scholarly journals Development of Family Medicine training in Botswana: Views of key stakeholders in Ngamiland

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Radiance M. Ogundipe ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Healthcare Delivery ◽  
Family Physicians ◽  
Training Programme ◽  
Holistic Health ◽  
District Health ◽  
Key Stakeholders ◽  
Quality Of Primary Care ◽  
Personal Welfare

Background: Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district.Aim: The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana.Setting: Maun and the surrounding Ngami subdistrict of Botswana.Methods: Thirteen in-depth interviews were conducted with purposively selected key stakeholders in the district health services. Data were recorded, transcribed and analysed using the framework method.Results: Participants welcomed the development of Family Medicine training in Maun and expect that this will result in improved quality of primary care. Participants expect the registrars and family physicians to provide holistic health care that is of higher quality and expertise than currently experienced, relevant research into the health needs of the community, and reduced need for referrals. Inadequate personal welfare facilities, erratic ancillary support services and an inadequate complement of mentors and supervisors for the programme were some of the gaps and challenges highlighted by participants.Conclusion: Family Medicine training is welcomed by stakeholders in Ngamiland. With proper planning introduction of the family physician in the district is expected to result in improvement of primary care. 

scholarly journals Semistructured interviewing in primary care research: a balance of relationship and rigour

2019 ◽  
Vol 7 (2) ◽  
pp. e000057 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lisa M Vaughn
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Data Collection ◽  
Health Services ◽  
Family Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Care Research ◽  
Care Research ◽  
Semistructured Interviews

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.

scholarly journals The views of key stakeholders in Zimbabwe on the introduction of postgraduate family medicine training: A qualitative study

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Cherifa Sururu ◽  
Robert Mash
Keyword(s):  
Family Medicine ◽  
Private Sector ◽  
Government Support ◽  
Economic Conditions ◽  
Successful Implementation ◽  
Structured Interviews ◽  
African Countries ◽  
District Health ◽  
Primary Health ◽  
Key Stakeholders

Background: Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened.Aim: To explore the views of key stakeholders on the introduction of postgraduate family medicine training.Setting: Key academic, governmental and professional stakeholders in Zimbabwean health and higher education systems.Method: Twelve semi-structured interviews were conducted with purposively selected key stakeholders. Data were recorded, transcribed and analysed using the framework method.Results: Anticipated benefits: More effective functioning of PHC and district health services with reduced referrals, improved access to more comprehensive services and improved clinical outcomes. Opportunities: International trend towards family medicine training, government support, availability of a small group of local trainers, need to revise PHC policy. Anticipated barriers: Family medicine is unattractive as a career choice because it is largely unknown to newly qualified doctors and may not be recognised in private sector. There is concern that advocacy is mainly coming from the private sector. Threats: Economic conditions, poor remuneration, lack of funding for resources and new initiatives, resistance from other specialists in private sector.Conclusion: Stakeholders anticipated significant benefits from the introduction of family medicine training and identified a number of opportunities that support this, but also recognised the existence of major barriers and threats to successful implementation.

scholarly journals Geographical distribution of family physicians in Japan: A nationwide cross-sectional study

2019 ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results 519 JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p<0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

scholarly journals A háziorvosok teljesítményének minőségi értékelése. Mi a probléma a háziorvosi indikátorokkal?

2016 ◽  
Vol 157 (9) ◽  
pp. 328-335 ◽  
Author(s):  
László Róbert Kolozsvári ◽  
Imre Rurik
Keyword(s):  
Primary Care ◽  
Family Physicians ◽  
Indicator System ◽  
Care Quality ◽  
Proper Solution ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Quality ◽  
Quality Of Primary Care

The Hungarian primary care quality indicator system has been introduced in 2009, and has been continuously developed since then. The system offers extra financing for family physicians who are achieving the expected levels of indicators. There are currently 16 indicators for adult and mixed practices and 8 indicators are used in paediatric care. Authors analysed the influencing factors of the indicators other than those related to the performance of family physicians. Expectations and compliance of patients, quality of outpatient (ambulatory) care services, insufficient flow of information, inadequate primary care softwares which need to be updated could be considered as the most important factors. The level of financial motivations should also be significantly increased besides changes in the reporting system. It is recommended, that decision makers in health policy and financing have to declare clearly their expectations, and professional bodies should find the proper solution. These indicators could contribute properly to the improvement of the quality of primary care services in Hungary. Orv. Hetil., 2016, 157(9), 328–335.

scholarly journals Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Yusuf Akoojee ◽  
Robert Mash
Keyword(s):  
Family Medicine ◽  
Clinical Skills ◽  
Clinical Skill ◽  
Family Physicians ◽  
Exit Examination ◽  
District Health ◽  
National Education ◽  
Core Skills ◽  
National Consensus ◽  
Training Programmes

Background: Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training.Methods: A Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians.Results: Consensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills.Conclusion: The findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

scholarly journals Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants

2019 ◽  
Vol 51 (4) ◽  
pp. 311-318 ◽  
Author(s):  
Mingliang Dai ◽  
Richard C. Ingham ◽  
Lars E. Peterson
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Nurse Practitioners ◽  
Family Physicians ◽  
Physician Assistants ◽  
Scope Of Practice ◽  
Certification Examination ◽  
Panel Size ◽  
Practice Characteristics ◽  
Number Of Patients

