Biomedical subjects
W R Phillips
Publications and source records attributed to W R Phillips.
Family physician beliefs about cancer screening. Development of a survey instrument.
To improve rates at which physicians provide cancer control procedures, it is first necessary to identify physician and environmental characteristics that explain variations in those rates. This study used an attitude-behavior model as a guiding framework to identify beliefs, sources of influence, facilitating conditions, and critical events that may be important determinants of physicians' rates for providing eight cancer control activities. Open-ended, semistructured interviews were conducted with 26 family physicians to discuss the factors that may have affected their policies for providing each of the eight cancer control activities. Content analysis of those interviews produced unique lists of beliefs, sources of influence, facilitating conditions, and critical events for each activity. These lists of factors are more comprehensive than those identified in previous studies. A questionnaire has been developed based on these findings, and a validation study is being conducted to identify the factors that best explain variation in rates at which cancer control activities are performed.
How patients and physicians address each other in the office.
Six hundred four patients in three primary care office settings were asked whether they preferred to be addressed by their physician by their first or last name and whether they preferred to address their physician by first or last name. Actual use of first vs last name by the physician addressing the patient and the patient addressing the physician was also recorded. Of the patients expressing a preference, 96 percent preferred that their physician address them by first name while 87 percent noted that this gesture actually occurred. Forty percent of the patients preferred to address the physician by first name while 14 percent actually did so. These findings suggest that physicians can feel comfortable addressing almost all of their patients by first name and that many of their patients may desire to address them by their first name. It is suggested that the physician at the time of the patient's first visit clarify the manner in which each addresses the other.
The quality of obstetric care in family practice: are family physicians as safe as obstetricians?
A literature review on the quality of obstetric care in family practice was conducted to determine whether family physicians are as competent in providing obstetric care as obstetricians. Three types of studies were reviewed: case series, historical cohorts, and population-based studies. No conclusion on the quality of obstetric care in family practice can be drawn from the available studies because of research design limitations. Available evidence suggests, however, that family physicians are as safe as obstetricians when delivering babies, particularly when they concentrate their efforts on providing personal prenatal care, refer high-risk pregnant women appropriately, and practice less technologically oriented care on women who deliver normal-weight babies. In addition, no evidence emerged that family physicians provided significantly poorer obstetric care than obstetricians. In fact, the results from population-based studies suggest that family physicians may be safer than obstetricians in delivering normal-weight infants because of their hypothesized less use of technological interventions in that low-risk group of patients. Further studies, especially prospective randomized trials in which the outcomes are assessed in a blinded fashion and case mix is rigorously controlled, are needed to provide a definitive answer. As practical, ethical, and economic constraints are likely to preclude such studies, the case-control design may provide a reasonable alternative.
Obstetrics in family practice: competence, continuity, and caring.
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Physician knowledge of risks of surgical and invasive diagnostic procedures.
Knowledge of the rates of major complications of surgical and invasive diagnostic procedures is essential to effective clinical decision making. A mail survey of 128 family or general physicians and general surgeons in Washington state tested their knowledge of the rates of death and major complications for ten procedures. Overall accuracy of physician knowledge was low, with 27% of responses correct, 26% underestimates, 27% overestimates and 21% admitting no knowledge. No significant differences in accuracy were found between specialty groups. Few associations were found between accuracy and physician board certification, years in practice or performance of the procedure. For every complication, many physicians made underestimation or overestimation errors by several orders of magnitude and a few consistently denied existence of any risk. Physicians could improve their knowledge of the rates of complications associated with procedures they carry out.
Psychological testing in family practice residency programs.
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Audit of obstetrical care and outcome in family medicine, obstetrics, and general practice.
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Attitudes toward social work in family medicine: a before and after survey.
An initial survey of attitudes among Family Medical Center staff rated social work as highly consistent with the values of family medicine, capable of competently addressing difficult problems, and contributing valuably to a team approach to continuous and comprehensive family medical care. After integration of a social worker into the practice, a repeat survey documented significant attitude changes, rating social work as more competent, passive, and difficult, and lowering the estimate of patients potentially helped by a social worker from 38 percent to 31 percent. Such attitudes may influence the evolution of the social worker's role in the family medicine patient care team.
On gonorrhea control programs.
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The interview in Family Practice Resident Selection.
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Pharmacological activity of coumarins isolated from Afraegle paniculata; Part II.
Xanthotoxin, xanthotoxol and marmesin, three coumarins isolated from Afraegle paniculata, have been treated for anti-inflammatory activity following oral administration. The investigations have shown that xanthotoxol and marmesin are devoid of such activity and that xanthotoxin has some activity. Xanthotoxin has been compared against aspirin.
The incidence of cytoplasmic and nuclear inclusions in nonspecific genital infections in men.
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