Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Family Practice”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Oral health practices among adolescents: a study from family practice clinics in Israel.

Dental caries and periodontal disease are highly prevalent among adolescents. Preventive dental visits and proper oral health practices effectively reduce the occurrence of these entities. The objective of this study was to determine the rates of tooth brushing, flossing, and visits to dentists and hygienists among Israeli adolescents in a family practice setting. One hundred and eighty-four 7th and 10th graders who attended preventive health visits completed questionnaires that included questions regarding dental visits and personal oral health habits. Structured counseling by the family nurse was provided following completion of the questionnaire. Ninety-seven percent of the teenagers brushed their teeth at least once a day, but only 7% used dental floss daily, 44.5% never flossed, and another 10% didn't know what dental floss was. Eighty-three percent had visited a dentist, but only 33% had been to a dental hygienist in the past two years. Twenty-nine percent did not know what a hygienist was. We conclude that primary care providers can promote oral health by screening and providing counseling to their adolescent patients.

Adolescent↗
PubMed1993

Nutrition knowledge and practices of physicians in a family-practice residency program: the effect of an education program provided by a physician nutrition specialist.

The purpose of this study was to determine the effects of a nutrition-education program provided by a physician nutrition specialist in a family-practice residency program on residents' and faculty members' nutrition knowledge and nutrition-related patient care, their patients' perceptions of the importance of nutrition, and the physicians' dietary patterns. The nutrition specialist provided recommendations for nutrition patient-care practices to the physicians for 6 mo. Pre- and post-intervention assessments included 1) nutrition exams for physicians and patients, 2) patient questionnaires concerning attitudes towards nutrition, 3) chart reviews, and 4) diet records for physicians. The educational intervention caused a small but statistically significant (P < 0.01) increase in physicians' nutrition-knowledge scores and a significantly higher (P < 0.05) frequency of physicians discussing nutrition and recommending diets for their patients. Effects were greater among residents than among faculty members. The results suggest that a physician nutrition specialist can provide effective nutrition education within a residency program.

Diet Records↗
PubMedDate not supplied

Longitudinal residency training: a survey of family practice residency programs.

BACKGROUND AND OBJECTIVES: Most family practice residency training consists of 2-4-week block rotations in specific curricular areas, supplemented by training in the family practice center. An alternative model, longitudinal residency training, emphasizes training in curricular areas over a 3-year time period. This study determined the frequency of longitudinal training in family practice residency programs. METHODS: We conducted a survey of 477 residency program directors listed in the American Academy of Family Physicians 2000 Directory of Family Practice Residency Programs. RESULTS: Sixty-eight percent (n=320) of program directors responded to the survey. A total of 3.6% of program directors described their program as "mostly longitudinal," and 14.2% described their program as "half block/half longitudinal." An additional 15% of program directors indicated interest in adopting or moving toward a longitudinal program in the next 2 wears. Responses suggest some inconsistencies in program directors' understanding of what constitutes a longitudinal curriculum. CONCLUSIONS: Longitudinal residency training is reported in 18% of family practice residency programs. Further work is needed to develop a definition of longitudinal residency training.

Adult↗
PubMed1979

Integrating hospital and family practice posts in vocational training for family medicine.

Postgraduate training programmes for family medicine are developing simultaneously in many different parts of the world. In the UK continuity of care is highly valued but vocational training schemes have not been able to provide continuity of care for patients throughout a three-year training course.In Puerto Rico a vocational training scheme exists in which residents are enabled to integrate their hospital and family practice work throughout a three-year course. This arrangement is described and compared and contrasted with vocational training in the UK.

Continuity of Patient Care↗
PubMed2006

Alternative models for academic family practices.

BACKGROUND: The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-supporting practices, but seek support from specialty colleagues or hospital practice plans. Alternative models for academic family practices that are economically viable and consistent with the principles of family medicine are needed. This article presents several "experiments" to address these challenges. METHODS: The basis of comparison is a traditional academic family medicine center. Apart of the faculty practice plan, our center consistently operated at a deficit despite high productivity. A number of different practice types and alternative models of service delivery were therefore developed and tested. They ranged from a multi-specialty office arrangement, to a community clinic operated as part of a federally-qualified health center, to a team of providers based in and providing care for residents of an elderly public housing project. Financial comparisons using consistent accounting across models are provided. RESULTS: Academic family practices can, at least in some settings, operate without subsidy while providing continuity of care to a broad segment of the community. The prerequisites are that the clinicians must see patients efficiently, and be able to bill appropriately for their payer mix. CONCLUSION: Experimenting within academic practice structure and organization is worthwhile, and can result in economically viable alternatives to traditional models.

