Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.Practice Management, Medical: The organization and operation of the business aspects of a physician's practice.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Physician-Patient Relations: The interactions between physician and patient.Newfoundland and Labrador: Province of Canada consisting of the island of Newfoundland and an area of Labrador. Its capital is St. John's.Suburban Health Services: Health services, public or private, in suburban areas. The services include the promotion of health and the delivery of health care.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Private Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.Professional Practice Location: Geographic area in which a professional person practices; includes primarily physicians and dentists.General Practice: Patient-based medical care provided across age and gender or specialty boundaries.Physician's Role: The expected function of a member of the medical profession.Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium.Freedom: The rights of individuals to act and make decisions without external constraints.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Education, Nursing, Diploma Programs: Programs usually offered in hospital schools of nursing leading to a registered nurse diploma (RN). Graduates are eligible for state examination for licensure as RN (Registered Nurse).Certification: Compliance with a set of standards defined by non-governmental organizations. Certification is applied for by individuals on a voluntary basis and represents a professional status when achieved, e.g., certification for a medical specialty.Office Management: Planning, organizing, and administering activities in an office.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Specialization: An occupation limited in scope to a subsection of a broader field.Education, Medical, Graduate: Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree.Office Nursing: Nursing practice limited to an office setting.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.Nova Scotia: A province of eastern Canada, one of the Maritime Provinces with NEW BRUNSWICK; PRINCE EDWARD ISLAND; and sometimes NEWFOUNDLAND AND LABRADOR. Its capital is Halifax. The territory was granted in 1621 by James I to the Scotsman Sir William Alexander and was called Nova Scotia, the Latin for New Scotland. The territory had earlier belonged to the French, under the name of Acadia. (From Webster's New Geographical Dictionary, 1988, p871 & Room, Brewer's Dictionary of Names, 1992, p384)Microcomputers: Small computers using LSI (large-scale integration) microprocessor chips as the CPU (central processing unit) and semiconductor memories for compact, inexpensive storage of program instructions and data. They are smaller and less expensive than minicomputers and are usually built into a dedicated system where they are optimized for a particular application. "Microprocessor" may refer to just the CPU or the entire microcomputer.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.United StatesSlovenia: Created 7 April 1992 as a result of the division of Yugoslavia.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Education, Medical: Use for general articles concerning medical education.Institutional Practice: Professional practice as an employee or contractee of a health care institution.Physician Incentive Plans: Compensatory plans designed to motivate physicians in relation to patient referral, physician recruitment, and efficient use of the health facility.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.Great BritainRural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Community Medicine: A branch of medicine concerned with the total health of the individual within the home environment and in the community, and with the application of comprehensive care to the prevention and treatment of illness in the entire community.British Columbia: A province of Canada on the Pacific coast. Its capital is Victoria. The name given in 1858 derives from the Columbia River which was named by the American captain Robert Gray for his ship Columbia which in turn was named for Columbus. (From Webster's New Geographical Dictionary, 1988, p178 & Room, Brewer's Dictionary of Names, 1992, p81-2)Practice (Psychology): Performance of an act one or more times, with a view to its fixation or improvement; any performance of an act or behavior that leads to learning.Curriculum: A course of study offered by an educational institution.Professional Competence: The capability to perform the duties of one's profession generally, or to perform a particular professional task, with skill of an acceptable quality.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Career Choice: Selection of a type of occupation or profession.Comprehensive Health Care: Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.Physicians: Individuals licensed to practice medicine.Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.Evidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.Focus Groups: A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.Family Nursing: The provision of care involving the nursing process, to families and family members in health and illness situations. From Lippincott Manual of Nursing Practice. 6th ed.Drug Prescriptions: Directions written for the obtaining and use of DRUGS.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Appointments and Schedules: The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc.EnglandModels, Educational: Theoretical models which propose methods of learning or teaching as a basis or adjunct to changes in attitude or behavior. These educational interventions are usually applied in the fields of health and patient education but are not restricted to patient care.Diagnosis: The determination of the nature of a disease or condition, or the distinguishing of one disease or condition from another. Assessment may be made through physical examination, laboratory tests, or the likes. Computerized programs may be used to enhance the decision-making process.Salaries and Fringe Benefits: The remuneration paid or benefits granted to an employee.Evidence-Based Practice: A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.Fees, Medical: Amounts charged to the patient as payer for medical services.