Physicians are often called upon to mentor students considering a career in medicine. There are seldom clear guidelines as to what either the student or the physician should do during these experiences. The following article is offered as a model of what the student and physician authors considered a productive ...

A survey instrument was developed based on a model of the substantive factors influencing the adoption of Information Technology (IT) enabled innovations by physicians. The survey was given to all faculty and residents in a Primary Care teaching institution. Computerized literature searching was the IT innovation studied. The results support ...

Following the 1990 FDA approval of the Trophocan catheter for use in transcervical chorionic villus sampling (CVS), an increasing number of US physicians have begun offering the procedure. To obtain privileges to perform CVS, some states such as California have enacted legislation requiring the performance of a certain number of ...

BACKGROUND: Medical ethics has traditionally been taught using dramatic, out-of-the-ordinary cases to illustrate principles. Little attention has been focused on the ethical decisions family physicians make routinely in the course of their practice. METHODS: As part of a multidisciplinary course in medical ethics at the University of Washington School of ...

Physician geographic maldistribution is a problem in the United States health care system. Innovative strategies are needed to entice resident family physicians training in the larger, more numerous suburban and urban training programs to practice in rural areas upon completing their training. This paper describes a strategy used at St. ...

BACKGROUND: After-hours telephone calls are a stressful and frustrating aspect of pediatric practice. At the request of private practice pediatricians in Denver, a metropolitan area-wide system was created to manage after-hours pediatric telephone calls and after-hours patient care. This system, the After-Hours Program (AHP), uses specially trained pediatric nurses with ...

OBJECTIVE: To assess the relationship between gender, background, and brief training and physicians' detection of and treatment for woman abuse. DESIGN: Quasi-experimental and correlational designs, plus control for background factors. SETTING: Two residency training programs: general internal medicine and family practice. PARTICIPANTS: Thirty-five participants were residents and four were faculty ...

This study surveyed 30 residency-trained family physicians all currently in practice to determine the nature of their psychosocial interactions with patients. In general, respondents were satisfied with the quality of their psychosocial training in residency and generally evaluated their competency on a range of psychosocial skills as adequate to excellent. ...

In response to shortages of generalist physicians, especially in rural areas, family practice residency programs were established at both of Kentucky's medical schools. In 1972 a family practice residency program became operational at the University of Louisville. A study was conducted to determine the effectiveness of this program. We were ...

OBJECTIVE: To identify the extent to which family physicians support school-based education programs regarding the human immunodeficiency virus (HIV). Sexually active adolescents are at risk for infection with HIV. Education programs on HIV that target this vulnerable group effectively prevent infection, yet family physicians are often not directly involved in ...

In response to a recent study indicating that primary care physicians were interested in receiving breast-screening education, an office-based training program was developed and delivered to fourteen physicians in Vermont and Florida. A nonphysician trainer and simulated patient provided instruction and feedback in clinical breast examination and in patient instruction ...

The MMA believes its peer review program is fundamental to organized medicine's desire to monitor the profession while simultaneously improving the quality of care provided to Minnesota patients. The association also recognizes the need to assist outside organizations with peer review. The overall goal of the peer review program will ...

The lack of adequate prenatal and gynecological care for indigent women has reached crisis proportions. The situation is aggravated by the diminishing supply of primary care physicians who are willing to practice obstetrics in community settings. Added to this condition is the rapidly declining number of medical students seeking careers ...

A needs assessment identified leadership, management, and interpersonal skills as training and development areas for hospital's physician executives. Training sessions were developed and occurred quarterly over a two-year period. Development strategies were designed to enhance transfer of learning from the classroom setting and incorporated personalized coaching sessions, development of a ...

BACKGROUND: The effective management of Papanicolaou (Pap) smears depends on the reliability and accuracy of obtaining and interpreting the specimen. Provider sampling error is one of the important factors contributing to inadequate specimens. Feedback on provider performance may be an effective way to improve the quality of Pap smears. METHODS: ...

The author reviews the traditional process of assessing both undergraduates in medical school and physicians in postgraduate training, contending that this traditional, and still dominant, process is inadequate because of its limitations. It focuses narrowly on end-point evaluation, using predominantly multiple-choice questions, rather than on identifying deficiencies during the training ...

