusions Perceived time needed is higher than time allocated for various types of consultation among primary care physicians in Germany. Time stress in primary care is particularly pronounced in case of new patient appointments. Early-career physicians are particularly affected by time stress.


1997 ◽  
Vol 9 (S1) ◽  
pp. 179-182
Author(s):  
Burton V. Reifler

Our topic was functional and global evaluations. We discussed the scales per se versus the concept of evaluation. In terms of usefulness for the primary care physician, we concluded that the concept of evaluating functional and global impairment was important, but due to time constraints on general practitioners (GPs), the use of ratings scales was impractical. However, we believed that for those of us with research interests, the rating scales and their psychometric properties are crucial.


2017 ◽  
Vol 57 (6) ◽  
pp. 667-671 ◽  
Author(s):  
Julia Mayne ◽  
Shilpa Pai ◽  
Lesley Morrow ◽  
Daniel Lima ◽  
Manuel E. Jimenez

Low literacy is associated with poor health. We sought to examine pediatricians’ attitudes and practices regarding literacy promotion in early childhood. We distributed a self-administered 23-item survey to a random sample of 500 board certified or eligible New Jersey primary care pediatricians. 134 surveys were returned, 25 of which were excluded. In all, 91% of pediatricians in our sample agreed that literacy promotion was an essential aspect of practice, and two-thirds agreed that they conduct activities to promote literacy. A total of 77% of pediatricians who completed their training ≤20 years ago agreed that they were adequately trained to promote literacy compared with 58% who completed their training >20 years ago ( P = .04). Physicians reported several barriers including time constraints and insufficient funding. While most pediatricians in our sample support literacy promotion, less conducted activities in practice. Further study is needed to understand how to facilitate implementation of literacy promotion guidelines.


2011 ◽  
Vol 42 (2) ◽  
pp. 14
Author(s):  
MARY ANN MOON
Keyword(s):  

2016 ◽  
Vol 16 (4) ◽  
pp. 247-258 ◽  
Author(s):  
Geoff McCombe ◽  
Anne Marie Henihan ◽  
Jan Klimas ◽  
Davina Swan ◽  
Dorothy Leahy ◽  
...  

Purpose Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to describe a qualitative feasibility assessment of a primary care-based complex intervention to promote screening and brief intervention for PAU, which also aims to examine acceptability and potential effectiveness. Design/methodology/approach Semi-structured interviews were conducted with 14 patients and eight general practitioners (GPs) who had been purposively sampled from practices that had participated in the feasibility study. The interviews were transcribed verbatim and analysed thematically. Findings Six key themes were identified. While all GPs found the intervention informative and feasible, most considered it challenging to incorporate into practice. Barriers included time constraints, and overlooking and underestimating PAU among this cohort of patients. However, the intervention was considered potentially deliverable and acceptable in practice. Patients reported that (in the absence of the intervention) their use of alcohol was rarely discussed with their GP, and were reticent to initiate conversations on their alcohol use for fear of having their methadone dose reduced. Research limitations/impelications Although a complex intervention to enhance alcohol screening and brief intervention among primary care patients attending for OAT is likely to be feasible and acceptable, time constraints and patients’ reticence to discuss alcohol as well as GPs underestimating patients’ alcohol problems is a barrier to consistent, regular and accurate screening by GPs. Future research by way of a definitive efficacy trial informed by the findings of this study and the Psychosocial INTerventions for Alcohol quantitative data is a priority. Originality/value To the best of the knowledge, this is the first qualitative study to examine the capability of primary care to address PAU among patients receiving OAT.


2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.


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