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Biomedical subjects

P L Stamps

Publications and source records attributed to P L Stamps.

18 recordsLinked to original sources
PubMed1995

Physicians and organizations: an uneasy alliance or a welcome relief?

BACKGROUND: Physicians are increasingly practicing within structured or organized practice settings, even though it is frequently assumed that such organizations are inherently dissatisfying to physicians. In this study, a sensitive measure of physician satisfaction is used to compare physicians working in four types of practice settings: private group practice, solo practice, a closed-panel health maintenance organization (HMO), and a hospital-based practice. METHODS: A questionnaire was mailed to all physicians in a four county area in western Massachusetts, from which 1302 practicing physicians were identified. Based on responses to the questionnaire, the physicians were placed into one of the four practice arrangements. Satisfaction was measured by using an index methodology, with six statistically acceptable measures of satisfaction. RESULTS: All physicians surveyed were most satisfied with the personal and lifestyle factors related to their practice, regardless of practice setting. Those in a private group practice were the most satisfied. However, physicians in an HMO setting were more satisfied with medicine as a profession and less dissatisfied with the state's medical practice climate than physicians in the other practice settings. It appears that HMOs provide professional satisfaction by buffering physicians from the external regulatory climate, permitting them to focus more on patient care. CONCLUSIONS: Identifying the factors that cause physician satisfaction and dissatisfaction within the various types of practice settings becomes increasingly important as current health care reform efforts continue to promote more structured practice environments. More research is needed to identify the various organizations physicians are involved with so that physicians' professional level of satisfaction can be maximized.

Group Practice↗
PubMed1987

Financial analysis in the health administration curriculum: a survey of ACEHSA programs.

Among the continuing curriculum issues in health administration programs is the appropriate amount of financial analysis. This field covers economics and financial management, with both subjects being given importance in the ACEHSA accreditation guidelines. This paper reports on a national survey of health administration programs intending to discover the importance placed on the study of economics and financial management. A second survey gathered information from alumni and preceptors of a specific ACEHSA program (the University of Massachusetts at Amherst) on their perception of the appropriate curriculum content for financial analysis. The most important conclusion of this study is the discovery that the long-accepted schism between school of public health and school of management programs does not exist. There are far more similarities than differences, at least in terms of financial management and economics. Financial analysis is a broad area and at present a great amount of diversity among programs is acceptable. The accreditation process may require narrower standards for this important content area.

Curriculum↗
PubMed1983

Location decisions of National Health Service Corps physicians.

Results of a survey of 100 National Health Service Corps (NHSC) physicians in 10 east coast states (94 per cent response rate) indicate that 56 have plans to locate in a rural area after their service obligation is complete and 15 have not yet decided. Those who decide for a rural practice value personal and community factors to a higher degree than professional factors and are more likely to have a primary care practice.

Career Choice↗
PubMed1983

Treatment of obesity in three rural primary care practices.

The experience of three rural primary care practices in treating obesity is described. Treatment alternatives utilized include behavior modification with a balanced deficit diet, use of the protein-sparing modified fast in a group setting, and use of this technique in conjunction with behavior modification on an individual basis. The results of these three case studies are evaluated by an index approach as well as the traditional mean pounds lost. Although treatment of obesity is often avoided because of reported low success rates, this study demonstrates that a family physician has more success than previously reported, with one of the sites showing maintenance of weight loss in 84 percent of a selected group of its patients.

Adolescent↗
PubMed1981

Statistical analysis of an attitude scale to measure patient satisfaction with medical care.

Patient satisfaction with medical care is concept that is viewed as important to consider but difficult to measure. The most widely reported and most standardized measure of patient attitudes toward medical care is the scale developed by Hulka et al. The purpose of this article is first to present the results of three separate administrations of this scale and, second, to detail the statistical analysis performed using these data sets. The results of these three administrations show remarkable similarity of results, thus leading to an inference of high reliability. Through the statistical analysis of the validity of the scale, however, it is demonstrated that further work is needed before the attitude scale can be generally used. The three phases of the statistical analysis include an item analysis, a Guttman scalogram analysis and a factor analysis. The results of these three validity analyses do not support the attitude scale in its current form. The result of this work leads us to conclude that this attitude scale is not ready to be used in a community setting for predictive purposes, as has been suggested. Our results indicate that further revision and analysis are necessary before we can approach a valid as well as reliable attitude scale to measure patient satisfaction with medical care. Although this suggests the need for extensive theoretical research, the effort is clearly worthwhile, as a valid and reliable measurement of patient satisfaction will provide us with invaluable insights into the process of health care delivery.

Consumer Behavior↗
PubMed1981

The cooperative information project: Part 2: some initial clinical, quality assurance, and practice management studies.

Many of the obstacles inherent in the conduct of primary care research have been overcome by an experimental program in northern New England, the Primary Care Cooperative Information Project. This project uses a medical information network in 44 rural medical practices to carry out both clinical and management research. This paper describes the developmental problems encountered and the results of some initial clinical, quality assurance, and practice management studies conducted by the network and presents observations on its future research directions.

