scholarly journals Alarming triad of progressive hoarseness in a male smoker

2021 ◽  
Vol 16 (3) ◽  
pp. 119-122
Author(s):  
Nur Ain Nabila Za'im ◽  
Mawaddah Azman
Keyword(s):  
Primary Care ◽  
Laryngeal Cancer ◽  
Primary Care Physicians ◽  
Glottic Carcinoma ◽  
Health Providers ◽  
Male Smoker ◽  
Vocal Health ◽  
Number Of Patients ◽  
Primary Care Health ◽  
History Of

Hoarseness accounts for 1% of all consultations in primary care. Suspicion of malignancy should be considered in individuals with risk factors presenting with unexplained hoarseness lasting more than two weeks. A significant number of patients with laryngeal cancer present at an advanced stage due to lack of awareness regarding vocal health. It is important to educate both the public and primary care health providers concerning laryngeal cancer. We present the case of an 81-year old male smoker who presented to us with a six-month history of progressive hoarseness. He was initially treated in two primary and one secondary care centres, where a diagnosis of laryngeal cancer was not considered. Careful assessment in our centre managed to determine a diagnosis of T3N0M0 glottic carcinoma. We will discuss this alarming triad of progressive hoarseness in a male smoker to help primary care physicians streamline their thoughts and identify red flags in a hoarse patient.

Electronic cigarettes: How confident and effective are allergists, pulmonologists, and primary care physicians in their practice behavior?

2020 ◽  
Vol 41 (3) ◽  
pp. 192-197
Author(s):  
Sherry S. Zhou ◽  
Alan P. Baptist
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Electronic Cigarettes ◽  
The United States ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Knowledge And Beliefs ◽  
Tobacco Cigarette ◽  
Number Of Patients ◽  
Personal Use

Background: There has been a striking increase in electronic cigarette (EC) use in the United States. The beliefs and practices toward ECs among physicians are unknown. Objective: The purpose of this study was to investigate EC practice patterns among allergists, pulmonologists, and primary care physicians. Methods: An anonymous survey was sent to physicians. The survey contained 32 questions and addressed issues related to demographics, cessation counseling behaviors, personal use, and knowledge and beliefs about ECs. Statistical analysis was performed by using analysis of variance, the Pearson χ2 test, Fisher exact test, and logistic regression. Results: A total of 291 physicians completed the survey (222 primary care physicians, 33 pulmonologists, and 36 allergists) for a response rate of 46%. The allergists asked about tobacco cigarette use as frequently as did the pulmonologists and more than the primary care physicians (p < 0.001), but they rarely asked about EC use. The pulmonologists scored highest on self-reported knowledge on ECs, although all the groups answered <40% of the questions correctly. The allergists did not feel as comfortable about providing EC cessation counseling as did the pulmonologists and primary care physicians (p < 0.001). All three groups were equally unlikely to recommend ECs as a cessation tool for tobacco cigarette users. Conclusion: Allergists lacked knowledge and confidence in providing education and cessation counseling for EC users. As the number of patients who use these products continues to increase, there is an urgent need for all physicians to be comfortable and knowledgeable with counseling about ECs.

scholarly journals Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Mika Lehto ◽  
Kaisu Pitkälä ◽  
Ossi Rahkonen ◽  
Merja K Laine ◽  
Marko Raina ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Health Centers ◽  
Health Record ◽  
Record System ◽  
Electronic Reminder ◽  
Primary Health ◽  
Primary Care Health ◽  
Before And After ◽  
Care Health

