14 research outputs found
Preventing Chronic Disease (PCD)
No full textA major contributor to shortfalls in delivery of recommended health care services is lack of physician time. On the basis of recommendations from national clinical care guidelines for preventive services and chronic disease management, and including the time needed for acute concerns, sufficiently addressing the needs of a standard patient panel of 2,500 would require 21.7 hours per day. The problem of insufficient time indicates that primary care requires broad, fundamental changes. The creation of primary care teams that include members such as physician assistants, nurse practitioners, dietitians, health educators, and lay coaches is important to meeting patients' primary care needs
Estimated time spent on preventive services by primary care physicians
No full text10.1186/1472-6963-8-245BMC Health Services Research8
Physicians' Beliefs about Discussing Obesity: Results from Focus Groups
No full textPurpose. Physicians are expected to discuss weight loss with overweight and obese patients. Physicians' beliefs, outcome expectancies, and strategies for addressing weight with patients have not been examined. Design. Two focus groups of family physicians and internists included questions about obesity and how physicians discuss weight loss with patients. Setting/Subjects. Family physicians (n = 11) and internists (n = 6) from Duke University Medical Center's Department of Community and Family Medicine and Department of Medicine. Analysis. Qualitative analysis approach using grounded theory methodology. Results. Physicians' responses centered on five key themes: (1) responsibility, (2) barriers, (3) target populations, (4) introducing topic, and (5) ways to talk about obesity. Conclusion. Physicians have many barriers related to discussing weight loss with patients. Given the obesity epidemic, the need to understand how to have these discussions, when to have these discussions, and with whom to have these discussions becomes paramount to providing effective care for patients with obesity. Limited physician training in weight-loss counseling explains why physicians find it challenging to discuss obesity with patients. </jats:sec
Alternative models for academic family practices
No full textAbstract Background The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. Methods The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. Results Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. Conclusion Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.</p
Abstract B01: PEG3 DNA methylation and cervical intraepithelial neoplasia in African American and European American women
No full textAbstract PR01: HPV genotype distribution and cervical intraepithelial neoplasia in African American and white women living in the Southeastern United States
No full text
