1.10-P22Improving medical doctors’ psychosocial skills after working in a Swiss outpatient clinic with high rates of migrants and vulnerable patients

IntroductionPrevious research has shown that multiple factors contribute to healthcare providers perceiving encounters as difficult, and are related to both medical and non-medical demands.AimTo measure the prevalence and to identify predictors of encounters perceived as difficult by medical residents.Design and settingCross-sectional study at the Department of Ambulatory Care and Community Medicine (DACCM), a university outpatient clinic with a long tradition of caring for vulnerable patients.MethodWe identified difficult doctor–patient encounters using the validated Difficult Doctor–Patient Relationship Questionnaire (DDPRQ-10), and characterised patients using the patient’s vulnerability grid, a validated questionnaire measuring five domains of vulnerability, both completed by medical residents after each encounter. We used a multiple linear regression model with the outcome variable as the DDPRQ-10 score, controlling for resident characteristics.ParticipantsWe analysed 527 patient encounters performed by all 27 DACCM residents (17 women and 10 men). We asked each medical resident to evaluate 20 consecutive consultations starting on the same date.OutcomeOne hundred and fifty-seven encounters (29.8%) were perceived as difficult.ResultsAfter adjusting for differences among residents, all five domains of the patient vulnerability grid were independently associated with a difficult encounter: frequent healthcare user; psychological comorbidity; health comorbidity; risky behaviours and a precarious social situation.ConclusionNearly a third of encounters were perceived as difficult by medical residents in our university outpatient clinic that cares for a high proportion of vulnerable patients. This represents twice the average ratio of difficult encounters in general practice. All five domains of patient vulnerability appear to have partial explanatory power on medical residents’ perception of difficult patient encounters.

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Childhood sexual abuse and dissociation in Japan: A clinical overview from an outpatient clinic standpoint

Psychiatry and Clinical Neurosciences ◽

10.1046/j.1440-1819.1998.0520s5s151.x ◽

1998 ◽

Vol 52 (S1) ◽

pp. S111-S115 ◽

Cited By ~ 2

Author(s):

SATORU SAITO

Keyword(s):

Sexual Abuse ◽

Childhood Sexual Abuse ◽

Outpatient Clinic ◽

Clinical Overview

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Is it possible to treat acute mild to moderate colonic diverticulitis by oral antibiotic and carbonated beverage in outpatient clinic?

Gastroenterology ◽

10.1016/s0016-5085(01)83651-9 ◽

2001 ◽

Vol 120 (5) ◽

pp. A733-A733

Author(s):

A MIZUKI ◽

H NISHIYA ◽

K FUKUI ◽

T HAYASHI ◽

N TSUKADA ◽

...

Keyword(s):

Outpatient Clinic ◽

Oral Antibiotic ◽

Colonic Diverticulitis ◽

Carbonated Beverage

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1557: Holmium Bladder Neck Incision (HOBNI) vs.Holmium Laser Enucleation of the Prostate (HOLEP) As Outpatient Clinic Procedures for Small Prostate Glands (<40g): A Randomised Trial With One Year Follow-Up

The Journal of Urology ◽

10.1016/s0022-5347(18)38765-2 ◽

2004 ◽

Vol 171 (4S) ◽

pp. 410-411

Author(s):

Peter J. Gilling ◽

Katie Kennett ◽

Tevita Aho ◽

Andre Westenberg ◽

Mark Fraundorfer

Keyword(s):

Outpatient Clinic ◽

Bladder Neck ◽

Randomised Trial ◽

Bladder Neck Incision ◽

Laser Enucleation ◽

One Year

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Abstract #270 Clinical Experience in the use of Glp 1 Analogs in an Endocrinology Outpatient Clinic in Tegucigalpa, Honduras

Endocrine Practice ◽

10.1016/s1530-891x(20)46614-5 ◽

2019 ◽

Vol 25 ◽

pp. 106

Author(s):

Maria Alejandra Ramos Guifarro ◽

Irma De Vicente ◽

Scarleth Betzabel Rodas ◽

Daniel Andrés Guifarro Rivera

Keyword(s):

Clinical Experience ◽

Outpatient Clinic

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684 A multidisciplinary heart failure care program based on a nurse-monitored outpatient clinic reduces readmissions, improves clinical status and qullity of life after 6 months

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(06)80439-x ◽

2006 ◽

Vol 5 (1) ◽

pp. 154-154

Author(s):

G GASCHINO ◽

A CHINAGLIA ◽

R ASTEGGIANO ◽

G TITTA ◽

D BLANC ◽

...

Keyword(s):

Heart Failure ◽

Outpatient Clinic ◽

Clinical Status ◽

Care Program ◽

Heart Failure Care

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Secondary medical prevention in patients with peripheral arterial disease - Prescriptions of vascular surgeons and medical doctors (angiologists) in a multidisciplinary vascular centre

VASA ◽

10.1024/0301-1526/a000020 ◽

2010 ◽

Vol 39 (2) ◽

pp. 145-152 ◽

Cited By ~ 6

Author(s):

Klein-Weigel ◽

Gutsche-Petrak ◽

Wolbergs ◽

Köning ◽

Flessenkamper

Keyword(s):

Peripheral Arterial Disease ◽

Oral Anticoagulants ◽

Arterial Disease ◽

Disease Stage ◽

Channel Blockers ◽

Medical Doctors ◽

Vascular Surgeon ◽

Medical Prevention ◽

Number Of Patients ◽

Peripheral Arterial

Background: We compared medical secondary prevention in patients with peripheral arterial disease stage II (Fontaine) located in the femoro-popliteal artery managed by vascular surgeons and medical doctors / angiologists in our multidisciplinary vascular center. Patients and methods: We retrospectively analyzed demission protocols of in-hospital treatments between 01.01.2007 and 20.06.2008. Results: We surveyed 264 patients (54.2 % women; mean age 67.52 ± 8.98 yrs), 179 (67.8 %) primarily treated by medical doctors / angiologists and 85 (32.2 %) primarily managed by vascular surgeons. Medical doctors / angiologists treated more women (n = 109) than men (n = 34), (p = 0.002) and documented smoking and diabetes mellitus more often (p < 0.001) than vascular surgeons. Besides, patients had similar cardiovascular risk profiles and concomitant diseases, vascular surgeons prescribed 5.47 ± 2.26 drugs, medical doctors / angiologists 6.37 ± 2.67 (p = 0.005). Overall, 239 (90.5 %) patients were on aspirin, 180 (68.2 %) on clopidogrel, and 18 (6.9 %) on oral anticoagulants. Significantly more patients treated by medical doctors / angiologists received clopidogrel (169 versus 11; p < 0.001), significantly more surgical patients received oral anticoagulants (11 versus 7; p = 0.016). The number of patients without prescriptions for any antithrombotic therapy was 6 (6.9 %) in patients treated by vascular surgeons and 0 (0 %) in patients managed by medical doctors / angiologists (p = 0.001). Prescription-rates of β-blockers, ACE-inhibitors, Angiotensin II-antangonists, calcium channel blockers, and diuretics were statistically not different between the two disciplines, but statins were prescribed significantly more often by medical doctors / angiologists (139 versus 49; p < 0001). With the exceptions of Clopidogrel (women > men) and diuretics (men > women) we observed no gender-specific prescriptions. Conclusions: We observed high prescriptions rates of secondary medical prevention in patients primarily treated by medical doctors / angiologists and vascular surgeons. We believe that this result is highly influenced by our multidisciplinary approach. Nevertheless, efforts have to be made to raise vascular surgeons awareness of statin use and complete prescription of antithrombotic and antiplatelet drugs.

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