Directors Recognize Difficulties in Providing Medical Care to Residents But Few Implement Policies to Address Them.

Abstract:

BACKGROUND AND OBJECTIVES:Residents find it difficult to access medical care. Some seek care within their own program. Our objectives were to (1) determine whether family medicine program directors see their own resident physicians as patients, (2) describe whether they perceive the residency culture as actively encouraging of this practice, and (3) assess perceptions about reasons to encourage or discourage this. METHODS:We used a paper-based self-administered survey November 2013--January 2014. A stratified random sample of family medicine residencies based on administrative type was used. Participants were directors of sampled programs. The main outcome measure was provision of medical care to resident physicians. RESULTS:A total of 137/250 directors (55%) responded. Thirty (22%) reported seeing residents as patients in their family medicine clinic while 107 did not (78%). Some directors who do see resident patients expressed discomfort in doing so (24%). Participants reported that other faculty physicians were significantly more likely to see residents (56%). Eighty-eight percent (114/129) agreed that "Having a doctor-patient relationship with a resident makes a supervisory relationship more difficult." Significant differences in attitudes were noted between directors who do and do not provide resident medical care. Few directors (10 %) agreed that their residency culture actively encouraged residents to establish doctor-patient relationships with faculty physicians. Only 16 (12%) had created written policies. CONCLUSIONS:It is uncommon for directors to see residents as patients, but most who do feel comfortable with it. Other faculty physicians provide care more frequently. Directors acknowledge potential difficulties with this practice, but few have addressed these issues by creating specific policies.

journal_name

Fam Med

journal_title

Family medicine

authors

Grover M,Edwards F,Chang YH,Bryan M,Diaz K,Kresin M,Moats C,Engle R

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

529-35

issue

7

eissn

0742-3225

issn

1938-3800

journal_volume

47

pub_type

杂志文章
  • Four-year training in family medicine: strength through versatility using the uniformed services as a model.

    abstract:BACKGROUND:There is concern regarding the number of US medical graduates choosing careers in primary care. To address this, the American Academy of Family Physicians (AAFP) Future of Family Medicine project has recommended increasing the length of family medicine residency from 3 to 4 years as one way to increase stude...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Stephens M,Lennon R,Saguil A,Reamy BV

    更新日期:2011-10-01 00:00:00

  • A gain in cultural competence through an international acupuncture elective.

    abstract:OBJECTIVE:This study describes an international acupuncture elective and its impact on medical students' development of cultural competence. METHODS:Collaborating with Chinese colleagues, we created a 4-week elective that teaches medical students about acupuncture in its native cultural environment. Three focus groups...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Mao JJ,Wax J,Barg FK,Margo K,Walrath D

    更新日期:2007-01-01 00:00:00

  • Physician-patient power struggles: their role in noncompliance.

    abstract::Physicians have tended to label the patient who doesn't follow their advice as resistant and noncompliant. However, compliance studies have not identified the physician's sometimes unwitting complicity in the noncompliance. Some physician-patient partnerships are marked by an intensifying power struggle which may have...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ross JL,Phipps E

    更新日期:1986-03-01 00:00:00

  • Reactions of family medicine community preceptors to teaching medical students.

    abstract:BACKGROUND AND OBJECTIVES:In 1993, the University of California, Los Angeles introduced an interdisciplinary course called ¿Doctoring¿ for all first-year medical students in which students visited family physicians' offices once a month for a total of four visits. The study's objectives were to ascertain preceptors' at...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Usatine RP,Hodgson CS,Marshall ET,Whitman DW,Slavin SJ,Wilkes MS

    更新日期:1995-10-01 00:00:00

  • The accuracy of patient encounter logbooks used by family medicine clerkship students.

    abstract:BACKGROUND:Family medicine predoctoral programs frequently have medical students record patient diagnoses in logbooks. Little is known about the accuracy of such logbooks. No studies have compared patient records dictated by students with cases recorded in logbooks. METHODS:Over 2 years, all patient encounters dictate...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Patricoski CT,Shannon K,Doyle GA

    更新日期:1998-07-01 00:00:00

  • The role of the chair's spouse in academic departments of family medicine.

    abstract:BACKGROUND AND OBJECTIVES:Family medicine has the highest percentage of unfilled budgeted faculty positions of all clinical and basic science departments. To successfully recruit and retain academic leaders, personal and professional issues need to be recognized and valued. This study reports the results of a national ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Taylor AD

    更新日期:1999-01-01 00:00:00

  • Is interruption in residency training associated with a change in in-training examination scores?

    abstract:BACKGROUND:Many military physicians interrupt their training to serve in the position of general medical officer (GMO) after completing their first year of postgraduate medical education. This study compares American Board of Family Practice In-training Examination (ITE) scores of military family practice residents who...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ellis DD,Kiser WR,Blount W

    更新日期:1997-03-01 00:00:00

  • The effect of cognitive status on outcomes following rehabilitation.

