Physician Incentives for Shared Management of Childhood Cancer Patients

PEDIATRICS ◽  
1981 ◽  
Vol 67 (6) ◽  
pp. 833-837
Author(s):  
Faye H. Strayer ◽  
Carol C. Fethke ◽  
Thomas Kisker ◽  
Nancy G. Dekrey
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Management Program ◽  
Family Time ◽  
Educational Value ◽  
Physician Incentives ◽  
Shared Management ◽  
Outpatient Visits ◽  
The Family ◽  
Overall Evaluation

Four years' experiences of 69 primary care physicians who delivered more than 70% of the chemotherapy to 174 children with cancer were assessed. Five academic pediatric oncologists were responsible for diagnosis, assignment to a clinical trial protocol, and overall management. The academicians saw the patients at diagnosis and at regularly scheduled intervals but provided care for less than 30% of the outpatient visits. Factors examined included: (1) why the primary care physicians agreed to participate in the care of these patients, (2) how they thought their participation affected the patient and the patient's family, (3) how participation affected their personal and professional development, (4) how participation affected their practice, (5) what their perceptions were concerning the merits of traditional specialist management, and (6) their overall evaluation of the Iowa shared-management program. The initial agreement by primary care physicians to participate in shared management was related to their perception that it would improve the overall care of their patients. The physicians agreed that the program saved the family time and money, was of educational value, personally satisfying, and not economically detrimental to their practice. They did not identify areas where specialist management had clear advantages over shared management and none reported dissatisfaction with this management program.

scholarly journals Inguinoscrotal pathology

2017 ◽  
Vol 11 (1-2S) ◽  
pp. 41 ◽  
Author(s):  
Luis Guerra ◽  
Michael Leonard
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Primary Care Physicians ◽  
Significant Proportion ◽  
Care Physician ◽  
Imaging Studies ◽  
Undescended Testes ◽  
Scrotal Pain ◽  
Outpatient Visits ◽  
Insight Into

Infants, children, and adolescents with inguinoscrotal pathology comprise a significant proportion of emergency department and outpatient visits. Visits to the emergency department primarily comprise individuals presenting with scrotal pain due to testicular torsion or torsion of the testicular appendages. At such time, immediate urological consultation is sought. Outpatient visits comprise those individuals with undescended testes, hydroceles, and varicoceles. Rare, but important problems, such as pediatric testicular tumours, may also present in the office setting. Many of these outpatient visits are to primary care physicians, who should have an appreciation of the timing and need for referral.The purpose of this review is to familiarize the general urologist and primary care physician with these varied pathologies and give insight into their assessment and management. Some of these same conditions are seen in adult patients, but there are some significant differences in their management in the pediatric group. In addition, the utility of imaging studies, such as ultrasound, are discussed within each pathological entity. It is hoped that this overview will assist our general urology and primary care colleagues in patient management for diverse inguinoscrotal pathologies.

scholarly journals Idea on the Clinical Services of Primary Care Physicians

2018 ◽  
Vol 1 (3) ◽  
pp. 99
Author(s):  
Adi Heru Sutomo ◽  
Fitriana Fitriana
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Direct Contact ◽  
Health Problems ◽  
Primary Care Doctor ◽  
Clinical Services ◽  
The Family ◽  
Patient Health ◽  
Primary Care Doctors

The increasing needs and health problems that exist in the community and the more critical the community-related health problems that require the ability of a primary care doctor able to handle existing health problems in the community. Primary care doctor complies with Alma Ata Declaration in 1978 as the backbone of health that makes direct contact with the community, so it is essential for a primary care doctor to involve the patient or the patient as part of the team. Patient experience information or patients given to primary care doctors is expected to further improve the quality of patient health services as individuals and is part of the family and society or community....................

Parents and primary care physicians have different views about copying medical letters to parents after paediatric outpatient visits

2014 ◽  
Vol 103 (10) ◽  
pp. e459-e464 ◽  
Author(s):  
Francois Cachat ◽  
Pedro Marques-Vidal ◽  
Eric Girardin ◽  
Hassib Chehade ◽  
Chantal Piot-Ziegler
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Outpatient Visits ◽  
Paediatric Outpatient

scholarly journals Follow-up and Treatment of an Orf Case Diagnosed at a Family Health Center

2021 ◽  
Author(s):  
Levent Çevik ◽  
Murat Öztürk
Keyword(s):  
Primary Care ◽  
Health Center ◽  
Primary Care Physicians ◽  
Skin Diseases ◽  
Specific Treatment ◽  
Small Ruminants ◽  
Family Health ◽  
Zoonotic Diseases ◽  
The Family

