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Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Physicians: Individuals licensed to practice medicine.Practice Management, Medical: The organization and operation of the business aspects of a physician's practice.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.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.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.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.United StatesPrivate Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.Physicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.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.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.Hospital-Physician Joint Ventures: A formal financial agreement made between one or more physicians and a hospital to provide ambulatory alternative services to those patients who do not require hospitalization.Physician's Role: The expected function of a member of the medical profession.Dentist's Practice Patterns: Patterns of practice in dentistry related to diagnosis and treatment.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.Specialization: An occupation limited in scope to a subsection of a broader field.Physicians' Offices: The room or rooms in which the physician and staff provide patient care. The offices include all rooms in the physician's office suite.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)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.Professional Practice Location: Geographic area in which a professional person practices; includes primarily physicians and dentists.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.Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.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.Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes, and the genital tract in the male. Common urological problems include urinary obstruction, URINARY INCONTINENCE, infections, and UROGENITAL NEOPLASMS.Independent Practice Associations: A partnership, corporation, association, or other legal entity that enters into an arrangement for the provision of services with persons who are licensed to practice medicine, osteopathy, and dentistry, and with other care personnel. Under an IPA arrangement, licensed professional persons provide services through the entity in accordance with a mutually accepted compensation arrangement, while retaining their private practices. Services under the IPA are marketed through a prepaid health plan. (From Facts on File Dictionary of Health Care Management, 1988)Canada: The largest country in North America, comprising 10 provinces and three territories. Its capital is Ottawa.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)Fees, Medical: Amounts charged to the patient as payer for medical services.Physician-Patient Relations: The interactions between physician and patient.Physicians, Women: Women licensed to practice medicine.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.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).Hospital-Physician Relations: Includes relationships between hospitals, their governing boards, and administrators in regard to physicians, whether or not the physicians are members of the medical staff or have medical staff privileges.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.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.Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Electronic Prescribing: The use of COMPUTER COMMUNICATION NETWORKS to store and transmit medical PRESCRIPTIONS.Investments: Use for articles on the investing of funds for income or profit.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.Personnel Staffing and Scheduling Information Systems: Computer-based systems for use in personnel management in a facility, e.g., distribution of caregivers with relation to patient needs.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.Programming, Linear: A technique of operations research for solving certain kinds of problems involving many variables where a best value or set of best values is to be found. It is most likely to be feasible when the quantity to be optimized, sometimes called the objective function, can be stated as a mathematical expression in terms of the various activities within the system, and when this expression is simply proportional to the measure of the activities, i.e., is linear, and when all the restrictions are also linear. It is different from computer programming, although problems using linear programming techniques may be programmed on a computer.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Prepaid Health Plans: Contracts between an insurer and a subscriber or a group of subscribers whereby a specified set of health benefits is provided in return for a periodic premium.Health Facility Size: The physical space or dimensions of a facility. Size may be indicated by bed capacity.

