Artykuły w czasopismach na temat „Physician”
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Abdulkader, Rizwan Suliankatchi, Deneshkumar Venugopal, Kathiresan Jeyashree, Zainab Al Zayer, K. Senthamarai Kannan i R. Jebitha. "The Intricate Relationship Between Client Perceptions of Physician Empathy and Physician Self-Assessment: Lessons for Reforming Clinical Practice". Journal of Patient Experience 9 (styczeń 2022): 237437352210775. http://dx.doi.org/10.1177/23743735221077537.
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Objectives: Clinical empathy is an important predictor of patient outcomes. Several factors affect physician’s empathy and client perceptions. We aimed to assess the association between physician and client perception of clinical empathy, accounting for client, physician, and health system factors. Methods: We conducted a hospital-based cross-sectional study in 3 departments (family medicine, internal medicine, and surgery) of King Saud Medical City in Riyadh, Saudi Arabia. We interviewed 30 physicians and 390 clients from 3 departments. Physicians completed the Jefferson Scale of Empathy (JSE) and the clients responded to the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). We used a hierarchical multilevel generalized structural equation approach to model factors associated with JSE and JSPPPE and their inter-relationship. Results: Mean (SD) score of client-rated physician empathy was 26.6 (6) and that of physician self-rated was 111 (12.8). We found no association between the 2 ( b = 0.06; 95% confidence intervals CI: −0.1, 0.21), even after adjusting for client, physician, and health system factors. Physician's nationality (0.49; 0.12, 0.85), adequate consultation time (1.05; 0.72, 1.38), and trust (1.33; 0.9, 1.75) were positively associated whereas chronic disease (−0.32; −0.56, −0.07) and higher waiting times (−0.26; −0.47, −0.05) were negatively associated. Conclusion: A physician's self-assessed empathy does not correlate with clients’ perception. We recommend training and monitoring to enhance clinical empathy.
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Levendowski, D., J. Lee-Iannotti, D. Shprecher, C. Guevarra, P. Timm, E. Angel, G. Mazeika i E. St. Louis. "P077 Reliability of the Clinical Characterization of Isolated REM Sleep Behavior Disorder". SLEEP Advances 2, Supplement_1 (1.10.2021): A46. http://dx.doi.org/10.1093/sleepadvances/zpab014.121.
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Abstract Purpose Compare agreements between polysomnography-based (PSG) diagnosis of isolated REM-sleep-behavior-disorder (iRBD) and Non-REM-Hypertonia (NRH), a novel biomarker independently associated with synucleinopathy-related neurodegenerative diseases. Methods Sixteen patients with histories of dream-enactment-behavior (DEB)(women=38%; age:64.6±13.0) underwent PSG with simultaneously-recorded Sleep Profiler (SP). Two boarded sleep neurologists independently characterized iRBD. Physician1 combined abnormal qualitative REM-sleep-without-atonia (RSWA) by submental electromyography, with video-confirmation of probably DEB. Physician2 relied solely on qualitative RSWA. SP was auto-staged, technically reviewed, and reprocessed for automated abnormal NRH detection. Kappa scores measured physician and NRH agreements. Results In the 14 records with REM sleep, iRBD was characterized in: Physician1=64%, Physician2=79%, NRH=71% of the records. Across the three methods, unanimous iRBD agreement occurred in 57% of the records (positive=7, negative=1). The between-physician agreement in iRBD classifications was fair (kappa=0.32). The agreement between NRH and Physician1 was moderate (kappa=0.52) versus slight with Physician2 (kappa=0.05). NRH comparisons to consensus physician agreement yielded one false-positive and one false-negative iRBD finding. Physician2 classified: a) iRBD in two cases that were negative by Physician1 and NRH, and b) one negative case that Physician1 and NRH characterized as iRBD. Physician1 identified one negative case that was classified iRBD by Physician2 and NRH. Additionally, NRH was abnormal in one of the two records with no REM sleep. Discussion NRH may assist in iRBD risk assessment, given it agreed with at least one physician in 86% of the cases and the between-physician iRBD agreement was only fair. NRH also characterized iRBD-risk in patients with insufficient REM sleep for RSWA assessment.
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Hsu, Yuan-Teng, Ya-Ling Chiu, Jying-Nan Wang i Hung-Chun Liu. "Impacts of physician promotion on the online healthcare community: Using a difference-in-difference approach". DIGITAL HEALTH 8 (styczeń 2022): 205520762211063. http://dx.doi.org/10.1177/20552076221106319.
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In this study, we use a difference-in-difference approach to explore how physician promotion, the advancement of a physician's offline reputation, affects patient behavior toward physicians in online healthcare communities; this allows us to explore how patients interpret the signals created by physician promotion. The study sample was collected from over 140,000 physician online profiles after 25 months of continuous observation, with 280 physicians who were promoted at month 13 as the treatment group and a control group obtained by propensity score matching. Our results show that a physician's promotion causes more patients to choose that physician, makes patients willing to give more psychological rewards, and makes them tend to give that physician a higher online rating. This implies that patient behavior is susceptible to the signal of physician promotion because the quality of the physician is unlikely to have changed significantly in the short term. These findings extend prior research on reputation in online communities and have crucial implications for theory and practice.
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Manning, Blaine T., Daniel D. Bohl, Charles P. Hannon, Michael L. Redondo, David R. Christian, Brian Forsythe, Shane J. Nho i Bernard R. Bach. "Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine". Orthopaedic Journal of Sports Medicine 6, nr 4 (1.04.2018): 232596711876687. http://dx.doi.org/10.1177/2325967118766873.
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Background: Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. Purpose: To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician’s midlevel provider to patients when initially selecting a physician. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Results: Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician’s midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. Conclusion: As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient satisfaction. Physicians may consider these data in clinical workforce planning, as patients preferred specific services to be physician or midlevel provided. It may be worthwhile to consider midlevel providers in marketing efforts, given that patients considered the credentials of the physician’s midlevel provider when initially selecting a new physician. Patients lacked consensus regarding reimbursement equity between physicians and midlevel providers, despite responding that the physician provides a higher-quality consultation. Our findings are important for understanding the midlevel workforce as it continues to grow in response to the increasing demand for orthopaedic sports care.
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Aruguete, Mara S., i Carlos A. Roberts. "Participants' Ratings of Male Physicians Who Vary in Race and Communication Style". Psychological Reports 91, nr 3 (grudzień 2002): 793–806. http://dx.doi.org/10.2466/pr0.2002.91.3.793.
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Research has shown minorities receive lower quality health care than White persons even with socioeconomic conditions controlled. This difference may partially be related to racially biased attitudes and impaired communication in interracial relationships between physicians and patients. This study investigated the effect of physicians' race and nonverbal communication style on participants' evaluations. Patients at a local health clinic were participants ( N = 116: 84% Black, 16% White). Each participant viewed one of four videotapes showing varied race of a physician (Black or White) and the physician's nonverbal behavior (expressing concern or distance), and then completed a questionnaire evaluating the depicted physician. Overall, participants did not give significantly different preferences for physicians of the same race. However, participants' evaluations were significantly associated with physicians' nonverbal style. Nonverbal concern was associated with highest satisfaction, trust, self-disclosure, recall of information, likelihood of recommending the physician, and intent to comply with the physician's recommendations. When male and female participants were compared, preference for a physician of the same race was found only among male participants who viewed verbally distant physicians. Results suggest that social skills are more important than race in shaping patients' perceptions of physicians.
