Psychiatry and Family Medicine: The McMaster Approach

Family physicians may spend up to 50% of their time dealing with emotional problems but will refer less than 10% of these cases for psychiatric treatment. This paper describes an approach developed at McMaster University which emphasizes the importance of understanding the needs of family physicians and helping them make optimum use of available psychiatric services. Such an approach aims at increasing the comfort and expertise of family physicians in handling the problems they see on a regular basis, involving them actively in their patient's care after a referral, and offering relevant services that supplement those of the family physician, while monitoring and correcting problems that can arise when the two specialities work together. The implications that this has on the training of family medicine and psychiatry residents are discussed as well as ways in which continuing education can be provided for family physicians in community practice.

Download Full-text

Hivatással és hálapénzzel kapcsolatos vélekedések a magyarországi családorvosok és családorvos rezidensek körében

Orvosi Hetilap ◽

10.1556/650.2016.30539 ◽

2016 ◽

Vol 157 (36) ◽

pp. 1438-1444

Author(s):

Péter Torzsa ◽

Dalma Csatlós ◽

Ajándék Eőry ◽

Csenge Hargittay ◽

Ferenc Horváth ◽

...

Keyword(s):

Family Medicine ◽

Quantitative Study ◽

Family Physician ◽

Health Sector ◽

Family Physicians ◽

Payment Method ◽

Informal Payment ◽

The Family ◽

Two Generations ◽

Human Resource Crisis

Introduction: The changing of the family medicine can be observed in the New Millennium. Migration, the aging of the healers and informal payment are crucial to the human resource crisis of the health sector. Aim: The aim of this study was to investigate the family physicians’ and residents’ opinions about the vocation and informal payment. Method: Exploratory, quantitative study was carried out among family physicians (n = 363) and family physician residents (n = 180). The central questions of the study were the vocation, the income and the informal payment. Results: The most decisive factors of the carrier choice were altruism, service and responsibility. Residents were significantly rejective (19.7% vs. 38.3%, p<0.001) about informal payment. They would accept smaller amounts of informal payment (14.3% vs. 8.9%, p<0.034), and would spend it on praxis development (1.4% vs.9.4% p<0.023). Conclusions: The attitudes of family physicians and residents are the same in case of the vocation, but on the issue of informal payment, the two generations have different opinions. Orv. Hetil., 2016, 157(36), 1438–1444.

Download Full-text

Effective Factors on Durability of Family Physicians in Rafsanjan University of Medical Sciences

Quarterly Journal of Management Strategies in Health System ◽

10.18502/mshsj.v5i1.3274 ◽

2020 ◽

Author(s):

Ahmad Jamalizadeh ◽

Zeynab Heydaripoor ◽

Mostafa Nasirzadeh ◽

Najmeh Talebizadeh ◽

Mehdi Rezaei ◽

...

Keyword(s):

Logistic Regression ◽

Environmental Factors ◽

Continuing Education ◽

Family Physician ◽

Family Physicians ◽

Personal Factors ◽

Validity And Reliability ◽

Medical Sciences ◽

Chi Square ◽

The Family

Background: The durability of physicians working in the family physician program is one of the most important factors in effective implementation of this program. This study aimed to investigate the individual, organizational, and environmental factors affecting the family physicians' durability in Rafsanjan University of Medical Sciences in 2019. Methods: This descriptive-analytical study was conducted using census method among family physicians active in Rafsanjan rural family physician program during 2013-2017. The data collection tool included a questionnaire designed by experienced experts in the field of family physician program that contained the participants' demographic characteristics as well as organizational and environmental factors. The questionnaire's validity and reliability were confirmed by cronbach's alpha of 0.86. The questionnaires were completed through interviews and the collected data were analyzed by SPSS 16 using Chi-square and logistic regression tests. Results: Based on the findings, 53 (84 %) physicians were female and 10 (16 %) were males. The average age of participants was 32.62 years and their average collaboration lasted about 36.83 months. The family physicians' durability was inversely associated with their interests in 'continuing education', 'being single', 'camping outdoor' and 'doing something else' (p < 0.05). The results of logistic regression showed the physicians' interest in continuing education as the most important factor in their lack of durability. Conclusion: According to the results, consideration of personal factors, in comparison with other factors, has a great effect on the durability of family physicians.

Download Full-text

Understanding the role of the family physician in early psychosis intervention

BJPsych Open ◽

10.1192/bjo.2018.67 ◽

2018 ◽

Vol 4 (6) ◽

pp. 447-453 ◽

Cited By ~ 1

Author(s):

Kelly K. Anderson ◽

Suzanne Archie ◽

Richard G. Booth ◽

Chiachen Cheng ◽

Daniel Lizotte ◽

...