Health education programs developed in academic medical centers are not optimally disseminated to community clinical settings. Strategies are needed to translate the findings of research on health education programs into programs useful in a wide range of health care settings. Focus group techniques were used to provide data for revising ...

The M.D. Rounds Report program was developed and implemented in June of 1992 as an adjunct to the HELP System at Rex Hospital. The program facilitates rapid access to information on allergies and current medications, laboratory results, radiology reports and therapist notes for a list of patients without physicians having ...

The Copenhagen pocket diagnostic chart can be used for early differentiation between obstructive and non-obstructive causes of jaundice. We present a reevaluation of the chart being used by a recently graduated physician and by two medical students. Non-error rates of 84-87% were found indicating that the students and the physician ...

To realize the full potential of CQI, the needs of internal customers throughout the health care organization must be met. This is best done through a collaborative customer-supplier dialogue, where suppliers take the initiative to understand their internal customers' needs and make their own requirements clear. Unfortunately, physicians--the most critical ...

The authors review curricular characteristics of combined baccalaureate-M.D. programs at 28 U.S. medical schools from 1961, when the first programs started, until 1991-92. Initially, in the 1960s, these programs were created (1) to offer talented high school graduates an accelerated track leading to the baccalaureate and M.D. degrees, (2) to ...

Two interrelated studies are reported. One reports the results of a questionnaire interview with a reference group of 51 general practitioners. The respondents express a considerable dissatisfaction with their previous medical training as it concerns their knowledge of the psychosomatic medical paradigm. The other study evaluates the effects of a ...

Responding to distortions in payment rates between services, policymakers in the United States have sought a systematic and rational foundation for determining physician fees. One such approach to paying physicians, the Resource-Based Relative Value Scale (RBRVS), determines fees by measuring the relative resource costs required to produce them. On January ...

As the only medical specialists who routinely provide continuous 24-hour daily coverage, emergency physicians are all too familiar with the demands of shift work. Although shift work has a pervasive effect on the practice of emergency medicine and is regarded as a major stressor, it has received little attention per ...

Occupational and environmental diseases are underrecognized. Among the barriers to the successful diagnosis, treatment, and prevention of these conditions are inadequate consultative and information resources. We describe the 10-year clinical and training experiences of an academically affiliated referral center that has as its primary goal the identification of work-related and ...

Questionnaires surveying policies and opinions about prenatal cocaine abuse were sent to training programs nationwide. Eighty-one pediatric and 81 obstetric programs from 42 states responded. Although respondents favored routinely screening all patients by maternal history (81%) and by urine toxicology (36%), only 64% and 8%, respectively, reported these as established ...

This article describes an evaluation of the implementation of a cholesterol management program in family physicians' offices as part of the Physician-Based Nutrition Program to Lower Coronary Heart Disease Risk (PBNP). The evaluation, conducted through a partnership evaluation model, used multiple case study methodology and combined the use of quantitative ...

This paper describes the ongoing need for physician executives and reviews current opportunities for training physicians in management. The authors discuss existing sources of funding and highlight one management training program that uses various mechanisms of a new funding model that can increase the number and diversity of learning opportunities, ...

Validation of otoscopic diagnostic accuracy is an important aspect of medical education and is necessary to substantiate clinical research observations. In addition, otoscopic accuracy is a prerequisite to optimal patient care. We describe an otoscopic validation program at the Children's Hospital of Pittsburgh (Pa) in which 27 physicians and three ...

OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after ...

Enrollment of senior citizens in a community Medicare demonstration project to explore the efficacy of preventive health screening and health education was accomplished by using a two-stage process. This process consisted of initial communication with community physicians through the University of California at Los Angeles Clinical Faculty Association to establish ...

Despite variances in length, scope and content of postgraduate medical education in radiation oncology, there is a thread of commonality that runs through all programs. Aside from the emphasis on internal medicine in Canada and the emphasis on technical radiotherapy in the United States, it is surprising how little different ...

Although physician support programs have gained in popularity in recent years, organizations must be careful to select the most effective mix of physician relations programs. A healthcare financial manager can help create a productive physician alliance program by analyzing physicians as strategic business units, providing financial and analytical support for ...

