scholarly journals Boan and Joint Disease Internal Medicine Specialist Provide Medical Care; New Evolutiion of the Treatment. Expectations of Primary Care Physicians

2008 ◽  
Vol 97 (10) ◽  
pp. 2484-2506
Author(s):  
Yoshiya Tanaka ◽  
Masataka Shiraki ◽  
Mitsumasa Kishimoto ◽  
Shingo Nakayamada ◽  
Tsutomu Takeuchi
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Medical Care ◽  
Primary Care Physicians ◽  
Joint Disease ◽  
Treatment Expectations

The Role of the Primary Care Physician in the Care of Children with Serious Heart Disease

PEDIATRICS ◽  
1994 ◽  
Vol 94 (3) ◽  
pp. 284-290
Author(s):  
Paul C. Young ◽  
Yu Shyr ◽  
M. Anthony Schork
Keyword(s):  
Primary Care ◽  
Heart Disease ◽  
Chronic Illness ◽  
Medical Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Care Needs ◽  
Care Services ◽  
Primary Care Services

Objective. To determine the roles of primary care physicians and specialists in the medical care of children with serious heart disease. Setting. Pediatric Cardiology Division; Tertiary Care Children's Hospital. Subjects. Convenience sample of parents, primary care physicians, and pediatric cardiologists of 92 children with serious heart disease. Design. Questionnaire study; questionnaires based on 16 medical care needs, encompassing basic primary care services, care specific to the child's heart disease and general issues related to chronic illness. Results. All children had a primary care physician (PCP), and both they and the parents (P) reported high utilization of PCP for basic primary care services. However, there was little involvement of PCP in providing care for virtually any aspect of the child's heart disease. Parents expressed a low level of confidence in the ability of PCP in general or their child's own PCP to meet many of their child's medical care needs. Both PCP and pediatric cardiologists (PC) were significantly more likely than parents to see a role for PCP in providing for care specific to the heart disease as well as more general issues related to chronic illness. PC and PCP generally agreed about the role PCP should play, although PC saw a bigger role for PCP in providing advice about the child's activity than PCP themselves did. PC were less likely to see the PCP as able to follow the child for long term complications than PCP did. PC were more likely than PCP to believe that PCP were too busy or were inadequately reimbursed to care for children with serious heart disease. Only about one-third of parents reported discussing psychosocial, family, economic, or genetic issues with any provider, and PCP were rarely involved in these aspects of chronic illness. Conclusions. Primary care physicians do not take an active role in managing either the condition-specific or the more general aspects of this serious chronic childhood illness. With appropriate information and support from their specialist colleagues primary care physicians could provide much of the care for this group of children. Generalists and specialists are both responsible for educating and influencing parents about the role primary care physicians can play in caring for children with serious chronic illness.

Psychiatric Training for Primary Care Residents: Proposed Standards

1988 ◽  
Vol 17 (4) ◽  
pp. 327-340 ◽  
Author(s):  
Edward C. Covington ◽  
Paul Rodenhauser ◽  
Marvin E. Gottlieb ◽  
Alma Houston
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Primary Care Physicians ◽  
Care Program ◽  
Psychiatric Training ◽  
Training Directors ◽  
Primary Care Program ◽  
Inappropriate Treatment ◽  
Missed Diagnosis ◽  
Primary Physicians

Most of the nation's psychiatric care is provided by primary care physicians, and this trend is expected to continue. Primary care physicians see themselves as poorly trained in psychiatry, and evidence supports a high incidence of missed diagnosis and inadequate or inappropriate treatment. In addition, poor training may underlie the indifference to psychiatric problems often demonstrated by primary physicians. The Ohio Psychiatric Association Foundation has designated an annual award to be given to the primary care program which provides the best psychiatric training in the state, and the psychiatric training directors met to develop criteria for selecting the recipients. The resulting standards emphasize the importance of training which is relevant to a medical care setting, provided by psychiatrists, and supportive of the integration of psychiatric methods into-medical care.

scholarly journals The aging male population and medical care for benign prostatic hyperplasia in Canada

2013 ◽  
Vol 4 (2) ◽  
pp. 123
Author(s):  
Nigel S. B. Rawson ◽  
Fred Saad
Keyword(s):  
Primary Care ◽  
Benign Prostatic Hyperplasia ◽  
Nous Avons ◽  
Medical Care ◽  
Primary Care Physicians ◽  
Prostatic Hyperplasia ◽  
Population Projections ◽  
Prise En Charge ◽  
Male Population ◽  
Statistics Canada