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Robinson, Andrew. "Physician turned physicist". Lancet 387, nr 10013 (styczeń 2016): 20. http://dx.doi.org/10.1016/s0140-6736(15)01301-x.
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Nakagawa, Keisuke, i Peter M. Yellowlees. "The Physician’s Physician". Psychiatric Clinics of North America 42, nr 3 (wrzesień 2019): 473–82. http://dx.doi.org/10.1016/j.psc.2019.05.012.
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Eberts, Margaret, i Daniel Capurro. "Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship". Applied Clinical Informatics 10, nr 04 (sierpień 2019): 729–34. http://dx.doi.org/10.1055/s-0039-1696667.
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Abstract Objectives Limited studies have been performed in South America to assess patient and physician perceptions of electronic health record (EHR) usage. We aim to study the perceptions of patients and physicians regarding the impact of EHRs on the patient–physician relationship. Methods We use a survey instrument to assess the physician computer experience and opinions regarding EHR impact on various aspects of patient care. An additional survey is used to assess patient opinions related to their medical visit. Surveys are administered in two outpatient clinics in a private, academic health care network. Results While a majority of physicians believed that EHRs have an overall positive impact on the quality of health care, many physicians had negative perceptions of the impact of EHRs on the patient–physician relationship. A majority of patients felt comfortable with their physician's use of the EHR and felt that their physician was able to maintain good personal contact while using the computer. Conclusion Although physicians believe EHRs have a generally positive impact on the overall quality of care, the EHR's impact on the patient–physician relationship is still of concern. Patients do not perceive a negative interference from the EHR on the patient–physician relationship.
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Viswanath Bandi i Rao O R S. "Role of Physician’s Personality on their Drug Prescription Behavior". International Journal of Research in Pharmaceutical Sciences 11, nr 4 (19.12.2020): 6954–61. http://dx.doi.org/10.26452/ijrps.v11i4.3700.
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Physicians Prescription behavior is the results of 4P's namely Product, Physicians, Promotion, and Patient's expectation. In today's world of evidence-based medicine with ever-growing demand in patient expectations, physician- Patient-centric managing a pathological condition is gaining acceptance from the normal disease management approach. Like all citizenry is Unique; similarly, physicians also possess a singular personality that responds differently even to an equivalent stimulus. Aiming for better patient care and Patient expectations, research work across the world has been administered for identifying the perfect physician personality traits right from selection of specialty, knowledge dissemination during the study period, and managing patients during the Practice sessions. However, there's little, or no research conducted thus far, in understanding the "Physician's personality" make-up focussing on their motives, values, preferences in their professional practice. Understanding "physician's personality" traits will lay a robust foundation for developing effective medico-marketing initiatives from the pharmaceutical industry with the assistance of smart and customized marketing initiatives resulting in a healthy environment for physician-Pharma association towards adopting better therapeutic interventions for patient benefit. This review is an effort to specialize in the research work done thus far in understanding the impact of "physician's personality" aimed toward improving patient care. Further research in understanding "Physician's personality" and its role in physicians prescribing decisions will help the Pharma industry towards developing much needed medico-marketing initiatives with optimal utilization of resources towards disseminating the latest therapeutic interventions to the physicians for better patient care which is the stepping stone for Physician-patient centric management.
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SHAPIRO, ROBYN S., KRISTEN A. TYM, DAN EASTWOOD, ARTHUR R. DERSE i JOHN P. KLEIN. "Managed Care, Doctors, and Patients: Focusing on Relationships, Not Rights". Cambridge Quarterly of Healthcare Ethics 12, nr 3 (lipiec 2003): 300–307. http://dx.doi.org/10.1017/s0963180103123134.
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For over a decade, managed care has profoundly altered how healthcare is delivered in the United States. There have been concerns that the patient-physician relationship may be undermined by various aspects of managed care, such as restrictions on physician choice, productivity requirements that limit the time physicians may spend with patients, and the use of compensation formulas that reward physicians for healthcare dollars not spent. We have previously published data on the effects of managed care on the physician-patient relationship from the physician's perspective. In 1999, we collected data on the impact of managed care arrangements on the physician-patient relationship from the patient's perspective. This article discusses our collective findings.
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Wyszkowska, Zofia, Katarzyna Białczyk i Tomasz Michalski. "Komunikacja pomiędzy lekarzem i pacjentem u chorych na nowotwory". Nierówności społeczne a wzrost gospodarczy 65, nr 1 (2021): 156–68. http://dx.doi.org/10.15584/nsawg.2021.1.9.
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The main goal of the study was to assess the doctor’s communication with the patient. The detailed goals concerned the assessment of satisfaction with the way the physician communicates with the patient, the assessment of the communication methods used, the duration of the visit to a physician’s office, understanding of the information provided to patients, the physician’s personal culture, and the subjectivity of the patient. A questionnaire developed specifically for the study objectives was used. The analysis used data from 238 questionnaires completed correctly by cancer patients treated in a specialist hospital. The database was created in Excel and the analysis was performed using Statistica software. The analysis of the data shows that the physician’s communication with the patient is a very important aspect in the treatment process. Not all respondents were satisfied with the way the physician communicated information about the further treatment process, which increased the sense of security loss and undermined confidence in the physician’s decisions. Most patients understood the recommendations and advice provided by the physician, but there was a group of respondents who did not understand all the words used by the physician, which may lead to the non-compliance of the patient to the treatment recommendations. Patients highly appreciated the personal culture of physicians but they expected greater subjectivity in their treatment. The analysis of statements indicated that the patients’ expectations in the area of physician – patient communication are growing, which obliges physicians to broaden their knowledge in communication techniques.
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Ferreyro, Bruno L., Michael O. Harhay i Michael E. Detsky. "Factors associated with physicians’ predictions of six-month mortality in critically ill patients". Journal of the Intensive Care Society 21, nr 3 (3.07.2019): 202–9. http://dx.doi.org/10.1177/1751143719859761.
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Background Physician's estimates of a patient's prognosis are an important component in shared decision-making. However, the variables influencing physician's judgments are not well understood. We aimed to determine which physician and patient factors are associated with physicians' predictions of critically ill patients' six-month mortality and the accuracy and confidence of these predictions. Methods Prospective cohort study evaluating physicians' predictions of six-month mortality. Using univariate and multivariable generalized estimating equations, we assessed the association between baseline physician and patient characteristics with predictions of six-month death, as well as accuracy and confidence of these predictions. Results Our cohort was comprised 300 patients and 47 physicians. Physicians were asked to predict if patients would be alive or dead at six months and to report their confidence in these predictions. Physicians predicted that 99 (33%) patients would die. The key factors associated with both the direction and accuracy of prediction were older age of the patient, the presence of malignancy, being in a medical ICU, and higher APACHE III scores. The factors associated with lower confidence included older physician age, being in a medical ICU and higher APACHE III score. Conclusions Patient level factors are associated with predictions of mortality at six months. The accuracy and confidence of the predictions are associated with both physician and patients' factors. The influence of these factors should be considered when physicians reflect on how they make predictions for critically ill patients.
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Dong, Wei, Xiangxi Lei i Yongmei Liu. "The Mediating Role of Patients’ Trust Between Web-Based Health Information Seeking and Patients’ Uncertainty in China: Cross-sectional Web-Based Survey". Journal of Medical Internet Research 24, nr 3 (11.03.2022): e25275. http://dx.doi.org/10.2196/25275.
