Primary Care Practise in Turkey and Training of Contracted Family Physicians

(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

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Academic Units for Primary Care Training and Enhancement: Improving Evidence and Training to Strengthen Primary Care

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2020.0145 ◽

2020 ◽

Vol 31 (4S) ◽

pp. 139-143

Author(s):

Irene Sandvold ◽

Jennifer Holtzman ◽

Nancy Douglas-Kersellius ◽

Tracey O. Smith ◽

Cynthia Harne ◽

...

Keyword(s):

Primary Care ◽

Primary Care Training ◽

Academic Units ◽

Care Training ◽

And Training

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Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063293 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3293

Author(s):

Jasneet Parmar ◽

Sharon Anderson ◽

Marjan Abbasi ◽

Saeed Ahmadinejad ◽

Karenn Chan ◽

...

Keyword(s):

Primary Care ◽

Family Caregivers ◽

Healthcare Providers ◽

Family Physicians ◽

Care Team ◽

Primary Care Team ◽

Caregiver Support ◽

Team Members ◽

Primary Care Teams ◽

Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

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Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

Global Advances in Health and Medicine ◽

10.1177/21649561211023377 ◽

2021 ◽

Vol 10 ◽

pp. 216495612110233

Author(s):

Malaika R Schwartz ◽

Allison M Cole ◽

Gina A Keppel ◽

Ryan Gilles ◽

John Holmes ◽

...

Keyword(s):

United States ◽

Primary Care ◽

Health Knowledge ◽

Care Delivery ◽

Primary Care Providers ◽

The United States ◽

Research Network ◽

Care Providers ◽

Integrative Health ◽

And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

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Preparing genomic revolution: Attitudes, clinical practice, and training needs in delivering genetic counseling in primary care in Hong Kong and Shenzhen, China

Molecular Genetics & Genomic Medicine ◽

10.1002/mgg3.1702 ◽

2021 ◽

Author(s):

Man Wai Cecilia Yu ◽

Jasmine Lee Fong Fung ◽

Amy Pui Pui Ng ◽

Zhuo Li ◽

Wang Lan ◽

...

Keyword(s):

Primary Care ◽

Hong Kong ◽

Genetic Counseling ◽

Clinical Practice ◽

Training Needs ◽

And Training ◽

Genomic Revolution

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Teaching Normal and Abnormal Behavior to Primary Care Physicians

The International Journal of Psychiatry in Medicine ◽

10.2190/t6xy-qlqd-e6bx-m0g3 ◽

1994 ◽

Vol 24 (2) ◽

pp. 115-120 ◽

Cited By ~ 2

Author(s):

Uriel Halbreich

Keyword(s):

Primary Care ◽

Differential Diagnosis ◽

Human Behavior ◽

Primary Care Physicians ◽

Family Physicians ◽

Abnormal Behavior ◽

General Internists ◽

Education Committee ◽

Personal Skills

Objective: This article delineates the framework for a curriculum on psychiatry, normal and abnormal human behavior for primary care physicians (PCPs). Methods: Curricula have been surveyed. Members of the Education Committee of the Association of Medicine and Psychiatry, as well as Family Physicians and General Internists involved in education have been consulted. Their recommendations are integrated. Results and Conclusions: The curriculum should be developed according to the needs of PCPs and from their perspective. Patient and problem-oriented, its content can be divided into: a) personal skills that should be developed; and b) knowledge of symptoms, their differential diagnosis (DDX) and management within the PCP's, facilities and abilities.

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The PUFFinCA scale: development of an instrument for evaluating the primary care functions of family physicians in childhood asthma

Primary Health Care Research & Development ◽

10.1017/s1463423618000609 ◽

2018 ◽

Vol 20 ◽

Author(s):

Ayşe Nur Usturali Mut ◽

Zeliha Aslı Öcek ◽

Meltem Çiçeklioğlu ◽

Şafak Taner ◽

Esen Demir

Keyword(s):

Primary Care ◽

Childhood Asthma ◽

Assessment Tool ◽

Asthma Management ◽

Correlation Coefficients ◽

Family Physicians ◽

Principal Component ◽

Care Assessment ◽

Provision Of Services ◽

Children With Asthma

AbstractAimTo develop the Primary care fUnctions oF Family physicians in Childhood Asthma (PUFFinCA) scale for evaluating the cardinal process functions of primary care services (accessibility, comprehensiveness, continuity and coordination) provided by family physicians (FPs) in the management of childhood asthma.BackgroundIn the literature on the functions of primary care, there is no assessment tool focusing on children with asthma. Primary care assessment scales adapted to various languages are not suitable to adequately address the needs of special patient groups, such as children with asthma.MethodsIn this methodological study, the instrument development process was completed in four stages: establishing the pool of items, evaluating the content validity, applying the scale and statistical analysis. The scale was applied to 320 children who had asthma and received care in the clinic of the Department of Pediatrics, Division of Allergy and Pulmonology at Ege University School of Medicine, Turkey. The Cronbach’s α and Spearman–Brown coefficient were calculated to determine the reliability of the scale. Principal component analysis was used to determine the construct validity of the scale.FindingsThe PUFFinCA scale was found to have four-factor structure and 25 items. Cronbach’s α coefficient was 0.93. It has been determined that the reliability was excellent and the item-total correlation coefficients were >0.30 each. The factors were titled FP’s ‘functions of accessibility, first contact and continuity’, ‘functions of coordination and comprehensiveness of health services related to asthma management’, ‘provision of preventive care related to asthma’ and ‘provision of services for paid vaccinations’.

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Plug the Leak: Align Public Spending With Public Need

Journal of Graduate Medical Education ◽

10.4300/jgme-d-11-00199.1 ◽

2012 ◽

Vol 4 (3) ◽

pp. 293-295 ◽

Cited By ~ 1

Author(s):

Donald E. Girard ◽

Patrick Brunett ◽

Andrea Cedfeldt ◽

Elizabeth A. Bower ◽

Christine Flores ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Medical Education ◽

Graduate Medical Education ◽

Public Spending ◽

Education Spending ◽

Graduate Medical ◽

Workforce Needs ◽

Training Physicians ◽

And Training

Abstract We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.

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Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm

PRiMER ◽

10.22454/primer.2021.304379 ◽

2021 ◽

Vol 5 ◽

Author(s):

Peggy R. Cyr ◽

Wendy Craig ◽

Hadjh Ahrns ◽

Kathryn Stevens ◽

Caroline Wight ◽

...

Keyword(s):

Primary Care ◽

Medical Students ◽

Skin Cancer ◽

Primary Care Physicians ◽

Survival Rates ◽

Family Physicians ◽

Skin Lesions ◽

Posttest Score ◽

Malignant Skin ◽

Attending Physicians

Introduction: Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. Methods: We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Results: Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P<.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant (P<.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. Conclusion: After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

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Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/prolas-2019-0026 ◽

2019 ◽

Vol 73 (2) ◽

pp. 164-170

Author(s):

Vineta Viktorija Vinogradova ◽

Jeļena Vrubļevska ◽

Elmārs Rancāns

Keyword(s):

Primary Care ◽

Mental Disorders ◽

Common Mental Disorders ◽

Current Knowledge ◽

Family Physicians ◽

Research Programme ◽

Primary Care Settings ◽

National Research Programme ◽

Management Approaches ◽

Training Programmes

Abstract Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.

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