scholarly journals What Does the Chinese Public Care About with Regard to Primary Care Physicians: Trustworthiness or Competence?

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 455
Author(s):  
Zhu ◽  
Cao
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Community Health Centers ◽  
Clinical Medicine ◽  
Chinese Patients ◽  
Convenience Sample ◽  
Public Care ◽  
Face To Face ◽  
Ease Of Access ◽  
Trust In Physicians

Background and Objective: China has launched a series of reforms to enhance primary care. The aims of these reforms are to strengthen the functionality of primary care to encourage patients to use primary care. Patients’ trust in physicians is important in clinical medicine; however, little is known about how Chinese patients’ preferences relate to their trust in primary care physicians. This study’s objectives are to measure the Chinese public’s trust in primary care physicians and to characterize reasons of their preferences for health care. Materials and Methods: This quantitative study comprises a face-to-face survey with a convenience sample (n = 273) of people visiting community health centers or stations (CHCSs) in Wuhan, China. We measured the patients’ preferences for the different level of hospitals and their trust in physicians, as well as the reasons of the patients’ preferences, using a Chinese version of the Wake Forest Physician Trust Scale and other variables (such as demographics, health status, and hospital preference). Results: Approximately two thirds (68.6%) of the participants had experienced a mild or chronic disease in the year before the survey, but only 26.4% preferred to visit CHCSs in such cases. The negative factors related to this lack of preference are the physicians’ competence (odds ratio [OR] = 0.250), the medical equipment (OR = 0.301), and the popularity of hospitals (OR = 0.172). The positive factors were ease of access (OR = 2.218) and affordability (OR = 1.900). The participants expressed a moderate trust in physicians in CHCSs (score of 3.02 out of 5). There is no association between the patients’ trust and their hospital preference (r = 0.019, p = 0.859). Of the participants, 92 suggested that the physicians in CHCSs should improve in terms of their competence (n = 53), attitude (n = 35), and/or medical ethics (n = 16). Conclusions: This study’s results suggest that patients consider improving physicians’ competence to be more important and urgent than improving those physicians’ trustworthiness in terms of reconstructing Chinese primary care. Improving the physicians’ competence would not only reduce the barriers that patients experience regarding CHCSs, but would also increase their trust in the physicians.

scholarly journals Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824401989909
Author(s):  
Eric Apaydin
Keyword(s):  
Primary Care ◽  
Los Angeles ◽  
Primary Care Physicians ◽  
Theory Approach ◽  
Structured Interviews ◽  
Job Roles ◽  
Face To Face ◽  
Administrative Work ◽  
Job Role ◽  
The Relationship

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.

scholarly journals Factors affecting general practitioners’ choice of drug therapy: A study in primary healthcare in Iceland

2021 ◽  
Vol 107 (11) ◽  
pp. 522-527
Author(s):  
Yrsa Ívarsdóttir ◽  
◽  
Jón Steinar Jónsson ◽  
Kristján Linnet ◽  
Anna Bryndís Blöndal ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Drug Interaction ◽  
Drug Therapy ◽  
Primary Care Physicians ◽  
New Drugs ◽  
Factors Affecting ◽  
Face To Face ◽  
Software Information ◽  
Strongly Agree

Introduction: This study aimed to analyse several factors that influence the decision-making of primary care physicians in Iceland in their choice of drug therapy for their patients. Also, to find which factors can act as a hindrance in making the best choices. Finally, to analyse which elements could be most important in facilitating decisions. Material and methods: A questionnaire was sent by e-mail to physicians working in primary care in Iceland. The questionnaire comprised closed questions, open text boxes, and ranking questions. The data was processed and analysed using Microsoft Excel. Results: The total number of primary care physicians who responded to the questionnaire was 93, a response rate of 40.7% of all the primary care physicians. The results reveal that physicians working in primary care consider clinical guidelines, the Icelandic National Formulary, and personal experience to be the most important factors when choosing a medication. Primary care physicians strongly agree that the lack of drug interaction software connected to medical records is a shortcoming. The most important factors that need improvement to facilitate primary care physicians' decision-making are drug formularies and interaction software. Conclusion: The results suggest some factors that support physicians in primary care in making decisions when choosing drug therapy, such as a drug formulary, drug interaction software, information about patients’ drug therapy, variable length in face-to-face consultations, evidence based information on new drugs, and counselling provided by clinical pharmacists.