*  Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey | BMC Complementary and...
Boon HS, Cherkin DC, Erro J, Sherman KJ, Milliman B, Booker J: Practice patterns of naturopathic physicians: results from a ... Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey. ... There were no practice pattern differences between the two organizations. From the respondents, 61% took the electronic survey ... The goal is for practicing doctors of chiropractic to acquire greater skill and competency with the evaluation, diagnosis, and ...
  https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-10-26
*  A survey of Korean medicine doctors' clinical practice patterns for autism spectrum disorder: preliminary research for clinical...
The aim of this study was to investigate autism spectrum disorder (ASD) clinical practice patterns of Korean medicine doctors ( ... Survey among Korea medicine doctors (KMDs) in Korea on patterns of integrative Korean medicine practice for lumbar ... A survey of Korean medicine doctors' clinical practice patterns for autism spectrum disorder: preliminary research for clinical ... This is the first survey report on clinical practice pattern of KM treatment of ASD. The draft of CPG for KM treatment of ASD ...
  https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/s12906-018-2162-4
*  Dr. C. Stephen Foster Creates Preferred Practice Patterns of Uveitis Management | Uveitis.org | OIUF
Dr. C. Stephen Foster Creates Preferred Practice Patterns of Uveitis Management. Published on March 14, 2016 ... Online Physician Forum. Our Online Physician Forum is currently under development. Please check back periodically. ... quality eye care in OID from the world's leading physicians - recently had his method of treating uveitis published as the new ...
  http://www.uveitis.org/news/dr-c-stephen-foster-creates-preferred-practice-patterns-of-uveitis-management/
*  Drug prescription pattern for asthma among nigerian doctors in general practice: A cross-sectional survey
... Ademola E. Fawibe, ... resident doctors (trainees in general/family practice), and Fellows in general/family practice (doctors with postgraduate ... doctors, without any significant difference in the prescription pattern, according to the working status and practice setting ... and doctors in private practice (P,0.001) significantly prescribed IV methylxanthines, more than other categories of doctors. ...
  http://pubmedcentralcanada.ca/pmcc/articles/PMC3339208/
*  Random or predictable?: Adoption patterns of chronic care management practices in physician organizations | Implementation...
Wiley JA, Rittenhouse DR, Shortell SM, Casalino LP, Ramsay PP, Bibi S, et al. Managing chronic illness: physician practices ... Random or predictable?: Adoption patterns of chronic care management practices in physician organizations. ... Specific study objectives are to describe patterns in adoption of care management practices by physician organizations and to ... Chronic careCare management practicesAdoptionPhysician organizations. Background. Many theories, models, and frameworks used to ...
  https://implementationscience.biomedcentral.com/articles/10.1186/s13012-017-0639-z/
*  Antimicrobial Use in Long-Term-Care Facilities | Infection Control & Hospital Epidemiology | Cambridge Core
Physician practice patterns. Arch Intern Med 1990;150:1465-1468.. 10.Kunin CM. The responsibility of the infectious disease ... The short- and long-term effects of a handbook on antimicrobial prescribing patterns of hospital physicians. Infect Control ... The use of an antibiotic order form for antibiotic utilization review: influence of physicians' prescribing patterns. J Infect ... 36.Peterson PK, Stein D, Guay DR, Logan G, Obaid S, Gruninger R, et al. Prospective study of lower respiratory tract infections ...
  https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/antimicrobial-use-in-longtermcare-facilities/A6648B5AC6747E0516035687324F7C63
*  C-Sections Rise to an All-Time High of One in Three Births
Established physician practice patterns. The Joint Commission and the Agency for Healthcare Research and Quality noted that no ... Doctors need to better understand when a C-section is called for, Cantor said. She also noted that patients need more awareness ... Common labor practices that can increase the likelihood of needing a C-section, such as induction of labor or having an ... Increasing willingness of physicians to perform C-sections. * Limited understanding by the mother of the potentially serious ...
  http://www.ibtimes.com/c-sections-rise-all-time-high-one-three-births-301319
*  A Comparison of Two Ways to Manage Anti-HIV Treatment (The SMART Study) - Full Text View - ClinicalTrials.gov
Physician's Practice Patterns. Anti-HIV Agents. Additional relevant MeSH terms: HIV Infections. Lentivirus Infections. ... Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your ... To learn more about this study, you or your doctor may contact the study research staff using the contact information provided ... doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical ...
  https://clinicaltrials.gov/show/NCT00027352?order=152
*  A Study of Two Methods of Determining When to Begin or Change Anti-HIV Treatment - Full Text View - ClinicalTrials.gov
Physician's Practice Patterns. Additional relevant MeSH terms: HIV Infections. Lentivirus Infections. Retroviridae Infections. ... Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your ... To learn more about this study, you or your doctor may contact the study research staff using the contact information provided ... The remaining patients in the CCP arm will have CD4 counts obtained according to their clinicians' current clinical practices. ...
  https://clinicaltrials.gov/show/NCT00001069?order=319
*  WHO IRIS: Evaluation of drug use in Jordan using WHO prescribing indicators
Physician's Practice Patterns. Prescriptions, Drug. Quality Indicators, Health Care. Retrospective Studies. World Health ... Patterns of prescribing and use of pharmaceuticals by physicians and patients in Jordan have not previously been studied. We ... retrospectively evaluated pharmaceutical drug prescribing practices in 21 primary health care facilities in Irbid governorate, ...
  http://apps.who.int/iris/handle/10665/119197
