We compared the characteristics and treatment outcomes of substance-impaired physicians monitored by two different programs in Oregon: a probationary program administered by the Oregon Board of Medical Examiners and the confidential, voluntary Diversion Program for Health Professionals. Demographic, substance use, and treatment outcome variables were obtained by a retrospective medical ...

Hemoperitoneum represents a major indication for surgical intervention after trauma. To improve the ability of surgical residents and trauma physicians to detect intraperitoneal and pericardial fluid using ultrasound as a diagnostic modality, we conducted a focused trauma ultrasound workshop consisting of discussion of ultrasound physics, demonstration of instrumentation, review of ...

This article addresses the needs of family physician preceptors who teach medical students in their community-based practices. Responses are provided to 20 typical questions that a family physician might ask when considering whether to become a preceptor. Areas covered by the questions and responses include physician motivation for becoming a ...

Planned Parenthood of New York City established a physician education program in first-trimester abortion using local anesthesia at its three clinics. This paper describes the program's technical and counseling skills curricula, individualized instruction, quality-assurance procedures, obstacles encountered, and solutions implemented. Major obstacles were slow initial recruitment, disincentives of off-site education, ...

OBJECTIVE: To gain information about the career status of residents who completed graduate medical education training programs in selected specialties and subspecialties during the 1993-1994 academic year. DESIGN: A descriptive one-page survey of residency program directors, including two mailed follow-up surveys, was conducted from January 1, 1995 to June 1, ...

Although health care professionals, licensing bodies, governments and the community are paying increasing attention to the negative consequences of sexual misconduct by physicians, education for professionals about this subject is rare and limited. Even less attention has been paid to the adverse effects of violations of boundaries between teachers and ...

BACKGROUND: The purpose of this study was to determine how much and in what ways family physicians' time at work is affected by the presence of a medical student in the practice. METHODS: The study included work sampling of 22 non-academic family physicians, each observed during 1 day with and ...

OBJECTIVE: To evaluate a learner-centred, small group CME program intended to improve the clinical performance of family physicians identified as having serious practice deficiencies by the University of Manitoba's Clinical Assessment and Enhancement Program. DESIGN: Nonrandomized control trial in which data were collected from patients' charts and physician performance was ...

To succeed in a capitated market, a physician-hospital organization (PHO) must deliver high-quality health care in the most cost-effective manner possible. Integral to the provision of cost-effective care for patients covered by capitated contracts is the development of a sound physician incentive program. Such a system is essential to align ...

BACKGROUND: This study hypothesized that an office-based training program in clinical breast examination (CBE) would improve the lump-detection skills of primary care physicians. METHODS: A one-group pretest-posttest design was utilized, without outcome measurements taken prior to instruction, immediately afterwards, and six months later. Fifty physicians from 117 practices that had ...

We describe the implementation of a World Wide Web-based Continuing Medical Educational (CME) program in Diagnostic Radiology which allows accumulation of Category I credit. The program implements an unknown case presentation format which includes multiple choice questions, didactic information, and literature references with links to abstracts. Physician participation is anticipated ...

Rapidly evolving characteristics of our health care system are creating new and expanding opportunities for physician managers. Formal graduate degree training in management has become desirable to prepare the physician for these new professional responsibilities. The Schools of Medicine and Management at Northwestern University instituted a formal combined degree program ...

Allied health education programs which are decentralized into medically underserved communities increase the likelihood that graduates will practice within these regions. However, assessing potential sites for decentralized allied health education programs is often done haphazardly, if at all. The University of Kentucky Physician Assistant Program obtained grant funds to develop ...

This project examined the feasibility of using an educational representative, modeled in part on a drug detailing representative, to increase health promotion counseling by rural family physicians in east Texas. The physicians were offered, at no charge, materials for patients and training for themselves and their office staff on patient ...

The author proposes a theory of how physicians learn that uses clinical problem solving as its central feature. His theory, which integrates insights from Maslow, Schön, Norman, and others, claims that physicians-in-training and practicing physicians learn largely by deriving insights from clinical experience. These insights allow the learner to solve ...

A telemedicine link to enable nurse practitioners at a remote minor injuries unit to obtain advice from an emergency physician at a main accident and emergency department is feasible and worthwhile. However, it is fraught with difficulties. These include technical difficulties, training problems, familiarization with the technology and provision of ...

Since the mid-1980s, the licensing authorities in Quebec, Ontario and Manitoba have introduced programs to conduct in-depth assessments of the clinical skills and abilities of physicians with suspected deficiencies. These assessments are intended to supplement the provincial licensing authorities' existing peer review or patient-complaint mechanisms by confirming the physicians' overall ...

