Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Private 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 235 records · Page 13Linked to original sources
PubMed2001

[Interviews with physicians in private practice as a starting point for quality improvement in hospitals].

Subjective criteria gain importance in care research and quality management. Therefore, psychiatrists in private practice and general practitioners working in the catchment area of a psychiatric hospital were surveyed by questionnaire evaluating expectations and satisfaction concerning their collaboration with the hospital. Psychiatrists and general practitioners rated legible interim discharge letters, good in-patient treatment, adequate diagnostics, and direct referral to the hospital as most important. Psychiatrists express dissatisfaction regarding prescription of expensive drugs, lack of involvement in planning new psychiatric institutions, delivery of discharge summaries, referring back the patient after in-patient care, and delay of hospital admission. As conclusion, quality management should pay more attention to ambulatory care physicians' points of view to reduce problems of interaction between clinicians and their colleagues in private practice and to improve the treatment continuity of psychiatric patients.

Aftercare↗
PubMed1998

[First annual report of practitioners of interventional cardiology in private practice in Germany. Results of procedures of left heart catheterization and coronary interventions in the year 1996].

The German Society for Cardiac Angiography and Interventions in Private Practice has started a registry of cardiac procedures since 1996 in order to establish a standard for performance. Although quality management for the cath lab makes sense and is also legally required, there is no generally recommended infrastructure for quality assurance existing in Germany at this time. Therefore, the German Society of Cardiologists in Private Practice (BNK) initiated a project in 1994 to develop a computer program for paperless documentation of diagnostic cardiac catheterizations and coronary interventions (PTCA) using a minimal data set. In 1996, 8 private associated groups participated in this project. The (anonymous) analysis of 10,316 diagnostic cardiac catheterizations and 2597 PTCA yielded the following results: In 95% of the patients, diagnostic cardiac catheterization was performed using the femoral and in 5% the brachial/radial approach. The mean volume of administered contrast medium was 164 +/- 138 ml/patient. The mean LV-EF was greater than 50% in 58.4% of the patients and between 30% and 50% in 10.1%. Coronary artery disease was diagnosed in 69.6% of the patients and valvular/congenital heart disease in 8.5%. In 18.4% of the patients undergoing diagnostic cardiac catheterizations no significant heart disease was identified. Mortality in the cath lab as well as the rate of cerebral insults was 0.05%. In 22.9% and 19% of the patients PTCA and cardiac surgery respectively was recommended. In patients undergoing PTCA, stable angina was present in 74.4% and unstable angina in 13.1%. Of the total number of PTCA procedures, 5.8% were performed in the setting of acute myocardial infarction. The PTCA lesion success rate was 96%, the mean diameter stenosis was 81% pre and 6% post-intervention. The mortality rate at 1 month post-PTCA was 0.4%, and myocardial infarction 1.0%. An acute occlusion occurred in 1.3% of the PTCA patients; 0.6% had to be transferred for emergency bypass surgery. None of the cath labs had on-site surgery. In comparison to other registries, our data show some similarities but also some different trends. Thus, our newly developed software proved to be reliable, fast and easy to use. Participating centers receive immediate feedback regarding their position within the whole group.

Angiocardiography↗
PubMed2001

[A proposed cooperation system between physicians in private practice and hospitals to prevent neglect of poor prognostic cases with mild urinary abnormalities].

Some outpatients with only mild urinary abnormalities have histologically active lesions. To prevent the progression of these lesions, they should not be overlooked at the initial diagnosis. For this purpose, I propose a new system of diagnostic cooperation between physicians in private practice and hospitals. A 50-year-old male showed proteinuria([symbol: see text]), occult blood([symbol: see text]), and one granular and red cell cast in the total fields in spot urine samples, a 24 hr urinary protein of 0.17 g, a serum creatinine of 1.2 mg/dl and a mean blood pressure of 112 mmHg at the first examination. Four months after the administration of an ACE-inhibitor, the urinary protein decreased to 0.04 g while the serum creatinine level increased to 1.5 mg/dl. Therefore, a biopsy was performed at Kyoto University Hospital. Twenty-one glomeruli were obtained revealing 6 with global sclerosis and 13 proliferative glomeruli, including 3 with crescentic and 4 with adhesive lesions. In addition, interstitial cell infiltration was observed. After treatment for active blomeruli lesions using prednisolone and warfarin, the 24 hr urinary protein decreased to 0 g and serum creatinine to 1.2 mg/dl, Since a correlation between the relative volume of the renal cortical interstitial involvement and the serum creatinine concentration has been reported, the possibility of glomerular-interstitial interaction was considered. Thus, to prevent the neglect of patients with apparently mild disease associated with a poor prognosis, I propose the establishment of a system of diagnostic cooperation consisting of physicians in private practice, general hospitals and central hospitals that can provide appropriate treatment principles and give instructions for patients with mild urinary abnormalities encountered in daily practice.

Biopsy↗
PubMed1993

Telephone medicine in a southern university private practice.

Routine, office-hour, patient-directed telephone calls to a general and multi-specialty-university, private-practice clinic were surveyed. The calls were short, averaging 1 to 2 minutes. Two-thirds of the calls concerned medications, and 13% were for new medical problems. Patients called with a variety of chronic conditions and less commonly for new problems. Medications such as antihypertensives, antibiotics, and diuretics were prescribed and refilled. The role of telephone medicine in providing access in some managed-care settings is yet to be studied.