Academic Medical Centers↗
PubMed2002

An observational study of precepting encounters in a family practice residency program.

BACKGROUND AND OBJECTIVES: Family practice residents spend substantial time in their family health centers. Little is known about the area of focus of discussions between preceptors and residents. In this study, we describe the percentages of time that preceptors spent in various focus areas in one family practice residency program. METHODS: We conducted a direct observational study of four purposefully selected half-day sessions, one at each of four continuity sites, which included 80 precepted encounters and 451 minutes. Percentages of precepting time were calculated by overall, by common or uncommon diagnoses, by postgraduate level, and by clinical or academic faculty. RESULTS: Preceptors discussed diagnosis or management 90% of the time; use of consultants and tests 6%; pathophysiology, pharmacology, other basic science 2%; and psychosocial factors 2%. There were no significant differences between percentage of time spent in each of the focus areas when comparing clinical to academic faculty or postgraduate year (PGY)-1, PGY-2, and PGY-3. Precepting about common problems had a higher percentage of time devoted to psychosocial issues than did precepting about uncommon problems (3.8% versus .4%). CONCLUSIONS: Preceptors focused on diagnosis and management in this family practice residency program. Further study is needed to determine if this unbalanced focus is a problem or is present in other programs.

Academic Medical Centers↗
PubMed1980

Public policy implications of graduate follow-up studies in family practice.

An assessment of the progress of family practice over the last ten years, from the point of view of public policy analysis, finds that family practice has adequately and successfully addressed the majority of the policy issues of concern to its major constituencies in the early 1970s. The decade of the 1980s finds family practice as a vigorous, thriving specialty, which has met many of the early expectations of its supporters. Now, however, because of its own growth and the changing environment of medical practice in the United States, family practice faces a broad range of expectations and policy challenges from a wider, and in some cases more hostile, constituency.

Family Practice↗
PubMed1996

Comparison of female and male graduates of southern Appalachian family practice residencies.

PURPOSE: One aim of Southern Appalachian family practice residencies is to produce graduates for surrounding physician-needy areas. Some evidence suggests that women are less likely to go to rural areas and that they practice differently than men. This study investigated the practice patterns and location of Appalachian family practice residency female and male graduates. METHODS: Surveys were sent to graduates of seven family practice residencies from 1984 to 1994 in the Southern Appalachian area to determine practice patterns, locations, and reasons for choosing practices. RESULTS: Women were more likely than men to be single and not to have children. More women worked part-time. Women's and men's practice patterns and characteristics were similar except that women were more likely to provide prenatal care and do vaginal deliveries. Women in similar percentages practiced in small towns, and a greater percentage of women practiced in rural areas with populations of less than 2,500. CONCLUSIONS: Female family practice residency graduates from Appalachian residencies are fulfilling the purposes of their residencies as well as male graduates, although more of them are working part-time.

Appalachian Region↗
PubMed2001

Impact of managed MediCal on California family practice programs.

BACKGROUND: An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. OBJECTIVE: To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. DESIGN: A cross-sectional, retrospective descriptive survey. METHODS: A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. RESULTS: Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. CONCLUSIONS: The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.

California↗
PubMed1993

Attitudes of graduating seniors at one medical school toward family practice.

BACKGROUND AND OBJECTIVES: Senior medical students' interest in family practice as a career choice has declined in recent years. METHODS: A questionnaire about attitudes toward family practice was mailed to the 1990 graduating class at the University of Maryland (N = 143), and 84 completed questionnaires were returned (59% response rate). RESULTS: Seniors believed that family practice was challenging (89%) and had intellectual content (integrity) comparable to other specialties (81%). Furthermore, students believed that family physicians provided comprehensive care (88%), were not replaceable by other health professionals (86%), and were able to keep abreast with technological medical advances (52%). However, only 4% of the graduating seniors selected family practice as a career. Most students believed that family practice lacked prestige (82%), and about one half (55%) believed that it was too broad in scope. CONCLUSIONS: Lack of prestige, stressful life-style, difficulty in mastering medical knowledge, and poor potential income were the main reasons given by students for not selecting family practice.

Adult↗
PubMed1982

Patterns of health care utilization in an academic family practice.