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Background In the physician-patient relationship, patients’ uncertainty about diseases and the lack of trust in physicians not only hinder patients’ rehabilitation but also disrupt the harmony in this relationship. With the development of the web-based health industry, patients can easily access web-based information about health care and physicians, thus reducing patients’ uncertainty to some extent. However, it is not clear how patients’ web-based health information–seeking behaviors reduce their uncertainty. Objective On the basis of the principal-agent theory and the perspective of uncertainty reduction, this study aims to investigate the mechanism of how web-based disease-related information and web-based physician-related information reduce patients’ uncertainty. Methods A web-based survey involving 337 participants was conducted. In this study, we constructed a structural equation model and used SmartPLS (version 3.3.3; SmartPLS GmbH) software to test the reliability and validity of the measurement model. The path coefficients of the structural model were also calculated to test our hypotheses. Results By classifying patients’ uncertainties into those concerning diseases and those concerning physicians, this study identified the different roles of the two types of patients’ uncertainty and revealed that web-based disease-related information quality and web-based physician-related information can act as uncertainty mitigators. The quality of disease-related information reduces patients’ perceived information scarcity about the disease (β=−.588; P<.001), and the higher the information scarcity perceived by patients, the higher their uncertainty toward the disease (β=.111; P=.02). As for physician-related information, web-based word-of-mouth information about physicians reduces patients’ perceived information scarcity about the physician (β=−.511; P<.001), mitigates patients’ fears about physician opportunism (β=−.268; P<.001), and facilitates patients’ trust (β=.318; P<.001). These factors further influence patients’ uncertainty about the physician. In addition, from the test of mediating effect, patients’ trust in the physician fully mediates the relationship between their perceived information scarcity about the physician’s medical service and their uncertainty about the physician. Patients’ trust also partially mediates the relationship between their fear of the physician’s opportunism and their uncertainty about the physician. As for the two different types of uncertainty, patients’ uncertainty about the physician also increases their uncertainty about the diseases (β=.587; P<.001). Conclusions This study affirms the role of disease-related web-based information quality and physician-related web-based word-of-mouth information in reducing patients’ uncertainties. With regard to the traits of principal-agent relationships, this study describes the influence mechanism based on patients’ perceived information scarcity, fears of physicians’ opportunism, and patients’ trust. Moreover, information about physicians is effective in reducing patients’ uncertainties, but only if the information enhances patients’ trust in their physicians. This research generates new insights into understanding the impact of web-based health information on patients’ uncertainties.
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He, Qijun, Yungeng Li, Zhiyao Wu i Jingjing Su. "Explicating the Cognitive Process of a Physician’s Trust in Patients: A Moderated Mediation Model". International Journal of Environmental Research and Public Health 19, nr 21 (4.11.2022): 14446. http://dx.doi.org/10.3390/ijerph192114446.
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Trust is considered a critical factor in the physician–patient relationship. However, little is known about the development and impact of physicians trusting their patients. A model that is premised on the integrated model of organizational trust was proposed in this article to reveal the cognitive processes involved in physicians’ trust, with perceived integrity and the ability of the patient as antecedents and the physicians’ communication efficacy as the outcome. A cross-sectional survey of 348 physicians in Zhejiang province, China, revealed that a physician’s trust in a patient mediated the relationship between the physicians’ perception of the integrity and ability of the patient, and the physician’s communication efficacy. The physicians’ educational backgrounds and work experience were also found to moderate an indirect effect: a lower level of education and longer work experience intensified the impact of the perceived integrity and ability of the patient on the physician’s trust, while shorter work experience made the association between the physician’s trust and communication efficacy more salient. This paper provided implications for both physician and patient sides.
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Patel, Rikinkumar, Ramya Bachu, Archana Adikey, Meryem Malik i Mansi Shah. "Factors Related to Physician Burnout and Its Consequences: A Review". Behavioral Sciences 8, nr 11 (25.10.2018): 98. http://dx.doi.org/10.3390/bs8110098.
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Physician burnout is a universal dilemma that is seen in healthcare professionals, particularly physicians, and is characterized by emotional exhaustion, depersonalization, and a feeling of low personal accomplishment. In this review, we discuss the contributing factors leading to physician burnout and its consequences for the physician’s health, patient outcomes, and the healthcare system. Physicians face daily challenges in providing care to their patients, and burnout may be from increased stress levels in overworked physicians. Additionally, the healthcare system mandates physicians to keep a meticulous record of their physician-patient encounters along with clerical responsibilities. Physicians are not well-trained in managing clerical duties, and this might shift their focus from solely caring for their patients. This can be addressed by the systematic application of evidence-based interventions, including but not limited to group interventions, mindfulness training, assertiveness training, facilitated discussion groups, and promoting a healthy work environment.
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Bial, Andrea, Anar Desai i Joanna Martin. "Physician Guide to Home Hospice Visits". Home Health Care Management & Practice 30, nr 1 (3.11.2017): 35–40. http://dx.doi.org/10.1177/1084822317738997.
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The field of hospice and palliative medicine continues to grow, attracting recent graduates as well as more senior physicians looking for career changes. Unfortunately, there is little, if any, training in most residencies regarding the home hospice visit, and there are not enough fellowship-trained physicians to fill the available positions. A systematic review of the literature was made for the years 2000 to 2016 to identify articles which provided practical, clinical guidelines for the physician home hospice visit. No single article provided this needed information. Thus, the authors formulated these guidelines based on the literature and their experiences to aid the home hospice physician—as well as other providers who may work with the physician—to understand the physician’s role in the home hospice visit.
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Ma, Xiaojing, Chanhyun Park, Hsien-Chang Lin, Sweta Andrews i Jongwha Chang. "Factors associated with physician prescribing behavior of dipeptidyl peptidase-4 inhibitors for type 2 diabetes in the US outpatient population". Journal of Hospital Administration 6, nr 2 (7.03.2017): 59. http://dx.doi.org/10.5430/jha.v6n2p59.
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Objective: Although the use of dipeptidyl peptidase-4 (DPP-4) inhibitors has been increasing after their first approval in 2006, little is known about their prescribing pattern. Therefore, the objective of this study is to evaluate the prescribing pattern of the DPP-4 inhibitors for the treatment of type 2 diabetes mellitus (T2DM) and examine sociological factors associated with physician prescribing behavior in the U.S. outpatient setting.Methods: This cross-sectional study was conducted utilizing data from the 2006-2010 National Ambulatory Medical Care Survey (NAMCS) and employed the Eisenberg model that explains physician decision making in the context of sociologic influences. For independent variables, the following characteristics were determined based on the Eisenberg model: patient characteristics, physician characteristics, the physician-health care system interaction, and the physician-patient relationship. The dependent variable was the use of DPP-4 inhibitors. Multivariate logistic regressions were used for analyses.Results: The estimated population size was 535,158,796 patients during five years, and 3.85% of them were prescribed DPP-4 inhibitors. Among the patient characteristic-related factors, the odds of the use of DPP-4 inhibitors was 73% lower in patients with Medicaid compared to patients with private insurance (OR = 0.27; 95% CI, 0.08-0.88; p = .030). For the physician characteristic-related factor, the odds of prescribing DPP-4 inhibitors for primary care physicians are about 86% higher than the odds for non-primary care physicians (OR = 1.86; 95% CI, 1.17-2.95; p = .008). In addition, physicians in private offices were 3.01 times more likely to prescribe DPP-4 inhibitors than physicians in the health maintenance organizations (HMO) (OR = 3.01; 95% CI, 1.03-8.78; p = .043).Conclusions: Patient characteristics, physician characteristics, and the physician’s relationship with the health care system were associated with an increased use of DPP-4 inhibitors. However, the physician’s relationship with the patient was not associated with an increased use of DPP-4 inhibitors.
