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.

Billing Codes Determine Lower Physician Income for Primary Care and Non-Procedural Specialties

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Arielle L. Langer ◽  
Miriam Laugesen
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Direct Consequence ◽  
Medical Specialties ◽  
Income Differences ◽  
Income Gap ◽  
Physician Income ◽  
The Difference ◽  
The Relationship

Abstract The income gap between specialists and primary care physicians and among specialists is well established, but the drivers of this difference are not well delineated. Using the Community Tracking Study (CTS) Physician Survey, we sought to isolate and compare premiums paid to physicians for specialization and the proportion of time spent on offices visit rather than procedures. We divided medical subspecialties according the proportion of Medicare billing for Evaluation and Management (E&M) codes for the specialty as a whole. We report substantial differences in income across physician specialty, and over 70 percent of the difference in income remained controlling for factors that may confound the relationship between income and specialty including gender, location and type of practice, and hours. We note a large variation in premiums for specialization: 11.3–46.8 percent above family medicine after controlling for confounders. Classifying medical subspecialties by E&M billing as procedural versus non-procedural specialties revealed clear income differences. Controlling for confounders, procedural medical specialties earned 37.5 percent more than family medicine, as compared with 15.3 percent for non-procedural medical specialties. This analysis suggests that differences in physician income and resulting incentives are a direct consequence of the payment structure itself, rather than compensation for additional years of training or a reflection of different underlying demographics.

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 Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

2020 ◽  
Vol 4 (5) ◽  
pp. 425-430
Author(s):  
Michael L. Parchman ◽  
Brooke Ike ◽  
Katherine P Osterhage ◽  
Laura-Mae Baldwin ◽  
Kari A Stephens ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Rural Areas ◽  
Building Blocks ◽  
Rural Practice ◽  
Barriers And Facilitators ◽  
External Support ◽  
Rural Setting ◽  
Opioid Prescribing ◽  
Patient Resources

AbstractBackground:Opioids are more commonly prescribed for chronic pain in rural settings in the USA, yet little is known about how the rural context influences efforts to improve opioid medication management.Methods:The Six Building Blocks is an evidence-based program that guides primary care practices in making system-based improvements in managing patients using long-term opioid therapy. It was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. To gain further insight about their experience with implementing the program, interviews and focus groups were conducted with staff and clinicians at the six organizations at the end of the 15 months and transcribed. Team members used a template analysis approach, a form of qualitative thematic analysis, to code these data for barriers, facilitators, and corresponding subcodes.Results:Facilitators to making systems-based changes in opioid management within a rural practice context included a desire to help patients and their community, external pressures to make changes in opioid management, a desire to reduce workplace stress, external support for the clinic, supportive clinic leadership, and receptivity of patients. Barriers to making changes included competing demands on clinicians and staff, a culture of clinician autonomy, inadequate data systems, and a lack of patient resources in rural areas.Discussion:The barriers and facilitators identified here point to potentially unique determinants of practice that should be considered when addressing opioid prescribing for chronic pain in the rural setting.

scholarly journals Drivers of information disclosure on health information exchange platforms: insights from an exploratory empirical study

2015 ◽  
Vol 22 (6) ◽  
pp. 1183-1186 ◽  
Author(s):  
Niam Yaraghi ◽  
Raj Sharman ◽  
Ram Gopal ◽  
Ranjit Singh ◽  
R Ramesh
Keyword(s):  
Primary Care ◽  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Information Disclosure ◽  
Primary Care Physicians ◽  
Medical Information ◽  
Health Information Exchange ◽  
Care Physician ◽  
Willingness To Disclose