The theoretical model of family practice is one of primary, comprehensive, and continuous care to families. This model is not yet fully documented. In a test of a model's reality, 130 regular users of an academic family practice were surveyed. Eighty-two (63 percent) identified the practice as their usual source of care. Projected use of the practice within this subset ranged from 100 percent for general health examination to 20 percent for marital/sexual problems. Only 35 percent of the other 156 members of these 82 patients' households were said to use the practices as their usual source of care. To the extent that these findings can be generalized to other settings, it can be concluded that the health care utilization patterns of family medicine patients and their immediate family members fall short of specialty's expectations.

Adolescent↗
PubMedDate not supplied

Characteristics of medical students by level of interest in family practice.

BACKGROUND AND OBJECTIVES: This study provides information on student factors associated with a career choice in family practice. METHODS: Information was used from multiple surveys completed by medical students, including the Premedical Questionnaire, the Matriculating Student Questionnaire, and the Graduation Questionnaire, as well as information from residency directors about residents in the Graduate Medical Education Tracking Census. These questionnaires are all a part of the Student and Applicant Information Management System of the Association of American Medical Colleges. Participants were 30,789 students graduating from US medical schools in 1991 and 1992. Comparisons were made between longitudinal student responses on the surveys to four types of outcomes. RESULTS: A total of 1,029 (3.3%) students were in the "Maintained" group (students who originally planned to enter family practice and were in a family practice residency at postgraduate year 1; 1,958 (6.4%) were "Gained" (originally chose a specialty other than family practice but entered a family practice residency); 1,950 (6.3%) were "Lost Interest" (originally identified family practice but entered another residency-two thirds of whom selected non-primary care specialties); 21,573 (70.1%) were "Never Interested" (did not express an early interest nor select a family practice residency); and the remainder (13.9%) had incomplete specialty data. Of those originally interested in family practice, 34.5% entered family practice residencies. Only 8.3% of those not originally interested entered family practice residencies. The four groups of students differed on many demographic, attitudinal, and experiential characteristics. Prestige, income, opportunities for research, and faculty status were more important to future specialists, while emphasis on primary care and prevention and practice in smaller communities were more important to the future family physicians. CONCLUSIONS: Medical schools could potentially increase the number of students selecting family practice residencies through both admissions policies and medical school experiences. These data provide some specifics on how to recruit students and prevent loss of those originally interested in family practice.

Adult↗
PubMed1979

A study of family practice in Wisconsin.

Studies of family practice in Wisconsin and elsewhere show that the clinical content of family practice has about 20 to 45 patient contacts per day and about two to six diagnoses per patient contact. Seventy-five percent of patient contacts are in the office and on the telephone, 15 to 20 percent in the hospital, and 5 to 10 percent elsewhere. There is a broad array of patient problems. Special Conditions and Examinations Without Illness contain the largest number of patient problems. About 60 percent of patients are female and present more endocrine and genitourinary problems. Men present more trauma, circulatory, and respiratory problems, and less health maintenance care. Well-baby and well-child examinations stop at age 15 years. Pre and postnatal care decline sharply at age 35 years, at which time surgical care increases. Infectious disease and trauma, ranking high in the young, are low in the elderly. Circulatory problems, obesity, diabetes, and arthritis increase greatly with age. There is no major difference in type of patient problems related to town size (ie, population). However, comparative studies may uncover different disease occurrence rates between regions.

Adolescent↗
PubMed2005

A randomized trial of mail vs. telephone invitation to a community-based cardiovascular health awareness program for older family practice patients [ISRCTN61739603].

BACKGROUND: Family physicians can play an important role in encouraging patients to participate in community-based health promotion initiatives designed to supplement and enhance their in-office care. Our objectives were to determine effective approaches to invite older family practice patients to attend cardiovascular health awareness sessions in community pharmacies, and to assess the feasibility and acceptability of a program incorporating invitation by physicians and feedback to physicians. METHODS: We conducted a prospective randomized trial with 1 family physician practice and 5 community pharmacies in Dundas, Ontario. Regular patients 65 years or older (n = 235) were randomly allocated to invitation by mail or telephone to attend pharmacy cardiovascular health awareness sessions led by volunteer peer health educators. A health record review captured blood pressure status, monitoring and control. At the sessions, volunteers helped patients to measure blood pressure using in-store machines and a validated portable device (BPM-100), and recorded blood pressure readings and self-reported cardiovascular risk factors. We compared attendance rates in the mail and telephone invitation groups and explored factors potentially associated with attendance. RESULTS: The 119 patients invited by mail and 116 patients contacted by telephone had a mean age of 75.7 (SD, 6.4) years and 46.8% were male. Overall, 58.3% (137/235) of invitees attended a pharmacy cardiovascular health awareness session. Patients invited by telephone were more likely to attend than those invited by mail (72.3% vs. 44.0%, OR 3.3; 95%CI 1.9-5.7; p < 0.001). CONCLUSION: While the attendance in response to a telephone invitation was higher, response to a single letter was substantial. Attendance rates indicated considerable interest in community-based cardiovascular health promotion activities. A large-scale trial of a pharmacy cardiovascular health awareness program for older primary care patients is feasible.

