Biomedical subjects

G C Fowler

Publications and source records attributed to G C Fowler.

4 recordsLinked to original sources

PubMed1999

A cost construction model to assess the cost of a family practice residency program.

BACKGROUND AND OBJECTIVES: This study uses a cost construction approach to evaluate the cost of training family practice residents in a university-based residency program. The approach calculates the cost of the educational program from a global institutional perspective, including all monetary and nonmonetary costs, independently of how they are financed. METHODS: Cost construction analysis is used to compute the instructional cost, which includes the cost of faculty and resident time directly related to teaching and the support of the teaching program. The value of the clinical care and supervision provided by the family practice residents is assessed as a replacement cost. Sensitivity analysis examines a range of assumptions concerning residents' productivity, replacement costs, and the cost allocation of activities that jointly produce clinical care and education. RESULTS: For a junior resident, the instructional cost is $94,835 per year, and the replacement cost is $65,052 per year. The value of the teaching and clinical services provided by senior residents, $124,247 per year, exceeds the cost of the resources used to educate them, $98,364 per year. CONCLUSIONS: The cost construction model can be used as a tool to allocate resources, negotiate for funding, and estimate variations in cost due to changes in curriculum and in the health care environment.

Costs and Cost Analysis↗

PubMed1997

Office procedures. Exercise testing.

Exercise testing is an effective method for evaluating patients with chest pain, for diagnosing and managing coronary artery disease, for determining prognosis in patients with known coronary disease, for determining exercise capacity, for evaluating exercise-induced arrhythmias, for verifying the safety of exercise, and for customizing an exercise prescription. With proper clinician training and careful selection of patients, exercise testing is a safe procedure (less than 1 complication per 10,000 cases). Performing office-based exercise testing improves clinician's basic electrocardiograph reading capabilities, communication, and his or her referral patterns with subspecialists. With an understanding of the basic principles of exercise testing, with proper supervision or consultation, and with proper selection of patients, most clinicians can enjoy exercise testing safely.

Adult↗

PubMed1993

Family physicians' support for school-based HIV prevention education programs.

OBJECTIVE: To identify the extent to which family physicians support school-based education programs regarding the human immunodeficiency virus (HIV). Sexually active adolescents are at risk for infection with HIV. Education programs on HIV that target this vulnerable group effectively prevent infection, yet family physicians are often not directly involved in the design and implementation of such programs. DESIGN: A systematic random sample of 2660 members of the American Academy of Family Physicians was surveyed using a mailed questionnaire to assess clinical experiences with HIV disease, willingness to provide HIV treatment, and support for school-based HIV education programs. The response rate was 63.7%. Poststratification weights were applied to adjust for the slight under-representation of non-board-certified physicians in the study sample. RESULTS: Support for school-based HIV counseling programs was overwhelmingly positive. The mean level of support was 1.28 (with 1 indicating strong approval and 4 strong disapproval). Physicians' attitudes toward programs that include condom availability were marginally less favorable (1.92). Residency trained (P = .009) and female physicians (P = .010) expressed the greatest support for school-based programs. Physicians with fewer professional concerns about providing direct HIV patient care (P = .030) and who believed that communication with their patients about sexuality was an acceptable component of clinical care (P < .001) were most likely to support school-based programs. CONCLUSIONS: Family physicians can play an important role in designing and implementing HIV education programs. The results of these analyses suggest family physicians may be relied on to endorse school-based HIV prevention programs, including programs that make condoms available to adolescents. School and public health authorities should enlist family physicians' assistance when planning and implementing these or related community-based HIV education activities.

Acquired Immunodeficiency Syndrome↗

PubMed1993

The female role in the transmission of HIV infection.

Women are increasingly recognized as a significant population at risk for human immunodeficiency virus (HIV) infection. In major cities in Africa, the Americas, and Europe, HIV infection is the leading cause of death in women aged 25 through 29 years. New patterns have emerged in the epidemic, the most dramatic of which is the increased rate of transmission for heterosexuals, directly associated with an increase in seropositivity among women and children. Between 1989 and 1990, the number of women diagnosed with the acquired immunodeficiency syndrome rose 34% compared with a 22% rise in men. The Centers for Disease Control and Prevention have increased support for studies related to prevention of HIV infection in response to these trends. Health professionals should demonstrate an understanding of the complex nature of sexuality, femininity, and the female role in society when educating female patients about virus avoidance, so that preventive behavior will be perceived as consistent with a woman's personal standards for sexual relationships.

Adolescent↗