scholarly journals How far are they coming from?

2019 ◽  
Vol 13 (12) ◽  
Author(s):  
Samuel Otis-Chapados ◽  
Karolane Coderre ◽  
Stéphane Bolduc ◽  
Katherine Moore
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Outpatient Clinic ◽  
Economic Burden ◽  
Continuing Medical Education ◽  
Pediatric Patients ◽  
Pediatric Urology ◽  
Round Trip ◽  
Voiding Disorders ◽  
The Mean

Introduction: In the province of Quebec, eight pediatric urologists practice in three tertiary centres covering large territories. To improve the availability of pediatric urology to distant families and to reduce the economic burden on them, we examined the chart of all patients attending the pediatric urological outpatient clinic. Our objectives were to evaluate the distance travelled by each urological pediatric outpatient and to report the most frequent urological referral complains. Methods: From July 2016 to June 2017, we retrospectively reviewed the charts of all the 3609 pediatric patients seen in the outpatient urological clinic in CHU de Québec. We specifically focused on the travelling distance covered by families and the purpose of referral. Results: Most patients were boys (78%) and the mean age was 7.2 years. The average one-way distance traveled by each family was 69 km. The patients came more frequently from Capitale-Nationale (63,7%) and Chaudière-Appalaches (21,9%), the closest regions. The most common reasons for consultations were postoperative followups (15%), phimosis and adherences (14%), enuresia (14%), hydronephrosis (13%), micturition disorder (11%), and cryptorchidism and retractile testicles (8%). Of all patients seen for phimosis or cryptorchidism, only 24% and 36% of them, respectively, were scheduled for surgery. Conclusions: Phimosis, cryptorchidism, and voiding disorders are the most frequent pediatric urological reasons for consultation; primary care continuing medical education seems worthwhile. It would, perhaps, be more beneficial for all to have the pediatric urologists travelling to perform clinics and surgeries in distant regions to save more than 300 km round trip to several families.

Presentation and Referral Patterns in Pediatric Closed Hand Fractures

Hand ◽  
2021 ◽  
pp. 155894472110085
Author(s):  
Landis R. Walsh ◽  
Laura C. Nuzzi ◽  
Amir H. Taghinia ◽  
Brian I. Labow
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Pediatric Patients ◽  
Primary Care Providers ◽  
Care Providers ◽  
Referral Patterns ◽  
Old Patients ◽  
Hand Surgeon ◽  
Hand Fractures ◽  
The Mean

Background Although pediatric hand fractures are common and generally have good outcomes, they remain a considerable source of anxiety for non–hand surgeons, who are less familiar with these injuries. We hypothesized that this anxiety may manifest as inefficiency in referral patterns. Methods The records of pediatric patients with isolated, closed hand fractures without concurrent trauma seen at our institution by a hand surgeon between January 2017 and December 2018 were retrospectively reviewed. Results There were 454 patients included; 62.1% were men, and the mean age was 9.6 years at initial encounter. Most patients (89.6%) were treated nonoperatively and incurred few complications (0.5%). Roughly half of all cases (n = 262) initially presented to an outside provider. Of these, 24.0% (n = 64 of 262) were evaluated by 2+ providers before a hand surgeon. Most commonly, these patients were referred from an outside emergency department (ED) to our ED before hand surgeon evaluation (n = 45 of 64). Forty-seven patients required surgery; however, none were performed urgently. Although a greater proportion of 7- to 11-year-old patients saw 2+ providers prior to a hand surgeon ( P = .007), fewer required surgery ( P < .001). Conclusions Pediatric closed hand fractures are mainly treated nonoperatively and nonemergently with generally excellent outcomes. Our data suggest that many patients continue to be referred through the ED or multiple EDs/providers for treatment. These inefficient referral patterns demonstrate the need for better education for ED and primary care providers, as well as better communication between these providers and local pediatric hand surgeons. Advancements in these areas are likely to improve efficiency of care and decrease costs.

scholarly journals Improving Type 2 Diabetes Patient Health Outcomes with Individualized Continuing Medical Education for Primary Care

2016 ◽  
Vol 7 (3) ◽  
pp. 473-481 ◽  
Author(s):  
Brian Lee ◽  
Dace Trence ◽  
Silvio Inzucchi ◽  
Jay Lin ◽  
Steven Haimowitz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Medical Education ◽  
Health Outcomes ◽  
Continuing Medical Education ◽  
Diabetes Patient ◽  
Patient Health