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Alberta: A province of western Canada, lying between the provinces of British Columbia and Saskatchewan. Its capital is Edmonton. It was named in honor of Princess Louise Caroline Alberta, the fourth daughter of Queen Victoria. (From Webster's New Geographical Dictionary, 1988, p26 & Room, Brewer's Dictionary of Names, 1992, p12)Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Nurse's Role: The expected function of a member of the nursing profession.Job Satisfaction: Personal satisfaction relative to the work situation.Physicians, Women: Women licensed to practice medicine.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.Interprofessional Relations: The reciprocal interaction of two or more professional individuals.Students, Medical: Individuals enrolled in a school of medicine or a formal educational program in medicine.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Organizational Innovation: Introduction of changes which are new to the organization and are created by management.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Nursing Research: Research carried out by nurses, generally in clinical settings, in the areas of clinical practice, evaluation, nursing education, nursing administration, and methodology.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Preventive Medicine: A medical specialty primarily concerned with prevention of disease (PRIMARY PREVENTION) and the promotion and preservation of health in the individual.Uncompensated Care: Medical services for which no payment is received. Uncompensated care includes charity care and bad debts.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.IsraelForeign Medical Graduates: Physicians who hold degrees from medical schools in countries other than the ones in which they practice.Self-Evaluation Programs: Educational programs structured in such a manner that the participating professionals, physicians, or students develop an increased awareness of their performance, usually on the basis of self-evaluation questionnaires.Physician-Nurse Relations: The reciprocal interaction of physicians and nurses.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Counseling: The giving of advice and assistance to individuals with educational or personal problems.Personnel Selection: The process of choosing employees for specific types of employment. The concept includes recruitment.Reimbursement, Incentive: A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Interdisciplinary Communication: Communication, in the sense of cross-fertilization of ideas, involving two or more academic disciplines (such as the disciplines that comprise the cross-disciplinary field of bioethics, including the health and biological sciences, the humanities, and the social sciences and law). Also includes problems in communication stemming from differences in patterns of language usage in different academic or medical disciplines.Patient-Centered Care: Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Teaching Materials: Instructional materials used in teaching.Partnership Practice: A voluntary contract between two or more doctors who may or may not share responsibility for the care of patients, with proportional sharing of profits and losses.Practice Management: Business management of medical, dental and veterinary practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.Computer User Training: Process of teaching a person to interact and communicate with a computer.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Attitude: An enduring, learned predisposition to behave in a consistent way toward a given class of objects, or a persistent mental and/or neural state of readiness to react to a certain class of objects, not as they are but as they are conceived to be.Third-Party Consent: Informed consent given by someone other than the patient or research subject.Clinical Clerkship: Undergraduate education programs for second- , third- , and fourth-year students in health sciences in which the students receive clinical training and experience in teaching hospitals or affiliated health centers.Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.Patient Care: The services rendered by members of the health profession and non-professionals under their supervision.Rural Health: The status of health in rural populations.Pharyngitis: Inflammation of the throat (PHARYNX).Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Preceptorship: Practical experience in medical and health-related services that occurs as part of an educational program wherein the professionally-trained student works outside the academic environment under the supervision of an established professional in the particular field.Patient Participation: Patient involvement in the decision-making process in matters pertaining to health.Teaching: The educational process of instructing.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Health Fairs: Community health education events focused on prevention of disease and promotion of health through audiovisual exhibits.CaliforniaHouse Calls: Visits to the patient's home by professional personnel for the purpose of diagnosis and/or treatment.