scholarly journals What are the knowledge, attitudes and beliefs regarding concussion of primary care physicians and family resident physicians in rural communities?

2020 ◽  
Vol 4 ◽  
pp. 205970022097454
Author(s):  
Heather Galbraith ◽  
Jairus Quesnele ◽  
Shannon Kenrick-Rochon ◽  
Sylvain Grenier ◽  
Tara Baldisera
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Assessment Tool ◽  
Local Health ◽  
Cross Sectional ◽  
Support Tool ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians

Background Primary care physicians and family medicine resident physicians report continued gaps in knowledge when diagnosing and managing pediatric patients with concussion. Methods A cross-sectional electronic survey of 130 primary care physicians and family medicine resident physicians in the Northeastern Ontario Local Health Integration Network (LHIN). Descriptive statistics, chi-squared Fisher exact tests, were used to compare physicians versus resident physicians with two-tailed p < 0.05 (with 95% confidence intervals). Results With a 48% response rate, when treating concussions 44% of providers either did not use any specific clinical practice guideline, standardized assessment tool, could not recall the source of a specific tool/guideline or omitted answering the question. However, 61% of all respondents would refer some or all concussion patients to a specialist for treatment. At least 41% of providers indicated they lacked access to a ‘Provider Decision Support Tool’ specific to concussion, and 88% of the 25 providers were without access to discharge instructions. Conclusion Similar to other jurisdictions, Northeastern Ontario primary care physicians and family medicine resident physicians report gaps in knowledge for both diagnosis and management of pediatric concussion. Consequently, they did not use current guidelines or best practices to guide management.

scholarly journals General practitioner attitudes and confidence to deprescribing for elderly patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Pier Riccardo Rossi ◽  
Sarah E. Hegarty ◽  
Vittorio Maio ◽  
Marco Lombardi ◽  
Andrea Pizzini ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Real Life ◽  
Care Physician ◽  
Local Health Authority ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Factors Affecting

Deprescribing is a patient-centered process of medication withdrawal intended to achieve improved health outcomes through discontinuation of one or more medications that are either potentially harmful or no longer required. The objective of this study was to assess the perceptions of primary care physicians on deprescribing and potential barriers to deprescribing in the Local Health Authority (LHA) of Turin, Piedmont, Italy. Secondary objective was to evaluate educational needs of primary care physician. Cross sectional survey of primary care physicians working in the LHA of Turin, Piedmont, Italy. 439 GPs (71.3% of the total number of primary care physicians) attended an educational session related to deprescribing and were asked to anonymously answer a paper survey. Participants were asked to complete a previously published questionnaire about deprescribing and potential factors affecting the deprescribing process. A correlation coefficient was calculated to assess the association between physicians’ confidence in deprescribing and attitudes or barriers associated with deprescribing. Many GPs (71%) reported general confidence in their ability to deprescribe. Most respondents (83%) reported they were comfortable deprescribing preventive medications, however almost half expressed doubts regarding deprescribing when medication was initially prescribed by a colleague (45%) or when patient and/or caregiver supported the opportunity to continue the assumption (49%). Around a third of doctors maintain that the absence of strong evidence supporting deprescribing prevents them from considering it (38%), that they do not have the necessary time to effectively go through the process of deprescribing (29%), and that fear of possible effects due on withdrawal prevents them from deprescribing (31%). There was no strong correlation between physicians’ confidence and attitudes or barriers associated with deprescribing. The present study confirms that general practitioners sense the importance of deprescribing and feel prepared to face it managing communication with patients and caregivers, but find barriers when enacting the practice in a real-life context.