Orf is a zoonotic disease transmitted by contact from small ruminants, which is also common in our country, and its causative agent is parapoxvirus. It usually occurs as lesions characterized by nodules on the fingers, and although it is a self-limiting disease that heals without treatment, it can be confused with other zoonotic diseases and cause complications as a result of unnecessary interventions. For this reason, it is important for primary care physicians to recognize orf disease, which does not require a specific treatment, and to distinguish it from other zoonotic skin diseases. In this study, in a 56-year-old male patient who applied to the family health center, after vaccination of ovine animals; A case of orf diagnosed by history and physical examination and treated with symptomatic methods is presented.

scholarly journals Care for Caregivers- A Mission for Primary Care 

2021 ◽  
Author(s):  
Aya Biderman ◽  
Sara Carmel ◽  
Shimon Amar ◽  
Yaacov G. Bachner
Keyword(s):  
Primary Care ◽  
Family Member ◽  
Preventive Care ◽  
Primary Care Physicians ◽  
Physical Symptoms ◽  
World Health ◽  
Convenience Sample ◽  
Medical Graduates ◽  
The Family ◽  
Health Organization

Abstract Background. The number of elderly people living in the community who are limited in daily activities is increasing worldwide. This generates prolonged care, which usually falls on one family member, the family caregiver. Caregivers sometimes develop psychosocial and physical symptoms. As a result, the World Health Organization (WHO) issued a clear directive to assess and support these caregivers. The present study focuses on providing preventive solutions by primary care physicians (PCP) to caregivers. Methods. Data were collected from a convenience sample of 201 PCP interviewed with specifically structured questionnaires. Results. The participants’ mean age was 48.5±11.2 years and 53.5% were female. Only 48.5% were Israel medical graduates and 72% were board-certified family physicians. Nearly 34% had formally been primary caregivers of family members. Most physicians (83.6%) were aware of the primary caregiver's high-risk for morbidity and mortality, and recommended preventive care. On a multivariate regression, awareness of the risk, country of medical school and board certification were considered to be of great significance in relation to providing preventive care. However, being a primary caregiver for a sick family member neither contributed significantly to the doctors’ awareness to caregiving risks nor to their preventive care.Conclusion. Although a high percentage of physicians were aware and concerned about caregivers’ welfare, their preventive care activities were relatively passive. PCPs should take a more active and preventive role.

Primary Care

2019 ◽  
pp. 194-200
Author(s):  
Inge Kriel ◽  
Geertruida de Bock ◽  
Sabine Siesling ◽  
Annette Berendsen
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Patient Management ◽  
The Elderly ◽  
Care Physician ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care For The Elderly ◽  
The Family

Abstract: Primary care physicians play a vitally important role in care and in the management of patients with breast cancer in any setting, but their contribution is especially valuable in a developing country setting. Communication between the family physician and the specialist ensures holistic patient management. Whereas the specialist focuses on management of the breast cancer, the generalist assesses and manages the complex interplay between pre-existing chronic medical conditions and the breast cancer. The biopsychosocial model is the cornerstone of general practice. The primary care physician plays an important role in managing breast cancer patients in all phases of the disease: prediagnosis, diagnosis, during treatment, after-treatment survivorship care, care for the elderly, and palliative care.

scholarly journals Implementation of an integrated primary care cardiometabolic risk prevention and management network in Montréal: does greater coordination of care with primary care physicians have an impact on health outcomes?

2017 ◽  
Vol 37 (4) ◽  
pp. 105-113 ◽  
Author(s):  
Sylvie Provost ◽  
Raynald Pineault ◽  
Dominique Grimard ◽  
José Pérez ◽  
Michel Fournier ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Outcomes ◽  
Care Coordination ◽  
Primary Care Physicians ◽  
Cardiometabolic Risk ◽  
Participation Rate ◽  
Interdisciplinary Team ◽  
Management Program ◽  
Interdisciplinary Teams ◽  
The Impact

Introduction Chronic disease management requires substantial services integration. A cardiometabolic risk management program inspired by the Chronic Care Model was implemented in Montréal for patients with diabetes or hypertension. One of this study’s objectives was to assess the impact of care coordination between the interdisciplinary teams and physicians on patient participation in the program, lifestyle improvements and disease control. Methods We obtained data on health outcomes from a register of clinical data, questionnaires completed by patients upon entry into the program and at the 12-month mark, and we drew information on the program’s characteristics from the implementation analysis. We conducted multiple regression analyses, controlling for patient sociodemographic and health characteristics, to measure the association between interdisciplinary team coordination with primary care physicians and various health outcomes. Results A total of 1689 patients took part in the study (60.1% participation rate). Approximately 40% of patients withdrew from the program during the first year. At the 12-month follow-up (n = 992), we observed a significant increase in the proportion of patients achieving the various clinical targets. The perception by the interdisciplinary team of greater care coordination with primary care physicians was associated with increased participation in the program and the achievement of better clinical results. Conclusion Greater coordination of patient services between interdisciplinary teams and primary care physicians translates into benefits for patients.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

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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