Primary Care Role in the Management of Childhood Depression: A Comparison of Pediatricians and Family Physicians

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_3) ◽  
pp. 957-962
Author(s):  
Jerry L. Rushton ◽  
Sarah J. Clark ◽  
Gary L. Freed
Keyword(s):  
Primary Care ◽  
North Carolina ◽  
Primary Care Physicians ◽  
Pediatric Patients ◽  
Response Rate ◽  
Childhood Depression ◽  
Mail Survey ◽  
Family Physicians ◽  
Future Studies

Objective. To provide a self-described assessment of pediatricians' and family physicians' management of childhood depression. Design. Mail survey of 595 general pediatricians and 557 family physicians in North Carolina. Results. The response rate was 66%. Most primary care physicians used referral (65%) and counseling (61%) for management of childhood depression. Family physicians used medications more commonly (18% vs 9%), and pediatricians referred patients more commonly (77% vs 48%). In logistic regression analysis, physicians comfortable with management of depression (odds ratio [OR], 4.8: 2.7–8.4), physicians who believed that antidepressants are more effective than counseling (OR, 2.6: 1.4–4.8), and family physicians (OR, 2.2: 1.9–4.1) were more likely to have used medications for childhood depression. Conclusions. Most primary care physicians refer pediatric patients with depression; however, practice patterns vary by specialty and other factors. Future studies must consider the role of primary care and evaluate how interspecialty variations affect costs and outcomes of childhood depression.

Understanding the Role of Primary Care Physicians in Managing ADHD

2007 ◽  
Author(s):  
Thomas J. Power ◽  
Nathan J. Blum ◽  
Jennifer A. Mautone ◽  
Patricia H. Manz ◽  
Leslee Frye
Keyword(s):  
Primary Care ◽  
Primary Care Physicians

scholarly journals 1289. Knowledge, Attitudes and Barriers of Pre-exposure Prophylaxis for HIV Infection Among Resident Physicians in Rural, Eastern North Carolina

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S394-S394
Author(s):  
Arianne Morrison ◽  
Ciarra Dortche ◽  
Nada Fadul
Keyword(s):  
Primary Care ◽  
North Carolina ◽  
Hiv Infection ◽  
Sexual Behaviors ◽  
Residency Program ◽  
Primary Care Physicians ◽  
Online Survey ◽  
Risky Sexual Behaviors ◽  
Resident Physicians ◽  
Exposure Prophylaxis

Abstract Background North Carolina bears a high burden of HIV and was ranked number 8 for the number of new infections in 2015. In 2014, the Centers for Disease Control and Prevention (CDC) published updated practice guidelines recommending the use of pre-exposure prophylaxis (PrEP) with daily oral dosing of tenofovir/emtricitabine to help prevent HIV infection in high-risk individuals. However, the use of PrEP in the primary care setting remains low and 1 in three primary care physicians is not aware of PrEP. The objective of our study was to evaluate PrEP knowledge among primary care resident physicians. Methods 149 resident physicians were surveyed at East Carolina University from the following specialties; Internal Medicine, Medicine-Pediatrics, Obstetrics Gynecology and Family Medicine. We collected participants’ age, biological sex, current residency program, and current year within the residency program. Results Sixty out 149 residents completed the online survey. 20% of residents had never heard of PrEP. 17% of residents did not feel comfortable discussing sexual preferences with their patients. 15% of residents thought prescribing would increase risky sexual behaviors and 12% would not prescribe PrEP to patients with multiple sexual partners. Only 3% of residents identified potential side effects of PrEP (e.g., an increase in creatinine levels or decrease in mineral bone density) as a reason to not prescribe PrEP. One resident had ever prescribed PrEP. 83% of residents wanted more information on PrEP and 95% of residents would be willing to prescribe PrEP if educational workshops were offered. Conclusion PrEP is an underutilized tool among resident physicians in Eastern, NC. We identified lack of knowledge of PrEP and concern for increased risky sexual behaviors as barriers to prescribing. Resident physicians require more education on PrEP in order to prescribe it to their patients. Disclosures All authors: No reported disclosures.

Teaching Normal and Abnormal Behavior to Primary Care Physicians

1994 ◽  
Vol 24 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Uriel Halbreich
Keyword(s):  
Primary Care ◽  
Differential Diagnosis ◽  
Human Behavior ◽  
Primary Care Physicians ◽  
Family Physicians ◽  
Abnormal Behavior ◽  
General Internists ◽  
Education Committee ◽  
Personal Skills

Objective: This article delineates the framework for a curriculum on psychiatry, normal and abnormal human behavior for primary care physicians (PCPs). Methods: Curricula have been surveyed. Members of the Education Committee of the Association of Medicine and Psychiatry, as well as Family Physicians and General Internists involved in education have been consulted. Their recommendations are integrated. Results and Conclusions: The curriculum should be developed according to the needs of PCPs and from their perspective. Patient and problem-oriented, its content can be divided into: a) personal skills that should be developed; and b) knowledge of symptoms, their differential diagnosis (DDX) and management within the PCP's, facilities and abilities.

