scholarly journals A Survey of Kansas Physicians' Perceptions of Physician Assistant Education and Qualifications

2015 ◽  
Vol 8 (1) ◽  
pp. 18-25
Author(s):  
Gina R Brown ◽  
LaDonna S Hale ◽  
Molly C Britz ◽  
Mindy J Schrader ◽  
Sedera L Sholtz ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Physician Assistant ◽  
Healthcare Team ◽  
Full Time ◽  
Patient Centered ◽  
Chi Square ◽  
Grade Point ◽  
Credit Hours ◽  
Regulatory Standards

BACKGROUND: Effective physician-physician assistant (PA) teams improve patient access and satisfaction, and increase productivity and revenue while reducing physician workload. This survey assessed perceptions of Kansas primary care physicians regarding educational requirements and qualifications of PAs, professional and legal regulations, and the most important skills and competencies for PAs to possess. Understanding these perceptions may lead to improved communication and refined expectations of physician-physician assistant teams, thereby increasing their utilization and effectiveness. METHODS: A 20-question survey was emailed to all 1,551 primary care physicians registered with the Kansas Board of Healing Arts in 2012. Descriptive data were reported as frequencies; comparisons between groups were analyzed using Chi-square. RESULTS: The response rate was 9.2% (n = 143). Physicians were highly accurate regarding the program’s generalist/primary care educational model and moderately accurate regarding the degree awarded, average pre-program grade point average, lock-step full-time curriculum, weeks of clinical rotations, recertification and continuing medical education hours, and Medicare PA fee schedule. Physicians had low accuracy regarding program and pharmacology credit hours, strict dismissal policy, pre-program healthcare experience, and co-signatory regulations. Physicians with PA supervisory experience had higher knowledge than those without (p = 0.001). Physicians most commonly selected history taking and performing physical exam as the most important skill (49%) and providing patient care that is patient-centered, efficient, and equitable as the most important competency (42%). CONCLUSIONS: Physicians often underestimated the average PA applicant qualifications, program rigor and intensity, professional regulatory standards, and co-signatory requirements. Correcting misperceptions and improving understanding of which PA skills and competencies are most valued by physicians may optimize PAs as part of the healthcare team.

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.

scholarly journals Digital consultations in Swedish primary health care: a qualitative study of physicians’ job control, demand and support

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerström ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients. Methods The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data. Results Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care. Conclusions This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals The myth of standardized workflow in primary care

2015 ◽  
Vol 23 (1) ◽  
pp. 29-37 ◽  
Author(s):  
G Talley Holman ◽  
John W Beasley ◽  
Ben-Tzion Karsh ◽  
Jamie A Stone ◽  
Paul D Smith ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Physical Work ◽  
Primary Care Visit ◽  
Patient Centered ◽  
Face To Face ◽  
Primary Care Clinics ◽  
Task List ◽  
Workflow Pattern ◽  
Electronic Health

Abstract Objective Primary care efficiency and quality are essential for the nation’s health. The demands on primary care physicians (PCPs) are increasing as healthcare becomes more complex. A more complete understanding of PCP workflow variation is needed to guide future healthcare redesigns. Methods This analysis evaluates workflow variation in terms of the sequence of tasks performed during patient visits. Two patient visits from 10 PCPs from 10 different United States Midwestern primary care clinics were analyzed to determine physician workflow. Tasks and the progressive sequence of those tasks were observed, documented, and coded by task category using a PCP task list. Variations in the sequence and prevalence of tasks at each stage of the primary care visit were assessed considering the physician, the patient, the visit’s progression, and the presence of an electronic health record (EHR) at the clinic. Results PCP workflow during patient visits varies significantly, even for an individual physician, with no single or even common workflow pattern being present. The prevalence of specific tasks shifts significantly as primary care visits progress to their conclusion but, notably, PCPs collect patient information throughout the visit. Discussion PCP workflows were unpredictable during face-to-face patient visits. Workflow emerges as the result of a “dance” between physician and patient as their separate agendas are addressed, a side effect of patient-centered practice. Conclusions Future healthcare redesigns should support a wide variety of task sequences to deliver high-quality primary care. The development of tools such as electronic health records must be based on the realities of primary care visits if they are to successfully support a PCP’s mental and physical work, resulting in effective, safe, and efficient primary care.

scholarly journals Trials and Tribulations: Palliative Care Trial Recruitment Approaches and Challenges

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 167-167
Author(s):  
Anna Rahman ◽  
Sindy Lomeli ◽  
Susan Enguidanos
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Controlled Trial ◽  
Trial Recruitment ◽  
Patient Identification ◽  
Patient Centered ◽  
Recruitment Methods ◽  
Home Based ◽  
Training And Support

Abstract In 2017, we received funding form the Patient-Centered Outcomes Research Institute to conduct a large, state-wide, randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations. Participants were randomized to either HBPC or enhanced usual care, where physicians were provided added training and support in core palliative care practices. Originally, we planned to obtain patient referrals to the trial from primary care physicians, however we were unable to engage primary care physicians in patient identification processes. In this session we will describe the numerous trial modifications made to our trial recruitment methods and the success of each approach. Ultimately, after 20 months of trial recruitment, we had recruited just 28 patients and 10 of their caregivers. Findings from this terminated trial may inform other researchers in development of participant recruitment methods.

scholarly journals Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support

2020 ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerstrom ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

scholarly journals Barriers Faced by Rural and Non-Rural Primary Care Physicians During the Process of Seeking Health Information from their Practice Settings

