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 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 Job satisfaction among primary care physicians in western China

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhuo Zhang ◽  
Guoshuai Shi ◽  
Lingui Li ◽  
Ying Bian
Keyword(s):  
Primary Care ◽  
Job Satisfaction ◽  
Turnover Intention ◽  
Primary Care Physicians ◽  
Satisfaction Score ◽  
Western China ◽  
Care Services ◽  
Primary Care Services ◽  
Primary Care Workforce ◽  
Quality Of Primary Care

Abstract Background There has been great shortage of primary care physicians (PCPs) in China, especially in western areas. Job satisfaction plays a great role in retaining people. The aim of this study is to investigate the job satisfaction of PCPs and associated factors in 11 provinces of western China, thus providing necessary reference values for stabilizing the primary care workforce and improving the quality of primary care services. Method A sample of 2103 PCPs working in western China were surveyed using a stratified, multistage and random sampling method in 2011. The characteristics of participants were recorded by a structured questionnaire. A multilevel model (MLM) and quantile regression (QR) were applied to assess the association between job satisfaction and possible risk factors. Results Of the 2103 doctors surveyed, the overall satisfaction score was 3.26 ± 0.68 (from 1 to 5). MLM indicated that age group, income satisfaction, unit policy approval, personal planning, career attitude, work value and patient recognition were positively correlated with job satisfaction, while turnover intention was negatively correlated with job satisfaction. QR were not completely consistent with MLM and further explored the differences in different job satisfaction score percentiles on each domains. Conclusion This study showed that the job satisfaction of PCPs in western China was not high. The MLM and QR discussed were not entirely consistent, the latter one provided more information and robust results. Measures should be taken in streamlining administration and institute decentralization, creating more opportunities for additional training, raising PCPs’ income, improving the social status of doctors and improving the relationship between doctors and patients.

Assessment of New York Primary Care Physicians’ Knowledge, Attitudes, and Practices Related to Fluoride Varnish in an Urban Medical-Setting

2020 ◽  
Vol 44 (4) ◽  
pp. 249-255
Author(s):  
Lisa Lian ◽  
Christie Lumsden ◽  
Richard Yoon ◽  
Dana Sirota
Keyword(s):  
Primary Care ◽  
New York ◽  
Interprofessional Education ◽  
Primary Care Physicians ◽  
Medical Center ◽  
Fluoride Varnish ◽  
Medical Setting ◽  
Attitudes And Practices ◽  
Hands On ◽  
Knowledge Attitudes And Practices

Objective: To determine changes in knowledge, attitudes, and practices of primary care physicians (PCPs) regarding fluoride varnish (FV). Study Design: Fifty-four PCPs at an urban medical center in New York completed a pre-intervention survey. A pediatric dental resident provided an hour-long educational lecture and a hands-on demonstration regarding FV application. Six months later, PCPs were sent a post-intervention survey via electronic mail. Results: Fifty-four PCPs participated in the pre-survey and FV training and 48% completed the post-survey. Prior to the FV training, 57% of PCPs knew that FV application by medical practitioners was reimbursable for children under 6-years-old and 2% of PCPs were applying FV. Post FV training, 62% of PCPs reported applying FV. Pre and post survey, barriers to FV application was not enough hands-on training (43% to 15% respectively) and not enough time (50% to 85% respectively). Conclusions: Post FV training, PCPs’ knowledge, attitudes and practices in regard to FV changed. Interprofessional education may be one approach to increasing FV application participation.

scholarly journals US Primary Care in 2029: A Delphi Survey on the Impact of Machine Learning

2020 ◽  
Author(s):  
Charlotte Blease ◽  
Anna Kharko ◽  
Cosima Locher ◽  
Catherine M. DesRoches ◽  
Kenneth D. Mandl
Keyword(s):  
Primary Care ◽  
Health Informatics ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Digital Health ◽  
Training Requirements ◽  
Modified Delphi ◽  
Primary Care Workforce ◽  
The Us ◽  
The Impact

AbstractObjectiveTo solicit leading health informaticians’ predictions about the impact of AI/ML on primary care in the US in 2029.DesignA three-round online modified Delphi poll.ParticipantsTwenty-nine leading health informaticians.MethodsIn September 2019, health informatics experts were selected by the research team, and invited to participate the Delphi poll. Participation in each round was anonymous, and panelists were given between 4-8 weeks to respond to each round. In Round 1 open-ended questions solicited forecasts on the impact of AI/ML on: (1) patient care, (2) access to care, (3) the primary care workforce, (4) technological breakthroughs, and (5) the long-future for primary care physicians. Responses were coded to produce itemized statements. In Round 2, participants were invited to rate their agreement with each item along 7-point Likert scales. Responses were analyzed for consensus which was set at a predetermined interquartile range of ≤ 1. In Round 3 items that did not reach consensus were redistributed.ResultsA total of 16 experts participated in Round 1 (16/29, 55%). Of these experts 13/16 (response rate, 81%), and 13/13 (response rate, 100%), responded to Rounds 2 and 3, respectively. As a result of developments in AI/ML by 2029 experts anticipated workplace changes including incursions into the disintermediation of physician expertise, and increased AI/ML training requirements for medical students. Informaticians also forecast that by 2029 AI/ML will increase diagnostic accuracy especially among those with limited access to experts, minorities and those with rare diseases. Expert panelists also predicted that AI/ML-tools would improve access to expert doctor knowledge.ConclusionsThis study presents timely information on informaticians’ consensus views about the impact of AI/ML on US primary care in 2029. Preparation for the near-future of primary care will require improved levels of digital health literacy among patients and physicians.

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