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Medically Underserved Area: A geographic location which has insufficient health resources (manpower and/or facilities) to meet the medical needs of the resident population.Medical History Taking: Acquiring information from a patient on past medical conditions and treatments.Episode of Care: An interval of care by a health care facility or provider for a specific medical problem or condition. It may be continuous or it may consist of a series of intervals marked by one or more brief separations from care, and can also identify the sequence of care (e.g., emergency, inpatient, outpatient), thus serving as one measure of health care provided.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Peer Review, Health Care: The concurrent or retrospective review by practicing physicians or other health professionals of the quality and efficiency of patient care practices or services ordered or performed by other physicians or other health professionals (From The Facts On File Dictionary of Health Care Management, 1988).Patients: Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Quebec: A province of eastern Canada. Its capital is Quebec. The region belonged to France from 1627 to 1763 when it was lost to the British. The name is from the Algonquian quilibek meaning the place where waters narrow, referring to the gradually narrowing channel of the St. Lawrence or to the narrows of the river at Cape Diamond. (From Webster's New Geographical Dictionary, 1988, p993 & Room, Brewer's Dictionary of Names, 1992, p440)Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Documentation: Systematic organization, storage, retrieval, and dissemination of specialized information, especially of a scientific or technical nature (From ALA Glossary of Library and Information Science, 1983). It often involves authenticating or validating information.Osteopathic Medicine: A medical discipline that is based on the philosophy that all body systems are interrelated and dependent upon one another for good health. This philosophy, developed in 1874 by Dr. Andrew Taylor Still, recognizes the concept of "wellness" and the importance of treating illness within the context of the whole body. Special attention is placed on the MUSCULOSKELETAL SYSTEM.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Education, Medical, Undergraduate: The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D.Drug Therapy: The use of DRUGS to treat a DISEASE or its symptoms. One example is the use of ANTINEOPLASTIC AGENTS to treat CANCER.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Educational Measurement: The assessing of academic or educational achievement. It includes all aspects of testing and test construction.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Attitude to Computers: The attitude and behavior associated with an individual using the computer.Delphi Technique: An iterative questionnaire designed to measure consensus among individual responses. In the classic Delphi approach, there is no interaction between responder and interviewer.Schools, Medical: Educational institutions for individuals specializing in the field of medicine.Information Systems: Integrated set of files, procedures, and equipment for the storage, manipulation, and retrieval of information.Evaluation Studies as Topic: Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Reminder Systems: Systems used to prompt or aid the memory. The systems can be computerized reminders, color coding, telephone calls, or devices such as letters and postcards.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Dentist's Practice Patterns: Patterns of practice in dentistry related to diagnosis and treatment.Geriatrics: The branch of medicine concerned with the physiological and pathological aspects of the aged, including the clinical problems of senescence and senility.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Manitoba: A province of Canada, lying between the provinces of Saskatchewan and Ontario. Its capital is Winnipeg. Taking its name from Lake Manitoba, itself named for one of its islands, the name derived from Algonquian Manitou, great spirit. (From Webster's New Geographical Dictionary, 1988, p724 & Room, Brewer's Dictionary of Names, 1992, p332)Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Benzodiazepines: A group of two-ring heterocyclic compounds consisting of a benzene ring fused to a diazepine ring.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.North CarolinaGeneral Practice, Dental: Nonspecialized dental practice which is concerned with providing primary and continuing dental care.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Disease Management: A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Infant, Newborn: An infant during the first month after birth.Practice Management, Dental: The organization and operation of the business aspects of a dental practice.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Diabetes Mellitus: A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.New Zealand: A group of islands in the southwest Pacific. Its capital is Wellington. It was discovered by the Dutch explorer Abel Tasman in 1642 and circumnavigated by Cook in 1769. Colonized in 1840 by the New Zealand Company, it became a British crown colony in 1840 until 1907 when colonial status was terminated. New Zealand is a partly anglicized form of the original Dutch name Nieuw Zeeland, new sea land, possibly with reference to the Dutch province of Zeeland. (From Webster's New Geographical Dictionary, 1988, p842 & Room, Brewer's Dictionary of Names, 1992, p378)Nurse's Practice Patterns: Patterns of practice in nursing related to provision of services including diagnosis and treatment.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.BelgiumRisk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Internet: A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.TexasMultivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Managed Care Programs: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.