BACKGROUND: We examined the effect of a 3-hr training program on physicians' lipid intervention knowledge, attitudes, and skills. The program teaches physicians skills to conduct a brief dietary risk assessment and provide patient-centered counseling to enable patients with elevated lipids to change their dietary patterns. METHOD: The training is part ...

BACKGROUND: The Maine Medical Assessment Foundation (MMAF) has successfully involved hundreds of Maine physicians in study groups to analyze data on small-area variation and assess physician decision-making patterns. In 1991 the MMAF model was replicated across a tri-state area (Maine, New Hampshire, Vermont) in an effort called the Outcomes Dissemination ...

OBJECTIVE: To assess the needs and determine the effect of a Continuing Medical Education (CME) program designed for primary care physicians on the management of osteoarthritis (OA). METHODS: The needs of potential CME consumers were determined using a standardized case recall questionnaire on the management of OA. A CME program ...

Health Canada's Emergency Drug Release Program, which allows physicians to acquire nonmarketed drugs to treat people with HIV infection, AIDS and other illnesses, handles about 44 000 requests annually. The executive director of the Drugs Directorate says the program's name is a misnomer, since few of the requests involve medical ...

OBJECTIVE: To design and implement an individualized program of evaluation and education to provide remedial experiences to physicians. DESIGN AND SETTING: An evaluation and educational program for physicians practicing in New York State. PARTICIPANTS: Physicians referred for evaluation and possible remedial educational experiences from the New York State Office of ...

Anesthetists are at special risk for becoming addicted to some of the drugs they work with. The problem was highlighted by the recent death of a physician in Comox, BC, and a doctor's brush with death at a hospital near Ottawa. The University of Ottawa has responded with a program, ...

PURPOSE: To use a controlled, randomized design to assess the effect on patient satisfaction of an intensive psychosocial training program for residents. METHOD: Twenty-six first-year residents, in two internal medicine and family practice community-based programs affiliated with the Michigan State University College of Human Medicine, were randomly assigned during 1991 ...

The Southern Regional Education Board (SREB) was formed in 1948 to facilitate multistate contracts for education exchange; at present, 15 states participate in this program. West Virginia is one of four states in the SREB that offer training in osteopathic medicine, and the West Virginia School of Osteopathic Medicine (WVSOM) ...

Physicians and other health care providers have multiple opportunities in the course of a typical practice year to identify and treat individuals who abuse alcohol and other drugs. Although substance abuse is very common in clinical practice, providers routinely fail to intervene in a timely fashion due to negative attitudes, ...

Within 10 years the College of Physicians and Surgeons of Alberta hopes to have an audit program in place to monitor the clinical skills of all physicians. The decision to develop an audit program resulted from a college-sponsored survey which indicated that many Albertans were surprised and concerned to learn ...

The use of ultrasonography for the investigation of urgent diagnostic dilemmas is by no means new. Although it has been widely used for almost 40 years, during the past two decades ultrasonography has achieved a primary role in Europe and Asia in the investigation of emergent conditions such as trauma. ...

A reliable and effective quality-control program in the peritoneal dialysis (PD) unit requires a team effort. Historically, the nursing staff has been responsible for PD program development, and in some programs the physicians are frankly uninvolved. An enthusiastic, knowledgeable, and committed physician is necessary. In the early days of continuous ...

Problems encountered in training GI fellows range from illnesses that affect patient care (impaired physician) to problems in the timely acquisition of the technical, cognitive, and personal skills required to perform endoscopy competently and independently. The key for fellowship programs in addressing potential problems is to develop a system that ...

To determine what adolescents students know or feel about testicular cancer, (TC) and the testicular self examination, (TSE), technique, 127 males students (mean age 16.14 years) were given a 21 item questionnaire. The role of the primary physician and the role of written and visual educational material were assessed for ...

BACKGROUND: The impact of a federal program that provides free childhood immunizations to private physicians for their Medicaid patients was examined. The aim of the study was to find out whether the program affected the availability of immunizations in rural and urban family physicians' practices. METHODS: A survey form about ...

State laws enacted between 1985 and 1992 were reviewed to examine state involvement in influencing the supply and distribution of generalist physicians. Forty-seven states enacted 238 relevant laws during this period. In 1991 and 1992, 36 states enacted 98 laws, as compared with 1985 and 1986, when 8 states enacted ...

Geriatric medicine is at a crossroads. Much time and effort have been given to develop training programs that aim at making physicians better able to care for the multiple and interacting problems affecting the elderly. It appears, however, that the best option at this time is to focus efforts and ...