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Lieberman, Judy. "From Physicist to Physician". Women's Review of Books 12, nr 5 (luty 1995): 29. http://dx.doi.org/10.2307/4021976.
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Mammoliti, Maryna, Christopher Richards-Bentley i Adam Ly. "Understanding attention deficit/hyperactivity disorder in physicians: workplace implications and management strategies". Canadian Journal of Physician Leadership 7, nr 4 (8.07.2021): 160–65. http://dx.doi.org/10.37964/cr24742.
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Physicians with attention deficit/hyperactivity disorder (ADHD) may have unrecognized workplace difficulties because of inattention and impulsivity. If these behaviours interfere with patient care or organizational functioning, leaders may erroneously attribute the physician’s actions to unprofessionalism. As such, corrective efforts with punitive measures may be ineffective. ADHD is a neurodevelopmental disorder that responds to evidence-based treatments, including medications, accommodations, and supports. Physician leaders who understand the unique presentations of ADHD in physicians may better identify when this condition may be contributing to workplace behaviour. Furthermore, physician leaders may have a professional or legal duty to accommodate or support physicians with underlying medical and/or psychiatric conditions, such as ADHD. Using our own clinical experience, we provide a general overview of ADHD in physicians and guide physician leaders on how to help physicians who may be struggling with ADHD in the workplace. We hope that our clinical experience and observations of this hidden problem will spur discussion, awareness, and action for further research and support.
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Antoszewska, Beata, i Aleksandra Tobota. "Relationship with a physician in the narratives of children and adolescents hospitalized due to cancer". Men Disability Society 44, nr 2 (30.06.2019): 99–110. http://dx.doi.org/10.5604/01.3001.0013.5768.
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The key value of the physician-patient relationship has been strongly emphasized in scientific literature for a long time. This relationship impacts significantly the patient’s therapeutic process. In case of children and adolescents suffering from cancer, the relationship with physician is of a specific value due to both the age of such patients and the type of disease. Children and adolescents meet various specialists (physicians) during their treatment; however, they establish a long-term and quite intensive relationship with their treating physician. This relationship is, by definition, most important during intensive and maintenance therapy. The physician’s involvement is indisputable and it is directly related to the therapeutic process and its success. However, what is also extremely important is the physician’s interest in a particular patient and a personalized nature of this relationship: treating physician (subject) – child (subject). The manner in which the physician communicates with and treats his or her patient has a significant impact on the patient’s wellbeing during treatment and afterwards. The relationship with a physician also determines the patient’s subjectivity and self-esteem in later everyday life. The paper presents the results of research focused on the opinions of children and adolescents concerning relationships with their treating physicians. The study was conducted in three institutions which belong to the Polish Paediatric Leukaemia and Lymphoma Study Group. It involved 62 children aged 7–17 years old at different stages of their cancer treatment.
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Schwartz, Robert J., Lenworth M. Jacobs i Margaret Lee. "The Role of the Physician in a Helicopter Emergency Medical Service". Prehospital and Disaster Medicine 5, nr 1 (marzec 1990): 31–39. http://dx.doi.org/10.1017/s1049023x00026480.
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AbstractThe purpose of this study was to measure the contributions of a physician crew member in a helicopter emergency medical service (HEMS) and to develop a method to utilize physician services more efficiently. A two-part study utilizing two independent sets of measurements of physician necessity was conducted. A post-flight questionnaire and the success rate for endotracheal intubation were used as measurement tools.With the passage of time, the fight nurses perceived the physician crew member' contribution to clinical judgment decreased from 21% to 1% of the flights and that the physician's contribution of technical skills (intubation) declined from 11% to 3%. The contribution to clinical decisions seemed more important on interhospital transports than on scene responses. The technical skills (judged by the tracheal intubation success rates) of a physician seemed more cogent on responses to the scene. When in the capacity of a second crew member with an experienced flight nurse, the endotracheal intubation success rate increased from 71% to 90%. Therefore, it seems that physician services could be restricted primarily to scene response flights. This limited utilization of flight physicians should make these physicians available for other duties.
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Engel, George L. "Physician-scientists and scientific physicians". American Journal of Medicine 82, nr 1 (styczeń 1987): 107–11. http://dx.doi.org/10.1016/0002-9343(87)90384-6.
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Andritz, Mary H., i Matthew P. Rogan. "Drug Dispensing by Physicians: Promoter's Claims Examined". Pediatrics 82, nr 3 (1.09.1988): 504–9. http://dx.doi.org/10.1542/peds.82.3.504.
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Experience in private pediatric practice is used to illustrate some potential advantages and disadvantages to patients and physicians of drug dispensing by physicians. Projections were based on the prescribing trends in the practice, the extent of patients' insurance reimbursement for prescriptions, the laws regarding dispensing, and the costs incurred when physicians purchase selected medications from a repackager or when patients procure them at a community pharmacy. Patients without insurance for prescriptions can potentially save money by purchasing medication at the physician's office but, in general, only if the physician's dispensing fee is minimal. Potential profits to physicians would be cut by an estimated 50% because of third-party enrollees choosing to have prescriptions filled at a pharmacy because of cost savings. Net profits are further reduced and may even be eliminated when the cost of physician and staff time to prepare, label, reorder, and maintain necessary records regarding dispensed medication are considered. Although it may be convenient for the patient to obtain initial supplies of medication at the time of an office visit, obtaining refills may be less convenient. The time and paperwork involved in dispensing by a physician cannot be considered as minimal interruptions in normal office procedure. The broad, attractive claims made in support of physician dispensing by physicians clearly overstate the benefits both to patients and to physicians.
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Miller, Victoria A., Melissa Cousino, Angela C. Leek i Eric D. Kodish. "Hope and Persuasion by Physicians During Informed Consent". Journal of Clinical Oncology 32, nr 29 (10.10.2014): 3229–35. http://dx.doi.org/10.1200/jco.2014.55.2588.
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Purpose To describe hopeful and persuasive messages communicated by physicians during informed consent for phase I trials and examine whether such communication is associated with physician and parent ratings of the likelihood of benefit, physician and parent ratings of the strength of the physician's recommendation to enroll, parent ratings of control, and parent ratings of perceived pressure. Patients and Methods Participants were children with cancer (n = 85) who were offered a phase I trial along with their parents and physicians. Informed consent conferences (ICCs) were audiotaped and coded for physician communication of hope and persuasion. Parents completed an interview (n = 60), and physicians completed a case-specific questionnaire. Results The most frequent hopeful statements related to expectations of positive outcomes and provision of options. Physicians failed to mention no treatment and/or palliative care as options in 68% of ICCs and that the disease was incurable in 85% of ICCs. When physicians mentioned no treatment and/or palliative care as options, both physicians and parents rated the physician's strength of recommendation to enroll in the trial lower. Conclusion Hopes and goals other than cure or longer life were infrequently mentioned, and a minority of physicians communicated that the disease was incurable and that no treatment and/or palliative care were options. These findings are of concern, given the low likelihood of medical benefit from phase I trials. Physicians have an important role to play in helping families develop alternative goals when no curative options remain.
