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Biomedical subjects

R B Hays

Publications and source records attributed to R B Hays.

At least 19 recordsLinked to original sources
PubMed1995

Developing group practices: a management challenge.

The advantages and disadvantages of forming larger professional practices are often debated. This paper reports an exploration of the issues through three case studies involving clusters of Sydney general medical practitioners who had expressed a desire to amalgamate their solo or small group practices. Their most frequently stated goals were to reduce financial overheads, to improve the range of services offered to their patients and to improve the opportunities for recreational and study leave. Several barriers to successful amalgamation were identified, and methods of overcoming these were explored. Practices can successfully amalgamate, but only where there is a group of like-minded general practitioners who are willing to invest time to achieve mutually agreed objectives. Amalgamation will not be appropriate in all circumstances. Larger group practices should benefit from the employment of a professional practice manager. These findings may be relevant to veterinary and dental practices.

Animals↗
PubMed1994

Forming large group practices: is it worth it?

OBJECTIVE: To investigate means of successful general practice amalgamation. PARTICIPANTS: Three clusters of Sydney general practitioners who wished to amalgamate their solo or small group practices. DESIGN: Structured interviews were conducted with individual general practitioners and group meetings were held with members of each cluster. RESULT: Successful amalgamation of solo/small practices starts with choosing compatible participants. Next, aims must be agreed upon and clearly spelt out. Commonly expressed goals of amalgamation were to reduce financial overheads, improve the range of patient services and increase opportunities for recreational and study leave. Financial and legal aid is essential for intending amalgamators. "Trial amalgamation" may be a safe option for those uncertain as to whether to commit themselves and their practices. CONCLUSIONS: Practices can successfully amalgamate, but only with a group of like-minded general practitioners who are willing to invest time to achieve mutually agreed objectives. Amalgamation is not always appropriate.

Attitude of Health Personnel↗
PubMed1994

Training for rural general practice.

OBJECTIVE: To identify requirements for vocational training and continuing education programs in rural general practice. DESIGN: A questionnaire was sent to all 487 rural doctors and 140 metropolitan and 140 provincial city general practitioners (GPs) in Queensland. A sample of medical educators, health professional and consumer representatives and rural doctors was also interviewed. Responses were compared by geographical area, practice characteristics and level of postgraduate training. RESULTS: There are significant differences between rural and urban practice profiles. Rural doctors have to practise a range of clinical skills in an environment with restricted access to health professional support, although the need for advanced training in procedural or other skills depends on the type of rural practice. Rural and urban doctors want more influence in determining continuing medical education (CME) programs. Interactive learning methods were rated as the most effective education methods by both rural and urban GPs. Rural doctors were less likely to consider that they spent enough time on CME. CONCLUSION: Vocational training programs should accommodate various rural career objectives, including those requiring advanced levels of procedural work. There is a significant unmet demand for CME tailored to the needs of individual doctors, both rural and urban, but distance and isolation may make this more critical in rural practice. These issues need to be addressed as training opportunities can contribute to improved retention of the rural medical workforce.

Australia↗
PubMed1994

Identifying helpful and unhelpful behaviours of loved ones: the PWA's perspective.

Twenty-five gay men with AIDS were interviewed about their social support networks and asked to describe specific interpersonal exchanges with network members which they perceived to be helpful and unhelpful. Content-analysis of responses revealed 12 main categories of helpful behaviours (providing encouragement, companionship, information, practical assistance, material aid, philosophical perspective, support for other network members, expressing concern, sharing feelings, acting as role model, allowing reciprocity, interacting naturally) and 11 categories of unhelpful behaviours (pessimism, physical avoidance, criticizing one's response to AIDS or medical treatment, making unreasonable demands, patronizing attitude, rude comments, insincerity, breaking confidentiality, acting judgmental or ashamed). The perceived helpfulness of particular behaviours varied depending on which network member performed them and the timing of the support attempt. Implications for increasing the effectiveness of support attempts by network members are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A sampling framework for rural and remote doctors.

A pilot survey by telephone interview, followed by a questionnaire of all rural doctors identified in Queensland, was used develop both a definition of rural practice that distinguishes it from urban general practice and a classification of rural and remote practice which assists in sampling of rural doctors. Questionnaire responses in specific geographic areas were compared using chi-square and Mantel-Haenszel chi-square tests. Several factors were found to differentiate rural from urban general practice consistently, thereby enabling a functional definition of rural practice to be developed. Within the broad group of rural doctors, gradients in practice characteristics were found to differentiate doctors in larger rural centres from those in smaller, more remote communities. These gradients were related to the distance and time of travel from support services. They formed the basis of a complex classification of rural and remote general practice. This functional definition of rural and remote medical practice should be considered by researchers of rural medicine issues when sampling rural and remote doctors. The strategies used in this study could be adapted for use in considering practice characteristics of other rural health professions.

