scholarly journals Improving Documentation of Pediatric Height, Weight, and Body Mass Index by Primary Care Providers

2018 ◽  
Vol 79 (4) ◽  
pp. 186-190
Author(s):  
Coraine V. Wray ◽  
Paula M. Brauer ◽  
Roschelle A. Heuberger ◽  
John V. Logomarsino
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Family Health ◽  
Family Physicians ◽  
Primary Care Providers ◽  
Growth Trajectories ◽  
Care Providers ◽  
Anthropometric Data ◽  
Health Care Practices ◽  
Care Practices

The regular documentation of anthropometric data in an electronic medical record (EMR) is one tracking method used by primary care providers to follow the growth trajectory and development of children in their health care practices. EMR reminders have been proposed as a method to increase recording of pediatric height and weight by primary care providers, leading to potentially better detection and management of children classified as overweight or obese. The aim of this pre–post study was to improve a Family Health Team’s physician documentation of pediatric height and weight through the implementation of an EMR reminder alert tool. The documentation rate for children 4–7 years old in the 6 months before intervention was 36% of children seen. After implementation of EMR reminder alerts, primary care physicians’ documentation rate rose to 45% (9% increase; P < 0.01), but it was below the 15% target increase. Better documentation of pediatric height and weight by family physicians is needed to improve monitoring of children’s growth trajectories. Additional strategies to increase documentation rates are needed.

Aging and Sexual Health: A Cross-Sectional Survey of Patients in a Canadian Urban Academic Family Health Team

2020 ◽  
Vol 39 (3) ◽  
pp. 365-372
Author(s):  
Erin Lurie ◽  
Meera Nathwani ◽  
Morgan Slater ◽  
Erica Pascoal ◽  
Sarah Chadwick ◽  
...  
Keyword(s):  
Primary Care ◽  
Sexual Health ◽  
Sexual Activity ◽  
Primary Care Physicians ◽  
Family Health ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Concerns

ABSTRACTPrimary care physicians are in a position to recognize sexuality as a core component of health. Data examining the sexual behaviours of Canadians over the age of 50 and the role of primary care in this domain is lacking. A cross-sectional survey was administered to patients over the age of 50, which assessed the importance of sexual activity, problems, and preferences in discussing sexual health with their primary care providers. A total of 39 per cent of patients indicated ongoing sexual activity and 52% of male participants reported current sexual activity compared with 25 per cent of females (p < 0.01). More males reported sexual activity as important than did females (69% vs. 45%, p < 0.01). Participants identifying sexual health concerns discussed physical dysfunctions more than emotional, social, or global health concerns (p < 0.01). More male participants discussed sexual health concerns with their family physician than did females (p < 0.01). The results of our study indicate that many individuals over the age of 50 continue to be sexually active, and that physical and non-physical concerns directly impact participation in sexual activity.

scholarly journals Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty

2021 ◽  
Vol 8 ◽  
pp. 237437352110077
Author(s):  
Daliah Wachs ◽  
Victoria Lorah ◽  
Allison Boynton ◽  
Amanda Hertzler ◽  
Brandon Nichols ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Waiting Times ◽  
Wait Time ◽  
Primary Care Providers ◽  
Wait Times ◽  
Care Providers ◽  
Female Physicians ◽  
Online Ratings ◽  
And Gender

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.

Are primary care physicians aware of peripheral artery disease risk reduction and management in the Saudi healthcare transformation era? A health cluster observational study

Vascular ◽  
2021 ◽  
pp. 170853812110443
Author(s):  
Sultan Alsheikh ◽  
Hesham AlGhofili ◽  
Omar A Alayed ◽  
Abdulkareem Aldrak ◽  
Kaisor Iqbal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Saudi Arabia ◽  
Risk Reduction ◽  
Peripheral Artery Disease ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Peripheral Artery ◽  
Artery Disease

Introduction Patients with peripheral artery disease (PAD) are often underdiagnosed and undertreated. This study aimed to assess the knowledge of the recommended target levels of blood pressure, low-density lipoprotein cholesterol, glycosylated hemoglobin A1C, and knowledge and attitude about PAD risk reduction therapies among physicians working in primary care settings in Saudi Arabia. Methods This observational cross-sectional study included family medicine consultants, residents, and general practitioners working in a health cluster in the capital city of Saudi Arabia using a self-administered questionnaire. Results Of the 129 physicians who completed the survey, 55% had completed PAD-related continuing medical education hours within the past 2 years. Despite this, the knowledge score of the recommended target levels was high in only 13.2% of the participants. Antiplatelet therapy was prescribed by 68.2% of the participants. Conclusion Here we identified the knowledge and action gaps among primary care providers in Saudi Arabia. Physicians had an excellent attitude about screening for and counseling about risk factors. However, they showed less interference in reducing these risk factors. We recommend addressing these knowledge gaps early in medical school and residency programs.

scholarly journals Barriers to and solutions for addressing insufficient professional interpreter use in primary healthcare