Corporal Punishment

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 792-793
Author(s):  
Den A. Trumbull ◽  
DuBose Ravenel ◽  
David Larson
Keyword(s):  
United States ◽  
Primary Care ◽  
Social Policy ◽  
Violence Prevention ◽  
Corporal Punishment ◽  
Primary Care Physicians ◽  
Scientific Evidence ◽  
The United States

The supplement to Pediatrics entitled "The Role of the Pediatrician in Violence Prevention" is timely, given the increasingly serious violence problem in the United States.1 Many of the supplement's recommendations are well-conceived and developed. However, the recommendation to "work toward the ultimate goal of ending corporal punishment in homes" (page 580)2 is unwarranted and counterproductive. Before one advises against a practice approved by 88% of American parents3 and supported by 67% of primary care physicians,4 there should be sufficient scientific evidence to support the proposed change in social policy.

scholarly journals Portuguese Primary Care physicians response rate in surveys: A systematic review

2018 ◽  
Vol 64 (3) ◽  
pp. 272-280 ◽  
Author(s):  
Nuno Basílio ◽  
Sara Cardoso ◽  
José Mendes Nunes ◽  
Liliana Laranjo ◽  
Maria da Luz Antunes ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Internal Validity ◽  
Response Rates ◽  
Monetary Incentives ◽  
Average Response ◽  
Average Response Rate ◽  
Effective Strategies ◽  
E Mail

Summary Introduction: Surveys are a useful tool in primary care. However, low response rates can introduce selection bias, impairing both external and internal validity. The aim of this study was to assess the average response rate in surveys with Portuguese general practitioners (GPs). Method: We searched the Medline, Web of Science, Scopus, Embase, PsychInfo, SciELO, IndexRMP, RCAAP, Revista Portuguesa de Medicina Geral e Familiar, Acta Médica Portuguesa and the proceedings of conferences of general practice from incepton to December 2016. We included all postal, e-mail, telephone and personal surveys to primary care physicians without language restrictions. We did not assess risk of bias of included studies, since the main outcome was survey response rate. We performed planned subgroup analyses of the use of monetary incentives, the use of non-monetary incentives, survey delivery modes and prior contact with participants. Results: A total of 1,094 papers were identified and 37 studies were included in this review. The response rate in surveys done to Portuguese GPs was 56% (95CI 47-64%). There was substantial heterogeneity among included studies (I2=99%), but subgroup analysis did not explain this heterogeneity. Conclusion: Consistent with other published studies, the average response rate in surveys done with Portuguese GPs was 56%, with substantial variation among studies. Use of monetary incentives, one of the most effective strategies to increase response rates, was not present in any of the included studies.

scholarly journals The Role of the Primary-Care Physician in Treating Relapses in Multiple Sclerosis Patients

2009 ◽  
Vol 11 (3) ◽  
pp. 122-126 ◽  
Author(s):  
Sarah A. Morrow ◽  
Marcelo Kremenchutzky
Keyword(s):  
Multiple Sclerosis ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Tertiary Care ◽  
Care Physician ◽  
Diagnosis And Treatment ◽  
High Prevalence ◽  
Tertiary Care Centers ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MS) is a common disabling neurologic disease with an overall prevalence in Canada of 240 in 100,000. Multiple sclerosis clinics are located at tertiary-care centers that may be difficult for a patient to access during an acute relapse. Many relapses are evaluated by primary-care physicians in private clinics or emergency departments, but these physicians' familiarity with MS is not known. Therefore, a survey was undertaken to determine the knowledge and experience of primary-care physicians regarding the diagnosis and treatment of MS relapses. A total of 1282 licensed primary-care physicians in the catchment area of the London (Ontario, Canada) Multiple Sclerosis Clinic were identified and mailed a two-page anonymous survey. A total of 237 (18.5%) responses were obtained, but only 216 (16.8%) of these respondents were still in active practice. Of these 216 physicians, only 9% reported having no MS patients in their practice, while 70% had one to five patients, 16.7% had six to ten, and 1.9% had more than ten (3.7% did not respond to this question). Corticosteroids were recognized as an MS treatment by 49.5% of the respondents, but only 43.1% identified them as a treatment for acute relapses. In addition, 31% did not know how to diagnose a relapse, and only 37% identified new signs or symptoms of neurologic dysfunction as indicating a potential relapse. Despite the high prevalence of MS in Canada, primary-care physicians require more education and support from specialists in MS care regarding the diagnosis and treatment of MS relapses.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

scholarly journals Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Peggy R. Cyr ◽  
Wendy Craig ◽  
Hadjh Ahrns ◽  
Kathryn Stevens ◽  
Caroline Wight ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Skin Cancer ◽  
Primary Care Physicians ◽  
Survival Rates ◽  
Family Physicians ◽  
Skin Lesions ◽  
Posttest Score ◽  
Malignant Skin ◽  
Attending Physicians

Introduction: Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. Methods: We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Results: Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P<.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant (P<.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. Conclusion: After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

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