This demonstration project examines the utility of interactive multimedia for prenatal ultrasound training. A laser-disc library was linked to a three-dimensional (3-D) heart model and other computer-based training materials through interactive multimedia. A testing module presented ultrasound anomalies and related questions to house-staff physicians through the image library. Users were ...

BACKGROUND: A workshop on community-oriented primary care (COPC) has been integrated into Hebrew University's family practice residency program for several years. The participants of the first three workshops did an evaluation to assess subsequent application of the COPC approach. METHODS: The main objectives of the 45-hour workshop are: a) to ...

A "snapshot" survey of physician coverage for evaluation and supervision of therapeutic apheresis procedures shows significant variation in current clinical practice between 39 blood center-and 41 non-blood center-based programs. Whereas 56% of blood center-based programs usually require physician's "in person" evaluation of the patient, 86% of non-blood center programs do ...

Medical student organizations--including the American Medical Student Association (AMSA), the Association of American Medical Colleges's Organization of Student Representatives (AAMC-OSR), and the American Academy of Family Physicians' National Congress of Student Members (AAFP-NCSM)--are responding to the increased need for generalist physicians. Through a variety of initiatives drawing on each organization's ...

An essential component of competency in respiratory medicine is the acquisition of consultative skills. The American Board of Internal Medicine (ABIM) and other certification bodies have recommended a greater emphasis on the evaluation of clinical skills by direct observation. In this study, consultative abilities are assessed using the format of ...

The purpose of this study was to determine the characteristics of academic Pediatric Emergency Medicine (PEM) faculty, the workload of these physicians, and the perceived effect this workload has had or will have on job satisfaction. A self-administered, seven-page, closed-end survey was used. participants were PEM departments with PEM Fellowship ...

The need for expert and unbiased participation in legal proceedings by physicians, industrial hygienists, toxicologists, environmental scientists, regulators, and similar professionals is hampered by lack of familiarity with the requirements of expert testimony and lack of opportunities for professional training in this activity. Drawing on material developed in a continuing ...

BACKGROUND: Videotapes have been variably successful in teaching physical examination skills, interviewing strategies, and clinically relevant didactic material to medical students, residents, and physicians. The literature does not include evaluations of their success in introducing procedural techniques into clinical practice. OBJECTIVES: This study assessed whether the presentation of an instructional ...

Missouri Physicians Health Program (MPHP) was established to help impaired physicians return to healthy personal and professional lives. One percent of Missouri physicians will suffer some sort of impairment; ie: substance abuse, or dependency of drugs or alcohol within a year. This is a confidential voluntary program. This program of ...

A survey was mailed to 100 physician executives identified through the 1991 American College of Physicians Executives directory. The subjects were asked to rate 17 managerial areas on their value to the subjects' current work, on the subjects' preparation in the areas, and on the need for training in the ...

The data with which Student illustrated the application of his famous distribution are examined from a number of aspects. Central to the discussion is the within-patient clinical trial at Kalamazoo whose results were published by Cushny and Peebles and misquoted by Student and Fisher. This trial is discussed from historical, ...

The appropriate use of pharmaceuticals, like much else in medicine, is receiving increased public scrutiny. Health care practitioners are looking for ways to reduce costs without negatively influencing quality of care. This article reviews methods for physicians and pharmacists to work together to implement cost-effective prescribing practices and assess clinical ...

BACKGROUND: Although the concept of community-oriented primary care (COPC) has generally been favorably viewed, it does not appear to have been widely applied. Further development of COPC will depend on data regarding the extent of knowledge about COPC, of COPC application and training, and of perceived obstacles to its use. ...

Given the importance of social support to recovering chemically dependent individuals at risk of relapse and the concerns of treaters that professionals may avoid affiliation with 12-step groups, the authors sought to confirm the results of an earlier study in which a sample of recovering physicians in Atlanta identified 12-step ...

BACKGROUND: The costs in time and money of medical student education for family physicians in private practice is uncertain, with the literature containing conflicting reports. METHOD: Questionnaires were mailed in 1992-93 to 56 primary care physicians who had taught third- or fourth-year students during the previous academic year in fulfillment ...

OBJECTIVE: To assess the long-term effect of an extensive rheumatology curriculum on graduates of family practice residencies. DESIGN: Cohort analytic study using a mailed survey and a multiple-choice test based on clinical vignettes that were administered 3 to 7 years after graduation from residency training. PARTICIPANTS: Practicing family physicians who ...