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Chronic disease in Northern OntarioNational Clinical Guideline CentreHalfdan T. MahlerClosed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Newfoundland Margarine Company Limited: The Newfoundland Butter Company founded by Sir John Chalker Crosbie in 1925 was one of threeVolume four, p. 168, Encyclopedia of Newfoundland and Labrador, ISBN 0-9693422-1-7.Behavior change (public health): Behavior change is a central objective in public health interventions,WHO 2002: World Health Report 2002 - Reducing Risks, Promoting Healthy Life Accessed Feb 2015 http://www.who.Outline of obstetrics: The following outline is provided as an overview of and topical guide to obstetrics:Libertarian perspectives on political alliances: Libertarian perspectives on political alliances vary greatly, with controversies among libertarians as to which alliances are acceptable or useful to the movement.Academy of Applied Pharmaceutical Sciences: Academy of Applied Pharmaceutical Sciences (AAPS) Inc. is an English-language private post-secondary career college specializing in pharmaceutical, food and healthcare training.Oncology Nursing Certification Corporation: The Oncology Nursing Certification Corporation (ONCC) was established for the development, administration, and evaluation of a program for certification in oncology nursing. Incorporated in 1984 and governed by a board of directors, ONCC is the certifying body for oncology nursing and meets standards established by the Accreditation Board for Specialty Nursing Certification and the National Commission for Certifying Agencies.Fremont College: Fremont College is a for-profit, degree-granting college that provides educational opportunities for working adults. The college is based in Cerritos, California with a second campus in Los Angeles, California, and a virtual campus online.Canadian Organ Replacement Registry: The Canadian Organ Replacement Registry CORR is a health organisation was started by Canadian nephrologists and kidney transplant surgeons in 1985 in order to develop the care of patients with renal failure. In the early 1990s data on liver and heart transplantation were added to the registry.Netherlands national rollball team: Vishwaraj JadejaShubenacadie, Nova Scotia: Shubenacadie (['ʃuːbə'nækədiː]) is a community located in Hants County, in central Nova Scotia, Canada. As of 2006, the population was 2,074.Visual 1050Referral (medicine): In medicine, referral is the transfer of care for a patient from one clinician to another.García Olmos L, Gervas Camacho J, Otero A, Pérez Fernández M.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,List of birds of Slovenia: This is a list of the bird species recorded in Slovenia. The avifauna of Slovenia include a total of 376 species, of which four have been introduced by humans and five are rare or accidental.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Society for Education Action and Research in Community Health: Searching}}Loader (computing): In computing, a loader is the part of an operating system that is responsible for loading programs and libraries. It is one of the essential stages in the process of starting a program, as it places programs into memory and prepares them for execution.Indian Journal of Community Medicine: The Indian Journal of Community Medicine is a peer-reviewed open-access medical journal published by Medknow Publications on behalf of the Indian Association of Preventive & Social Medicine. The journal publishes articles on family health care, epidemiology, biostatistics, public health administration, health care delivery, national health problems, medical anthropology, and social medicine.British Columbia Medical Journal: The British Columbia Medical Journal is a peer-reviewed general medical journal covering scientific research, review articles, and updates on contemporary clinical practices written by British Columbian physicians or focused on topics likely to be of interest to them, such as columns from the BC Centre for Disease Control and the Insurance Corporation of British Columbia. Although it is published by the British Columbia Medical Association (BCMA), it maintains distance from the BCMA in order to encourage open debate.Tower of Babel (M. C. Escher): Tower of Babel is a 1928 woodcut by M. C.Syllabus: A syllabus (pl. syllabi) is an outline and summary of topics to be covered in an education or training course.Upsilon Phi Delta: Upsilon Phi Delta (ΥΦΔ) is the national academic honor society for students in healthcare administration in the United States. The organization was formed in 1965 to further the profession of health administration and the professional competence and dedication of its members.Essex School of discourse analysis: The Essex School constitutes a variety of discourse analysis, one that combines theoretical sophistication – mainly due to its reliance on the post-structuralist and psychoanalytic traditions and, in particular, on the work of Lacan, Foucault, Barthes, Derrida, etc. – with analytical precision, since it focuses predominantly on an in-depth analysis of political discourses in late modernity.Becky JamesSamuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.Transitional care: Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a variety of health conditions often need health care services in different settings to meet their many needs.Bestbets: BestBETS (Best Evidence Topic Reports) is a system designed by emergency physicians at Manchester Royal Infirmary, UK. It was conceived as a way of allowing busy clinicians to solve real clinical problems using published evidence.American Osteopathic Board of Internal MedicineHenry Whitelock Torrens: Henry Whitelock Torrens (1806–1852), son of Major Henry Torrens, was born on May 20, 1806. He received his B.Red Moss, Greater Manchester: Red Moss is a wetland mossland in Greater Manchester, located south of Horwich and east of Blackrod. (Grid Reference ).Online patient education: Online Patient Education also known as Online Patient Engagement is a method of providing medical information and education to patients using Learning Management Systems delivered through the Internet.Evaluation of bariatric Centers of Excellence Web sites for functionality and efficacy.Eco-Runner Team Delft: Eco-Runner Team DelftAlberta Hospital EdmontonJob satisfaction: Job satisfaction or employee satisfaction has been defined in many different ways. Some believe it is simply how content an individual is with his or her job, in other words, whether or not they like the job or individual aspects or facets of jobs, such as nature of work or supervision.Mercuriade: Mercuriade was an Italian physician, surgeon and medical author in the 14th century. She is one of the few woman physicians known from the Middle Ages.Leiden International Medical Student ConferencePsychiatric interview: The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a psychiatric assessment.Instruments used in preventive medicine: Instruments used specially in preventive medicine are as follows:British Pediatric Association Classification of Diseases: The British Pediatric Association Classification of Diseases is a system of diagnostic codes used for pediatrics.Tel Aviv Sourasky Medical Center: Tel Aviv Sourasky Medical Center (commonly referred to as Ichilov Hospital) is the main hospital serving Tel Aviv, Israel, and its metropolitan area. It is the third-largest hospital complex in the country.Ron WaksmanStandard evaluation framework