During the past 20 years there has been a resurgence of interest in the history of the eugenics movements, particularly those of the United States and Germany. Unfortunately, most of these accounts have been published in nonmedical and nongenetic journals, so they are not readily available to geneticists or physicians. ...

With the scientific advances made in medicine during the past 200 years, the training of physicians in America has changed from that of a mentor/apprenticeship relationship to one in which students are part of an impersonal, mass production process. From a historical perspective, it is contended that basic science and ...

Otolaryngologic manpower in Canada has been carefully monitored since the mid-1970s. Within that frame of reference it is now possible to make some projections as to what the manpower picture will be into the next century. These projections are based on a computer model of population demographics as developed by ...

Reducing malpractice claims incidence and improving the quality of patient care are the goals of the Massachusetts Emergency Physician Risk Management Program. This innovative program entails computer audit of records in high-risk diagnostic categories. The program focuses on increasing physician awareness of high-risk diagnoses and on medical record documentation of ...

The evaluation of mammographic interpretations is a difficult challenge for a professional quality assessment program. As most images are read by a single observer and pathologic proof is obtained only if prompted by the report or if clinical symptoms warrant surgical intervention, it is difficult to construct a meaningful quality ...

A review of the grading process used in an obstetrics and gynecology clerkship prompted an analysis of physician ratings of student clinical performance. The study assessed the following: 1) the degree to which raters distinguished among six categories of performance, 2) the concordance among raters in terms of evaluation criteria ...

The example of the Pennsylvania State Board of Medicine's Impaired Professional Program (IPP) shows that the function of licensing boards with respect to impaired physicians can be significantly expanded in a positive direction. Although most of the physicians in the IPP are impaired by drugs or alcohol, the program is ...

In order to improve clinical teaching in the ambulatory care setting, clinical teachers need to know the range of instructional strategies available to them. One potentially useful strategy is that of reflection. In this paper, reflective practice will be described in the context of the professional training of physicians, with ...

This article describes some of the issues relevant to the different kinds of contracts that are likely to be offered to physicians entering private practice upon completion of residency programs or in the early years of practice and discusses how such issues can be resolved in the course of negotiating ...

Individuals trained as both military physicians and military pilots have existed in the armed forces of the world since 1911. This paper traces the history of pilot-physicians in the United States Air Force. The USAF pilot-physician program was founded by Harry G. Armstrong in 1947 and continues to the present ...

Computer-based diagnostic systems are widely regarded as having only a supportive role in assisting physicians make diagnostic decisions. Continuing progress in the design of diagnostic software, however, may not only produce systems which have heuristic and consultative value, but which may render the traditional role of the physician as a ...

Programming the new DDD pacemakers is becoming increasingly difficult. One must take into account the pacemaker's complexity, the fact that some parameters are linked to others, and the clinical profile of the patient. This difficult problem will lead to the design of software to assist programming, which will help the ...

OBJECTIVE: To find which procedures gastroenterologists do in their practice, where they learned the procedures, and what training they recommend to achieve and maintain competence in each. DESIGN: Mailed survey. PARTICIPANTS: A random sample of 700 gastroenterologists who were members of the American College of Physicians, of whom 510 (73%) ...

This paper presents a review and comparison of qualitative improvements in the organization, needs assessment, educational methodology, evaluation, and research in continuing medical education (CME) in the United States and Canada. Although accreditation now establishes minimal standards for CME and reduces the chances of irresponsible programs, some organizational issues (such ...

A voluntary physician-initiated and physician-managed clinical review program for pediatric cardiology uses clinical practice data and expected outcome to influence physicians to change their clinical behavior. The program offers a model for clinical review in situations where disease incidence is relatively low and physician performance is difficult to assess and ...

The authors present information on how to conduct an examination of musculoskeletal structures with the purpose of accurately locating the source of a patient's symptoms when musculoskeletal pathology is suspected. An accurate identification of the structure at fault will enable the physician to formulate a more specific and effective treatment ...

Patient nonadherence to therapeutic regimens is a serious issue in the practice of medicine. Empiric studies done by professionals from diverse backgrounds have shown that physicians who use educational strategies can be effective in gaining the cooperation of patients to follow their recommendations. The educational model that currently is most ...