Abstract Objective The objective of this research is to empirically explore the drivers of patients’ consent to sharing of their medical records on health information exchange (HIE) platforms. Materials and Methods The authors analyze a dataset consisting of consent choices of 20 076 patients in Western New York. A logistic regression is applied to empirically investigate the effects of patients’ age, gender, complexity of medical conditions, and the role of primary care physicians on patients’ willingness to disclose medical information on HIE platforms. Results The likelihood of providing consent increases by age (odds ratio (OR) = 1.055; P  < .0001). Female patients are more likely to provide consent (OR = 1.460; P  = .0003). As the number of different physicians involved in the care of the patient increases, the odds of providing consent slightly increases (OR = 1.024; P  = .0031). The odds of providing consent is significantly higher for the patients whom a primary care physician has been involved in their medical care (OR = 1.323; P  < .0001). Conclusion Individual-level characteristics are important predictors of patients’ willingness to disclose their medical information on HIE platforms.

scholarly journals Are health websites credible enough for elderly self-education in the most prevalent elderly diseases?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saeideh Valizadeh-Haghi ◽  
Shahabedin Rahmatizadeh ◽  
Ali Soleimaninejad ◽  
Seyedeh Fatemeh Mousavi Shirazi ◽  
Parisa Mollaei
Keyword(s):  
Health Information ◽  
Chronic Diseases ◽  
The Elderly ◽  
Chronic Obstructive ◽  
Chi Square ◽  
Obstructive Pulmonary Disease ◽  
Significant Difference ◽  
Health Decision ◽  
Chi Square Test ◽  
The Difference

Abstract Background The Elderly and their caregivers need credible health information to manage elderly chronic diseases and help them to be involved in health decision making. In this regard, health websites are considered as a potential source of information for elderlies as well as their caregivers. Nevertheless, the credibility of these websites has not been identified yet. Thus, this study aimed to evaluate the credibility of the health websites on the most prevalent chronic diseases of the elderly. Methods The terms “Chronic obstructive pulmonary disease”, “Alzheimer's”, “Ischemic heart disease”, and “Stroke” were searched using the three popular search engines. A total of 216 unique websites were eligible for evaluation. The study was carried out using the HONcode of conduct. The chi-square test was carried out to determine the difference between conforming and nonconforming websites with HONcode principles and website categories. Results The findings showed that half of the evaluated websites had fully considered the HONcode principles. Furthermore, there was a significant difference between websites category and compliance with HONcode principles (p value < .05). Conclusion Regarding the poor credibility of most prevalent elderly diseases’ websites, the potential online health information users should be aware of the low credibility of such websites, which may seriously threaten their health. Furthermore, educating the elderly and their caregivers to evaluate the credibility of websites by the use of popular tools such as HONcode of conducts before utilizing their information seems to be necessary.

scholarly journals Potentially Inappropriate Prescribing in Older Adults with Hypertension or Diabetes Mellitus and Hypertension in a Primary Care Setting in Bahrain

2018 ◽  
Vol 27 (3) ◽  
pp. 241-249 ◽  
Author(s):  
Khalid A.J. Al Khaja ◽  
Husain Ahmed Isa ◽  
Sindhan Veeramuthu ◽  
Reginald P. Sequeira
Keyword(s):  
Diabetes Mellitus ◽  
Older Adults ◽  
Primary Care ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Inappropriate Prescribing ◽  
Family Physicians ◽  
Continuous Variables ◽  
Potentially Inappropriate Prescribing ◽  
The Difference