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Grady, Colleen Marie. "Can complexity science inform physician leadership development?" Leadership in Health Services 29, nr 3 (4.07.2016): 251–63. http://dx.doi.org/10.1108/lhs-12-2015-0042.
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Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes. Originality/value This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.
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Greenblum, Jake, i Ryan K. Hubbard. "Responding to religious patients: why physicians have no business doing theology". Journal of Medical Ethics 45, nr 11 (20.06.2019): 705–10. http://dx.doi.org/10.1136/medethics-2019-105452.
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A survey of the recent literature suggests that physicians should engage religious patients on religious grounds when the patient cites religious considerations for a medical decision. We offer two arguments that physicians ought to avoid engaging patients in this manner. The first is the Public Reason Argument. We explain why physicians are relevantly akin to public officials. This suggests that it is not the physician’s proper role to engage in religious deliberation. This is because the public character of a physician’s role binds him/her to public reason, which precludes the use of religious considerations. The second argument is the Fiduciary Argument. We show that the patient-physician relationship is a fiduciary relationship, which suggests that the patient has the clinical expectation that physicians limit themselves to medical considerations. Since engaging in religious deliberations lies outside this set of considerations, such engagement undermines trust and therefore damages the patient-physician relationship.
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Williams, Carol A., i Monette T. Gossett. "Nursing Communication: Advocacy for the Patient or Physician?" Clinical Nursing Research 10, nr 3 (1.08.2001): 332–40. http://dx.doi.org/10.1177/c10n3r8.
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Communication among nurses, patients, and physicians is a key component of effective health care. In addition to communication with patients, nurses directly or indirectly influence physician-patient communications. This secondary analysis examined registered nurses' interactions with a simulated patient regarding what the physician had told the patient about the reason for hospitalization. Taped interviews (N = 86) were transcribed and content analyzed to classify nurses' approaches to assessment and intervention. The second researcher coded 10% of the transcripts to ensure satisfactory interrater consistency. Major patterns of nursing communication were the following: assessing what the physician had told the patient (85%), encouraging clarification with the physician (62%), encouraging a second opinion, and defending the physician's competence (9%). Findings support literature suggesting that nurses mediate and clarify communications between the patient and the physician. Patient advocacy was also illustrated; however, a small number of nurses advocated most clearly for the physician
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Dalia, Samir, i Fred J. Schiffman. "Who's My Doctor? First-Year Residents and Patient Care: Hospitalized Patients' Perception of Their “Main Physician”". Journal of Graduate Medical Education 2, nr 2 (1.06.2010): 201–5. http://dx.doi.org/10.4300/jgme-d-09-00082.1.
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Abstract Background Studies have shown that a large portion of patient satisfaction is related to physician care, especially when the patient can identify the role of the physician on the team. Because patients encounter multiple physicians in teaching hospitals, it is often difficult to determine who the patient feels is his or her main caregiver. Surveys evaluating resident physicians would help to improve patient satisfaction but are not currently implemented at most medical institutions. Intervention We created a survey to judge patient satisfaction and to determine who patients believe is their “main physician” on the teaching service. Methods Patients on a medical teaching service at The Miriam Hospital during 20 days in March 2008 were asked to complete the survey. A physician involved in the research project administered the surveys. Surveys included 3 questions that judged patient's perception and identification of their primary physician and 7 questions regarding patient satisfaction. Completed surveys were analyzed using averages. Results Of the 126 patients identified for participation, 102 (81%) completed the survey. Most patients identified the intern (first-year resident) as their main physician. Overall, more than 90% of patients expressed satisfaction with their main physician. Conclusion Most patients on the teaching service perceived the intern as their main physician and were satisfied with their physician's care. One likely reason is that interns spend the greatest amount of time with patients on the teaching service.
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Mehra, Payal, i Anubhav Mishra. "Role of Communication, Influence, and Satisfaction in Patient Recommendations of a Physician". Vikalpa: The Journal for Decision Makers 46, nr 2 (czerwiec 2021): 99–111. http://dx.doi.org/10.1177/02560909211027090.
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As per the India Brand Equity Foundation, by 2022, India’s healthcare market is expected to reach US$372 billion. While exponential growth in the availability of private hospitals has been recorded in the past few years, many hospitals are not able to attract enough patients due to poor quality of services, unavailability of skilled healthcare workers, and unethical medical practices. These issues were painfully exposed during the COVID-19 pandemic. Patients rely on recommendations from friends and relatives to select a physician or hospital. This study undertakes a customer-oriented view of patients to explore patients’ perceptions of physicians’ communication and how it influences the recommendation of a physician. For the study, data are collected from 626 patients spread across three cities of North India. We find that physician communication leads to favourable recommendations, and the patient’s perceived influence and satisfaction play an important role in this process. The physician should display empathy and compassion while communicating to patients, which helps build a favourable perception of the physician. This leads to a higher level of satisfaction with the healthcare provider. Furthermore, the study also examines the effects of socio-demographic variables, such as patient’s income, patient’s gender, and physician’s gender. People with high (vs low) income are more satisfied with physician communication, whereas people with low (vs high) income are more likely to recommend a physician. Interestingly, female patients are more satisfied with a physician’s communication skills than males. Aligned with the patriarchal society, patients show more acceptance of male (vs female) doctors, but in contrast, patients are more likely to recommend a female (vs male) doctor. So, we recommend that healthcare providers ensure that patients get sufficient time to spend with their physicians to discuss problems and not ‘rush’ the patients to improve revenues.
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Adamson, Matthew, Kelsey Choi, Stephen Notaro i Crina Cotoc. "The Doctor–Patient Relationship and Information-Seeking Behavior". Journal of Palliative Care 33, nr 2 (7.03.2018): 79–87. http://dx.doi.org/10.1177/0825859718759881.
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Background: In cancer communication, patients and physicians often understand a patient’s experience and situation differently. This can negatively impact health outcomes and the physician–patient relationship. Aim: To explore how cancer patients’ interpretations of the physician’s role as information giver affect the communication relationship with the physician and their information-seeking behavior regarding different aspects of their cancer care. Design: Participants completed a semistructured qualitative interview addressing their treatment experience and communication with their physician. Interviews were coded and analyzed using inductive thematic analysis. Setting/Participants: Ten patients with cancer treated at a regional cancer center in central Illinois participated in the study. Cancer stages I to IV and 4 cancer types were represented. Results: Participants’ orientations to the relationship with their physician (and their information-seeking behavior) were classified into 4 general categories: (1) “questioners” have a general mistrust toward their physicians and the information doctors are giving; (2) “the undecided” focuses on physician “fit,” often requiring time to step away in order to make decisions and process information; (3) “cross-checkers” are concerned with content of their treatment protocol, often double-checking the treatment plan; and (4) “the experience-oriented” feel a gap between their experience and their physician’s experience (and perspective), often seeking information from other survivors. All categories described a perceived lack of adequate exchange of information and the need to seek information outside of the physician–patient relationship to compensate. Conclusion: Participants exhibited different information-seeking behaviors based on how they interpreted the role of their physician as information giver. This affected what kind of information they sought and how they understood the information received, which in turn affected understanding of their broader experience and care.