Objectives: One purpose of electronic reminders is improvement of the quality of documentation in office-hours primary care. The aim of this study was to evaluate how implementation of electronic reminders alters the rate and/or content of diagnostic data recorded by primary care physicians in office-hours practices in primary care health centers. Methods: The present work is a register-based longitudinal follow-up study with a before-and-after design. An electronic reminder was installed in the electronic health record system of the primary health care of a Finnish city to remind physicians to include the diagnosis code of the visit in the health record. The report generator of the electronic health record system provided monthly figures for the number of various recorded diagnoses by using the International Classification of Diseases, 10th edition, and the total number of visits to primary care physicians, thus allowing the calculation of the recording rate of diagnoses on a monthly basis. The distribution of diagnoses before and after implementing ERs was also compared. Results: After the introduction of the electronic reminder, the rate of diagnosis recording by primary care physicians increased clearly from 39.7% to 87.2% (p < 0.001). The intervention enhanced the recording rate of symptomatic diagnoses (group R) and some chronic diseases such as hypertension, type 2 diabetes and other soft tissue disorders. Recording rate of diagnoses related to diseases of the respiratory system (group J), injuries, poisoning and certain other consequences of external causes (group S), and diseases of single body region of the musculoskeletal system and connective tissue (group M) decreased after the implementation of electronic reminders. Conclusion: Electronic reminders may alter the contents and extent of recorded diagnosis data in office-hours practices of the primary care health centers. They were found to have an influence on the recording rates of diagnoses related to chronic diseases. Electronic reminders may be a useful tool in primary health care when attempting to change the behavior of primary care physicians.

scholarly journals Barriers and Facilitators towards an Integrated Chronic Care Model as experienced by primary care health providers

2016 ◽  
Vol 16 (6) ◽  
pp. 78 ◽  
Author(s):  
Geert Goderis ◽  
Gunther D'hanis ◽  
Gert Merckx ◽  
Wim Verhoevven ◽  
Pierre Sijbers ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Barriers And Facilitators ◽  
Health Providers ◽  
Care Model ◽  
Primary Care Health ◽  
Care Health

scholarly journals Lifestyle Medicine Around the World: Lifestyle Medicine in Israel

2019 ◽  
Vol 14 (4) ◽  
pp. 377-381
Author(s):  
Lilach Malatskey ◽  
Igal Hekselman ◽  
Shani Afek
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Medical Profession ◽  
Daily Practice ◽  
Well Being ◽  
The United States ◽  
Noncommunicable Disease ◽  
Active Member ◽  
Health Providers ◽  
Lifestyle Medicine

In 2015, the Centers for Disease Control in the United States declared that 7 of 10 deaths per year are caused by chronic diseases; in Israel, the situation is consistent with this assessment. Healthy Israel 2020, an Israeli Ministry of Health initiative, places physicians at the forefront of health promotion and preventive medicine. In 2012, the Israeli Society of Lifestyle Medicine (ISLM) was established under the auspices of the Israel Association for Family Physicians. This decision was taken because we, the authors, wanted to promote change in the primary care services through the recruitment of key leaders for implementation of lifestyle medicine (LM), including improved attitudes, knowledge, motivation, and skills of primary care physicians and health providers. Today, the ISLM is an active member of the Israeli Medical Association, promoting educational activities, physician’s health, and well-being initiatives; developing tools for health-promoting clinics; and more. Our future plans are to incorporate LM as an integral part of daily practice in all sectors of the medical profession in Israel. This is challenging, but we see this as the only way to effectively combat the noncommunicable disease epidemic.

scholarly journals Medical Cannabis for the Primary Care Physician

2019 ◽  
Vol 10 ◽  
pp. 215013271988483 ◽  
Author(s):  
Deepika Slawek ◽  
Senthil Raj Meenrajan ◽  
Marika Rose Alois ◽  
Paige Comstock Barker ◽  
Irene Mison Estores ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
The United States ◽  
Care Physician ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Efficacy And Safety ◽  
Medical Cannabis ◽  
Number Of Patients

Medical cannabis use is common in the United States and increasingly more socially acceptable. As more patients seek out and acquire medical cannabis, primary care physicians will be faced with a growing number of patients seeking information on the indications, efficacy, and safety of medical cannabis. We present a case of a patient with several chronic health conditions who asks her primary care provider whether she should try medical cannabis. We provide a review of the pharmacology of medical cannabis, the state of evidence regarding the efficacy of medical cannabis, variations in the types of medical cannabis, and safety monitoring considerations for the primary care physician.

scholarly journals General practitioners’ challenges and strategies in dealing with Internet-related health anxieties—results of a qualitative study among primary care physicians in Germany

2020 ◽  
Vol 170 (13-14) ◽  
pp. 329-339
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
Content Analysis ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Qualitative Approach ◽  
The Internet ◽  
State Of Health ◽  
Medical Practices ◽  
Number Of Patients ◽  
Consultation Time