A snap shot of patients’ recall, attitudes, and perceptions of their pain contracts from a family medicine resident outpatient clinic

2018 ◽  
Vol 14 (1) ◽  
pp. 43 ◽  
Author(s):  
Robinder Bahniwal, MD ◽  
Jarrett Sell, MD ◽  
Abdul Waheed, MD, FAAFP
Keyword(s):  
Family Medicine ◽  
Outcome Measures ◽  
The United States ◽  
Recall Rate ◽  
Patient Attitudes ◽  
Cross Sectional ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Attitudes And Perceptions ◽  
Penn State

Objective: Determine patient recall, attitudes, and perceptions of their pain contract in a family medicine resident outpatient clinic.Design: A cross-sectional study design using a telephone survey to all eligible subjects who signed a hardcopy pain contract from August 29, 2014 to May 19, 2016 at a resident outpatient clinic.Setting: Penn State Hershey Family and Community Medicine Residency clinic.Participants: All patients who signed a hardcopy pain contract at the practice site who met specific inclusion criteria.Main outcome measures: What proportions of items are remembered from the standardized Penn State Hershey pain contract and does recall vary with time of contract signing.Secondary outcome measures: Patient attitudes and perceptions of their pain contract.Results: Ninety-five percent of patients recalled agreeing to random urine drug screens (UDS) and 60 percent recalled they were not to receive prescriptions from another provider unless approved by their practice site. The recall rate for the remaining 33 items in the contract ranged from 0 percent to 20 percent. The highest recall rate was for contracts signed between 0-3 months. Patient feedback regarding the pain contract was recorded and while five were positive or neutral, 15 patients recorded negative attitudes toward the process, the physician, and/or the UDS.Conclusions: This study highlights limited recall and negative patient attitudes toward the pain contract. Considering the public health concerns with regard to the current opioid epidemic in the United States, additional training of providers, redesign of pain contracts and new models for informing patients about safe chronic pain management may be warranted.

scholarly journals Perspectives of primary care physicians on acceptance and barriers to COVID-19 vaccination

2021 ◽  
Vol 9 (4) ◽  
pp. e001228
Author(s):  
Philip Day ◽  
Chance Strenth ◽  
Neelima Kale ◽  
F David Schneider ◽  
Elizabeth Mayfield Arnold
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Local Community ◽  
Professional Associations ◽  
Vaccine Uptake ◽  
Vaccine Hesitancy ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Patient Concerns

ObjectivesThe purpose of this study was to examine the perspectives of primary care physicians in Texas around vaccine acceptance and potential patient barriers to vaccination. National surveys have shown fluctuating levels of acceptance for COVID-19 vaccination, and primary care physicians could play a crucial role in increasing vaccine uptake.DesignThis study employed a cross-sectional anonymous survey design to collect data using an online questionnaire. Participants were asked about vaccination practices and policies at their practice site, perceptions of patient and community acceptance and confidence in responding to patient vaccine concerns.SettingFrom November 2020 to January 2021, family medicine physicians and paediatricians completed an online questionnaire on COVID-19 vaccination that was distributed by professional associations.ParticipantsThe survey was completed by 573 practising physicians, the majority of whom identified as family medicine physicians (71.0%) or paediatricians (25.7%), who are currently active in professional associations in Texas.ResultsAbout three-fourths (74.0%) of participants reported that they would get the vaccine as soon as it became available. They estimated that slightly more than half (59.2%) of their patients would accept the vaccine, and 67.0% expected that the COVID-19 vaccine would be accepted in their local community. The majority of participants (87.8%) reported always, almost always or usually endorsing vaccines, including high levels of intention to recommend COVID-19 vaccination (81.5%). Participants felt most confident responding to patient concerns related to education about vaccine types, safety and necessity and reported least confidence in responding to personal or religious objections to COVID-19 vaccination.ConclusionsThe majority of the physicians surveyed stated that they would receive the COVID-19 vaccination when it was available to them and were confident in their ability to respond to patient concerns. With additional education, support and shifting COVID-19 vaccinations into primary care settings, primary care physicians can use the trust they have built with their patients to address vaccine hesitancy and potentially increase acceptance and uptake.

scholarly journals Japanese and United States Family Medicine Resident Physicians' Attitudes about Training

2002 ◽  
Vol 3 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Michael D. Fetters ◽  
Kazuya Kitamura ◽  
Junichi Mise ◽  
Warren P. Newton ◽  
Daniel W. Gorenflo ◽  
...  
Keyword(s):  
United States ◽  
Family Medicine ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians

scholarly journals Assessing Family Medicine Residents’ Communication Skills in Oman Using the Communication Assessment Tool: A Cross-sectional Study