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Bååthe, Fredrik, Gunnar Ahlborg Jr, Lars Edgren, Annica Lagström i Kerstin Nilsson. "Uncovering paradoxes from physicians’ experiences of patient-centered ward-round". Leadership in Health Services 29, nr 2 (2016): 168–84. http://dx.doi.org/10.1108/lhs-08-2015-0025.
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Purpose The purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician’s professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician’s professional identity was centered. Physicians with more of an I-perspective experienced challenges with the new round, while physicians with more of a We-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians’ professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians’ professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.
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Prager, Elena, Vilsa E. Curto, Alexa Magyari, Marema Gaye i Anna D. Sinaiko. "Tiered Physician Network Plans and Patient Choices of Specialist Physicians". JAMA Network Open 6, nr 11 (9.11.2023): e2341836. http://dx.doi.org/10.1001/jamanetworkopen.2023.41836.
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ImportanceTiered physician network (TPN) health plans sort physicians into tiers based on their cost and quality, and patients pay lower copays for visits with physicians in the lower-cost and better-quality tiers. When the plans are first introduced, they lead patients to seek care from higher-value physicians.ObjectivesTo examine whether TPNs are associated with patient choice of physician when the plans have been in place for 8 to 12 years and whether there are inequities in patient out-of-pocket costs associated with inequities in access to physicians in lower-copay tiers.Design, Setting, and ParticipantsThis cross-sectional study comprising 46 645 physicians and 585 399 patients in TPNs, including 54 683 patients who had a new patient visit with a physician in a TPN, used health insurance claims data from a large employer purchaser from July 1, 2014, to June 30, 2019. Statistical analysis was performed from November 2020 to August 2023.ExposureEvaluation and management visit with a physician in a TPN.Main Outcomes and MeasuresMain outcomes were new patient market share per physician–carrier–zip code–year, distance from centroid of patient zip code to centroid of zip code of nearest low- or medium-copay physician, and mean TPN physician office visit copay per patient. A regression discontinuity design was used to estimate the association of a physician’s tier ranking, and a difference-in-differences analysis was used to estimate the association of copayment differences across tiers with market share among new patients. Equity in access was measured by comparing travel distance to the nearest physician in a low-copay or medium-copay tier and mean copayments across patient incomes.ResultsThe main analysis sample included 46 645 physician–carrier–zip code–year observations, 9506 (20.4%) of which were in the low-copay tier, 31 798 (68.2%) in the medium-copay tier, and 5341 (11.5%) in the high-copay tier. The 54 683 new patients in the sample had a mean (SD) age of 46.4 (16.7) years and included 33 542 women (61.3%). There was no association of having a worse tier ranking (0.045 percentage points [95% CI, −0.058 to 0.148 percentage points]) or of copayment differences between tiers (0.001 percentage points [95% CI, −0.002 to 0.004 percentage points]) with physician market share among new patients. The patients with the lowest income paid slightly lower mean (SD) copayments for office visits to a TPN physician than the patients with high income ($48.08 [$16.42] vs $51.59 [$16.79], a 6.8% difference).Conclusions and RelevanceIn this cross-sectional study of TPN health plans, there was no association between physician tier ranking and physician market share among any group of patients. These findings suggest there are limitations in TPNs’ steering of patients toward high-value physicians. These plans were not associated with exacerbated health inequity in this setting.
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Avinger, Anna McNair, Tekiah McClary, Margie Dixon i Rebecca D. Pentz. "Evaluation of Standard-of-Care Practices Among Physicians Who Treat Other Physicians". JAMA Network Open 5, nr 10 (18.10.2022): e2236914. http://dx.doi.org/10.1001/jamanetworkopen.2022.36914.
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ImportanceEthical discussions have suggested that physicians who treat other physicians may put their physician-patients at risk of receiving non–standard-of-care treatment, which may result in worse outcomes. This phenomenon occurs when a physician treats a fellow physician as a VIP (very important person), and is therefore known as VIP syndrome. It is important to assess physicians’ perceptions when treating physician-patients.ObjectiveTo determine whether the physicians treating other physicians have attitudes toward or act in ways that could place physician-patients at risk for VIP syndrome.Design, Setting, and ParticipantsThis 2-part qualitative study was conducted from December 1, 2021, to February 28, 2022. Physicians who worked at a single comprehensive cancer center with experience treating other physicians were eligible to participate. Convenience sampling was used. Emails and flyers were sent out with study information, and if interested, physicians were able to schedule an interview. Of 24 physicians responding, 3 did not have experience treating other physicians, yielding a sample of 21 (88%), which was sufficient to reach a saturation of themes. After the initial structured interview of physicians, follow-up key informant interviews were performed.ExposuresThe structured interview was developed on the basis of a literature review and focused on factors that may contribute to VIP syndrome.Main Outcomes and MeasuresParticipant responses to open-ended questions were qualitatively coded using standard multilevel semantic analysis to assess physician perceptions of treating fellow physicians. A series of Likert-scaled questions were used to identify potential contributing factors to VIP syndrome.ResultsTwenty-one physicians (11 men [52%], 11 White [52%], and 15 [71%] younger than 49 years) participated. Although no physician interviewed stated that they altered their usual treatment plans, 11 (52%) agreed that their physician-patients tried to dictate their own care, and 17 (81%) believed that their physician-patients obtained privileges, such as use of medical knowledge to participate in in-depth discussions of care, ability to obtain and use the treating physicians personal contact information, and receiving faster access to care. Eleven respondents (52%) reported increased stress, and 12 (57%) experienced more pressure not to disappoint their physician-patients.Conclusions and RelevanceThe findings of this qualitative study suggest that when physicians treat other physicians, the physician-patients may obtain privileges unavailable to patients who are not physicians. Therefore, guidelines to help physicians navigate the complex relationships between themselves and their physician-patients are needed to ensure equitable outcomes between physician and nonphysician patients.
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Saifee, Danish Hasnain, Matthew Hudnall i Uzma Raja. "Physician Gender, Patient Risk, and Web-Based Reviews: Longitudinal Study of the Relationship Between Physicians’ Gender and Their Web-Based Reviews". Journal of Medical Internet Research 24, nr 4 (8.04.2022): e31659. http://dx.doi.org/10.2196/31659.