(1/9663) Nurses and nursing in primary medical care in England.

In 1974 we sent questionnaires on attachment and employment of nurses to 9214 general practices in England. There were 7863 replies (85%), of which 551 were excluded from the study. A total of 2654 nurses were directly employed by 24% (1774) of the practices, and 68% (4972) had attached nurses. Practices in health centres were larger and had greater nursing resources than those in other premises. We suggest that practices may employ nurses to compensate for ineffective nursing attachments, and we conclude that general-practice-employed nurses are becoming "professionalised".  (+info)

(2/9663) Randomised controlled trial of effect of feedback on general practitioners' prescribing in Australia.

OBJECTIVE: To evaluate the effect on general practitioners' prescribing of feedback on their levels of prescribing. DESIGN: Randomised controlled trial. SETTING: General practice in rural Australia. PARTICIPANTS: 2440 full time recognised general practitioners practising in non-urban areas. INTERVENTION: Two sets of graphical displays (6 months apart) of their prescribing rates for 2 years, relative to those of their peers, were posted to participants. Data were provided for five main drug groups and were accompanied by educational newsletters. The control group received no information on their prescribing. MAIN OUTCOME MEASURES: Prescribing rates in the intervention and control groups for the five main drug groups, total prescribing and potential substitute prescribing and ordering before and after the interventions. RESULTS: The intervention and control groups had similar baseline characteristics (age, sex, patient mix, practices). Median prescribing rates for the two groups were almost identical before and after the interventions. Any changes in prescribing observed in the intervention group were also seen in the control group. There was no evidence that feedback reduced the variability in prescribing nor did it differentially affect the very high or very low prescribers. CONCLUSIONS: The form of feedback evaluated here-mailed, unsolicited, centralised, government sponsored, and based on aggregate data-had no impact on the prescribing levels of general practitioners.  (+info)

(3/9663) Computer use by general practitioners in Scotland.