Keyword(s):

Primary Care ◽

Administrative Data ◽

Family Physician ◽

Psychiatric Treatment ◽

First Episode Psychosis ◽

First Episode ◽

Health Administrative Data ◽

Episode Psychosis ◽

The Family

BackgroundThe family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.AimsOur objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.MethodWe will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.DiscussionThese findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.Declaration of interestNone.

Download Full-text

Continuing education as one of the priority methods of postgraduate study: prospects and problems of implementation in the family medicine

Family Medicine ◽

10.30841/2307-5112.2(70).2017.115513 ◽

2017 ◽

Vol 0 (2(70)) ◽

pp. 161-164

Author(s):

Л. В. Глушко ◽

Х. С. Симчич ◽

С. В. Федоров ◽

В. Т. Рудник ◽

І. В. Козлова ◽

...

Keyword(s):

Family Medicine ◽

Continuing Education ◽

Postgraduate Study ◽

The Family

Download Full-text

Awareness of Family Physician Residents of their Roles in Disaster Health Management: A Cross-Sectional Study in Saudi Arabia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i41b32365 ◽

2021 ◽

pp. 254-261

Author(s):

Fawaz Hassan Alamri ◽

Faisal Dhahi Aldahash ◽

Sa’ad Alqahtani

Keyword(s):

Saudi Arabia ◽

Disaster Management ◽

Family Physician ◽

Emergency Services ◽

Health Management ◽

Family Physicians ◽

Cross Sectional Study ◽

Disaster Medicine ◽

Cross Sectional ◽

The Family

Background: Family physicians have a pivotal role in responding to the medical community's needs and have a crucial role in disaster health management. Family physicians have several tasks and duties during and after the disaster, such as event detection, critical information’ collection and distribution, and rehabilitative activities. It is important to identify the level of awareness of the family physicians regarding their role in the management of disasters. Aim: To assess the awareness of family physician residents of their roles in disaster health management, Saudi Arabia. Methods: This study was cross-sectional; it was performed on Saudi family physician residents in family practice clinics and centers in Saudi Arabia. A self-administrated questionnaire has been sent electronically to the participants to investigate their awareness. IMB SPSS version 22 was used to analyze the collected data. Results: This study included 400 family physicians; more than one-half 52.75%were in the age of 28-30 years old. There were 61.5% worked previously at hospital emergency services. A few percentages reported receiving training on disaster medicine management in the clinic, 38.5%. 47.75% reported willingness to train on disaster management. There was 71% of physicians had high knowledge regarding their role in disaster management. Conclusion: There was high awareness among the family physicians regarding their role in the management of disaster with an acceptable attitude toward receiving training.

Download Full-text

Abordagem do Doente com Psoríase pela Medicina Geral e Familiar: Algoritmo de Referenciação e Gestão Partilhada com a Dermatologia

Acta Médica Portuguesa ◽

10.20344/amp.13159 ◽

2020 ◽

Vol 33 (13) ◽

Author(s):

Tiago Torres ◽

Martinha Henrique ◽

Hugo Oliveira ◽

Madalena Rodrigues ◽

Paulo Ferreira ◽

...

Keyword(s):

Family Physician ◽

Family Physicians ◽

High Impact ◽

Psoriatic Patient ◽

Shared Management ◽

Systemic Treatments ◽

The Family ◽

Topical Treatments

Introduction: The implementation of models capable of improving referral quality, limiting the growth of waiting lists in hospitals, and ensuring the best possible treatment and follow-up of the psoriatic patient is of the utmost importance.Material and Methods: A panel of Family Physicians and Dermatologists discussed and created a simple and effective algorithm of referral for patients with psoriasis.Results: The proposed algorithm starts when the Family Physician suspects of psoriasis. In case of diagnostic doubt, the patient should be referred to Dermatology. In case of a confirmed diagnosis, the Family Physician should assess the patient’s severity and responder profile, evaluate comorbidities and assess the presence of psoriatic arthritis. If psoriasis is mild, topical treatments should be initiated, and if there is no clinical improvement or worsening of the disease, the patient should be referred to Dermatology. If psoriasis is moderate to severe, is located in high impact locations, or in pediatric age, the patient should be referred to Dermatology. In order to enable shared management in terms of follow-up and treatment of these patients, it is critical that the Family Physician has the necessary knowledge regarding the systemic treatments used in psoriasis and their side effects.Discussion and Conclusion: Only a shared management of the psoriatic patient can allow for the best treatment and follow-up of these patients, a more rational use of available medical resources, thus giving the patient the best possible quality of life.