scholarly journals P.025 Is this headache normal?: Assessing electronic referrals for headache from primary care physicians

2018 ◽  
Vol 45 (s2) ◽  
pp. S22-S22
Author(s):  
L Panamsky ◽  
A Bradi ◽  
L Sitwell ◽  
C Liddy ◽  
A Afkham ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Unusual Presentation ◽  
Imaging Findings ◽  
Electronic Resources ◽  
Consultation Service ◽  
Face To Face ◽  
Electronic Consultation ◽  
Headache Type ◽  
Clinical Resource

Background: Headache is one of the most frequent complaints in primary care. We reviewed headache questions submitted to an electronic consultation service in Ontario to classify the types of headaches and describe the questions being asked. We also identified reasons why answers were not retrievable within UpToDate, an online clinical resource. Methods: 65 headache eConsults were further divided into 85 questions and categorized by headache type and question theme. Questions were manually searched within UpToDate to determine if they could be answered using this resource. The intent to refer the patient for a face-to-face referral after the eConsult was collected. Results: The top classifications were migraine, unclassified headache, and exertional and/or coital headache. The themes -identified were medication questions (41.7%), investigation questions (33.3%), clinical concerns despite normal neurologic exam and/or imaging (15.5%); and abnormal imaging findings (9.5%). Answers to 40.1% of the questions were not retrievable in UpToDate. The main reason for irretrievability was an unusual presentation. Only 33.8% of eConsults resulted in a face-to-face referral to a specialist. Conclusions: Although electronic resources may be useful in some cases, clinical nuances cannot be accounted for. By providing physicians with rapid access to specialists, eConsult services may obviate the need for formal, face-to-face referrals.

scholarly journals Descriptive Analysis of Patient Experience in Shanghai Primary and Tertiary Care Settings

2018 ◽  
Author(s):  
Kyle Kai Ho Ng ◽  
Jonathan Gendron ◽  
Chao Meng ◽  
Yan Zhou ◽  
Peter Kuling ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Patient Experience ◽  
Community Health Centers ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Chinese Patients ◽  
Tertiary Care Centre ◽  
Barriers To Access ◽  
Current Design

 Context: China has recently undertaken a nationwide healthcare reform of primary care for its citizens. The new Ottawa-Shanghai Joint School of Medicine (OSJSM) entered this context of reform by developing family medicine training centres for its students.Objective: This study seeks to understand patients’ demographic, perceptions of family medicine, and alignment of needs and values towards family medicine to inform the creation of these new centres.Study Design: To this end, a culturally and linguistically appropriate patient experience survey was created and administered at two primary (CaoJiaDu and TangQiao Community Health Centers) and at a tertiary care centre (Renji Hospital). The survey consisted of questions on demographics, frequency of healthcare usage, satisfaction of care, barriers to access, prioritized values and percep­tions of family medicine. It was administered to 400 patients conveniently sampled to have a balance of primary/tertiary settings.Results: Despite common assumptions that Chinese patients may prefer specialist services, this study revealed a 68.3% preference for General Practitioners (GP) over Specialists. There was also overall agreement and preference for values of continuity, comprehen­siveness, and coordination in healthcare.Conclusion: These findings reveal that primary care is present in Shanghai and that the core values of family medicine are desired by a majority of respondents. Further analysis, qualitative corroboration and repeating the study in a wider population may be re­quired for more generalizable conclusions, as this study in its current design was limited by convenience sampling.

scholarly journals Physician related barriers towards insulin therapy at primary care centres in Trinidad: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Shastri Motilal
Keyword(s):  
Primary Care ◽  
Insulin Therapy ◽  
Primary Care Physicians ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Convenience Sample ◽  
The Public