BACKGROUND: Despite the widespread adoption by general practitioners (GPs) of desktop computers, there has been very little evaluation of the way in which the computer is actually used during consultations and the way in which it affects patient satisfaction. AIM: To ascertain the extent to which the computer is used in the consultation and to investigate the possible relationship between computer use and patient satisfaction. METHOD: Six GPs completed a short questionnaire about the extent to which they use the computer during surgeries. Eighty-four consultations from the surgeries of these GPs were video recorded. Patient satisfaction data on these 84 patients were collected at the time of the surgery using the previously validated Consultation Satisfaction Questionnaire. RESULTS: All six GPs stated that they usually used the computer during consultations. However, video observation revealed that the computer was used in just 51% of surgeries. The proportion of time that the computer was used for varied from 0.03 to 0.4, with a mean value of 0.12. The commonest function for which the computer was used was prescribing. The consultations in which the computer was used (CU) were on average 148 seconds longer than the non-computerized consultations (NCU). There was no difference in patient satisfaction between the two groups. CONCLUSION: Despite this group of GPs having a self-declared interest in the use of computers, the extent to which the computer was used was much lower than expected from the GPs' self-reported use. This may be partly explained by the fact that using the computer takes up valuable time within the consultation and does not appear to contribute to patient satisfaction. If desktop computers are to be used to their full potential in general practice, more work is required to evaluate their impact on the consultation process itself.  (+info)

(4/9663) Relationship between practice counselling and referral to outpatient psychiatry and clinical psychology.

BACKGROUND: Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship. AIM: To investigate the relationship between the provision of counselling in general practice and the use of outpatient psychiatry and clinical psychology services across a geographical area. METHOD: Information on referrals to outpatient psychiatry and clinical psychology from all general practices in the London Borough of Islington over one year (October 1993 to September 1994) was collected from the routine information systems of the main hospital departments serving this area. Referral rates per 1000 practice population were compared for practices with and without a practice-based counsellor. RESULTS: Fifteen (35%) of the 43 practices had a counsellor based in the practice. The median referral rate to clinical psychology was higher in practices with a counsellor (4.1 per 1000) than in practices without a counsellor (0.8 per 1000). There was no relationship between the provision of practice counselling and median referral rates to outpatient psychiatry (1.8 per 1000 with a counsellor, 1.7 per 1000 without a counsellor). CONCLUSION: Provision of practice counselling in the study was associated with higher referral rates to clinical psychology and no difference in referral rates to outpatient psychiatry. This is in contrast to the hypothesis that counselling reduces the use of secondary care mental health services.  (+info)

(5/9663) Why do dyspeptic patients over the age of 50 consult their general practitioner? A qualitative investigation of health beliefs relating to dyspepsia.

BACKGROUND: The prognosis of late-diagnosed gastric cancer is poor, yet less than half of dyspeptic patients consult their general practitioner (GP). AIM: To construct an explanatory model of the decision to consult with dyspepsia in older patients. METHOD: A total of 75 patients over the age of 50 years who had consulted with dyspepsia at one of two inner city general practices were invited to an in-depth interview. The interviews were taped, transcribed, and analysed using the computer software NUD.IST, according to the principles of grounded theory. RESULTS: Altogether, 31 interviews were conducted. The perceived threat of cancer and the need for reassurance were key influences on the decision to consult. Cues such as a change in symptoms were important in prompting a re-evaluation of the likely cause. Personal vulnerability to serious illness was often mentioned in the context of family or friends' experience, but tempered by an individual's life expectations. CONCLUSION: Most patients who had delayed consultation put their symptoms down to 'old age' or 'spicy food'. However, a significant minority were fatalistic, suspecting the worst but fearing medical interventions.  (+info)

(6/9663) A single-blind, placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking.

BACKGROUND: Tobacco smoking is a major cause of preventable disease and premature death. Physicians should play an active role in the control of smoking by encouraging cessation and helping the smoker to choose the most suitable aid to cessation. AIM: To evaluate a simple, ear acupuncture treatment for the cessation of smoking. METHOD: Randomized, single-blind, placebo-controlled trial of 78 currently smoking volunteers from the general public. Volunteers attended an acupuncture clinic in a general practice setting and were given a single treatment of electroacupuncture using two needles at either an active or a placebo site plus self-retained ear seeds for two weeks. The major outcome measure was biochemically validated total cessation of smoking at six months. RESULTS: A total of 12.5% of the active treatment group compared with 0% of the placebo group ceased smoking at six months (P = 0.055, 95% confidence interval -0.033 to 0.323). CONCLUSION: This simple ear electroacupuncture treatment was significantly more effective in helping volunteers to quit smoking than placebo treatment.  (+info)

(7/9663) Out-of-hours service in Denmark: the effect of a structural change.