Background and Objectives: Little is known about how the presence of nurse practitioners (NPs) and physician assistants (PAs) in a practice impacts family physicians’ (FPs’) scope of practice. This study sought to examine variations in FPs’ practice associated with NPs and PAs. Methods: We obtained data from American Board of Family Medicine practice demographic questionnaires completed by FPs who registered for the Family Medicine Certification Examination during 2013-2016. Scope of practice score was calculated for each FP, ranging from 0-30 with higher numbers equating to broader scope of practice. FPs self-reported patient panel size. Primary care teams were classified into NP only, PA only, both NP and PA, or no NP or PA. We estimated variation in scope and panel size with different team configurations in regression models. Results: Of 27,836 FPs, nearly 70% had NPs or PAs in their practice but less than half (42.5%) estimated a panel size. Accounting for physician and practice characteristics, the presence of NPs and/or PAs was associated with significant increases in panel sizes (by 410 with PA only, 259 with NP only and 245 with both; all P&lt;0.05) and in scope score (by 0.53 with PA only, 0.10 with NP only and 0.51 with both; all P&lt;0.05). Conclusions: We found evidence that team-based care involving NPs and PAs was associated with higher practice capacity of FPs. Working with PAs seemed to allow FPs to see a greater number of patients and provide more services than working with NPs. Delineation of primary care team roles, responsibilities and boundaries may explain these findings.

scholarly journals Geographical distribution of family physicians in Japan: a nationwide cross-sectional study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuhei Yoshida ◽  
Masatoshi Matsumoto ◽  
Saori Kashima ◽  
Soichi Koike ◽  
Susumu Tazuma ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Census Data ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Government Support ◽  
Free Access ◽  
Cross Sectional ◽  
Physician Distribution

Abstract Background Geographical maldistribution of physicians, and their subsequent shortage in rural areas, has been a serious problem in Japan and in other countries. Family Medicine, a new board-certified specialty started 10 years ago in Japan by Japan Primary Care Association (JPCA), may be a solution to this problem. Methods We obtained the workplace information of 527 (78.4%) of the 672 JPCA-certified family physicians from an online database. From the national census data, we also obtained the workplace information of board-certified general internists, surgeons, obstetricians/gynaecologists and paediatricians and of all physicians as the same-generation comparison group (ages 30 to 49). Chi-squared test and residual analysis were conducted to compare the distribution between family physicians and other specialists. Results Five hundred nineteen JPCA-certified family physicians and 137,587 same-generation physicians were analysed. The distribution of family physicians was skewed to municipalities with a lower population density, which shows a sharp contrast to the urban-biased distribution of other specialists. The proportion of family physicians in non-metropolitan municipalities was significantly higher than that expected based on the distribution of all same-generation physicians (p < 0.001). Conclusions Family physicians distributed in favour of rural areas much more than any other specialists in Japan. The better balance of family physician distribution reported from countries with a strong primary care orientation seems to hold even in a country where primary care orientation is weak, physician distribution is not regulated, and patients have free access to healthcare. Family physicians comprise only 0.2% of all Japanese physicians. However, if their population grows, they can potentially rectify the imbalance of physician distribution. Government support is mandatory to promote family medicine in Japan.

The development of patient suicide post-vention guidelines for psychiatry trainees and supervisors

2020 ◽  
Vol 28 (5) ◽  
pp. 589-594
Author(s):  
Jessica Henry ◽  
Meagan Ramages ◽  
Gary Cheung
Keyword(s):  
Literature Review ◽  
Review Process ◽  
Support Systems ◽  
Training Programme ◽  
Time Frame ◽  
Stressful Events ◽  
Training Experience ◽  
District Health ◽  
Patient Suicide ◽  
Key Stakeholders

Objectives: Patient suicide is one of the most stressful events for psychiatrists and psychiatry trainees. However, there is often a lack of consistent guidance and support available to clinicians, including post-vention. The aim of this paper is to describe the development of a resource that could support psychiatry trainees following patient suicide. Methods: Following a literature review, we adapted two US patient suicide post-vention guidelines to reflect local processes and support systems available by consulting a number of key stakeholders in the training programme and district health boards. Results: The first part of the post-vention guidelines included procedural processes such as the serious incident review process and reporting to coroner’s office. The second part included a checklist for trainee, supervisor, local training facilitator and director of training according to the following time frame: first 24 hours, first 1–2 weeks and following months. Conclusions: Post-vention guidelines and teaching about patient suicide and its effects could improve the training experience of psychiatry trainees and facilitate the development of resilience as they progress through training.

Integration of occupational therapists into family medicine groups: Physicians’ perspectives

2019 ◽  
Vol 83 (7) ◽  
pp. 458-468
Author(s):  
Valérie Locas ◽  
Cassandra Préfontaine ◽  
Nathalie Veillette ◽  
Brigitte Vachon
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Occupational Therapists ◽  
Early Screening ◽  
Care Services ◽  
Primary Care Services ◽  
Age Related ◽  
Quality Of Primary Care ◽  
Timely Access

Introduction Occupational therapists remain poorly integrated into family medicine groups in Canada. Physicians are key partners because they can advocate for resources and formulate recommendations to improve the quality of services delivered in their clinics. It is important to explore their perception of the occupational therapist’s role in family medicine groups and the factors influencing their integration. Method A descriptive qualitative study was conducted. Six family physicians participated in an individual interview. Results were analysed using thematic analysis. Results Physicians consider that occupational therapists can meet the needs of diverse primary care clients. Benefits of this integration include improved clients’ functional status, early screening for developmental and age-related problems, and timely access to required care. The main barriers to integration are lack of funding, space and knowledge of the occupational therapist’s role. The strategies identified to facilitate integration are promoting and clarifying the role of occupational therapists in family medicine groups and developing effective integration models. Conclusion According to physicians, the inclusion of occupational therapists in family medicine groups could help primary care teams address many of their clients’ needs and improve the overall quality of primary care services. Targeted strategies are needed to promote the integration of occupational therapists into this practice context.

Sign in / Sign up

Export Citation Format

Share Document