Humans↗
PubMed1994

Training by helicopter. Extracts from a rural medical educator's notebook.

This paper reports the experience of one visiting clinical teacher on a teaching visit to a trainee rural doctor in the remote tropical north. Such teaching visits are interesting, may be adventurous and are always welcomed by trainees as they may have limited opportunities to discuss challenging clinical issues with other doctors.

Family Practice↗
PubMed1992

Social support, AIDS-related symptoms, and depression among gay men.

This study examined the impact of social support and HIV-related conditions on depression among 508 gay men participating in the San Francisco Men's Health Study, a population-based prospective study of single men aged 25-54 years. The number of HIV-related symptoms experienced significantly predicted depression cross-sectionally and 1 year later. Satisfaction with each of three types of social support (emotional, practical, informational) was inversely correlated with depression. Men who were more satisfied with the social support they received were less likely to show increased depression 1 year later. Degree of satisfaction with informational support appeared especially critical in buffering the stress associated with experiencing HIV symptoms. These findings offer valuable insight in understanding the psychological needs of gay men confronting the AIDS crisis and have important practical implications for designing mental health services to meet those needs.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Teaching health promotion and illness prevention to trainee general practitioners.

This study demonstrates that the provision of feedback based on the observation of videotaped consultations can be used to increase self-awareness of deficiencies in health promotion and illness prevention skills. Trainee general practitioners were found to have some awareness of deficiencies in this important aspect of general practice, and this awareness increased as a result of self-observation and the feedback. Performance was self-evaluated to be better at the end of the general practice term than at the beginning.

Australia↗
PubMed1990

A training programme for rural general practice.

An improvement in methods of training graduates for general practice has been recommended as a result of several investigations into the problems faced by rural medical practitioners. This paper describes a rural vocational training programme conducted by the Family Medicine Programme in North Queensland. The programme combines educational support, professional support and mentorship with a medical educator experienced in rural practice. The educational support is partly chosen by members of the rural group, and is designed to meet needs of group members and the communities they serve. The cost of such a programme is high, due to travel and communication over long distances, but is justifiable if it improves recruitment and retention of rural practitioners.

Clinical Competence↗
PubMed1990

Analysis of videotaped consultations to certify competence.

The assessment of videotaped genuine consultations in order to provide feedback to the learner is now a well accepted part of postgraduate training for general practice. This article reports on a pilot study which investigates the adaptation of videotape assessment of genuine patient consultations as an alternative to the present simulated patient interview segments of the examination for Fellowship of the Royal Australian College of General Practitioners. In particular, the study addresses: the feasibility and cost of collecting and assessing a suitable range of videotaped consultations using portable videocamera equipment and remote examiners; the interobserver reliability of four independent examiners; and the correlation between scores on two different rating scales. The results demonstrate that the assessment of videotaped genuine consultations has the potential to become a means of end-point assessment of clinical competence. The problem of how to collect videotapes of a suitable range and number of consultations to permit a candidate to demonstrate proficiency needs to be addressed and will be followed up in a trial of the method during 1990.

Australia↗
PubMed1990

Help-seeking for AIDS-related concerns: a comparison of gay men with various HIV diagnoses.

Examined help-seeking and psychological distress among four groups of gay men (30 AIDS-diagnosed, 107 HIV-seropositive, 149 HIV-seronegative, 244 untested) in the AIDS Behavioral Research Project, a longitudinal survey of San Francisco gay men. The men reported high levels of anxiety, depression, and help-seeking from their social networks. AIDS-diagnosed and HIV-positives reported the most AIDS worry and were the most likely to seek help. High percentages of AIDS-diagnosed men sought help from all sources (peers, professionals, family), whereas nondiagnosed men were more likely to seek help from peers. Regardless of the men's HIV status, peers were perceived to be the most helpful source. Family members were less likely sought and perceived as least helpful. The strengths and limitations of peers as social support providers for AIDS-related concerns are discussed, including implications for the design of community programs to enhance the abilities of peer helpers.

Acquired Immunodeficiency Syndrome↗