BACKGROUND: In Denmark, the provision of out-of-hours care by general practitioners (GPs) was reformed at the start of 1992. Rota systems were replaced locally by county-based services. The new out-of-hours service resulted in a considerable reduction in the total number of GPs on call. AIM: To describe how the patients experienced the change from a satisfaction point of view, and how the pattern of patient contact and the fee for GPs changed with the new system. METHOD: The county of Funen was chosen as the geographical area where data were collected. A questionnaire measuring patient satisfaction was posted before the change, immediately after the change, and three years later to a random selection of patients who had been in contact with the out-of-hours service within two weeks before the mailing date. All primary care services for the Danish population are stored in a database (National Health Service Registry). From this continuously updated database, the contact pattern and the fee for GPs were extracted for 1991, 1992, and 1995. RESULTS: The total number of patient contacts was reduced by 16% in the first year, but by only 6% three years later. Three years after the change, there were more than twice as many telephone consultations as before the change, and there were only a third as many home visits. After three years, the GPs' fees were reduced by 20%. There was a significant decrease in patient satisfaction, although the overall level remained high. This decrease was lower three years after the change than immediately after the new system was introduced. CONCLUSION: The new service had a major cost-effectiveness benefit, but there was a price to pay in patient satisfaction.  (+info)

(8/9663) Health at work in the general practice.

BACKGROUND: Poor mental health and high stress levels have been reported in staff working in general practice. Little is known about how practices are tackling these and other issues of health at work in the absence of an established occupational healthcare service. AIM: To establish the extent of knowledge and good practice of health at work policies for staff working in general practice. METHOD: Practice managers in 450 randomly selected general practices in England were interviewed by telephone, and the general practitioner (GP) with lead responsibility for workplace health in the same practice was surveyed by postal questionnaire. We surveyed the existence and implementation of practice policies, causes and effects of stress on practice staff, and agreement between practice managers and GPs on these issues. RESULTS: Seventy-one per cent of GPs and 76% of practice managers responded, with at least one reply from 408 (91%) practices and responses from both the practice manager and GPs from 252 (56%) practices. Seventy-nine per cent of practices had a policy on monitoring risks and hazards. The proportion of practices with other workplace health policies ranged from 21% (policy to minimize stress) to 91% (policy on staff smoking). There was a tendency for practices to have policies but not to implement them. The three causes of stress for practice staff most commonly cites by both GP and practice manager responders were 'patient demands', 'too much work', and 'patient abuse/aggression'. Sixty-five per cent of GPs felt that stress had caused mistakes in their practices. Although there was general agreement between the two groups, there was a considerable lack of agreement between responders working in the same practices. CONCLUSIONS: The study revealed substantial neglect of workplace health issues with many practices falling foul of health and safety legislation. This report should help general practices identify issues to tackle to improve their workplace health, and the Health at Work in the NHS project to focus on areas where their targeted help will be most worthwhile.  (+info)



physicians


  • That decrease will be partially offset by RVU increases announced for office visits and other evaluation and management services that family physicians frequently perform, but Medicare fees will still decline significantly if the conversion factor goes down. (aafp.org)
  • For more information, I would encourage you to visit the Medicare participation options web page on the American Academy of Family Physicians' web site . (aafp.org)
  • This article is part of a series designed to educate and prepare family physicians to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (aafp.org)
  • Find the best in General or Family Practice Physicians on Kudzu. (kudzu.com)
  • Not looking for Family Practice Physicians in Arizona? (kudzu.com)

physician


  • Dr. Cris Johnson, MD is a board certified family physician in Lacey, Washington. (yellowbot.com)
  • Sylvester Family Practice provides full-time primary care for both children and adults with family physician Louise Wilder, M.D. and nurse practitioner Todd McDonald, FNP-BC. (chamberorganizer.com)
  • Medicare uses a single conversion factor for all payments, which means that a family physician and a general surgeon would be paid the same amount for a 99213. (aafp.org)
  • Some practices have even begun to tie physician compensation and advancement to Likert-scale patient evaluation data. (aafp.org)

checkup


  • Whether you need a routine checkup or something more serious, Bridgeport Family Practice is happy to help. (groupon.com)

clinic


  • Sylvester Family Practice also offers a medically supervised weight loss clinic and lung function testing. (chamberorganizer.com)

nurse


  • Does the practice use a nurse triage system? (aafp.org)