Adolescent↗
PubMed1981

The Cooperative Information Project: Part 1: A sentinel practice network for service and research in primary care.

This is the first of two papers describing the Primary Care Cooperative Information Project (COOP Project), a program that integrates the interests of community physicians, medical school faculty, and health policymakers. This integration has been accomplished through the uniting of 44 rural medical practices in Maine, New Hampshire, and Vermont with faculty at Dartmouth Medical School in clinical research, quality assurance, practice management, and continuing medical education activities. This paper describes the structure, goals, and history of the COOP Project, together with the design, cost, and output of its computerized medical information system.

Family Practice↗
PubMed1979

Changes in patient perceptions toward a family practice: a case study.

This paper presents the results of an evaluation of a family practice that focuses on changes in patient perceptions over five years. The evaluation includes an analysis of patient attitudes as well as behavior. Patient attitudes are measured by means of a personal interview and behavior is analyzed by creation of a Family Utilization Index. Significant changes are noted in the areas of both reported and actual utilization, with fewer changes in the areas relating to patients' perceptions of health and illness or in attitudes toward either the model of family practice of the specific site of obtaining care. This is not a definitive model for evaluation of family practice, but it is one of the few empirical studies available and suggests the need for more documentation of the effectiveness of family practice as a model for delivering primary care services.

Adolescent↗
PubMed1978

Measurement of work satisfaction among health professionals.

This paper describes a three-year research project that investigates the concept of occupational satisfaction of health professionals and suggests a method of measuring their level of occupational satisfaction. Additionally, the research examines factors defining occupational satisfaction important to health professionals. This process involves the development of a scale that measures the relative importance of various components of satisfaction, attitudes toward these components, and a weighted Index of Work Satisfaction. The methodology utilized in the development of this scale in an institutional setting with a sample of nurses is described, along with the transfer of this scale to three categories of health professionals involved in an outpatient setting. Responses from the physicians, nurses, and support staff in the ambulatory setting and responses from the hospital nurses indicate that the scale does measure occupational satisfaction of health professionals both in institutional and noninstitutional settings. Finally, statistical analysis of the original scale is reported and a revised scale is suggested for wider use.

Group Practice↗
PubMed1978

Toward the evaluation of family practice: development of a family utilization index.

This paper describes a research project that establishes criteria for utilization patterns of a family practice that could be used to develop evaluation techniques for family practice as a method of delivering primary medical care. The criteria are summarized in a Family Utilization Index, which measures the utilization patterns of a family unit. Changes in the Utilization Index are compared over a five-year period. Changes in attitudes and opinions about family practice in general and the specific Family Medicine Clinic are also compared over time and related to changes in the Family Utilization Index. Utilization patterns have significantly shifted over a five-year period, with more total visits to the clinic due to an increase in the number of family members per family unit using the clinic. Both the utilization patterns and attitudes toward the role of the family physician have shifted, indicating an increased acceptance of family practice.

Adolescent↗
PubMed1977

Appointment-keeping behavior re-evaluated.

Many of the traditional approaches to the problem of appointment-keeping behavior have ignored the organizational factors that may be implicated in differentially high broken appointment rates leading to an implicit assumption that low-income and ethnic minority patients will be more likely to break appointments. A case study at a Model Cities Health Center which maintains a kept appointment rate of 85 per cent examined the relationship of broken appointments to age, sex, ethnic background, and payment mechanisms. The results suggest alternative explanations for differentially high broken appointments centering on the role of the institution in reinforcing appointment-keeping behavior.

Adult↗
PubMedDate not supplied

Measuring patient satisfaction.

Though there is some controversy concerning how much weight patient perceptions should be given, there is no question that they must be considered. Focusing on patients in the ambulatory care setting, the author offers practical notes on measuring patient satisfaction based on her experiences at five sites over the past eight years. General methodological considerations are provided, including where and how to interview patients, as well as specific examples of types of measurement instruments and the results to be obtained. Findings of satisfaction surveys can be useful in altering the services provided in an effort to more adequately meet patient needs.

Ambulatory Care Facilities↗
PubMedDate not supplied

Nurses' satisfaction with their work situation.

Although job satisfaction is related to performance within the work setting, precise definitions and methods of measuring satisfaction are lacking, especially in medical settings. This article describes a two-year research project that investigated the concept of occupational satisfaction and methods of measuring this concept among in-and outpatient nurses. The Index of Work Satisfaction, a scale that measures relative importance of various components of satisfaction and attitudes toward the components, as well as an overall summary score, was developed. Methodology of the scale development, utilizing hospital nurses and nurses involved in a private group-practice setting, is described. Analysis of the responses from the nurses indicated that the scale measured occupational satifaction of nurses in both settings.

Attitude of Health Personnel↗