    abstract:BACKGROUND AND OBJECTIVES:Impaired cognition is a determinant of poor recovery following a hip fracture. Because of the risk of poorer outcomes, individuals with impaired cognitive function may be refused admission into a rehabilitation program. This study considered the impact of cognitive status on functional ability...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Resnick B,Daly MP

    更新日期:1997-06-01 00:00:00

  • When is a test positive? The use of decision analysis to optimize test interpretation.

    abstract::Clinical laboratory are often provided as numerical values that are then interpreted as being positive or negative. While this approach might simplify interpretation, it also makes interpretation contingent on a standard test cutoff point. Alternatively, test results can be interpreted for a specific patient with refe...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bergus GR

    更新日期:1993-11-01 00:00:00

  • Home visit program for teaching elder abuse evaluations.

    abstract:BACKGROUND AND OBJECTIVES:A home visit program was designed to teach family practice residents how to evaluate patients for elder abuse and capacity (the ability to make one's own decisions). METHODS:Residents assessed potential abuse victims reported to Arizona's Adult Protective Service (APS) in their homes. Written...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Jogerst GJ,Ely JW

    更新日期:1997-10-01 00:00:00

  • Pregnancy Options Counseling and Abortion Referrals Among US Primary Care Physicians: Results From a National Survey.

    abstract:BACKGROUND AND OBJECTIVES:Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. METHODS:We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Holt K,Janiak E,McCormick MC,Lieberman E,Dehlendorf C,Kajeepeta S,Caglia JM,Langer A

    更新日期:2017-07-01 00:00:00

  • Shorter dosing interval of opiate solution shortens hospital stay for methadone babies.

    abstract:BACKGROUND AND OBJECTIVES:Methadone maintenance is the standard of care for pregnant opiate addicts. However, withdrawal of an infant from methadone after birth often results in a lengthy hospital stay. This study identified potentially modifiable factors that are associated with the length of hospital stay of infants ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Jones HC

    更新日期:1999-05-01 00:00:00

  • Factors influencing cessation of pregnancy care in Oregon.

    abstract:BACKGROUND AND OBJECTIVES:Anecdotal evidence suggests that many providers who previously delivered babies are no longer doing so, both in Oregon and nationally. This study determined the proportion of pregnancy care providers who have stopped or are planning to stop providing this care in Oregon and identified the impo...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Smits AK,Clark EC,Nichols M,Saultz JW

    更新日期:2004-07-01 00:00:00

  • Tracking the contribution of a family medicine clerkship to the clinical curriculum.

    abstract:BACKGROUND AND OBJECTIVES:Medical educators are working to articulate the objectives and measure the outcomes of medical education. In clinical training, faculty need methods to identify both the principal educational contributions of individual clerkships and how prior experiences influence student learning. METHODS:...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Maple SA,Jones TA,Bahn TJ,Kiovsky RD,O'Hara BS,Bogdewic SP

    更新日期:1998-05-01 00:00:00

  • The domain of family practice: scope, role, and function.

    abstract::The family physician is the physician generalist who takes professional responsibility for the comprehensive care of unselected patients with undifferentiated problems and who is committed to the person regardless of age, gender, illness, or organ system. The clinical specialty of family practice is patient centered, ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Phillips WR,Haynes DG

    更新日期:2001-04-01 00:00:00

  • Screening for mental health using adolescent-reported parenting.

    abstract:BACKGROUND AND OBJECTIVES:Little is known in primary care practices about the relationship between parenting and adolescent mental health. In addition, current parenting measures have a narrow focus or do not lend themselves to clinical intervention. This study examined the clinical utility of a new instrument measurin...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Godkin MA,Baker S,Paradise JE,Domal L,Grant L

    更新日期:1994-09-01 00:00:00

  • Teaching medical students to prioritize preventive services.

    abstract:BACKGROUND:Clinicians cannot provide all recommended preventive services in a single office visit and must learn to prioritize. This skill is not overtly addressed in medical school. METHODS:We designed a workshop to teach third-year medical students to prioritize preventive services during an office visit. In a prosp...

    journal_title:Family medicine

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Chumley HS,Dobbie A,Pollock M,Delzell JE Jr

    更新日期:2006-11-01 00:00:00

  • Do the five A's work when physicians counsel about weight loss?

    abstract:BACKGROUND AND OBJECTIVES:More than two thirds of Americans are overweight or obese. Physician counseling may help patients lose weight; however, physicians perceive these discussions as somewhat futile and time-consuming. An effective and efficient tool for smoking cessation is the Five A's (Ask, Advise, Assess, Assis...

    journal_title:Family medicine

    pub_type: 临床试验,杂志文章

    doi:

    authors: Alexander SC,Cox ME,Boling Turer CL,Lyna P,Østbye T,Tulsky JA,Dolor RJ,Pollak KI

    更新日期:2011-03-01 00:00:00

  • A method for assigning authorship in multiauthored publications.