Summary Time and again, it is discussed that in medical practices, the number of patients who develop health anxieties due to extensive health information searches on the Internet is increasing. The objective of this study is to explore and describe general practitioners’ experiences and attitudes towards cyberchondria patients as well as strategies to stabilize affected patients. Following a qualitative approach, oral personal semi-standardized interviews with general practitioners (N = 38) in Rhineland-Palatinate, Germany, were conducted in 2019. In the course of a content analysis, one can see that most interviewees see the emergence of Internet-related health anxieties as an increasing problem in everyday care. Affected patients not only show marked levels of doubt and nervousness as well as hypersensitivity to their own state of health, but also low confidence in the physician. In addition to compliance-related difficulties, the high need for advice and the demand for further diagnostics are regarded as major problems. Various approaches were identified by which general practitioners respond to unsettled patients (more consultation time, recommendation of reputable websites, information double-checking, expanded history questionnaire, additional psychosocial training).

Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

2018 ◽  
Vol 58 (2) ◽  
pp. 213-225 ◽  
Author(s):  
David J. Kolko ◽  
Eunice Torres ◽  
Kevin Rumbarger ◽  
Everette James ◽  
Renee Turchi ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Integrated Care ◽  
Primary Care Physicians ◽  
Empirical Literature ◽  
Health Providers ◽  
Pediatric Health ◽  
Care Experience ◽  
Pediatric Health Care

This study reports on a statewide survey of medical and behavioral health professionals to advance the knowledge base on the benefits and obstacles to delivering integrated pediatric health care. Surveys distributed in 3 statewide provider networks were completed by 110 behavioral health specialists (BHSs) and 111 primary care physicians (PCPs). Survey content documented their perceptions about key services, benefits, barriers, and needed opportunities related to integrated care. Factor analyses identified 8 factors, and other items were examined individually. We compared responses by specialty group (BHS vs PCP) and integrated care experience (no vs yes). The findings revealed differences across domains by specialty subgroup. In several cases, BHS (vs PCP) respondents, especially those with integrated care experience, reported lower benefits, higher barriers, and fewer resource requests. The implications of these results for enhancing care integration development, delivery, training, and research are discussed along with the study’s limitations and empirical literature.

scholarly journals Early detection of asthma and chronic obstructive pulmonary disease in primary care patients

2013 ◽  
Vol 66 (1-2) ◽  
pp. 46-52 ◽  
Author(s):  
Marija Vukoja ◽  
Predrag Rebic ◽  
Zorica Lazic ◽  
Marija Mitic-Milikic ◽  
Branislava Milenkovic ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Number Of Patients ◽  
Primary Care Patients

Introduction. Asthma and chronic obstructive pulmonary disease are often unrecognized and undertreated. The aim of this study was to describe the frequency of chronic obstructive pulmonary disease and asthma in primary care patients in Serbia, and to examine the agreement between general practitioners and pulmonologists on the diagnosis of chronic obstructive pulmonary disease and asthma. Material and Methods. In this multicenter observational study, the general practitioners identified eligible patients from October 2009 to June 2010. The study included all adult patients with respiratory symptoms and/or smoking history based on structured interview. The patients were referred to a pulmonologist and underwent a diagnostic work-up, including spirometry. Results. There were 2074 patients, 38.4% men, their mean age being 54?15.5 years. The patients were mostly current (40.3%) or ex-smokers (27.4%). The common symptoms included shortness of breath (84.9%), cough (79.1%) and wheezing (64.3%). The diagnosis of chronic obstructive pulmonary disease was confirmed by pulmonologists in 454 (21.9%) and asthma in 455 (21.9%) patients. The chronic obstructive pulmonary disease was newly diagnosed in 226 (10.9%) and asthma in 269 (13%) of the cases. There was a moderate agreement between the pulmonologists and general practitioners on the diagnosis of chronic obstructive pulmonary disease (kappa 0.41, 95%CI 0.36-0.46) and asthma (kappa 0.42, 95% CI 0.37-0.465). Conclusion. A significant number of patients seen in the general practitioner?s office were diagnosed with chronic obstructive pulmonary disease or asthma and half of them represent new cases. A substantial proportion of patients referred to a pulmonologist by primary care physicians have been misdiagnosed.

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