2021 ◽  
Keyword(s):  
Family Medicine ◽  
Communication Skills ◽  
Primary Care Physicians ◽  
Assessment Tool ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Communication Assessment ◽  
The Family ◽  
Family Medicine Residents

Objective: Primary care physicians are the first means of access to further healthcare services and act as a doorkeeper for different specialties at the secondary and tertiary levels; thus, communication skills are one of the most vital skills to be taught to residents in the family medicine specialty. This study aimed to evaluate the communication skills of family medicine residents in Oman from the perspective of their patients. Methods: This cross-sectional study was performed at the Family and Community Medicine Clinic of Sultan Qaboos University Hospital as well as various Ministry of Health training health centers in Muscat, Oman. An Arabic version of the validated 14-item Communication Assessment Tool (CAT) was used to evaluate patients’ perceptions regarding the communication skills of family medicine residents at the end of their consultation. Data were collected between September 2020 and May 2021 from 602 patients who received care or interacted with 60 residents from the Oman Medical Specialty Board (OMSB) Family Medicine Residency Program at different residency levels. Results: The mean percentage of CAT items rated as excellent was 73.8%. The item “Treated me with respect” was most commonly rated as excellent (84.2%), whilst the item "Involved me in decisions as much as I wanted" was least frequently rated as excellent (62.0%). Various factors were found to significantly affect CAT rating, including residency level, type of clinic, number of times seeing the same resident, and the patient's education level. In contrast, other factors such as time of consultation, the gender of either the resident or the patient, and the nationality of the patient did not affect CAT rating. Conclusion: Some areas of weakness especially with the item "encouraged me to ask questions" and involved me in decisions as much as I wanted" identified in the communication skills of OMSB family medicine residents. These findings are comparable with those reported by similar studies worldwide.

scholarly journals Integrating Buprenorphine Treatment Into Family Medicine Resident Clinic

2020 ◽  
Vol 52 (9) ◽  
pp. 653-655
Author(s):  
Jeffrey D. Tiemstra ◽  
Lauren H. Walsh
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Clinical Experience ◽  
Demographic Data ◽  
Opioid Use ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
The Mean ◽  
Active Patients ◽  
Chronic Comorbidities

Background and Objectives: Medication-assisted treatment (MAT) for opioid use disorder with buprenorphine in primary care is effective and patient-accessible yet remains underutilized, including among residency training programs. One concern in residency programs is that MAT patients must be seen at least monthly and will overwhelm residents’ clinic schedules and dilute their clinical experience. Our family medicine residency initiated an MAT program integrated into residents’ continuity clinic schedules. After 2 years we assessed the chronic medical comorbidities we were managing in our MAT population.Methods: We performed a retrospective review of all active patients receiving MAT. We collected basic demographic data and whether we were the patient’s primary care provider (PCP) or were only providing MAT. For the patients for whom we were the PCP we recorded the chronic comorbidities that required medical management.Results: One hundred fifty-seven active patients were 52% male and 48% female. The mean age was 38 years (SD=10) with a range of 22 to 77 years, with nine patients over age 60 years (6%). One hundred three patients used us as their PCP (66%). For these patients the mean number of chronic comorbidities was 2.3; only 10 patients reported no comorbidities. Psychiatric comorbidities were the most common with 69% of patients with a mood disorder, although nonpsychiatric comorbidities still averaged 1.5 per patient.Conclusions: MAT integrated into family medicine resident continuity clinics provides a broad and substantial primary care clinical experience for residents.

scholarly journals Improving After-Clinic Work Workflow in a Family Medicine Residency

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Nguyen V ◽  
◽  
Jaqua E ◽  
Oh A ◽  
Altamirano M ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Patient Care ◽  
Primary Care Physicians ◽  
Training Session ◽  
P Value ◽  
Post Intervention ◽  
Family Medicine Residency ◽  
Resident Physicians ◽  
Family Medicine Residents