*  WHO IRIS: Psychotropic drugs prescriptions in Al-Qassim Region, Saudi Arabia
Physician's Practice Patterns. Prescriptions, Drug. Quality Assurance, Health Care. Subject: Psychotropic Drugs. ... Polypharmacy [85%] was the predominant mode of practice. The most common diagnoses were mood [23.1%], anxiety [17.7%] and ... programmes are suggested to improve the quality of psychotropic prescriptions and modify multiple pharmacotherapy practice. ...
  http://apps.who.int/iris/handle/10665/118680
*  Hospital Quality: Adverse Event Reporting by Hospitals | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Through realigned payment policies, public reporting of adverse events, and readily available best practices, hospitals are ... Nonetheless, many hospitals and clinicians are slow to adopt or use recommended patient safety practices. ... the use of unsafe practices and antiquated technologies in the hospital industry. This, in turn, resulted in a frightening ...
  http://piperreport.com/blog/2008/12/21/hospital_quality_and_medicare_adverse_event_reporting/
*  Medicare Payment Policy: MedPAC Recommendations to Congress | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Physician Services: *Update Medicare Part B payments for physician services in 2009 by the projected change in input prices ... MedPAC reiterated its recommendation that the Congress implement a quality incentive program for physicians and facilities that ... to establish a process for measuring and reporting physician resource use on a confidential basis for a period of two years. ...
  http://piperreport.com/blog/2008/02/29/medicare_payment_policy_medpac_recommendations_to_congress/
*  Health Care Policy | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Physician Payment Reform: Effects of New Payment Models on Physician Practices, Experience, and Finances. Kip Piper - November ... affected physicians and physician practices in the United States? A recent RAND Corporation study, sponsored by the American ... MACRA and Accountable Care Organizations: Medicare Physician Payment Reform Issues for ACOs. Kip Piper - July 12, 2016. 0 ...
  http://piperreport.com/blog/category/health-care-policy/
*  Part B vs Part D: Navigating Medicare Drug Coverage | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Medicare Part B Drug Coverage in Physician Offices:. For Medicare Part B drug coverage in a physician's office, here are the ... 1. Must be furnished "incident to" a physician service. Normally, this means the drug is physician prescribed and dispensed or ... 1. Drugs billed by physicians and provided incident to physician service for that patient (e.g., chemotherapy drugs). ...
  http://piperreport.com/blog/2006/02/03/part_b_vs_part_1/
*  Opioid Recovery and Patient Access to Medication Assisted Treatment in Medicaid, Medicare Part D, and Private Health Insurance ...
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Physicians must complete an 8-hour course, must obtain a waiver from the U.S. Drug Enforcement Administration (DEA), and are ... The study - Physician Capacity to Treat Opioid Use Disorder with Buprenorphine‐Assisted Treatment - was conducted by ... A new analysis by the IMS Institute for Health Informatics of the prescribing patterns and payer mix for buprenorphine show ...
  http://piperreport.com/blog/2016/09/25/opioid-recovery-and-patient-access-to-medication-assisted-treatment-in-medicaid-medicare-part-d-and-private-health-insurance/
*  Medicare Reimbursement: Primers on Medicare Payment Methods for Providers, Health Plans, and Drug Plans | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Medicare Part B for Physician Services, Other Outpatient Services, Medical Equipment, ad Supplies: ... physicians, Medicare Advantage plans, prescription drug plans, and other health care providers. MedPAC is an advisory agency to ...
  http://piperreport.com/blog/2009/11/02/medicare_reimbursement_primers_on_medicare_payment_methods_for_providers_he/
*  Primary Care Physicians and Hospital Emergency Departments: Improving Communications | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Second, physician communication can be improved through payment reforms. The changing model of how physicians are paid and ... Limited Rrole of Cross-Covering Providers: EDs and emergency physicians are less likely to speak to a physician that has ... Shared Electronic Health Records: Using EMRs may streamline physician to physician contact, but many note that EHRs don't ...
  http://piperreport.com/blog/2011/05/28/primary-care-physicians-and-hospital-emergency-departments-improving-communications/
*  Medicare Part D: Comparing Prescription Drug Use in Special Needs Plans and Other Medicare Advantage Plans | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... recur and involve drugs prescribed by the same physician and filled by the same pharmacy. ... also a need for genuine medication therapy management programs and more information and decision support tools for physicians ...
  http://piperreport.com/blog/2008/12/23/medicare_part_d_comparing_prescription_drug_use_in_special_needs_plans_and/
*  How Undocumented Immigrants Could Receive Obamacare Subsidies: Hypothetical Uses of ACA Waivers | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... it will be wise to consider precedents and practices in structuring 1115 waivers. This is especially true given the likelihood ...
  http://piperreport.com/blog/2014/11/28/how-undocumented-immigrants-could-receive-obamacare-subsidies-hypothetical-uses-of-aca-waivers/
*  Health Care Payment Reform: Considerations for Global Payments in Medicaid | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... BCBSMA is implementing global payments with select hospitals and physician groups. ...
  http://piperreport.com/blog/2009/11/19/health_care_payment_reform_considerations_for_global_payments_in_medicaid/
*  American Health & Drug Benefits: June 2010 Issue | Piper Report
Physician Practice Patterns and Perspectives on Change: Insights from National Survey. December 10, 2016. ... Medication Adherence: Effectiveness of Physician Alerts to Resolve Potential Gaps in Pharmacotherapy ...
  http://piperreport.com/blog/2010/07/01/american_health_drug_benefits_june_2010_issue/

Samuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,National Clinical Guideline CentreCanadian Intermountain Joint Venture: The Canadian Intermountain Joint Venture (CIJV) is a partnership of "government agencies, Aboriginal groups, nongovernmental organizations, industry, universities and landowners" for the implementation of the North American Waterfowl Management Plan in the inter-mountain areas of south and central British Columbia in Canada, and the south-western mountain region of Alberta. Its region of operation includes "all the mountain national parks", with boundaries delineated by the border with the United States to the south, the eastern crest of the Rocky Mountains to the east, the crest of the Coast Mountains to the west, and the boreal forest to the north.Dentists Act 1984: The Dentists Act 1984 (c. 24) is an Act of the Parliament of the United Kingdom regulating dentistry.Halfdan 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.Department of Urology, University of Virginia: {{Infobox universityCanadian 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.Chronic disease in Northern OntarioMercuriade: 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.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.American Osteopathic Board of Internal MedicineToyota NZ engine: The Toyota NZ engine family is a straight-4 piston engine series. The 1NZ series uses aluminum engine blocks and DOHC cylinder heads.List of companies listed on the Oslo Stock Exchange: The Oslo Stock Exchange (Norwegian: Oslo Børs) serves as the main market for trading in the shares of Norwegian companies. It opens at 9:00am and closes 4:30pm local time (CET).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.Ravi Iyengar: Ravi Iyengar, is a systems biologist and director of the Experimental Therapeutics Institute at the Icahn School of Medicine at Mount Sinai in New York City, as well as the Dorothy H. and Lewis Rosenstiel Professor and chairman of the Department of Pharmacology and Systems Therapeutics and director and principal investigator of the NIGMS-funded Systems Biology Center New York at The Mount Sinai Medical Center.Ideal number: In number theory an ideal number is an algebraic integer which represents an ideal in the ring of integers of a number field; the idea was developed by Ernst Kummer, and led to Richard Dedekind's definition of ideals for rings. An ideal in the ring of integers of an algebraic number field is principal if it consists of multiples of a single element of the ring, and nonprincipal otherwise.