Aged↗
PubMed1985

The family and hypertension in family practice.

The influence of the family in the care of family practice patients has not been studied extensively. This study uses hypertension as an index condition to characterize the extent of involvement of family around family practice center (FPC) patients and to examine whether the presence of family members influences patient outcomes. Records of 366 hypertensive patients were reviewed for information about blood pressures, demographic characteristics, associated medical conditions, and treatment. Three hundred forty-three of these patients responded to questions about family members, including their use of the FPC and whether they also had hypertension. Twenty percent of patients lived alone. Of the rest, two thirds had some, and one half had all family members enrolled in the FPC. Seventy-three listed family with hypertension, and 42 said these relatives were treated at the FPC. At the time of the first visit to the FPC for hypertension, the mean diastolic blood pressure was 93 mmHg. At their most recent visit, the mean was 83 mmHg, and 69 percent were below 90 mmHg. There was no association between blood pressure control and family enrollment in the FPC.

Adult↗
PubMed2002

The increase in international medical graduates in family practice residency programs.

BACKGROUND AND OBJECTIVES: The number of filled positions in family practice residency programs decreased by 18.6% from 1997-2001. This study sought to determine the degree of reliance on international medical graduates (IMGs) to fill family practice residency positions and the relative proportion of US citizen IMGs. METHODS: We analyzed the 1992-2001 National Resident Matching Program results, the 2000 American Medical Association Masterfile, and the 1992-2001 American Academy of Family Physicians Annual Survey of Family Practice Residency Programs. RESULTS: The percentage of IMGs matching in family practice remained stable between the years of 1992-1996 (10.0%-11.8%) but since 1997 has increased to a high of 21.4% in 2001. This rise in IMGs corresponds with a drop in the total percentage of family practice residency positions filled in the Match from 90.5% in 1996 to 76.3% in 2001. Despite the drop in Match numbers, the percentage of first-year family practice positions filled in July has remained in the range of 95.5%-97.8% since 1996. IMGs account for an increasing percentage of post-Match fills from 16.7% in 1996 to 47.9% in 2001. In 1999, a majority of family practice programs (279 [55.6%]), had at least one IMG. Of these, 48 programs (9.6%) had at least 50% of residents who were IMGs, and eight programs (1.6%) were entirely composed of IMGs. In five states (Connecticut, Illinois, Michigan, New Jersey, and New York), more than 25% of family practice residents were IMGs. CONCLUSIONS: Family practice is becoming increasingly reliant on IMGs to fill residency positions.

Career Mobility↗
PubMed1994

Christian mission hospitals as family practice educational resources.

With the worldwide family practice movement, a need has arisen to develop new residency training programs in economically developing countries. Christian mission hospitals exist in many areas where there is a need for more family physicians. These hospitals have been providing service and education, and some are now becoming training sites for family physicians. Currently, seven such institutions have operational family practice residency programs, all of which welcome personnel exchanges with faculty or residents in North American training programs. Christian mission hospitals with family practice residency programs exist in South America, Asia, and Africa.

Christianity↗
PubMed1980

Reliability of morbidity data in family practice.

Because of its relative youth, family practice research has not yet developed a tradition of proven research techniques. New techniques, even those already proven effective in other disciplines, must be evaluated in the family practice setting if the results that they generate are to have any credibility. The collection of morbidity data has become a major activity in family practice research, but this has occurred without sufficient examination of its reliability. Several problems, both potential and real, exist requiring more detailed scrutiny, discussion, and possibly action. These problems of recording, diagnosis, coding, and population, and their ramifications, are explored with the aim of stimulating such action and encouraging a rigorous approach to the collection, publication, and interpretation of morbidity statistics.

Diagnosis↗