2016 ◽  
Vol 17 ◽  
pp. 69-85
Author(s):  
Salman Bin Naeem ◽  
Rubina Bhatti
Keyword(s):  
Primary Care ◽  
Health Information ◽  
Information Content ◽  
Primary Care Physicians ◽  
Rural Practice ◽  
Rural Setting ◽  
Practice Setting ◽  
Chi Square ◽  
The Difference ◽  
Content Availability

To compare the barriers (e.g., relating to health information content, efficiency, availability, etc.) that obstruct the health information behavior of primary care physicians (PCPs) in a rural versus non-rural practice setting. A survey was conducted in the Public health facilities of the District of Multan, Pakistan. Primary care physicians (PCPs) were classified into rural and non-rural according to their practice setting. The term non-rural was used to avoid the confusion with other terms such as urban and metropolitan. Convenience sampling was used to gather the data for this study. Post-hoc Chi-square test was applied to assess any difference between the demographic information of the rural and non-rural PCPs. Mann-Whitney U statistics were applied to assess the differences among the barriers (e.g., relating to health information content, efficiency, availability, etc.) faced by PCPs in rural and non-rural practice settings. The difference in gender of the PCPs was much higher in rural than non-rural practice settings. Almost half the respondents were in the 31-40 year age range, and that- of this group most were working in non-rural settings. The barriers faced by PCPs (relating to health information content, availability, cost, efficiency and skills) in rural and non-rural practice settings were significantly different. Age as well as working experience was statistically significant factors which were perceived by PCPs as the barriers lying in their way of seeking health information. The findings of this study showed that PCPs in a non-rural setting faced significantly greater barriers relating to information content, efficiency, skills, availability, and cost) than the ones faced by PCPs in a rural setting.

Patient experience at the time of practice transformation into Patient-Centered Medical Homes

2013 ◽  
Vol 1 (2) ◽  
pp. 290 ◽  
Author(s):  
Lisa Kern ◽  
Rina Dhopeshwarker ◽  
Alison Edwards ◽  
Rainu Kaushal
Keyword(s):  
Primary Care ◽  
Patient Experience ◽  
Medical Home ◽  
Primary Care Physicians ◽  
New York State ◽  
Patient Centered Medical Home ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Processes Of Care ◽  
Patients Experience

Purpose: The Patient-Centered Medical Home (PCMH) is a model of primary care that is being promoted for its potential ability to improve patient-centeredness, improve quality and decrease costs. The effect of the PCMH on patient experience is not clear, with some reports suggesting that patient experience may worsen during transformation. We sought to measure patient experience at the time practices transform into PCMHs.Methods: We conducted a cross-sectional survey of 419 adult patients who were cared for by 85 primary care physicians across 12 practices in the Hudson Valley region of New York State. We measured patient experience, using the 35 questions in the Clinician & Group – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) – Adult Primary Care Questionnnaire (plus 14 additional questions drawn from other survey instruments) and compared the results to national CG-CAHPS benchmarks.Results: Patients’ experience overall was fairly positive, with 79% giving their doctors a ranking of 9 or 10 on a 10-point scale, with 10 being the highest. Patients’ experience in this sample was significantly more positive than the national benchmark on each of 6 subscales (p ≤ 0.05).  Patients were generally most satisfied with individual face-to-face encounters with their physicians and somewhat less satisfied with processes of care (such as receiving results from a test or receiving follow-up after discharge from the hospital).Conclusions: This study suggests that medical home transformation does not adversely impact patient experience and identifies organizational processes of care that could potentially be improved with the patient-centered medical home.

scholarly journals Impact of the Affordable Care Act on Grant-Supported Primary Care Faculty Development

2014 ◽  
Vol 6 (3) ◽  
pp. 419-423 ◽  
Author(s):  
Kathleen A. Klink ◽  
Sylvia E. Joice ◽  
Shannon K. McDevitt
Keyword(s):  
Primary Care ◽  
Faculty Development ◽  
Affordable Care Act ◽  
Interprofessional Education ◽  
Primary Care Physicians ◽  
Title Vii ◽  
Next Generation ◽  
Patient Centered ◽  
Patient Protection ◽  
Primary Care Workforce

Abstract Health reform requires well-trained primary care physicians with new skills. Teaching faculty need to develop proficiency to deliver care in new models and systems, to lead change, and to teach these skills to the next generation of clinicians. Title VII Section 747 of the Public Health Service Act, modified and reauthorized under the Patient Protection and Affordable Care Act (ACA), is the only federal program that specifically supports the professional development of primary care faculty. We analyzed the effect of the modifications under the ACA on a funding opportunity announcement addressing faculty development needs and attributes of funded applications, including geographic regions. The data offer useful insights to programs interested in tapping sources of support for primary care faculty development. The data also show that targeted federal funding can bring about changes that contribute to an up-to-date, responsive primary care workforce. Title VII programs, as amended by the ACA, focus on curriculum development, teaching in community-based settings, and integrating patient-centered medical home concepts and interprofessional education and practice into the training of the next generation of physicians. These strategies drive change and improve the quality of care and patient outcomes.

scholarly journals Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support

2020 ◽  
Author(s):  
Hanna Fernemark ◽  
Janna Skagerstrom ◽  
Ida Seing ◽  
Carin Ericsson ◽  
Per Nilsen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Environment ◽  
Primary Care Physicians ◽  
Psychosocial Work Environment ◽  
Mobile Telephone ◽  
Full Time ◽  
Psychosocial Work ◽  
Structured Interviews ◽  
Demand Control

Abstract Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.

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