Background: The male Canadian population is aging and more menwill be seeking medical care for benign prostatic hyperplasia (BPH).We examined the projected increase in older Canadian males between2005 and 2018 to evaluate urologic health-care needs.Methods: We used Statistics Canada population projections toderive predictions of the male population aged 50 or more from2005 to 2018 and results from the Olmsted County Study of UrinarySymptoms to estimate numbers of males aged ≥50 with moderateto severe lower urinary tract symptoms (msLUTS) in the sameperiod. Data from the Canadian Institute for Health Informationwere used to estimate the number of urologists in 2018.Results: The number of Canadian men aged ≥50 is projected torise between 2005 and 2018 by 39.5% and the number withmsLUTS by 41.3%. However, the number of practicing urologistsin Canada in 2018 is likely to be similar to the 584 practicing in2007. An increase in the number of urologists proportional to theincrease in men aged ≥50 with msLUTS would require 799 urologistsin 2018.Interpretation: Little opportunity exists to expand the number of traineesin urology. Other alternatives must be sought to deal with increasednumbers of older men with msLUTS. Initial management of BPHhas moved towards being a responsibility of primary care physicians,but they appear to view BPH as a quality-of-life issue. It iscrucial that urologists work closely with primary care physicians toensure that the management of LUTS progression is optimized.Introduction : La population masculine canadienne vieillit, et deplus en plus d’hommes consulteront un médecin en raison d’unehyperplasie bénigne de la prostate (HBP). Nous avons étudié levieillissement prévu de cette population entre 2005 et 2018 afind’évaluer les besoins en soins urologiques.Méthodologie : À l’aide des projections démographiques de StatistiqueCanada, nous avons formulé des prévisions quant à la populationmasculine de 50 ans et plus entre 2005 et 2018; les résultatsde l’étude du comté d’Olmsted sur les symptômes urinaires nousont permis d’évaluer le nombre d’hommes de 50 ans et plus quidevraient présenter des symptômes modérés ou graves touchantles voies urinaires inférieures pendant la même période. Desdonnées de l’Institut canadien d’information sur la santé ont permisd’évaluer le nombre d’urologues en 2018.Résultats : Le nombre de Canadiens de 50 ans et plus devrait augmenterde 39,5 % entre 2005 et 2018, et le nombre d’hommesprésentant des symptômes modérés ou graves touchant les voiesurinaires inférieures, de 41,3 %. En revanche, le nombre d’urologuespratiquant en 2018 au Canada devrait être semblable aunombre établi en 2007 (soit 584). Pour que la hausse du nombred’urologues soit proportionnelle à la hausse du nombre d’hommesde 50 ans et plus qui présenteront des symptômes modérés ougraves touchant les voies urinaires inférieures, il faudrait que cenombre atteigne 799 en 2018.Conclusion : Il est peu probable que le nombre de médecins sespécialisant en urologie augmente. D’autres solutions doiventdonc être mises de l’avant afin de faire face au nombre croissantd’hommes âgés au prise avec des symptômes modérés ou gravestouchant les voies urinaires inférieures. La prise en charge initialede l’HBP incombe maintenant aux médecins de premiersrecours, mais ces derniers semblent considérer l’HBP comme unproblème de qualité de vie. Il est primordial que les urologuescollaborent étroitement avec les médecins de soins primaires pourassurer une prise en charge optimale des symptômes touchantles voies urinaires inférieures.

scholarly journals Quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension, by primary care physicians in different Russian regions

2021 ◽  
Vol 26 (4) ◽  
pp. 4332
Author(s):  
O. M. Drapkina ◽  
R. N. Shepel ◽  
L. Yu. Drozdova ◽  
A. M. Kalinina ◽  
E. S. Bulgakova ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Resistant Hypertension ◽  
Clinical Guidelines ◽  
Primary Care Physicians ◽  
Adult Population ◽  
Russian Regions ◽  
Target Values

In view of the high prevalence of hypertension (HTN) among Russian population, it becomes extremely important to meet the criteria for the medical care quality within the periodic examinations for this group of patients.Aim.  To assess the quality of follow-up monitoring of the adult population with grade 1-3 hypertension, with the exception of resistant hypertension (RH), by primary care physicians in different Russian regions.Materials and methods. As part of working visits of the expert group from the National Medical Research Center for Therapy and Preventive Medicine in 38 Russian regions in the period from February 1, 2020 to December 15, 2020, an analysis of ambulatory records of patients with grade 1-3 hypertension was carried out. A total of 3614 ambulatory medical records (AMRs) were analyzed, of which the grade 1-3 hypertension, with the exception of RH, was revealed in 764 ones. The analysis of records was carried out using an original checklist. Statistical processing was carried out using the software package IBM SPSS Statistics 20 (USA) and Microsoft Office Excel 2016 (USA).Results. An analysis of 764 AMRs was performed. The mean age of patients was 63,9-11,2 (women, 64,7-11,3 years; men, 62,7-10,9 years). The majority (58,9%) of participants were women. Follow-up monitoring was established in a timely manner in 450 people (58,9%) of patients, of which there were 189 men (42%) and 261 women (58%). In 87,9% (n=672) of cases, the diagnosis formulation met the established clinical guidelines criteria. In 36 cases (4,7%), there was no evidence in favor of hypertension according to the current clinical guidelines. In 21,1% (n=161) of cases, the minimum recommended periodicity of visits was not observed. In last visits of 323 patients, the blood pressure did not reach the target values. AMRs did not contain information on low-density lipoprotein cholesterol (LDL-C) in 91б4% of cases (n=698). Among patients with a known level of LDL-C, the target values were achieved only in 15,2% of cases (n=10).Conclusion. Our analysis revealed the insufficient quality of outpatient medical care to hypertensive patients within the periodic examinations. Proposals are created for monitoring and measures to improve the quality of care for this category of patients.

