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Biomedical subjects

G J Povar

Publications and source records attributed to G J Povar.

At least 19 recordsLinked to original sources
PubMed1996

Primary care: questions raised by a definition.

In Defining Primary Care: An Interim Report, the Institute of Medicine offers a set of attributes for primary care that raise many unresolved empirical and philosophical questions. For instance, the "integrated nature" of primary care immediately challenges the validity of the content of research in primary care using data such as ICD-9 codes, which, by nature, reduce patients to disaggregated sets of problems rather than coherent wholes. Likewise, considering accessibility as a hallmark of primary care focuses attention on how health care is organized, and whether depending on primary care-trained professionals as the necessary or ideal first point of access might be a deterrent to the delivery of optimal care among some populations. Primary care clinicians should and will be held accountable for achieving the attributes of practice that make primary care unique. This paper provides a detailed examination of the Institute's definition, and identifies many aspects that require additional thought and research before these attributes can be applied as criteria for the evaluation of primary care practice.

Health Services Accessibility↗
PubMed1987

The humanities, humanistic behavior, and the humane physician: a cautionary note.

Efforts to teach and evaluate humanistic qualities in physicians in residency training are marred by ambiguous goals. The humane physician can be characterized by four distinct qualities: technical competence, humanistic attitude, knowledge of humanistic concepts, and humanistic behavior. Education in the humanities can foster humanistic attitudes, but it cannot promise to lead to changes in behavior. Likewise, although formal training in communication teaches the skills necessary for humanistic behavior, without an understanding of humanistic concepts these skills may not serve medical or moral ends. Evaluation of the humane physician must also include modalities that test attitude, knowledge, and behavior. Testing one characteristic does not ensure competence in other areas; knowledge of the requirements for informed consent, for example, does not guarantee one's ability to discuss this concept effectively with patients. In this article, we suggest ways to combine the humanities and communication skills in the clinical setting and we emphasize both the training and the evaluation of humane physicians.

Attitude of Health Personnel↗
PubMed1984

The teaching of liberal arts in internal medicine residency training.

Forty-four members of the Association of Program Directors in Internal Medicine and 58 members of the Society for Research and Education in Primary Care Internal Medicine completed questionnaires on the teaching of liberal arts in internal medicine residency programs and the importance of liberal arts to the practice of medicine. They rated economics of medical care and bioethics as essential to residency training. Law and organization of the health care system as well as economics and bioethics were rated as essential to medical practice. Although there was great variability in the curricula represented, over 40 percent of the respondents reported having formal lecture and/or seminar exposure to these topics in their programs. Problems encountered in implementing liberal arts programs included lack of curriculum time, limited-faculty members, and a lack of interest on the part of residents. There is a need both to arrive at a consensus among residency directors and to explore means of developing interdisciplinary faculties if the liberal arts are to form an established part of internal medicine residency training.

Bioethics↗
PubMed1984

Patients' therapeutic preferences in an ambulatory care setting.

One thousand two hundred-fifteen adult outpatients of an urban health maintenance organization completed questionnaires containing four hypothetical clinical situations. Of these patients, 72 per cent preferred a non-drug "home remedy" when given a choice among that and two different drug options. Risk aversion and willingness to accept current discomfort were stronger than demographic variables in predicting this preference. We conclude that patients informed about the risks and benefits of drug and non-drug therapies will prefer the latter if that option is offered.

Adult↗
PubMed1983

Medical students' skills, attitudes, and behavior needed for literature reading.

Skills, attitudes, confidence, and behavior needed for literature reading were studied in first- versus fourth-year medical students at George Washington University in Washington, D.C. Questions on diagnostic test skills were used for comparison. Anonymous questionnaires were completed by 114 first-year and 84 fourth-year students. Fourth-year students read considerably more literature than first-year students, valued reviews over original research, and placed more value on the journal's reputation. They had greater confidence and objective knowledge than first-year students on diagnostic test skills but not greater confidence or objective knowledge on literature reading skills. Most dramatic was their "lower" willingness to admit uncertainty, even when taking into account their level of knowledge. Less willingness to admit uncertainty on the part of fourth-year medical students than first-year students may reflect medical education's emphasis on specific answers and its failure to teach students how to analyze data and draw conclusions. A need exists for specific training in literature reading skills with preevaluations and postevaluations of skills, attitudes, and behavior.

Attitude↗
PubMedDate not supplied

Ethics committees: is there a role for them in the laboratory?

Ethics committees are commonly found in United States health-care institutions. As multidisciplinary committees within the medical staff structure, they are active in education, policy development, and case consultation. Clinical pathology laboratories face a number of ethically sensitive issues, including the confidentiality of sensitive data, problems of patient-caregiver or caregiver-patient transfer of the human immunodeficiency virus (HIV), and conflicts about allocating scarce resources such as blood. Ethics committees can be an important resource to clinical laboratorians seeking to develop ethically defensible policies and procedures.

Acquired Immunodeficiency Syndrome↗