Interprofessional Relations: The reciprocal interaction of two or more professional individuals.Health Occupations: Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.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.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)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.Physician-Nurse Relations: The reciprocal interaction of physicians and nurses.Students, Health Occupations: Individuals enrolled in a school or formal educational program in the health occupations.Students, Nursing: Individuals enrolled in a school of nursing or a formal educational program leading to a degree in nursing.Education, Professional: Formal education and training in preparation for the practice of a profession.Education, Pharmacy: Formal instruction, learning, or training in the preparation, dispensing, and proper utilization of drugs in the field of medicine.Education, Nursing: Use for general articles concerning nursing education.Students, Pharmacy: Individuals enrolled in a school of pharmacy or a formal educational program leading to a degree in pharmacy.Professional Role: The expected function of a member of a particular profession.Models, 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.Social Networking: Individuals connecting by family, work or other interests. It also includes connectivity facilitated by computer-based communications.Curriculum: A course of study offered by an educational institution.Patient Simulation: The use of persons coached to feign symptoms or conditions of real diseases in a life-like manner in order to teach or evaluate medical personnel.Interdisciplinary Studies: Programs of study which span the traditional boundaries of academic scholarship.Leadership: The function of directing or controlling the actions or attitudes of an individual or group with more or less willing acquiescence of the followers.Education, Medical: Use for general articles concerning medical education.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).Nursing Administration Research: Research concerned with establishing costs of nursing care, examining the relationships between nursing services and quality patient care, and viewing problems of nursing service delivery within the broader context of policy analysis and delivery of health services (from a national study, presented at the 1985 Council on Graduate Education for Administration in Nursing (CGEAN) meeting).Staff Development: The process by which the employer promotes staff performance and efficiency consistent with management goals and objectives.Students, Medical: Individuals enrolled in a school of medicine or a formal educational program in medicine.Pharmacists: Those persons legally qualified by education and training to engage in the practice of pharmacy.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Competency-Based Education: Educational programs designed to ensure that students attain prespecified levels of competence in a given field or training activity. Emphasis is on achievement or specified objectives.Nurse's Role: The expected function of a member of the nursing profession.Schools, Pharmacy: Educational institutions for individuals specializing in the field of pharmacy.Pharmacy: The practice of compounding and dispensing medicinal preparations.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Vacuum Curettage: Aspiration of the contents of the uterus with a vacuum curette.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.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Physician Assistants: Health professionals who practice medicine as members of a team with their supervising physicians. They deliver a broad range of medical and surgical services to diverse populations in rural and urban settings. Duties may include physical exams, diagnosis and treatment of disease, interpretation of tests, assist in surgery, and prescribe medications. (from http://www.aapa.orglabout-pas accessed 2114/2011)Education, Dental: Use for articles concerning dental education in general.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)Delegation, Professional: The process of assigning duties to a subordinate with lesser qualifications.Hospitalists: Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.Nurses: Professionals qualified by graduation from an accredited school of nursing and by passage of a national licensing examination to practice nursing. They provide services to patients requiring assistance in recovering or maintaining their physical or mental health.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Educational Measurement: The assessing of academic or educational achievement. It includes all aspects of testing and test construction.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.Organizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.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)Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Schools, Dental: Educational institutions for individuals specializing in the field of dentistry.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)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)Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.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.Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.Nursing Evaluation Research: Research carried out by nurses that uses interviews, data collection, observation, surveys, etc., to evaluate nursing, health, clinical, and nursing education programs and curricula, and which also demonstrates the value of such evaluation.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.Teaching: The educational process of instructing.Organizational Culture: Beliefs and values shared by all members of the organization. These shared values, which are subject to change, are reflected in the day to day management of the organization.Organizational Innovation: Introduction of changes which are new to the organization and are created by management.Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.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.Professional Practice Location: Geographic area in which a professional person practices; includes primarily physicians and dentists.Problem-Based Learning: Instructional use of examples or cases to teach using problem-solving skills and critical thinking.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.Safety Management: The development of systems to prevent accidents, injuries, and other adverse occurrences in an institutional setting. The concept includes prevention or reduction of adverse events or incidents involving employees, patients, or facilities. Examples include plans to reduce injuries from falls or plans for fire safety to promote a safe institutional environment.Learning: Relatively permanent change in behavior that is the result of past experience or practice. The concept includes the acquisition of knowledge.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.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.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.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.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.WashingtonInternal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Physicians: Individuals licensed to practice medicine.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)Universities: Educational institutions providing facilities for teaching and research and authorized to grant academic degrees.Professional-Patient Relations: Interactions between health personnel and patients.Medication Errors: Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage.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.Factor Analysis, Statistical: A set of statistical methods for analyzing the correlations among several variables in order to estimate the number of fundamental dimensions that underlie the observed data and to describe and measure those dimensions. It is used frequently in the development of scoring systems for rating scales and questionnaires.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.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)FloridaInternet: 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.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.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.United StatesRural Health: The status of health in rural populations.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.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.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).Benchmarking: Method of measuring performance against established standards of best practice.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.