scholarly journals Career Choice and Primary Care in the United Arab Emirates

2015 ◽  
Vol 7 (4) ◽  
pp. 663-666 ◽  
Author(s):  
Nicoline Schiess ◽  
Halah Ibrahim ◽  
Sami Shaban ◽  
Maria Nichole Perez ◽  
Satish Chandrasekhar Nair
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Career Choice ◽  
United Arab Emirates ◽  
Primary Care Physicians ◽  
Career Choices ◽  
Calculated Data ◽  
Subspecialty Training ◽  
Limited Information ◽  
Cross Sectional Survey

ABSTRACT Background  The low number of medical trainees entering primary care is contributing to the lack of access to primary care services in many countries. Despite the need for primary care physicians in the Middle East, there is limited information regarding trainees' career choices, a critical determinant in the supply of primary care physicians. Objective  We analyzed the career choices of medical students in the United Arab Emirates (UAE), with a larger goal of reforming postgraduate training in the region and enhancing the focus on primary care. Methods  We conducted a cross-sectional survey of applicants to a large established internal medicine residency program in the UAE. We calculated data for demographics, subspecialty choice, and factors affecting subspecialty choice, and we also reported descriptive statistics. Results  Our response rate was 86% (183 of 212). Only 25% of applicants (n = 46) were interested in general internal medicine. The majority of respondents (n = 126, 69%) indicated a desire to pursue subspecialty training, and the remainder chose careers in research or administration. A majority of respondents (73%) were women, unmarried, and childless. Educational debt or lifestyle were not indicated as important factors in career choice. Conclusions  Low interest in primary care was similar to that in many Western countries, despite a much higher percentage of female applicants and a reduced emphasis on lifestyle or income factors in career decisions. Reasons for the reduced interest in primary care deserve further exploration, as do tests of interventions to increase interest, such as improving the primary care clerkship experience.

scholarly journals The Role of North Carolina Medical Schools in Producing Primary Care Physicians for the State

2020 ◽  
Vol 11 ◽  
pp. 215013272092426
Author(s):  
Kendall M. Campbell ◽  
Jhojana L. Infante Linares ◽  
Dmitry Tumin ◽  
Keia Faison ◽  
Miranda N. Heath
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
North Carolina ◽  
Primary Care Physicians ◽  
Medical Schools ◽  
Care Physician ◽  
The State ◽  
Physician Shortage ◽  
School Of Medicine ◽  
Primary Care Specialty

Introduction: Primary care physicians serve on the front lines of care and provide comprehensive care to patients who may have difficulty accessing subspecialists. However, not enough students are entering residency in primary care fields to meet the primary care physician shortage. The authors sought to compare primary care match rates among graduates of medical schools in the state of North Carolina from 2014 to 2018. Methods: The 4 allopathic medical schools in the state of North Carolina were selected for this study: East Carolina University (ECU) Brody School of Medicine, University of North Carolina (UNC) Chapel Hill, Duke School of Medicine, and Wake Forest School of Medicine. Primary care specialties were defined as family medicine, internal medicine, pediatrics, and internal medicine/pediatrics. The proportion of students matching to a residency in any of these fields, and in each specific field, was compared across schools. Results: Over 2014-2018, 214 ECU Brody School of Medicine graduates, 386 UNC graduates, 165 Duke graduates, and 196 Wake Forest graduates matched to a primary care specialty. ECU had the highest proportion of its graduates match in a primary care specialty (53%, compared with 34% to 45% at other schools; P < .001), and was particularly distinguished by having the highest proportions of graduates match to residencies in family medicine (18%) and pediatrics (16%). Conclusion: During the study period of 2014-2018, the ECU Brody School of Medicine matched more medical students into primary care specialties than the other medical schools in the state. This school’s community-driven mission and rural location, among other characteristics facilitating sustained student commitment to primary care careers, can inform the development of new medical schools in the United States to overcome the primary care physician shortage.

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