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fabienne N. Jaeger ◽  
Nicole Pellaud ◽  
Bénédicte Laville ◽  
Pierre Klauser
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Key Factors ◽  
Cross Sectional ◽  
Interpreter Use ◽  
Health Authorities ◽  
Professional Interpreter ◽  
Paediatric Primary Care

Abstract Background The aim of this nationwide study was to investigate barriers to adequate professional interpreter use and to describe existing initiatives and identify key factors for successful interpreter policies in primary care, using Switzerland as a case study. Methods Adult and paediatric primary care providers were invited to participate in an online cross-sectional questionnaire-based study. All accredited regional interpreter agencies were contacted first by email and, in the absence of a reply, by mail and then by phone. Local as well as the national health authorities were asked about existing policies. Results 599 primary care physicians participated. Among other reasons, physicians identified cumbersome organization (58.7%), absent financial coverage (53.7%) and lack of knowledge on how to arrange interpreter interventions (44%) as main barriers. The odds of organising professional interpreters were 6.6-times higher with full financial coverage. Some agencies confirmed difficulties providing professional interpreters for certain languages at a timely manner. Degrees of coverage of professional interpreter costs (full coverage to none) and organization varied between regions resulting in different levels of unmet needs. Conclusions Professional interpreter use can be improved through the following points: increase awareness and knowledge of primary care providers on interpreter use and organization, ensure financial coverage, as well as address organizational aspects. Examples of successful interventions exist.

A novel continuum-based framework for translating behavioral health integration to primary care settings

2020 ◽  
Vol 10 (3) ◽  
pp. 580-589 ◽  
Author(s):  
Matthew L Goldman ◽  
Ekaterina Smali ◽  
Talia Richkin ◽  
Harold A Pincus ◽  
Henry Chung
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Technical Assistance ◽  
New York State ◽  
Behavioral Health Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Behavioral Health Integration ◽  
Care Practices ◽  
Primary Care Practices

Abstract Although evidence-based behavioral health integration models have been demonstrated to work well when implemented properly, primary care practices need practical guidance on the steps they can take to build behavioral health integration capacities. This is especially true for practice settings with fewer resources. This study is a pilot field test of a framework continuum composed of core components of behavioral health integration that can be used to translate the implementation of behavioral health into diverse clinical settings guided by a practice's priorities and available resources. This framework, in combination with technical assistance by the study team, was piloted in 11 small primary care sites (defined as ≤5 primary care providers) throughout New York State. Surveys were collected at baseline, 6 months, and 12 months. Informal check-in calls and site visits using qualitative semistructured individual and group interviews were conducted with 10 of the 11 sites. A mixed-methods approach was used to incorporate the survey data and qualitative thematic analysis. All practices advanced at least one level of behavioral health integration along various components of the framework. These advances included implementing depression screening, standardizing workflows for positive screens, integrating patient tracking tools for follow-up behavioral health visits, incorporating warm hand-offs to on-site or off-site behavioral health providers, and formalized external referrals using collaborative agreements. Practices reported they had overall positive experiences using the framework and offered feedback for how to improve future iterations. The framework continuum, in combination with technical assistance, was shown to be useful for primary care practices to advance integrated behavioral health care based on their priorities and resource availability. The results combined with feedback from the practices have yielded a revised “Framework 2.0” that includes a new organization as well as the addition of a “Sustainability” domain.

scholarly journals Semistructured interviewing in primary care research: a balance of relationship and rigour

2019 ◽  
Vol 7 (2) ◽  
pp. e000057 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lisa M Vaughn
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Data Collection ◽  
Health Services ◽  
Family Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Care Research ◽  
Care Research ◽  
Semistructured Interviews

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.

scholarly journals Primary care providers' bereavement care practices: recommendations for research directions

2014 ◽  
Vol 29 (12) ◽  
pp. 1221-1229 ◽  
Author(s):  
Angela R. Ghesquiere ◽  
Sapana R. Patel ◽  
Daniel B. Kaplan ◽  
Martha L. Bruce
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Research Directions ◽  
Care Practices ◽  
Bereavement Care

scholarly journals Effect of a Cooperation Strategy between Primary Care Physicians and Hospital Liver Units on HBV Care in Campania, Italy

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Rosa Zampino ◽  
Nicolina Capoluongo ◽  
Adriana Boemio ◽  
Margherita Macera ◽  
Martina Vitrone ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Endemic Area ◽  
Primary Care Providers ◽  
Hbv Infection ◽  
Care Providers ◽  
Financial Difficulties ◽  
Liver Disease Progression ◽  
Patients At Risk ◽  
Cooperation Strategy

Aims. This study is aimed at assessing the efficacy of an active search and treat strategy for HBV-infected subjects in an endemic area (Campania, Italy). To do this, we created a cooperation bundle between 24 General Practitioners (GPs) and 3 Hospital Liver Units (HLU). We assessed whether this strategy improved the detection of HBV infection in patients at risk and the overall quality of care, with the aim of reducing liver disease progression. Methods. We estimated that, among about 20,000 patients cared for by the 24 GPs, approximately 280 patients unaware of or underestimating HBV infection would be found. Identified patients were to be referred to the HLU for clinical evaluation and treatment from February 2016 for 12 months. Results. Unexpectedly, screening and enrolment were poor (48 patients only). GP workloads, patient financial difficulties, and patients' refusal were the major causes of enrolment failure according to GPs. All patients referred to HLU completed the program; most of them were HBV inactive carriers. Conclusions. This program failed to scavenge chronic HBV-infected patients in an endemic area and establish a successful clinical collaboration between GPs and HLU. Underlying reasons are diverse and call for new strategies to implement cooperation between primary care providers and hospital specialists.