Eco-Runner Team Delft: Eco-Runner Team DelftDocument-centric collaboration: Document-centric collaboration is a new approach to working together on projects online which puts the document and its contents at the centre of the process.Professional student: The term Professional student has two uses in the university setting:Syllabus: A syllabus (pl. syllabi) is an outline and summary of topics to be covered in an education or training course.Q Division Studios: Q Division Studios is a recording studio located in Somerville, Massachusetts, United States, at the heart of the Boston area's music scene. Founded in 1986, Q Division was originally located at 443 Albany Street in Boston, but moved to its current two-studio facility in 2000.Cross-cultural leadership: Cross-cultural psychology attempts to understand how individuals of different cultures interact with each other (Abbe et al., 2007).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.Leiden International Medical Student ConferenceNuclear pharmacy: Nuclear Pharmacy involves a lot of preparation of radioactive materials that will be used to diagnose and treat specific diseases. It was the first pharmacy specialty established in 1978 by the Board of Pharmaceutical Specialties.Vacuum aspiration: Vacuum or suction aspiration uses aspiration to remove uterine contents through the cervix. It may be used as a method of induced abortion, a therapeutic procedure used after miscarriage, or a procedure to obtain a sample for endometrial biopsy.Society for Education Action and Research in Community Health: Searching}}OtenabantDJ College of Dental Sciences and Research: Divya Jyoti (DJ) College of Dental Sciences and Research is a dental college located in Modinagar in the nagar panchayat of Niwari in Ghaziabad district in the Indian state of Uttar Pradesh. The founder and chairman is Ajit Singh Jassar.Chronic disease in Northern OntarioBogon filtering: Bogon filtering is the practice of filtering bogons, which are bogus IP addresses of a computer network. Bogon is also an informal name for an IP packet on the public Internet that claims to be from an area of the IP address space (or network prefix or network block) reserved, but not yet allocated or delegated by the Internet Assigned Numbers Authority (IANA) or a delegated Regional Internet Registry (RIR).Carteret General Hospital: Carteret General Hospital is a 135 bed, non-profit hospital in Morehead City, North Carolina. Carteret General was founded in 1967.Richard Wells (nurse): Richard J. Wells CBE, RN, FRCN (1950–1993) was a British nurse, nursing adviser and health care administrator.History of communication studies: Various aspects of communication have been the subject of study since ancient times, and the approach eventually developed into the academic discipline known today as communication studies.Psychiatric 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.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.Dental Schools Council: The Dental Schools Council represents the interests of UK dental schools as it relates to national health, wealth, knowledge acquisition through teaching, research, and the profession of dentistry.Universities UK http://www.Halfdan T. MahlerList of subjects related to the Quebec independence movement: This is a list of subjects related to the Quebec independence movement.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.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.Standard evaluation frameworkGraphic facilitation: Graphic Facilitation is the use of large scale imagery to lead groups and individuals towards a goal. The method is used in various processes such as meetings, seminars, workshops and conferences.American Osteopathic Board of Neurology and Psychiatry: United StatesHamid GhodseAustralian National BL classBio Base EuropeEnvironmental issues in Puget Sound: Puget Sound is a deep inlet of the Pacific Ocean in Washington, extending south from the Strait of Juan de Fuca through Admiralty Inlet. It was explored and named by Captain George Vancouver for his aide, Peter Puget, in 1792.American Osteopathic Board of Internal MedicineSamuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.Alberta Hospital EdmontonAntenor Orrego Private UniversityGlobal Health Delivery ProjectDisease management (health): Disease management is defined as "a system of coordinated healthcare interventions and communications for populations with conditions in which patient self-care efforts are significant."Care Continuum Alliance.Miami-Dade County Corrections and Rehabilitation Department: The Miami-Dade County Corrections and Rehabilitation Department is an agency of the government of Miami-Dade County, Florida. It has its headquarters in the Gladeview census-designated place in an unincorporated area.Internet organizations: This is a list of Internet organizations, or organizations that play or played a key role in the evolution of the Internet by developing recommendations, standards, and technology; deploying infrastructure and services; and addressing other major issues.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.Closed-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.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Von Neumann regular ring: In mathematics, a von Neumann regular ring is a ring R such that for every a in R there exists an x in R such that . To avoid the possible confusion with the regular rings and regular local rings of commutative algebra (which are unrelated notions), von Neumann regular rings are also called absolutely flat rings, because these rings are characterized by the fact that every left module is flat.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.Referral (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.