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Background Web-based reviews of physicians have become exceedingly popular among health care consumers since the early 2010s. A factor that can potentially influence these reviews is the gender of the physician, because the physician’s gender has been found to influence patient-physician communication. Our study is among the first to conduct a rigorous longitudinal analysis to study the effects of the gender of physicians on their reviews, after accounting for several important clinical factors, including patient risk, physician specialty, and temporal factors, using time fixed effects. In addition, this study is among the first to study the possible gender bias in web-based reviews using statewide data from Alabama, a predominantly rural state with high Medicaid and Medicare use. Objective This study conducts a longitudinal empirical investigation of the relationship between physician gender and their web-based reviews using data across the state of Alabama, after accounting for patient risk and temporal effects. Methods We created a unique data set by combining data from web-based physician reviews from the popular physician review website, RateMDs, and clinical data from the Center for Medicare and Medicaid Services for the state of Alabama. We used longitudinal econometric specifications to conduct an econometric analysis, while controlling for several important clinical and review characteristics across four rating dimensions (helpfulness, knowledge, staff, and punctuality). The overall rating and these four rating dimensions from RateMDs were used as the dependent variables, and physician gender was the key explanatory variable in our panel regression models. Results The panel used to conduct the main econometric analysis included 1093 physicians. After controlling for several clinical and review factors, the physician random effects specifications showed that male physicians receive better web-based ratings than female physicians. Coefficients and corresponding SEs and P values of the binary variable GenderFemale (1 for female physicians and 0 otherwise) with different rating variables as outcomes were as follows: OverallRating (coefficient –0.194, SE 0.060; P=.001), HelpfulnessRating (coefficient –0.221, SE 0.069; P=.001), KnowledgeRating (coefficient –0.230, SE 0.065; P<.001), StaffRating (coefficient –0.123, SE 0.062; P=.049), and PunctualityRating (coefficient –0.200, SE 0.067; P=.003). The negative coefficients indicate a bias toward male physicians versus female physicians for aforementioned rating variables. Conclusions This study found that female physicians receive lower web-based ratings than male physicians even after accounting for several clinical characteristics associated with the physicians and temporal effects. Although the magnitude of the coefficients of GenderFemale was relatively small, they were statistically significant. This study provides support to the findings on gender bias in the existing health care literature. We contribute to the existing literature by conducting a study using data across the state of Alabama and using a longitudinal econometric analysis, along with incorporating important clinical and review controls associated with the physicians.
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Yin, Qiuju, Haoyue Fan, Yijie Wang, Chenxi Guo i Xingzhi Cui. "Exploring the Peer Effect of Physicians’ and Patients’ Participation Behavior: Evidence from Online Health Communities". International Journal of Environmental Research and Public Health 19, nr 5 (27.02.2022): 2780. http://dx.doi.org/10.3390/ijerph19052780.
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Background: Little research has studied the peer effect of physicians and patients in online health communities (OHCs) simultaneously. The study investigates the impact of the focal physician’s peers (F-peers) on the focal physician (F-physician), and the impact of patients of the focal physician’s peers (F-P-patients) on the focal physician’s patients (F-patients). Moreover, based on brand extension and accessible–diagnosable theories, this study explores the moderating effects of the intensity of F-peers’ knowledge sharing behavior and department reputation. Methods: This study collects data of 3297 physicians and related patients from Haodf.com platform between January 2019 and December 2019. Both two-way fixed effect and panel negative binomial regression are adopted to quantify the effects. Results: Results show that the behavior of F-peers positively affects the behavior of the F-physician, while the behavior of F-P-patients positively affects the behavior of F-patients. Moreover, both the intensity of F-peers’ knowledge sharing behavior and department reputation have a compound moderating effect. Conclusions: This study contributes to the literature of peer effects by constructing the conceptual framework of different types of individual participation behaviors in OHCs. The findings offer practical guides for establishing an incentive mechanism and formulating peer incentives or competition strategies in OHCs.
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Schulz, Peter Johannes, i Fabia Rothenfluh. "Influence of Health Literacy on Effects of Patient Rating Websites: Survey Study Using a Hypothetical Situation and Fictitious Doctors". Journal of Medical Internet Research 22, nr 4 (6.04.2020): e14134. http://dx.doi.org/10.2196/14134.
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Background Physician rating websites (PRWs) are a device people use actively and passively, although their objective capabilities are insufficient when it comes to judging the medical performance and qualification of physicians. PRWs are an innovation born of the potential of the Internet and boosted very much by the longstanding policy of improving and encouraging patient participation in medical decision-making. A mismatch is feared between patient motivations to participate and their capabilities of doing so well. Awareness of such a mismatch might contribute to some skepticism of patient-written physician reviews on PRWs. Objective We intend to test whether health literacy is able to dampen the effects that a patient-written review of a physician’s performance might have on physician choice. Methods An experiment was conducted within a survey interview. Participants were put into a fictitious decision situation in which they had to choose between two physicians on the basis of their profiles on a PRW. One of the physician profiles contained the experimental stimulus in the form of a friendly and a critical written review. The dependent variable was physician choice. An attitude differential, trust differential, and two measures of health literacy, the newest vital sign as an example of a performance-based measure and eHealth Literacy Scale as an example of a perception-based measure, were tested for roles as intermediary variables. Analysis traced the influence of the review tendency on the dependent variables and a possible moderating effect of health literacy on these influences. Results Reviews of a physician’s competence and medical skill affected participant choice of a physician. High health literacy dampened these effects only in the case of the perception-based measure and only for the negative review. Correspondingly, the effect of the review tendency appeared to be stronger for the positive review. Attitudes and trust only affected physician choice when included as covariants, considerably increasing the variance explained by regression models. Conclusions Findings sustain physician worries that even one negative PRW review can affect patient choice and damage doctors’ reputations. Hopes that health literacy might raise awareness of the poor basis of physician reviews and ratings given by patients have some foundation.
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Fu, Yanhong, David Schwebel i Guoqing Hu. "Physicians’ Workloads in China: 1998–2016". International Journal of Environmental Research and Public Health 15, nr 8 (3.08.2018): 1649. http://dx.doi.org/10.3390/ijerph15081649.
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Background: Physicians play a primary role in patients’ health. Heavy workloads can threaten the health of physicians and their patients. This study examined workload changes among physicians in Chinese health institutions from 1998–2016. Methods: This study examined data from the online China Statistical Yearbook of 1999–2017, which is released annually by the National Bureau of Statistics of the People’s Republic of China. Three relevant and available indicators were retrieved: (1) number of physicians, (2) number of patient visits and (3) number of inpatient admissions. Patient visits per physician and inpatient admissions per physician from 1998–2016 were calculated to approximate physician workloads in Chinese health institutions. Results: Between 1998 and 2016, patient visits per physician in China increased by 135% and inpatient admissions per physician rose by 184%. Both indicators demonstrate a stabilizing trend in the most recent five years, including a slight decrease (7%) in patient visits per physician since 2012. Conclusions: Physician workload increased dramatically for Chinese physicians from 1998–2016, a trend that could potentially threaten physicians’ health and the quality of patient care. The findings highlight the importance of interventions and efforts to relieve physician workloads in China.
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Khalid, Bilal, Fareeha Ayyub, Anila Rehman, Ume Sughra i Khizar Nabeel. "Physician’s satisfaction with clinical laboratory services of District Headquarter hospitals of Azad Jammu & Kashmir". Journal of Shifa Tameer-e-Millat University 5, nr 1 (3.09.2022): 37–42. http://dx.doi.org/10.32593/jstmu/vol5.iss1.192.
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Introduction: For proper patient management, clinical services and physician decisions are heavily reliant on laboratory test results. As a result, physician satisfaction with laboratory services is a critical indicator of service quality, emphasizing the importance of improving laboratory services to benefit patients.
Objectives: To determine physician satisfaction and factors affecting physician satisfaction with laboratory services in Azad Jammu & Kashmir (AJK).
Methodology: Data were collected in all the seven DHQs of AJK over three months. Data was collected through a structured questionnaire from (N=202) physicians using a non-probability convenient sampling technique. Chi-Square tests were used to determine the factors which showed a statistically significant relationship with outcome.
Results: A total (N=202) of respondents included in the study with an overall mean score of physician’s satisfaction with clinical lab services was 38 ± 9.6 ranging from a minimum score of satisfaction 22 to a maximum of 56. A statistically significant association was found between the age of the Physicians, area of residence, and their level of education with a satisfaction level of lab services with the p-value= 0.013, 0.013, and 0.001respectively.