Barriers To Diagnosis In Myeloproliferative Neoplasms

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5248-5248
Author(s):  
Raymond H L Yip ◽  
Lynda M Foltz
Keyword(s):  
Primary Care ◽  
Median Time ◽  
Primary Care Physicians ◽  
Myeloproliferative Neoplasms ◽  
Diagnostic Testing ◽  
Primary Care Providers ◽  
Care Providers ◽  
Average Delay ◽  
Delay In Diagnosis ◽  
Hemorrhagic Complications

Abstract Background Timely diagnosis of patients (pts) with polycythemia vera (PV) and essential thrombocythemia (ET) is important given the risks of thrombotic and hemorrhagic complications, disease progression and associated symptoms.  Pts often present initially to primary care physicians, who may have limited previous experience with PV/ET given the low prevalence.  Little is known about the timeliness of referral or diagnostic testing after identification of abnormal blood test results or if delays in diagnosis affect patient outcomes. Objectives To determine the time from initial lab abnormality to referral, diagnosis and treatment of pts with PV and ET. Methods Pts at a single Canadian academic institution newly diagnosed with PV or ET from Jan 2010 to May 2013 were identified.  Retrospective data was collected including demographics, lab values, diagnostic testing and treatments. Results Demographics: 26 pts with PV and 34 with ET were identified.  Median age was 67.5 (44-89) y for PV and 66.5 (34-92) y for ET. Delay in Referral and Diagnosis: 98% of pts were referred directly to a hematologist by their primary care physician.  69% of PV pts were referred within 30 days and 92% within 90 days of initial lab abnormality.  Median time from referral to diagnosis was 98 (0-221) days.  41% of ET pts were referred within 30 days and 56% within 90 days of initial lab abnormality.  Median time from referral to diagnosis was 121 (8-638) days.  PV pts were referred sooner, median 20 (0-187) days, than ET pts, median 67 (0-3743) days (p=0.01).  The median delay from referral until hematology assessment was 51 days for PV compared to 78 days for ET (p=0.08).  After assessment by the hematologist, it required a median of 35 days to make a diagnosis of PV and 25 days for a diagnosis of ET (p=0.31). Referrals by platelet (plt) count: There was a trend to earlier referral of ET pts with higher platelet (plt) counts.  15/20 (75%) ET pts with plt count >600 were referred within 90 days of initial lab abnormality whereas only 4/14 (29%) of pts with plt count 450-600 were referred within 90 days (p=0.056). Treatment of PV pts: 22/26 (85%) pts received phlebotomy at or after referral at the direction of a hematologist.  Average delay in referral (and phlebotomy initiation) for patients treated with phlebotomy was 32 days.  13/26 (50%) pts were initiated on treatment with hydroxyurea within 2 months of diagnosis.  Average delay in diagnosis (and hydroxyurea initiation) in this subgroup was 142 days.   11/26 (42%) pts were receiving ASA prior to the initial hematological consultation.  12/26 (46%) were initiated on ASA at or shortly after hematological consultation.  Average delay to hematology consultation (and ASA initiation) was 90 days in this subgroup. Treatment of ET pts: 8/34 (24%) pts were initiated on treatment with hydroxyurea within 2 months of diagnosis.  Average delay in diagnosis (and hydroxyurea initiation) in this subgroup was 790 days. 17/34 (50%) pts were receiving ASA prior to the initial hematological consultation.  15/34 (44%) were initiated on ASA at or shortly after hematological consultation.  Average delay to hematology consultation (and ASA initiation) was 355 days in this subgroup. No thrombotic or major hemorrhagic complications occurred in any PV/ET pts between the time of initial lab abnormality and diagnosis. Discussion This study demonstrates the marked variability in time from lab abnormality to referral and diagnosis for PV/ET pts.  Primary care providers were more likely to promptly refer PV pts than ET pts, and particularly tended to overlook referral and investigation of pts with modestly elevated plt counts of 450-600.  This is a concern, as risk of thrombosis in ET pts is independent of plt count.  Delays were also apparent in wait times for hematology appointments and subsequent diagnostic tests.   The delay in diagnosis led to a delay in initiation of therapy to reduce risk of thrombosis in both PV and ET pts.  Possible strategies to expedite diagnosis include targeted education of primary care physicians focusing on identification of lab features of PV/ET.  Directive comments on lab reports by community hematopathologists may also facilitate prompt referral and investigation. Disclosures: No relevant conflicts of interest to declare.

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