(1/1663) Hospital restructuring and the changing nature of the physical therapist's role.
BACKGROUND AND PURPOSE: This study was conducted to identify role behavior changes of acute care physical therapists and changes in the organizational and professional context of hospitals following restructuring. METHODS: A Delphi technique, which involved a panel of 100 randomly selected acute care physical therapy managers, was used as the research design for this study. Responses from rounds 1 and 2 were synthesized and organized into exhaustive and mutually exclusive categories for round 3. Data obtained from round 3 were used to develop a comprehensive perspective on the changes that have occurred. RESULTS: Changed role behaviors in patient care and professional interaction, including increased emphasis on evaluation, planning, teaching, supervising, and collaboration, appeared to be extensions of unchanged role behaviors. Reported changes in the structural and professional context of physical therapy services included using critical pathways to guide care, providing services system-wide, and using educational activities and meetings to maintain a sense of community. The importance of professionalism to physical therapists' work was identified and related to specific role behavior changes. CONCLUSION AND DISCUSSION: The changing role of physical therapists in acute care hospitals includes an increased emphasis on higher-level skills in patient care and professional interaction and the continuing importance of professionalism. (+info)
(2/1663) Development of clinical guidelines in a health district: an attempt to find consensus.
OBJECTIVE: To formulate consensus based guidelines for antenatal care in a health district. DESIGN: Prospective formulation of draft guidelines by a working group of consultant obstetricians and general practitioners with an obstetric interest, canvassing opinions of all GPs in the district by questionnaire, and revision and final circulation of the guidelines. SETTING: One health district. SUBJECTS: All 160 GPs in the district and members of the working party. MAIN MEASURES: Questionnaire responses to specific proposals within the draft guidelines for managing anaemia, antepartum haemorrhage, and hypertension. RESULTS: 136 GPs responded (response rate 85%); responders and nonresponders did not differ in age, sex, or presence on obstetric list. Overall they favoured more conservative management than suggested in the guidelines. For example, only 38% (44/116) prescribed iron routinely and 34% (38/113) referred to hospital for haemoglobin concentration of < or = 10 g/l; 10% referred women unnecessarily for oedema unassociated with proteinuria; and 20% managed active bleeding progressing to old brown staining as an urgent admission. The guidelines were revised according to the relative weight of the views obtained. CONCLUSION: Establishing guidelines is mainly a political process. Canvassed views influenced guidelines most when internal disagreement existed within the working party. IMPLICATIONS AND ACTION: Regular revising of the guidelines is planned, which, in conjunction with repeating the questionnaire to monitor changing practice, will allow a long term district wide clinical review. (+info)
(3/1663) Clinical audit and the purchaser-provider interaction: different attitudes and expectations in the United Kingdom.
OBJECTIVES: To explore and describe the views on clinical audit of healthcare purchasers and providers, and in particular the interaction between them, and hence to help the future development of an appropriate interaction between purchasers and providers. DESIGN: Semistructured interviews. SETTING: Four purchaser and provider pairings in the former Northern Region of the National Health Service (NHS) in England. SUBJECTS: Chief executives, contracts managers, quality and audit leaders, directors of public health, consultants, general practitioners, audit support staff, and practice managers (total 42). MAIN MEASURES: Attitudes on the present state and future development of clinical audit. RESULTS: Purchasers and providers shared common views on the purpose of clinical audit, but there were important differences in their views on the level and appropriateness of involvement of health care purchasers, integration with present NHS structures and processes (including contracting and the internal market), priority setting for clinical audit, the effects of clinical audit on service development and purchasing, change in behaviour, and the sharing of information on the outcomes of clinical audit. CONCLUSIONS: There are important differences in attitudes towards, and expectations of, clinical audit between health care purchasers and providers, at least in part due to the limited contact between them on audit to date. The nature of the relation and dialogue between purchasers and providers will be critical in determining whether clinical audit meets the differing aspirations of both groups, while achieving the ultimate goal of improving the quality of patient care. (+info)
(4/1663) Essential dataset for ambulatory ear, nose, and throat care in general practice: an aid for quality assessment.