Conclusion: It is concluded that physician satisfaction with laboratory services in public hospitals of AJK was very low, more than 50% of the patients showed dissatisfaction with the services. The main factors which affect the overall satisfaction of physicians with laboratory services were the absence of the assistance handbook, laboratory request form, and turnover time of the reports.
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Ishikawa, Masatoshi. "Temporal trends of physician geographical distribution and high and intermediate physician density areas and factors related to physicians’ movement to low physician density areas in Japan: a longitudinal study (1996–2016)". BMJ Open 10, nr 11 (listopad 2020): e041187. http://dx.doi.org/10.1136/bmjopen-2020-041187.
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ObjectivesA major issue in Japan’s health policy is the geographical maldistribution of physicians. This study aimed to analyse temporal trends in the geographical distribution of physicians and analyse physicians in high and intermediate physician density areas and factors related to their movement to low physician density areas in Japan.DesignA longitudinal study.SettingAll physicians in 344 secondary medical districts.ParticipantsI analysed data from the biennial national census, conducted by the Ministry of Health, Labour and Welfare between 1996 and 2016 and and divided it into two cohorts of 10 years each: 1996–2006 and 2006–2016.Primary and secondary outcome measuresI estimated the temporal trends in the number and percentages of physicians, and used logistic regression to analyse physicians in high and intermediate physician density areas and the factors related to their movement to low physician density areas.ResultsThe overall number of Japanese doctors increased by 31% between 1996 and 2016. The number of physicians per population in the physician high-density areas increased by 29%, while those in low-density areas increased by 32%, suggesting that the gap between areas marginally decreased. The multivariable logistic regression analyses revealed that academic hospital experience had the highest OR for predicting physician movement to low physician density areas after 10 years, both in the 1996 and 2006 cohorts. Other factors that positively correlated with physician movement were being male, being younger than 40 years, being qualified after the age of 30, urban area, intermediate physician density area and practice in a non-academic hospital.ConclusionsAs less-experienced physicians demonstrate high mobility among geographic categories, and retention rates are low in low physician density areas, especially for less-experienced physicians, a new system that considers these factors would create opportunities for younger physicians to work in low-density areas.
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Khana, Rajes, Manmeet Mahinderjit Singh, Faten Damanhoori i Norlia Mustaffa. "Breast Self-Examination System Using Multifaceted Trustworthiness: Observational Study". JMIR Medical Informatics 8, nr 9 (23.09.2020): e21584. http://dx.doi.org/10.2196/21584.
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Background Breast cancer is the leading cause of mortality among women worldwide. However, female patients often feel reluctant and embarrassed about meeting physicians in person to discuss their intimate body parts, and prefer to use social media for such interactions. Indeed, the number of patients and physicians interacting and seeking information related to breast cancer on social media has been growing. However, a physician may behave inappropriately on social media by sharing a patient’s personal medical data excessively with colleagues or the public. Such an act would reduce the physician’s trustworthiness from the patient’s perspective. The multifaceted trust model is currently most commonly used for investigating social media interactions, which facilitates its enhanced adoption in the context of breast self-examination. The characteristics of the multifaceted trust model go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. Thus, in this study, we explored and evaluated use of the multifaceted trust model for breast self-examination as a more suitable trust model for patient-physician social media interactions in breast cancer screening. Objective The objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians. Methods We used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum. Results Based on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (P<.001). Moreover, the trust level of a patient for a particular physician was found to increase after several interactions. Conclusions Multifaceted trustworthiness has a significant impact on a breast self-examination system. Evaluation of trustworthiness indicators helps to ensure a trustworthy system and ethical interaction between a patient and physician. A new patient can obtain a consultation by referring to the best physician according to preference of other patients. Patients can also trust a physician based on another patient’s recommendation regarding the physician’s trust level. The correlation analysis further showed that the most preferred trustworthiness indicator is honesty.
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Matthews, Amy L., Craig M. Harvey, Richard J. Schuster i Francis T. Durso. "Emergency Physician to Admitting Physician Handovers: An Exploratory Study". Proceedings of the Human Factors and Ergonomics Society Annual Meeting 46, nr 16 (wrzesień 2002): 1511–15. http://dx.doi.org/10.1177/154193120204601622.
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Current emphasis on the number of deaths due to medical errors has pushed the patient safety issue to the forefront at many medical institutions. The Institute of Medicine's recommendation for improved coordination and collaboration between physicians, as well as the paucity of related literature, has led the authors to explore the nature of the handover between emergency department and admitting physicians. Research was conducted at two Ohio hospitals to document the phases and issues found in emergency department (ED) handovers. The phases for ED handovers were similar to those found in shift changes in other types of industries (e.g., paper mill, air traffic control) with minor variations in the order of the phases. Three areas were identified where potential errors could occur including the spoken communication between physicians, selection of diagnostic tests based on the specific admitting physician, and the use of surrogates by the admitting physician. Physicians identified the level of trust in ED resident physicians, incomplete handovers between ED physicians at their shift change, differences in exams and treatment plans based on admitting physician, and notification of possible admission prior to receiving results for exams as potential problem areas. The findings of this research illustrate the need for future research into physician communication. These studies have tremendous opportunity to enable the Institute of Medicine's goal of improving communication between physicians for better patient care and outcomes.
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McCullough, Tammy, H. Robert Dodge i Susan Moeller. "Physician Recruitment: Understanding What Physicians Want". Health Marketing Quarterly 16, nr 2 (1.01.1999): 55–64. http://dx.doi.org/10.1080/07359683.1999.12096515.
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Ryan, Eileen P. "Physician wellbeing – what do physicians want?" Journal of Osteopathic Medicine 121, nr 7 (31.05.2021): 607–9. http://dx.doi.org/10.1515/jom-2021-0144.
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Brock, Douglas, i Terry Scott. "Training Physician Assistants to Be Physicians". Academic Medicine 90, nr 3 (marzec 2015): 264. http://dx.doi.org/10.1097/acm.0000000000000630.
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Noy, Shlomo, i Ran Lachman. "Physician hospital conflict among salaried physicians". Health Care Management Review 18, nr 4 (1993): 60–61. http://dx.doi.org/10.1097/00004010-199301840-00008.
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Noy, Shlomo, i Ran Lachman. "Physician—hospital conflict among salaried physicians". Health Care Management Review 18, nr 4 (1993): 60–69. http://dx.doi.org/10.1097/00004010-199323000-00008.
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Balzora, Sophie, i Elizabeth Weinshel. "Addressing Physician Burnout Among Practicing Physicians". Clinical Gastroenterology and Hepatology 16, nr 1 (styczeń 2018): 153–54. http://dx.doi.org/10.1016/j.cgh.2017.07.015.
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Peppin, John F. "Physicians' values and physician-value neutrality". Journal of Religion and Health 34, nr 4 (grudzień 1995): 287–300. http://dx.doi.org/10.1007/bf02248738.
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Zuber, T. J. "Physician payment reforms and family physicians". JAMA: The Journal of the American Medical Association 267, nr 15 (15.04.1992): 2034b—2034. http://dx.doi.org/10.1001/jama.267.15.2034b.
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Zuber, Thomas J. "Physician Payment Reforms and Family Physicians". JAMA: The Journal of the American Medical Association 267, nr 15 (15.04.1992): 2034. http://dx.doi.org/10.1001/jama.1992.03480150040019.
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