    abstract:BACKGROUND AND OBJECTIVES:Determining authorship for publications is often a difficult process, even more so when individuals from several disciplines collaborate with community organizations to conduct projects. Although multidisciplinary and community-academic partnerships provide fertile ground for publication effor...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ahmed SM,Maurana CA,Engle JA,Uddin DE,Glaus KD

    更新日期:1997-01-01 00:00:00

  • Longitudinal versus traditional residencies: a study of continuity of care.

    abstract:BACKGROUND AND OBJECTIVES:Continuity of care is one of the presumed advantages of longitudinal residencies. However, it is not clear how well such residencies provide continuity of care, and, further, there is no recognized acceptable rate of good continuity. We compared traditional and longitudinal residencies to dete...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Merenstein D,Damico F,Devine B,Mahaniah KJ,Solomon M,Reust CE,Rosenbaum DJ

    更新日期:2001-11-01 00:00:00

  • Cross-cultural communication with patients who use American Sign Language.

    abstract:BACKGROUND:Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS:A search of MEDLINE and PsychINFO databases for research on physician-...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Barnett S

    更新日期:2002-05-01 00:00:00

  • Qualitative and quantitative methods for the assessment of clinical preceptors.

    abstract::The improvement of clinical teaching skills has consistently been an important focus of faculty development in family medicine. Successful faculty development programs depend on an understanding of the components of clinical teaching and a profile of the strengths and weaknesses of each faculty member with respect to ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Lewis BS,Pace WD

    更新日期:1990-09-01 00:00:00

  • Beta-blockers and depression in elderly hypertension patients in primary care.

    abstract:BACKGROUND AND OBJECTIVES:Previous findings regarding a possible association between beta-blocker use and depression are mixed. To our knowledge there have been no studies investigating the association of beta-blockers with depression in primary care hypertension patients without previous myocardial infarction. The aim...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ringoir L,Pedersen SS,Widdershoven JW,Pouwer F,Keyzer JM,Romeijnders AC,Pop VJ

    更新日期:2014-06-01 00:00:00

  • Generalist courses in US medical schools and their relationship to career choice.

    abstract::We conducted a survey of required first-year generalist courses offered by US medical schools during 1980, 1985, and 1990 to see if significant growth had occurred in this curricular area and to determine if the presence of these courses was associated with an increase in the percent of graduates selecting family prac...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Mengel MB,Davis AB,Barton ED

    更新日期:1992-03-01 00:00:00

  • The central city site: an urban underserved family medicine training track.

    abstract:BACKGROUND AND OBJECTIVES:We describe the development of an urban track in family medicine residency designed to recruit a high percentage of minority students and promote their future practice in urban, underserved areas of Milwaukee. We report here on the residents and their first practice location and compared this ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bade E,Baumgardner D,Brill J

    更新日期:2009-01-01 00:00:00

  • A new method for teaching the repair of perineal trauma of birth.

    abstract:BACKGROUND AND OBJECTIVES:Repair of perineal birth trauma is one of the most common surgical techniques in pregnancy care. Because of the three-dimensional nature of the required repair, students and residents often have difficulty learning this procedure. METHODS:We developed a new method to teach learners the repair...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Cain JJ,Shirar E

    更新日期:1996-02-01 00:00:00

  • Transforming your presentation into a publication.

    abstract::Publication in scientific journals is required for academic promotion at universities. It is also the method by which most family medicine faculty members disseminate their scholarly work, establish a reputation in their field, and develop a clinical, teaching, or scholarly expertise. Publications are able to reach a ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Schrager S

    更新日期:2010-04-01 00:00:00

  • Pilot test of family medicine faculty development fellowship accreditation guidelines.

    abstract:BACKGROUND:We conducted a pilot test of accreditation guidelines for family medicine faculty development fellowship programs from September 1997 to March 1999. The accreditation guidelines included 8 application categories with 27 requirements and 5 self-study criteria. The process included completion of the accreditat...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Reznich CB,Mavis BE

    更新日期:2000-11-01 00:00:00

  • An unusually high prevalence of asthma in Ethiopian immigrants to Israel.

    abstract:BACKGROUND AND OBJECTIVES:The past 20 years have seen a large immigration of Ethiopian Jews to Israel, primarily in 2 airlifts, one in 1984-1985 and one in 1991. Infectious and parasitic diseases were the dominant health problems in the early years. Recently, we noticed changing health patterns in this population, part...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Rosenberg R,Vinker S,Zakut H,Kizner F,Nakar S,Kitai E

    更新日期:1999-04-01 00:00:00

  • Coaching Primary Care Clinicians in the Ambulatory Setting: Direct Observation and Deliberate Practice.

    abstract:BACKGROUND AND OBJECTIVES:Clinical coaching programs can improve clinician performance through feedback following direct observation and the promotion of reflection. This study assessed the feasibility and acceptability of a primary care coaching program applied in community-based practices. METHODS:Using a 31-item be...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2019.791011

    authors: Crocetti M,Kumra T,Fingerhood M,Peairs K,Wolfe L,Wright SM

    更新日期:2019-11-01 00:00:00