Objectives: The aims of this study were to evaluate: (1) the prevalence and types of potentially inappropriate prescribing in older adults with hypertension or diabetes mellitus and hypertension, and (2) whether or not differences in the training of primary care physicians were associated with potentially inappropriate prescribing. Materials and Methods: Primary care prescriptions issued by family physicians and general practitioners were audited using Screening Tool of Older Persons’ Prescriptions criteria (version 1), with 18 out of 65 applicable criteria. Descriptive statistics were used to test the difference between proportions, and two-tailed t test was used for continuous variables. Results: A total of 2,090 outpatient prescriptions were written during the study period; of these, 712 (34.1%) were potentially inappropriate. The mean number of drugs per patient was 6.03 (±2.5). Of the 712 prescriptions, 543 (76.3%) were used for the treatment of acute medical illnesses. The most common examples of potentially inappropriate prescribing were: orphenadrine (n = 174; 8.33%), long-term nonsteroidal anti-inflammatory drugs for > 3 months (n = 150; 7.18%), proton pump inhibitors for > 8 weeks (n = 135; 6.46%), antihypertensive therapy duplication (n = 59; 2.82%), long-acting glyburide (n = 48; 2.29%), and chlordiazepoxide for > 1 month (n = 44; 2.11%). Family physicians showed a greater tendency toward potentially inappropriate prescribing compared to general practitioners, but the difference was nonsignificant (n = 514 [34.75%] vs. n = 162 [31.3%]; p = 0.16). Conclusions: The prevalence of potentially inappropriate prescribing (i.e., 34.1%) was within the spectrum reported worldwide and unrelated to the training backgrounds of physicians. Most of the identified potentially inappropriate prescribing (76.3%) in older adults was associated with medications for acute medical illnesses and hence inappropriate polypharmacy should be discouraged.

scholarly journals Exercise Counseling by Primary Care Physicians in Jordan—A Preliminary Study

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Othman Beni Yonis ◽  
Rami Saadeh ◽  
Zaher Chamseddin ◽  
Hussam Alananzeh
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Exercise Counseling ◽  
Chi Square Test

Despite the value of physical activity and exercise to patients, little is known about the perception and practices of Jordanian primary care physicians (PCPs) regarding counseling patients about exercise. This study was aimed at assessing counseling about exercise by PCPs in Jordan. A cross-sectional study targeting a random sample of physicians from family medicine, internal medicine and general practice in academic, public, and private sectors. Chi-square test of independence was used to assess the association of perceptions and practices of physicians regarding exercise counseling with their specialty. Logistic regression models were used to examine the association of demographic information with selected items of perception and practice. A total of 218 physicians participated in the study. They were mainly males (67%), family medicine physicians (42.2%), and had a mean age of 33.7 (±9.87) years. Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%). Family medicine physicians counseled more patients, more frequently, and their desire to counsel more patients was significantly higher than other physicians ( P = .002). The Perceptions and practices of Jordanian PCPs toward exercise counseling for their patients were found positive; however the desire to counsel more patients was low. Lack of patients’ motivation to practice exercise, time constraint and limited resources were the most frequently reported barriers to counseling. Further investigation on how to overcome such barriers is recommended.

How Primary Care Physicians Elicit Sensitive Health Information From Patients: Describing Access to Psychosocial Information

2020 ◽  
Vol 30 (9) ◽  
pp. 1338-1348
Author(s):  
Charles R. Senteio ◽  
Deborah B. Yoon
Keyword(s):  
Primary Care ◽  
Health Information ◽  
Primary Care Physicians ◽  
Care Physician ◽  
Financial Strain ◽  
Structured Interviews ◽  
Personalized Care ◽  
Related Information ◽  
Health Related ◽  
Patient Disclosure

Multiple communication models describe factors that influence disclosure of sensitive health information. However, these models do not address the receiver’s perspective of health-related information, nor do they address how the receiver promotes disclosure. In the primary care chronic disease visit, the patient (sender) must disclose sensitive health-related psychosocial information to the primary care physician (PCP) (receiver) for the PCP to understand potential barriers to care (e.g., financial strain) and make treatment decisions (e.g., referral to social work). A vital gap exists in understanding how PCPs perceive that patients disclose. We conducted individual, semi-structured interviews ( n = 17) to understand PCPs’ perceptions of patient disclosure of sensitive, psychosocial information in the clinical visit. PCPs facilitate patient disclosure by (a) building and maintaining rapport and (b) nurturing the patient–provider relationship. This article describes PCPs’ perceptions of how they access psychosocial information which is vital to inform clinical decisions that facilitate personalized care.

Sign in / Sign up

Export Citation Format

Share Document