Introduction: The broad range of patients and diagnoses addressed by primary care physicians lends to a larger after-work clinic load. The resulting after-clinic work, including various in-basket tasks, can be a substantial burden to physicians, and potentially leading to burnout. The goal of this study is to generate a standardized workflow to improve physician after-clinic work efficiency and patient care. Methods: A nine-question pre- and post-intervention survey about afterclinic work management was administered to family medicine residents at a multi-specialty FQHC in California. The intervention was done in June 2020 and included a twenty-minute training session explaining how to implement a standardized in-basket management flowchart in a family medicine residency clinic. Results: Pre- and post-intervention data were analyzed using nonindependent paired sample t-tests. The survey was sent to all 40 family medicine residents. Pre- and post-intervention survey response rate was 77.5% and 97.5% respectively. The result of the nine questions post intervention were statistically significant (p value of <0.001). The standardized flowchart addressed adequate supervision of resident physicians’ patient care. Conclusion: The post-intervention results showed that having a clear and standardized flowchart enhanced the overall knowledge and understanding by the resident physicians in how to management the in-basket workflow. With increased patient access via telehealth and enhanced electronic medical records, it is essential to have effective teaching and supervision of resident physician after-clinic work. Successful teaching of after-clinic work will improve work-life balance and the overall success of the new primary care physician.

scholarly journals Impact of Family Medicine Resident Physicians on Emergency Department Wait Times and Patients Leaving Without Being Seen

CJEM ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 475-483
Author(s):  
Wang Xi ◽  
Vikram Dalal
Keyword(s):  
Emergency Department ◽  
Family Medicine ◽  
Retrospective Chart Review ◽  
Initial Assessment ◽  
Wait Times ◽  
Family Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Number Of Patients ◽  
Resident Group

AbstractObjectiveTo quantify the effect of family medicine resident physicians on emergency department (ED) wait times and patients leaving without being seen or treated.MethodsIn a medium-volume community ED over twelve months, we used retrospective chart review to compare wait times between patients seen during shifts where staff were working alone versus with a resident. We measured the time from initial triage time to physician initial assessment (T1) and disposition time (LOS), and number of patients leaving without being seen or treated.ResultsIn our analysis, 21,141 patients (91% of total visits) were included; 48% were in the staff-with-resident group, and 52% were in the staff-only group. Mean T1 in the resident group was significantly shorter than the staff-only group (1 hour 23 minutes versus 1 hour 38 minutes, difference 15 minutes, 95% CI 13 to 17 minutes, p<0.001). Mean total LOS in the resident group was also reduced (2 hours 38 minutes versus 2 hours 50 minutes, difference 12 minutes, 95% CI 8 to 17 minutes, p<0.001). Fewer patients left without being seen in the resident group than the staff only group (2.8% versus 4.9%, p<0.001). There were no differences in patients leaving without being treated (0.5% versus 0.5%).ConclusionsThis is the first study to demonstrate that residents are associated with a reduction in ED wait times and patients leaving without being seen in a low-acuity, community hospital, compared to previous studies demonstrating no difference or increased wait times.

scholarly journals Exercise Counseling by Primary Care Physicians in Jordan—A Preliminary Study

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Othman Beni Yonis ◽  
Rami Saadeh ◽  
Zaher Chamseddin ◽  
Hussam Alananzeh
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Exercise Counseling ◽  
Chi Square Test

Despite the value of physical activity and exercise to patients, little is known about the perception and practices of Jordanian primary care physicians (PCPs) regarding counseling patients about exercise. This study was aimed at assessing counseling about exercise by PCPs in Jordan. A cross-sectional study targeting a random sample of physicians from family medicine, internal medicine and general practice in academic, public, and private sectors. Chi-square test of independence was used to assess the association of perceptions and practices of physicians regarding exercise counseling with their specialty. Logistic regression models were used to examine the association of demographic information with selected items of perception and practice. A total of 218 physicians participated in the study. They were mainly males (67%), family medicine physicians (42.2%), and had a mean age of 33.7 (±9.87) years. Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%). Family medicine physicians counseled more patients, more frequently, and their desire to counsel more patients was significantly higher than other physicians ( P = .002). The Perceptions and practices of Jordanian PCPs toward exercise counseling for their patients were found positive; however the desire to counsel more patients was low. Lack of patients’ motivation to practice exercise, time constraint and limited resources were the most frequently reported barriers to counseling. Further investigation on how to overcome such barriers is recommended.

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