Content, Utilization and Impact of a Hematology e-Consultation Service

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 42-42 ◽  
Author(s):  
Karima Khamisa ◽  
Adam Fogel ◽  
Clare Liddy ◽  
Erin Keely ◽  
Amir Afkham
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Response Time ◽  
Continuing Medical Education ◽  
Primary Care Providers ◽  
Care Providers ◽  
Specialist Care ◽  
Face To Face ◽  
Course Of Action ◽  
Clinical Content

Abstract Background Limited access to specialist care remains a major barrier to health care in Canada. The Champlain BASE (Building Access to Specialists through eConsultation) eConsult service is a secure web-based tool that gives primary care providers (PCPs) expedited access to specialist advice for their patients in Ontario, Canada. Hematology is the third most commonly consulted specialty in the eConsult service, accounting for 8% of all cases. The purpose of this study is to perform an in-depth analysis to describe the types of questions, content, utilization, and impact of hematology eConsults submitted by PCPs. Additionally, the results will inform future continuing medical education activities for PCPs. Methods All Hematology eConsults completed between April 1, 2011 and January 31, 2015 were included. We analyzed and categorized each consultation by: (1) clinical content (up to two per case) using a modification of the International Classification for Primary Care (ICPC-2); and (2) type of questions asked by the PCP based on a validated taxonomy. Other data including PCP designation, time for specialist to complete the eConsult, specialist response time, perceived value of the eConsult by the PCP, and the need for a face-to-face referral following the eConsult was collected in real time via the eConsult service and a survey completed by the initiating PCP at the closure of each eConsult. Results There were a total of 436 Hematology eConsults submitted, 87% from physicians and 13% from Nurse Practitioners. Most cases were answered within 3 days. The most common types of questions being asked pertained to management of hematologic disorders (25%), interpretation of a laboratory test (22%) and appropriate further investigative tests (18%). Common clinical content categories were anemia (22%), neutropenia (13%), high ferritin (11%), monoclonal gammopathy of undetermined significance or an abnormal protein electrophoresis (10%) and thrombocytopenia (10%). Two clinical content categories were included in 19% of cases. Self-reported response time by hematologists was under 10 minutes in >75% of cases. Over 66% of cases did not require a face-to-face visit with the specialist following an eConsult; in fact, in 46% of cases an unnecessary referral was avoided. In 4% of cases, a face-to-face consultation was initiated where one was not originally contemplated. PCPs gained new or additional advice for a course of action in 58% of eConsults, and were able to confirm their original course of action in 39% of cases. PCPs rated the value of the eConsult service as ≥4/5 for both themselves and patients in >90% of cases. Impact The hematology eConsult service has significantly increased access to specialist care in a timely manner compared to traditional face-to-face consultations. The service allowed a significant proportion of patients to avoid traditional consultations leading to the potential of cost savings and increased patient safety. Identifying the most common questions and content being asked via the eConsult service will allow for more informed continuing medical education programs for PCPs so that patients can be better served in the primary care setting. Disclosures Khamisa: Amgen: Speakers Bureau.

scholarly journals Continuing Medical Education for Primary Care Physicians in Israel: A Cross-Sectional Study

2013 ◽  
Vol 2013 ◽  
pp. 1-10
Author(s):  
Pesach Shvartzman ◽  
Howard Tandeter ◽  
Daniel Vardy ◽  
Eran Matz ◽  
Anthony Heymann ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Continuing Medical Education ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Personal Initiative ◽  
Rural Clinic ◽  
Self Administered Questionnaire

Acquiring a medical degree is only the beginning of a prolonged learning process. At some point, formal studies end, and continuing medical education (CME) may be left to personal initiative. To assess lifetime learning (LL) and CME among primary care physicians in Israel, a self-administered questionnaire, based on the Jefferson Scale of Physician Lifelong Learning (JSPLL), was mailed to 4,104 primary care physicians. A total of 979 completed the study, 53.4% males with a mean age of 51.8 ± 8.3 (range 31–79). A logistic regression model showed that male gender (OR = 1.5, P<0.05), teaching (OR = 4.5, P<0.0001), and not working in a rural clinic (OR = 0.6, P<0.01), increased the LL score. The results of the study demonstrate a need to address special subgroups that have a lower tendency to engage in LL activities. Policymakers should develop strategies to increase these physicians' interest in LL activities and the accessibility of these activities to them, including the availability of LL resources at home so physicians can get updates at their convenience. Primary care physicians should also be encouraged to become involved in teaching of any type, as this is a facilitating factor for LL activities.