Download Full-text

Evaluation of the Quality of Services in Primary Health Care Institutions

Medicina ◽

10.3390/medicina47010009 ◽

2011 ◽

Vol 47 (1) ◽

pp. 9

Author(s):

Leonas Valius ◽

Daiva Rastenytė ◽

Vilija Malinauskienė ◽

Daina Krančiukaitė-Butylkinienė

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Physician ◽

Family Physicians ◽

Quality Of Services ◽

Primary Health ◽

The Family ◽

Primary Health Care Institutions ◽

Primary Health Care Settings

The aim of the study was to evaluate patients’ satisfaction with the quality of provided services in private primary health care institutions in Kaunas. Material and Methods. A questionnaire-based inquiry of 280 persons registered to family physicians at primary health care settings was performed. The study was carried out using 20-item anonymous questionnaires with questions about the quality of services provided in primary health care settings. Results. More than 50.0% of the respondents stated that they waited for more than 15 minutes at the physician’s office, while 17.0% of the respondents stated that the waiting time exceeded 30 minutes. More than 25.0% of the respondents positively evaluated the possibility to consult their family physician by phone. In 67.0% of patients, the family physician determined the cause of the disorder and administered treatment; in 32.0% of patients, the family physician referred them to a specialist, and 1.0% of patients were urgently sent to hospital. More than 90.0% of the respondents were satisfied with the services provided by their family physicians. Those who were dissatisfied with these services indicated that the provided treatment failed to eliminate the disorder, that they wanted to be referred to a specialist, and that they expected more diagnostic tests to be performed for more effective treatment. Conclusions. A greater part of the patients indicated that the main reason for long waiting at the physician’s office was physicians’ wish to serve too many patients. More than two-thirds (67.0%) of the patients stated that their family physicians determined the cause of the disorder and prescribed treatment. The overwhelming majority (more than 90.0%) of the patients were satisfied with the services provided by their family physicians.

Download Full-text

A Preliminary Study of the Attitudes and Barriers of Family Physicians to Prescribing HIV Preexposure Prophylaxis

Kansas Journal of Medicine ◽

10.17161/kjm.v10i2.8651 ◽

2019 ◽

Vol 10 (2) ◽

pp. 40-42 ◽

Cited By ~ 9

Author(s):

Nicholas Ojile ◽

Donna Sweet ◽

K. James Kallail

Keyword(s):

Family Medicine ◽

High Risk Patient ◽

Family Physicians ◽

Perceived Barriers ◽

Limiting Factors ◽

Preexposure Prophylaxis ◽

The Family ◽

Preliminary Study ◽

Sex With Men ◽

Medicine Community

Introduction. Attitudes of individuals who provide HIV caretowards prescribing Preexposure Prophylaxis (PrEP) to at-riskpopulations have been studied, but few studies indicate if familyphysicians would be willing to prescribe PrEP as most familyphysicians do not specialize in HIV medicine. Few data existon the perceived barriers preventing family physicians fromprescribing PrEP. The purpose of this project was to assess theattitudes and perceived barriers of family physicians in Kansastowards prescribing PrEP to high risk patient populations. Methods. This study was a descriptive, observational,and cross-sectional survey of family physicians who respondto email surveys issued through the Family MedicineResearch and Data Information Office (FM RADIO). Results. Fifty-three percent of family physicians take a sexualhistory on new patients less than frequently, and only35% frequently ask about the use of safe sex practices. Only29% frequently ask if the patient has sex with men, women,or both. Seventy-six percent of respondents would be willingto prescribe PrEP to men who have sex with men, and anequal percentage would be willing to prescribe to heterosexuallyactive men and women who are at substantial risk of acquiringHIV. While 59% of participants agreed that PrEP belongsin the primary care domain of treatment, 71% agreedthat they had limited or no knowledge of PrEP guidelines. Conclusions. This preliminary study indicated a need for increasedfamily physician screening of new patients for high risksexual behaviors who would be eligible for PrEP. The limitedknowledge of PrEP guidelines and its use in clinical practiceare significant limiting factors to increasing prescribing practicesin the family medicine community rather than a perceivedethical dilemma of prescribing PrEP to men who have sex withmen. As a result, an increase in continuing medical educationabout PrEP could significantly increase its prescribing inthe family medicine community. KS J Med 2017;10(2):40-42.

Download Full-text