(1/6616) Physician advice and individual behaviors about cardiovascular disease risk reduction--seven states and Puerto Rico, 1997.

Cardiovascular disease (CVD) (e.g., heart disease and stroke) is the leading cause of death in the United States and accounted for 959,227 deaths in 1996. Strategies to reduce the risk for heart disease and stroke include lifestyle changes (e.g., eating fewer high-fat and high-cholesterol foods) and increasing physical activity. The U.S. Preventive Services Task Force and the American Heart Association (AHA) recommend that, as part of a preventive health examination, all primary-care providers counsel their patients about a healthy diet and regular physical activity. AHA also recommends low-dose aspirin use as a secondary preventive measure among persons with existing CVD. To determine the prevalence of physician counseling about cardiovascular health and changes in individual behaviors, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) for seven states and Puerto Rico. This report summarizes the results of that analysis, which indicate a lower prevalence of counseling and behavior change among persons without than with a history of heart disease or stroke.  (+info)

(2/6616) 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)

(3/6616) A comparison of three methods of setting prescribing budgets, using data derived from defined daily dose analyses of historic patterns of use.

BACKGROUND: Prescribing matters (particularly budget setting and research into prescribing variation between doctors) have been handicapped by the absence of credible measures of the volume of drugs prescribed. AIM: To use the defined daily dose (DDD) method to study variation in the volume and cost of drugs prescribed across the seven main British National Formulary (BNF) chapters with a view to comparing different methods of setting prescribing budgets. METHOD: Study of one year of prescribing statistics from all 129 general practices in Lothian, covering 808,059 patients: analyses of prescribing statistics for 1995 to define volume and cost/volume of prescribing for one year for 10 groups of practices defined by the age and deprivation status of their patients, for seven BNF chapters; creation of prescribing budgets for 1996 for each individual practice based on the use of target volume and cost statistics; comparison of 1996 DDD-based budgets with those set using the conventional historical approach; and comparison of DDD-based budgets with budgets set using a capitation-based formula derived from local cost/patient information. RESULTS: The volume of drugs prescribed was affected by the age structure of the practices in BNF Chapters 1 (gastrointestinal), 2 (cardiovascular), and 6 (endocrine), and by deprivation structure for BNF Chapters 3 (respiratory) and 4 (central nervous system). Costs per DDD in the major BNF chapters were largely independent of age, deprivation structure, or fundholding status. Capitation and DDD-based budgets were similar to each other, but both differed substantially from historic budgets. One practice in seven gained or lost more than 100,000 Pounds per annum using DDD or capitation budgets compared with historic budgets. The DDD-based budget, but not the capitation-based budget, can be used to set volume-specific prescribing targets. CONCLUSIONS: DDD-based and capitation-based prescribing budgets can be set using a simple explanatory model and generalizable methods. In this study, both differed substantially from historic budgets. DDD budgets could be created to accommodate new prescribing strategies and raised or lowered to reflect local intentions to alter overall prescribing volume or cost targets. We recommend that future work on setting budgets and researching prescribing variations should be based on DDD statistics.  (+info)

(4/6616) 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)

(5/6616) Clinical experience and choice of drug therapy for human immunodeficiency virus disease.

To determine if providers experienced in the management of human immunodeficiency virus (HIV) disease preferred different treatment regimens than providers with less experience, we analyzed data from a national survey of primary care providers' preferred regimens for the management of 30 HIV-related medical conditions. We mailed questionnaires to 999 correct addresses of providers in > 20 cities in the United States in May 1996. We received 524 responses (response rate, 52%). We found a statistically significant association between the number of HIV-infected patients cared for by the provider and the likelihood that the provider would report prescribing highly active antiretroviral therapy and multidrug combinations for treatment of opportunistic infections. Providers with few HIV-infected patients were substantially less likely to report using new therapeutic regimens or new diagnostic tools. We concluded that the preferred regimens of experienced providers are more likely to be consistent with the latest information on treatment for HIV disease than are those of less experienced providers.  (+info)

(6/6616) Practice patterns, case mix, Medicare payment policy, and dialysis facility costs.

OBJECTIVE: To evaluate the effects of case mix, practice patterns, features of the payment system, and facility characteristics on the cost of dialysis. DATA SOURCES/STUDY SETTING: The nationally representative sample of dialysis units in the 1991 U.S. Renal Data System's Case Mix Adequacy (CMA) Study. The CMA data were merged with data from Medicare Cost Reports, HCFA facility surveys, and HCFA's end-stage renal disease patient registry. STUDY DESIGN: We estimated a statistical cost function to examine the determinants of costs at the dialysis unit level. PRINCIPAL FINDINGS: The relationship between case mix and costs was generally weak. However, dialysis practices (type of dialysis membrane, membrane reuse policy, and treatment duration) did have a significant effect on costs. Further, facilities whose payment was constrained by HCFA's ceiling on the adjustment for area wage rates incurred higher costs than unconstrained facilities. The costs of hospital-based units were considerably higher than those of freestanding units. Among chain units, only members of one of the largest national chains exhibited significant cost savings relative to independent facilities. CONCLUSIONS: Little evidence showed that adjusting dialysis payment to account for differences in case mix across facilities would be necessary to ensure access to care for high-cost patients or to reimburse facilities equitably for their costs. However, current efforts to increase dose of dialysis may require higher payments. Longer treatments appear to be the most economical method of increasing the dose of dialysis. Switching to more expensive types of dialysis membranes was a more costly means of increasing dose and hence must be justified by benefits beyond those of higher dose. Reusing membranes saved money, but the savings were insufficient to offset the costs associated with using more expensive membranes. Most, but not all, of the higher costs observed in hospital-based units appear to reflect overhead cost allocation rather than a difference in real resources devoted to treatment. The economies experienced by the largest chains may provide an explanation for their recent growth in market share. The heterogeneity of results by chain size implies that characterizing units using a simple chain status indicator variable is inadequate. Cost differences by facility type and the effects of the ongoing growth of large chains are worthy of continued monitoring to inform both payment policy and antitrust enforcement.  (+info)

(7/6616) Reactions to medical abortion among providers of surgical abortion: an early snapshot.