A SUMMARY: Attitudes and Preferences: Primary Care Physicians and Continuing Medical Education

1981 ◽  
Vol 29 (2) ◽  
pp. 30-30
Author(s):  
Phyllis K. Mansfield ◽  
Donna S. Queeney ◽  
Johny van Nieuwkerk ◽  
A. Douglas Chervenak ◽  
Carl A. Lindsay
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Continuing Medical Education ◽  
Primary Care Physicians

A Continuing Medical Education Initiative for Canadian Primary Care Physicians: The Driving and Dementia Toolkit: A Pre- and Postevaluation of Knowledge, Confidence Gained, and Satisfaction

2003 ◽  
Vol 51 (10) ◽  
pp. 1484-1489 ◽  
Author(s):  
Anna M. Byszewski ◽  
Ian D. Graham ◽  
Stephanie Amos ◽  
Malcolm Man-Son-Hing ◽  
William B. Dalziel ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Continuing Medical Education ◽  
Primary Care Physicians ◽  
Education Initiative

scholarly journals Decentralizing PrEP delivery: Implementation and dissemination strategies to increase PrEP uptake among MSM in Toronto, Canada

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248626
Author(s):  
Maxime Charest ◽  
Malika Sharma ◽  
Allison Chris ◽  
Alexandre Schnubb ◽  
David C. Knox ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Sexual Health ◽  
Continuing Medical Education ◽  
Primary Care Physicians ◽  
Scale Up ◽  
Health Clinic ◽  
Online Questionnaire ◽  
Online Module ◽  
Implementation And Dissemination

Pre-exposure prophylaxis (PrEP) is traditionally prescribed by HIV specialist physicians. Given finite specialist resources, there is a need to scale up PrEP delivery by decentralizing services via other healthcare professionals. We aimed to assess the feasibility of delivering PrEP to men who have sex with men (MSM) through primary care physicians and sexual health clinic nurses. We piloted a multi-component, implementation and dissemination research program to increase provision of PrEP through primary care physicians and sexual health clinic nurses in Toronto, Canada. Community-based organizations (CBOs) provided prospective participants with information cards that contained links to an online module on engaging providers in a conversation about PrEP. In our patient-initiated continuing medical education (PICME) strategy, participants saw their family doctors and gave them the card, which also contained a link to a Continuing Medical Education module. In the nurse-led strategy, participants visited one of two participating clinics to obtain PrEP. We administered an optional online questionnaire to patients and providers at baseline and six months. CBOs distributed 3043 cards. At least 339 men accessed the online module and 196 completed baseline questionnaires. Most (55%) intended to visit nurses while 21% intended to consult their physicians. Among 45 men completing follow-up questionnaires at 6 months, 31% reported bringing cards to their physicians and obtaining PrEP through them; sexual health clinics delivered PrEP to 244 patients. Participants who went through the PICME approach reported no changes in relationships with their providers. Nurses showed fidelity to PrEP prescribing guidelines. Nurse-led PrEP and patient-initiated continuing medical education (PICME) for primary care physicians are feasible strategies to increase PrEP uptake. Nurse-led PrEP delivery was preferred by most patients.

scholarly journals The Influence of a Continuing Medical Education Campaign on New Strategies to Improve Appropriate Use of Antibiotics

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Brenda A. Bucklin ◽  
Ronald S. Gibbs ◽  
Carolyn Wieber ◽  
Leslie Myers
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Continuing Medical Education ◽  
Antibiotic Use ◽  
Primary Care Providers ◽  
Dose Effect ◽  
Drug Resistant ◽  
Care Providers ◽  
Appropriate Use ◽  
Antibiotic Overuse

Introduction. Widespread use of antibiotics has led to drug-resistant bacteria and reports of drug-resistant infections. A continuing medical education (CME) campaign was used to improve antibiotic use among primary care providers. Methods. The Office of CME and Professional Development at the University of Colorado School of Medicine produces a semiannual, week-long course for primary care providers. A 2-year multifaceted CME campaign consisted of course content on antibiotic use, a practice audit, and two surveys to measure perceptions of the problem of antibiotic overuse, potential barriers to achieving appropriate use, and strategies to overcome barriers. Results. The overall response rate in the 2nd part of the campaign was 68.4%. Sixty-six percent of respondents had implemented at least one strategy to reduce antibiotic overuse. The rate was significantly higher among those who had attended previous reviews (81.0%) compared with those who had attended neither (54%, p=0.0002). However, there was no “dose effect” on the rate of implementing a new strategy. Conclusions. Overuse of antibiotic therapy has important public health implications. Results suggest that mixed interactive and didactic CME program was effective in increasing awareness of antibiotic overuse and strategies for reducing antibiotic administration.

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