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Biomedical subjects

R Schneeweiss

Publications and source records attributed to R Schneeweiss.

9 recordsLinked to original sources
PubMed1992

Rural training tracks in four family practice residencies.

The use of rural training tracks (RTTs) in family practice residencies is a new strategy (beginning in the late 1980s) to increase the number of residents selecting rural careers. The authors describe the four residencies (in Washington, Nebraska, New York, and Kentucky) that have established RTTs. The first residency year is completed in an urban tertiary care center, and the second and third years are completed in a distant rural community wherein the primary faculty are the members of a rural family practice group. Inpatient experience for the residents is provided by community hospitals that offer obstetrics, emergency room care, and first-line critical care. The residents' training is supplemented by specialty faculty practicing in the rural communities. The curricula are highly structured and are evaluated to ensure training experiences of high quality. The RTTs' financial support comes from state initiatives, hospital reimbursement, recruitment budgets, and outpatient care revenues. The authors conclude that the RTT concept has the potential to lessen the shortage of rural physicians.

Family Practice↗
PubMed1991

Recruiting physicians to rural practice. Suggestions for success.

Medical school graduates from 1986 to 1988 and current residents in 12 family practice residency programs in the Northwest (N = 302) were surveyed to identify important factors in the recruitment process for their first postresidency placement. The study sought to compare the recruitment practices of rural communities and urban sites. Specific questions addressed in the study concerned sources of information about practice opportunities, stage in training when job search was initiated, factors related to unsuccessful site visits, and activities scheduled in the visit. Results indicated that referrals from faculty were the most valued source of information. Most job searches were initiated in the first 6 months of the third year in training. An unreceptive physician community and a reluctant spouse or partner were substantial problems for residents making site visits to rural communities. Rural sites tended to provide a broader mix of professional and personal activities during the visit.

Career Choice↗
PubMed1991

A system for drug utilization review in ambulatory care.

BACKGROUND: It is more difficult to conduct drug utilization reviews in ambulatory care settings than in inpatient care settings. This is true for several reasons: it is harder to identify outpatients who are receiving specific medications; often there is less evidence on which to base clinical standards for drug use; and it is more difficult to ensure patient compliance with drug therapy. METHODS: This article describes a drug utilization review system designed to operate in ambulatory care clinics. The system consists of (1) a computerized database for efficient identification of patients who receive prescriptions for a specific medication, (2) clinic-wide consensus guidelines, (3) reminders in the medical record, (4) regular chart audits, and (5) feedback to physicians. RESULTS: Experience in monitoring the use of serum theophylline assays illustrates how this system can be used in an ambulatory care clinic. According to guidelines adopted in our clinic, overuse of assays is not a problem. The system of physician reminders and chart audits can help prevent underuse. CONCLUSIONS: Despite the difficulties in conducting drug utilization reviews in the ambulatory setting, a system based on clinic-wide guidelines is feasible and should be an integral part of quality assurance programs.

Adolescent↗
PubMed1977

A conversion code from the RCGP to the ICHPPC classification system.

Faculty members from four family medicine training programs participated in the production of a definitive conversion of the Royal College of General Practitioners Classification of Diseases as modified for use with problem-oriented medical records (RCGP) to the International Classification of Health Problems for Primary Care (ICHPPC). The method used to produce the conversion and the several problems encountered are described. A detailed translation with the appropriate ICHPPC equivalent for each RCGP diagnostic title and code number is provided.

Disease↗
PubMed1975

A computer-administered interview on life events: improving patient-doctor communication.

A computer-administered interview on life events (CAI-LEV) was developed for use by patients in the waiting room of the model family practice unit at the Medical University of South Carolina, Charleston, South Carolina. Computer printouts of CAI-LEV are immediately available for doctor/patient communication, so that CAI-LEV fits into ongoing patient flow and care. Throughout a three-month study, confidentiality of information was protected by the use of numbers for patient responses to questions in 16 areas covering a wide range of possible life events. The adept physician can utilize the printout to assess stress in the patient's current situation, to focus quickly on any particular area of concern, or to initiate a counseling session. Of some 250 completed interview, 93 have been reviewed by residents and faculty after in-depth utilization during patient care. Of these 93 physician-evaluated interviews, 40 percent yielded important new information, while in 22 percent of the cases, doctor/patient communication was improved.

Adult↗
PubMedDate not supplied

How family physicians choose an office computer system.

BACKGROUND: Purchasing an office computer can be time consuming and frustrating. Financial costs and time demands make it difficult for the family physician, especially in solo practice, to follow the many recommendations offered in the literature. The purpose of this study was to identify the most helpful selection factors used by family physicians who had already purchased an office computer. METHODS: In May 1990 an 18-item questionnaire was mailed to a random sample of 26 percent of the 1167 active members of the Washington Academy of Family Physicians. A final response rate of 45 percent was achieved. Twenty-three percent of the nonresponders were contacted to obtain information about practice demographics and office computer status. RESULTS: Seventy-three percent of responders reported using a computer in their practice. The mean cost ranged from $17,300 for solo practitioners to $55,000 for multispecialty groups. Respondents who reported performing a prepurchase needs assessment, involving the office staff in the decision process, and making cost comparisons were more satisfied with their computer systems than those who did not (P less than 0.05). Satisfaction and acceptance were lower and negatively related to an increasing amount of time needed for the system to become fully operational (P less than 0.01). The level of involvement by the practitioner in the decision process was highly predictive of satisfaction with a computer system: those physicians who were most involved were also the most satisfied. CONCLUSIONS: Family physicians responsible for selecting an office computer for their practices are advised to become personally involved in the decision process, evaluate the practice's needs and goals, involve the office staff, and compare costs before choosing a system. A set of guidelines for selecting an office computer is presented.

Computer Literacy↗