OBJECTIVE: To describe the documentation of care for the usual range of ear, nose, and throat (ENT) problems seen in primary care as a basis for developing a computerised information system to aid quality assessment. DESIGN: Descriptive study of the pattern of ENT problems and diagnoses and treatment as recorded in individual case notes. SETTING: The primary health care centre in Mjolby, Sweden. PATIENTS: Consultations for ENT problems from a 10% sample randomly selected from all consultations (n = 22,600) in one year. From this sample 375 consultations for ENT problems (16% of all consultations) by 272 patients were identified. MAIN MEASURES: The detailed documentation of each consultation was retrieved from the individual records and compared with the data required for a computer based information system designed to help in quality management. RESULTS: Although the overall picture gained from the data retrieved from the notes suggested that ENT care was probably adequate, the recorded details were limited. The written case notes were insufficient when compared with the details required for a computerised system based on an essential dataset designed to allow assessment of diagnostic accuracy and appropriateness of treatment of ENT problems in primary care. CONCLUSION: There is a gap between the amount and the type of information needed for accurate and useful quality assessment and that which is normally included in case notes. More detailed information is needed if general practitioners' notes are to be used for regular quality assessment of ENT problems but that would mean more time spent on keeping notes. This would be difficult to justify. IMPLICATIONS: The routine information systems used at this primary healthcare centre did not produce sufficient documentation for quality assessment of ENT care. This dilemma might be resolved by specially designed desktop computer software accessed through an essential dataset. (+info)
(5/1663) Reducing malpractice risk through more effective communication.
This activity is designed for physicians, health plan administrators, and other providers. GOAL: To help physicians, health plan administrators, and other providers learn more about the relationship between provider communication behaviors and subsequent negligence litigation and learn how to reduce malpractice risk through improving communication behaviors. OBJECTIVES: 1. To describe research findings concerning the relationship between provider communication behaviors and subsequent claims of negligence. 2. To describe the major interviewing deficiencies that have been identified as precipitants of malpractice litigation. 3. To describe three functions of effective interviewing. 4. To describe training and learning methods that can improve provider-patient relationships, leading to improved clinical outcomes and decreased malpractice risk. (+info)
(6/1663) Turfing: patients in the balance.
OBJECTIVE: To examine the language of "turfing," a ubiquitous term applied to some transfers of patients between physicians, in order to reveal aspects of the ideology of internal medicine residency. SETTING: Academic internal medicine training program. MEASUREMENTS: Using direct observation and a focus group, we collected audiotapes of medical residents' discussions of turfing. These data were analyzed using interpretive and conversation analytic methods. The focus group was used both to validate and to further elaborate a schematic conceptual framework for turfing. MAIN RESULTS: The decision to call a patient "turfed" depends on the balance of the values of effectiveness of therapy, continuity of care, and power. For example, if the receiving physician cannot provide a more effective therapy than can the transferring physician, medical residents consider the transfer inappropriate, and call the patient a turf. With appropriate transfers, these residents see their service as honorable, but with turfs, residents talk about the irresponsibility of transferring physicians, burdens of service, abuse, and powerlessness. CONCLUSIONS: Internal medicine residents can feel angry and frustrated about receiving patients perceived to be rejected by other doctors, and powerless to prevent the transfer of those patients for whom they may have no effective treatment or continuous relationship. This study has implications for further exploration of how the relationships between physicians may uphold or conflict with the underlying moral tenets of the medical profession. (+info)
(7/1663) Tolerance in a rigorous science.
Scientists often evaluate other people's theories by the same standards they apply to their own work; it is as though scientists may believe that these criteria are independent of their own personal priorities and standards. As a result of this probably implicit belief, they sometimes may make less useful judgments than they otherwise might if they were able and willing to evaluate a specific theory at least partly in terms of the standards appropriate to that theory. Journal editors can play an especially constructive role in managing this diversity of standards and opinion. (+info)
(8/1663) How well do GPs and hospital consultants work together? A survey of the professional relationship.
BACKGROUND: The professional relationship between GPs and hospital consultants (sometimes referred to as 'specialists') is important in a healthcare system based upon the generalist as the first point of contact for patients and the gate-keeper for hospital services. This relationship has been the subject of considerable interest over the years, but little empirical research. OBJECTIVES: We aimed to compare the attitudes of GPs and specialists to key issues, and to produce a validated objective measure of their ability to work together. METHODS: We conducted a Likert-style survey based upon statements made in qualitative interviews with GPs and specialists working in the South and West of England. The questionnaire was modified and validated during a multi-stage pilot and was distributed to a stratified random sample of 800 clinicians. RESULTS: GPs and specialists demonstrate a good level of agreement, mutual understanding and respect, though there are significant differences between the two branches of the profession in terms of attitude towards financial parity and direct access to special investigations. CONCLUSIONS: A measure of the ability of GPs and specialists to work together has been developed, with acceptable internal consistency and validity. It may be used in other geographical areas to assess a relationship which is central to the efficient and effective operation of the National Health Service. (+info)