Doctor


  • Bandera Family Dental Practice has 1 doctor at 1 office location . (docshop.com)
  • I think I got my permanent family doctor right now. (kudzu.com)
  • Family Doctor / G.P. (ratemds.com)

routine


  • A consent form specifies methods by which a patient agrees to let your practice use his or her protected information for routine TPO purposes. (aafp.org)

Medicare


  • 1 Given that the average family physician's patient mix is 22-percent Medicare, 2 the RUC is likely to have a direct influence on one-fifth of your income. (aafp.org)

medicine


  • Jason Wilbur, MD , is assistant professor of family medicine at the University of Iowa.Mark Graber, MD, is associate professor of family and emergency medicine at the University of Iowa. (ecampus.com)
  • He is currently licensed to practice medicine in Washington. (yellowbot.com)
  • This business specializes in General Practice Medicine. (yellowbot.com)

services


  • Keep your mind and body healthy with the efficient and beneficial medical treatments and services offered at Bridgeport Family Practice. (groupon.com)
  • The Department of Developmental Services (DDS) is seeking self-advocates, family members, DDS staff, state agency staff and community members from universities, educational, aging, civic and other organizations to participate in our new Supporting Families Community of Practice state team. (ct.gov)
  • If you are interested in participating on the Community of Practice State Team, please complete the attached document and return it to robin.wood@ct.gov , or mail it to CT Department of Developmental Services, 460 Capital Avenue, Hartford, CT 06106. (ct.gov)

help


  • If you need help, both the AMA and the AAFP offer affordable, step-by-step guides to implementing the privacy rule (see www.ama-assn.org/ama/pub/category/8910.html or http://www.aafp.org/online/en/home/practicemgt/regulatory-compliance/hipaa.html for more information). (aafp.org)

provides


  • Bridgeport Family Practice in Bridgeport, PA provides individualized care for a wide variety of medical treatments. (groupon.com)

medical


  • With a medical treatment from Bridgeport Family Practice in Bridgeport, you can maintain control of your body and your health. (groupon.com)
  • Located at 1010 West Franklin Street, adjacent to the Worth County Health Department, Sylvester Family Practice is a facility of Tift Regional Medical Center along with HealthPlus. (chamberorganizer.com)
  • To be sure, standards of courtesy and professionalism should form the bedrock of any medical practice. (aafp.org)

Download


  • Although not specifically required by HIPAA, you may also want to consider using a Patient Consent Form in your practice ( download here ). (aafp.org)

patient


  • Should a patient complain that his or her privacy rights have been violated, a consent form may afford you an extra measure of protection if your practice is investigated for HIPAA noncompliance. (aafp.org)
  • Any practice, hospital or health plan in the United States that electronically transmits patient-identifiable health care information must comply with the HIPAA regulations or face civil and criminal penalties. (aafp.org)

staff


  • From time to time, we offer our staff some unexpected paid time off to participate in events that are important to them, such as a child's school play or a family occasion. (aafp.org)
  • At my former practice, our original staff was still going strong after four years. (aafp.org)

health


  • The privacy component of the Health Insurance Portability and Accountability Act (HIPAA) will take effect on April 14, 2003, and by then, your practice should have made a good-faith attempt to be ready. (aafp.org)
  • Representatives of the CPT Editorial Panel, the Health Care Professionals Advisory Committee and the Practice Expense Review Committee comprise three other seats. (aafp.org)

form


  • To comply, you'll need to identify situations in your practice where special authorization is needed (see page 31 for a list ) and develop an authorization form for patients to sign. (aafp.org)
  • The sample authorization form that can be downloaded here can be adapted for use in your practice. (aafp.org)

recommendations


  • The AAFP's RUC representative and alternate are appointed by the chair of the AAFP Board of Directors based on recommendations from the AAFP Commission on Practice Enhancement. (aafp.org)

office


  • To comply, you'll need to develop a Notice of Privacy Practices and provide it to your patients at the first office visit after April 14, 2003 (or earlier, if you have it ready). (aafp.org)