 (+info)

(8/6616) Voluntary euthanasia under control? Further empirical evidence from The Netherlands.

Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control.  (+info)


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  • behavior
  • The poor anti-asthma prescribing behavior among these doctors is associated with a low level of participation at update training on asthma management and poor awareness of asthma guidelines. (pubmedcentralcanada.ca)
  • The target income hypothesis suggests that a physician is motivated to maintain a certain level of desired income (the target) and if their actual income falls below this level, they will then modify their behavior to restore their income back up to the target. (wikipedia.org)
  • DRGs were designed to provide practice pattern information that administrators could use to influence individual physician behavior. (wikipedia.org)
  • Indicators
  • We retrospectively evaluated pharmaceutical drug prescribing practices in 21 primary health care facilities in Irbid governorate, northern Jordan using World Health Organization-recommended core indicators.The mean number of drugs prescribed was 2.3 overall, ranging from 1.9 to 3.0. (who.int)
  • reimbursement
  • As of 2009, fifteen U.S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors, and the State of Washington requires insurance companies to offer reimbursement for services provided by naturopathic physicians. (wikipedia.org)
  • Hospital
  • Historically, traditional payment policies - coupled with lax oversight by regulators, weak leadership from many corners of the hospital and physician communities, and an uninformed, reverential public - have served to perpetuate (sometimes even reward) the use of unsafe practices and antiquated technologies in the hospital industry. (piperreport.com)
  • This is led by new payment and reporting policies by Medicare and some state Medicaid programs , influential players like IHI and the Leapfrog Group , the Hospital Quality Alliance , and a growing demand for disclosure of hospital and physician performance . (piperreport.com)
  • He practices surgical oncology and advanced laparoscopic surgery at the Johns Hopkins Hospital and teaches public health policy at the Johns Hopkins Bloomberg School of Public Health. (wikipedia.org)
  • In their role as first-line providers, emergency physicians are responsible for initiating resuscitation and stabilization, starting investigations and interventions to diagnose and treat illnesses in the acute phase, coordinating care with specialists, and determining disposition regarding patients' need for hospital admission, observation, or discharge. (wikipedia.org)
  • In many modern emergency departments, Emergency physicians are tasked with seeing a large number of patients, treating their illnesses and arranging for disposition-either admitting them to the hospital or releasing them after treatment as necessary. (wikipedia.org)
  • examination
  • Cognitive expertise - physicians must take and pass a proctored and secure examination at least once every ten years. (wikipedia.org)
  • Following regulations established by the ABMS, in order to be certified, a physician must: Complete the requisite predoctoral medical education Meet the training requirements Meet the licensure requirements and procedural requirements Pass a secure board certification examination Physicians may become board certified when they have successfully completed residency or fellowship training and by passing a secure examination. (wikipedia.org)
  • Examination (examples of objective data): Observe sleep pattern and rest pattern. (wikipedia.org)
  • If appropriate - PQRST questions PQRST P - Palliative, Provocative Q - Quality or quantity R - Region or radiation S - Severity or scale T - Timing (Morton, 1977) COLDSPA C - Character O - Onset L - Location D - Duration S - Severity P - Pattern A - Associated factors (Weber, 2003)[full citation needed] Examination (examples of objective data): Orientation. (wikipedia.org)
  • patients
  • To fully address the complexities of chronic conditions and support productive interactions between patients and practice teams, multiple related innovation adoption decisions may be necessary. (biomedcentral.com)
  • The remaining patients in the CCP arm will have CD4 counts obtained according to their clinicians' current clinical practices. (clinicaltrials.gov)
  • Patterns of prescribing and use of pharmaceuticals by physicians and patients in Jordan have not previously been studied. (who.int)
  • MedPAC reiterated its recommendation that the Congress implement a quality incentive program for physicians and facilities that treat dialysis patients. (piperreport.com)
  • Physicians must complete an 8-hour course, must obtain a waiver from the U.S. Drug Enforcement Administration (DEA), and are limited in the number of their patients being treated using buprenorphine. (piperreport.com)
  • Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients (particularly hospitalized patients) under his or her care. (wikipedia.org)
  • This practice pattern approach has been identified as a novel approach to address opioid overprescribing in narcotic naive patients after standardized procedures where opioid prescribing should be limited. (wikipedia.org)