Abstract Background Physician related factors with respect to insulin therapy can contribute to diabetes mellitus (DM) mismanagement. Patient related factors have been previously explored in a Trinidad survey. The main objective of this study was to explore primary care physicians’ (PCPs) related barriers towards insulin therapy. Methods A cross-sectional study on a convenience sample of PCPs in the public primary care system was done using an online survey. Results Of the 170 PCPs contacted, 75 (44%) responded. There were 47 females (62.7%) and 28 males (37.3%) with a mean age of 35.9 yrs. Nearly 40% of physicians admitted that the education given to patients was inadequate to allow initiation of insulin therapy. Half the respondents admitted to insufficient consultation times and inadequate appointment frequency to allow for intensification of insulin therapy. Forty percent of PCPs admitted that HbA1c results were unavailable to guide their management decisions. Only 6.7% of physicians said they had access to rapid acting insulin, while 5.3% said they had access to insulin pens. Conclusion PCPs in Trinidad treating diabetes at the public primary care clinics face several barriers in administering proper insulin therapy. Addressing these factors can improve glycemic control in this population.

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 Knowledge, attitude and practice of Lebanese primary care physicians in nutrition counseling: a self-reported survey

2017 ◽  
Vol 18 (06) ◽  
pp. 629-634 ◽  
Author(s):  
Rasha A. Hseiki ◽  
Mona H. Osman ◽  
Rana T. El-Jarrah ◽  
Ghassan N. Hamadeh ◽  
Najla A. Lakkis
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Patient Adherence ◽  
Nutrition Counseling ◽  
Nutritional Knowledge ◽  
Nutritional Counseling ◽  
Convenience Sample ◽  
Adherence To Diet ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

AimThis study aims to assess the knowledge, attitude and practice of primary care physicians (PCPs) in Lebanon regarding nutrition counseling and to investigate possible related barriers.BackgroundNutrition counseling is an important aspect of patient care, especially with the increase in nutrition-related disorders.MethodsThis is a descriptive study among a convenience sample of PCPs in Lebanon at two annual conferences in 2014 using an anonymous questionnaire.FindingsResponse rate was 54.6%. Overall, physicians considered that they have good to very good nutritional knowledge. Although they rated their formal nutritional education poorly, they had a positive attitude towards nutritional counseling and reported practicing general nutritional counseling with their patients. Barriers to nutritional counseling were: time, perceived poor patient adherence to diet, gap in physician’s nutritional knowledge and lack of insurance coverage for dietitian fees. Changes should be made to medical education curricula to include nutrition courses related to prevalent health problems.

Physicians' Experiences with Prehospital Do-Not-Resuscitate Orders in North Carolina

1996 ◽  
Vol 11 (2) ◽  
pp. 91-100 ◽  
Author(s):  
Debbie A. Travers ◽  
Greg Mears
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Care Physicians ◽  
Sample Survey ◽  
Do Not Resuscitate ◽  
Convenience Sample ◽  
Health Care Settings ◽  
Professional Groups ◽  
Program Support ◽  
Dnr Orders

AbstractIntroduction:Many states are implementing prehospital do-not-resuscitate (DNR) programs through legislation or by state or local protocol. There are no outcome studies in the literature regarding the utilization of, access to, or barriers to prehospital DNR programs, nor are there studies that evaluated whether they meet the patients' needs.Study Objective:To explore physicians' perceptions of the utilization of, access to, and barriers to a southeastern state's prehospital DNR program, and to identify key professional groups needing information about prehospital DNR issues.Methods:A convenience sample survey and a descriptive review using retrospective, self-report questionnaires sent to all physicians who requested and obtained a supply of the state's out-of-facility DNR forms in 1993.Results:Respondents reported that the most common terminal conditions for patients with prehospital DNR orders are cancer and multiple chronic diseases in elderly patients. More than half of the physicians recalled that enrolled patients had engaged the services of emergency medical services (EMS), most often because the patients' conditions worsened, and the families were uncertain about what to do. Most of the enrolled patients have at least one other DNR order in another health-care setting, and are at home with hospice care or home-health care at the time of the prehospital DNR order implementation. The most frequent barrier to honoring dying patients' wishes in the prehospital environment is a lack of knowledge of prehospital issues by patients, families, primary care physicians, and nursing home staff. Ninety-eight percent of the respondents support a single, universal DNR order that would apply across all health-care settings.Conclusions:Patients, families, and key health-care professional groups need to be targeted with educational programs regarding prehospital DNR issues. Primary care physicians, using the current prehospital DNR program, support more comprehensive approaches to DNR orders across health-care settings.

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