  • This model allows the physician to continue to see their non-retainer patients while providing their "concierge" patients a fee for the increased or "special" services. (wikipedia.org)
  • This is considered an urgent referral that needs a "hot hand-off" or direct communication between the physician that found an abnormality and the ophtalmologist receiving the referral to discuss the patients history and current exam. (wikipedia.org)
  • These lists are intended to encourage physicians to adopt a "think twice" attitude to avoid unnecessary and potentially harmful tests and procedures, and to foster discussions between patients and physicians about inappropriate care. (wikipedia.org)
  • A systematic survey of patients in seven countries revealed that 10-20% of patients believed that their physicians had provided treatment of little or no value in the past two years. (wikipedia.org)
  • Emergency physicians also provide episodic primary care to patients during off hours and for those who do not have primary care providers. (wikipedia.org)
  • health
  • How have alternative health care payment models, aimed at lowering costs while improving patient outcomes, affected physicians and physician practices in the United States? (piperreport.com)
  • Makary is the first author of the original scientific publications describing "The Surgery Checklist" For his original work on the checklist, Makary was asked to serve in roles at the World Health Organization where he worked closely with Dr. Gawande, and others, to develop the official World Health Organization Surgical Checklist. (wikipedia.org)
  • Gordon's functional health patterns is a method devised by Marjory Gordon to be used by nurses in the nursing process to provide a more comprehensive nursing assessment of the patient. (wikipedia.org)
  • The following questions pertain to those asked by the nurse to provide an overview of the individual's health status and health practices that are used to reach the current level of health or wellness. (wikipedia.org)
  • Choosing Wisely Canada (CWC) is a Canadian-based health education campaign launched on April 2, 2014 under the leadership of Dr. Wendy Levinson, in partnership with the Canadian Medical Association, and based at the University of Toronto. (wikipedia.org)
  • Rural emergency physicians may be the only health care providers in the community, and require skills that include primary care and obstetrics. (wikipedia.org)
  • chiropractic
  • Licensure laws exist in all 50 U.S. states for doctors of chiropractic. (biomedcentral.com)
  • Naturopathy was adopted by many chiropractors, and several schools offered both Doctor of Naturopathy (ND) and Doctor of Chiropractic (DC) degrees. (wikipedia.org)
  • In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. (wikipedia.org)
  • treatment
  • 3. To justify off-label coverage for a medically necessary, medically accepted drug, the physician must determine that all drugs on plan's formulary for the treatment of the same condition (a) would not be as effective and/or (b) have adverse effects for patient. (piperreport.com)
  • However, new research suggests there are problems in patient access to medication-assisted treatment, particularly in some state Medicaid programs, and in the availability of experienced physicians with the necessary federal certification. (piperreport.com)
  • SAMHSA maintains an online database of physicians certified to provide medication-assisted treatment of opioid addiction and dependency. (piperreport.com)
  • This agency relationship is influenced by information asymmetry between a physician and a patient, where it is assumed that the physician has more knowledge about diagnostic and treatment options than the patient. (wikipedia.org)
  • The professional uncertainty hypothesis suggests that due to autonomy and individual practice patterns, physicians differ in their opinions regarding the effectiveness, appropriateness, and success rates of various treatment options for a particular condition. (wikipedia.org)
  • Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal without any conflict. (wikipedia.org)
  • care
  • C. Stephen Foster, MD, Professor of Ophthalmology(PT) at Harvard Medical School, Department of Ophthalmology Mass. Eye and Ear, and founder of Massachusetts Eye Research & Surgery Institution (MERSI) -a state-of-the-art facility dedicated to patient-centered, quality eye care in OID from the world's leading physicians - recently had his method of treating uveitis published as the new standard in managing the disease. (uveitis.org)
  • The percentage of doctors providing charity care dropped from 76% in 1996-97 to 68% in 2004-2005. (wikipedia.org)
  • One of these models, the Accountable care organization (ACO), reimburses a physician through a gain-sharing model that encourages them to collaborate with other providers to deliver care thus removing some of the individual incentives to induce demand. (wikipedia.org)
  • This leads to a level of uncertainty which may result in a lack of uniformly acceptable standards of care that can be followed by all physicians. (wikipedia.org)
  • This standard of care in treating uveitis/OID was published in July 2015 as the preferred practice patterns in the Journal of Survey of Ophthalmology. (wikipedia.org)
  • In addition to the wide range of medical diseases, dermatologists have practices devoted to skin surgery (including aesthetic procedures), care of children with skin disease, immunologic diseases of the skin and pathology of the skin. (wikipedia.org)
  • In exchange for the retainer, doctors provide enhanced care, including principally a commitment to limit patient loads to ensure adequate time and availability for each patient. (wikipedia.org)
  • The Fee for Care ('FFC') is an annual retainer model, where the patient pays a monthly, quarterly, or annual retainer fee to the physician. (wikipedia.org)
  • Some concierge practices are cash-only or 'direct' primary care practices and do not accept insurance of any kind. (wikipedia.org)
  • In light of these concerns, Choosing Wisely Canada hopes to optimize value, reduce waste and improve patient outcomes by promoting patient-physician conversations about low-value care. (wikipedia.org)
  • However, many emergency physicians work in urgent care settings, since there is obvious overlap. (wikipedia.org)
  • assessment
  • Through periodic self-assessment of medical knowledge, communication skills, patient safety and practice quality measures, physicians in MOC continue to document the high standards they have achieved. (wikipedia.org)
  • Lifelong learning and self-assessment - physicians participate in a minimum amount of continuing medical education and self-assessment programs. (wikipedia.org)
  • The MOC program structure tries to address these concerns with a sound theoretical rationale via the six ACGME competencies framework and a respectable body of scientific evidence, and to address its relationship to patient outcomes, physician performance, validity of the assessment or educational methods utilized and learning or improvement potential. (wikipedia.org)
  • current
  • Relative advantage speaks to the perceived benefits of the innovation relative to current practice or other, alternative innovations. (biomedcentral.com)
  • Management
  • The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management. (wikipedia.org)
  • quality
  • The ABD originally had nine Directors but has expanded to 17, reflecting the increasing complexity of the field and in response to the public demand for physician accountability in matters of quality assurance. (wikipedia.org)
  • A major new role for the ABD lies in the rigorous maintenance of certification program that enrolls physicians in a lifelong certification process encompassing a variety of quality measures and outcomes. (wikipedia.org)
  • Through this pattern the nurse is able to determine regularity, quality, and quantity of stool and urine. (wikipedia.org)
  • Drug
  • 2. Drug plans are not required to list off-label on formularies, but physicians may still prescribe off-label drugs for medically accepted indications. (piperreport.com)
  • family
  • This is a recommended screening by the American Academy of Pediatrics and American Academy of Family Physicians for neonates and children at every office visit. (wikipedia.org)
  • model
  • There is also a hybrid concierge model where physicians charge a monthly, quarterly, or annual retainer or membership fee for services that Medicare and insurers do not cover. (wikipedia.org)
  • services
  • Update Medicare Part B payments for physician services in 2009 by the projected change in input prices less MedPAC's adjustment for productivity growth. (piperreport.com)
  • Enact legislation requiring the Centers for Medicare and Medicaid Services (CMS) to establish a process for measuring and reporting physician resource use on a confidential basis for a period of two years. (piperreport.com)
  • To learn more about the staggering opioid problem in Medicaid and some best practices in addressing it, please read Best Practices for Addressing Prescription Opioid Overdoses, Misuse, and Addiction , a useful 15-page informational bulletin from the Center for Medicaid and CHIP Services (CMCS) at the Centers for Medicare and Medicaid Services (CMS). (piperreport.com)
  • this could induce the physician to offer a higher number of services than would be the optimal amount for the patient in order to increase revenue. (wikipedia.org)
  • The retainer fee covers most services provided by the physician in his/her office. (wikipedia.org)
  • certification
  • Maintenance of Certification has four elements Professional standing - physicians must document that their state licenses are active and unrestricted. (wikipedia.org)
  • More than 140,000 physicians - including more than 8,000 physicians holding certifications that hold certifications which are valid indefinitely - are currently enrolled in ABIM's Maintenance of Certification program. (wikipedia.org)
  • relationship
  • Jonathan Gruber and Maria Owings looked at the relationship between physician financial incentives and cesarean section delivery by examining declining fertility rates in the United States. (wikipedia.org)
  • adequate
  • The American Board of Dermatology and Syphilology was incorporated in 1932 in order to set standards in the field of dermatology and to assure the adequate training and experience of those physicians wishing to call themselves dermatologists. (wikipedia.org)
  • citation needed
  • citation needed] The oldest surviving house in Lexington is The Homestead, built by Dr. William Rainey Holt (1798-1868), a physician born in what is today Alamance County. (wikipedia.org)