Adult↗
PubMed1999

100 total laparoscopic hysterectomies in private practice in Brazil.

STUDY OBJECTIVE: To evaluate of 100 total laparoscopic hysterectomies performed in a private practice. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Private hospital. PATIENTS: One hundred women. INTERVENTIONS: Total laparoscopic hysterectomy (TLH). MEASUREMENTS AND MAIN RESULTS: The most common indications for TLH were chronic menorrhagia (uterine myomas), pelvic pain (severe endometriosis), and uterine enlargement. Four of our first 20 procedures were converted to laparotomy in which bipolar was used exclusively. In the others cases the Endo Gia stapler was used in the first step of the procedure (section of broad ligaments) in combination with bipolar coagulation. Mean operating time was 90 minutes (range 45-150 min) and hospital stay was 36 hours (range 18 hrs-2 days). The two intraoperative complications were hemorrhage requiring blood transfusion and a rectal injury; the four postoperative complications were two cases of vesicovaginal fistula, and one each of colonic vaginal fistula and vaginal cuff infection (total complication rate 5%). Ninety-six women returned to work in 2 weeks. CONCLUSION: Total laparoscopic hysterectomy can be performed safely and effectively when the surgical team is sufficiently trained and experienced in managing complications. We believe that it will become standard treatment for benign uterine disease. (J Am Assoc Gynecol Laparosc 6(2):169-171, 1999)

Adult↗
PubMed2000

Female vs. male outpatient depression: a 448-case study in private practice.

1. Aims of the study were to find the prevalence of female depression, and to study the differences between female and male depression, in private practice. Four hundred forty eight consecutive unipolar and bipolar II depressed outpatients were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery Asberg Depression Rating Scale, and the Global Assessment of Functioning scale. 2. Prevalence of female depression was 67.8%. Female to male ratio was 2:1. Among the variables investigated (age at intake, age at onset, duration of illness, severity, chronicity, psychosis, recurrences, atypical features, comorbidity), atypical features and comorbidity were significantly associated with female depression. 3. Private practice outpatient female depression (chronic, psychotic, or recurrent) was not more severe than male depression.

Adult↗
PubMed2006

[Effectiveness of antiviral therapy in patients with chronic hepatitis C treated by private practice gastroenterologists].

The standard treatment for patients with chronic hepatitis C consists of pegylated interferon (PegIFN) alpha in combination with ribavirin. Information on treatment effectiveness outside clinical trials is sparse. To study community-based health care, a regional network supported by the German network of competence for hepatitis (Hep-Net) was created between gastroenterologists in private practice and a tertiary referral centre. A treatment register containing evidence-based guidelines was established and 212 consecutive patients who were treated with either PegIF Nalpha 2a/ribavirin (n = 126) or PegIFNalpha2b/ribavirin (n = 86) for 24 weeks (HCV genotype 2, 3) and 48 weeks (HCV genotype 1, 4, 5), respectively, were included and followed prospectively. Twenty-four weeks after cessation of antiviral treatment a sustained virological response was achieved in 54 % of the patients. By univariate analyses, infection with HCV genotypes 2 or 3 (p < 0.0001), younger age (p < 0.0001), normal gamma-glutamyltransferase levels before initiation of treatment (p = 0.003), and absence of language communication problems (p = 0.023) were associated with a sustained virological response. The presence of liver cirrhosis in patients with HCV genotype 1, 4, 5 infection was associated with lower sustained response rates (p = 0.025). Patients infected with HCV genotype 1 in whom the PegIFNalpha dose was reduced had higher virological relapse rates (p = 0.049). With regard to the treating physician, sustained virological response rates ranged from 26 - 67 % in patients infected with HCV genotype 1. Our study shows that virological response rates similar to those in international randomised clinical trials can be achieved by private practice gastroenterologists. The presented network allows characterization of the treatment outcome in chronic hepatitis C not only with regard to virus- and host-related factors but also on an individual physician basis.

Adult↗
PubMed1982

Medicaid participation by psychiatrists in private practice.

Using national survey data, the authors examined the characteristics of psychiatrists in private practice who treat Medicaid patients. They found that the average Medicaid participation rate was 8%; 39.9% of psychiatrists did not see any Medicaid patients. Participating psychiatrists were more likely to be foreign medical graduates and to have a hospital-oriented practice. Psychiatrists with large Medicaid practices saw significantly more patients per week but spent less time with them. These psychiatrists were also disproportionately located in the West. The authors conclude that these variations are a result of state program differences in Medicaid reimbursement and eligibility policies.

Appointments and Schedules↗
PubMed1989

Smoking counseling and preventive medicine. A survey of internists in private practices and a health maintenance organization.

Physicians could help a large number of patients quit smoking by taking time to advise them about quitting, helping them plan a date to quit, giving them self-help materials, following up, and referring some to smoking cessation programs. To determine the attitudes and practices of internists concerning smoking cessation and selected preventive medical practices, we surveyed a random sample of internists in private practice and in a large health maintenance organization (Kaiser-Permanente Medical Group) in the San Francisco Bay area. Overall, internists consider counseling about smoking to be at least as worthwhile as many other practices, such as screening for breast cancer, and more worthwhile than periodic physical examinations. Despite these beliefs, 57% to 65% of internists reported that they spend two minutes or less counseling smokers during new patient visits. Many internists never use recommended strategies for counseling about smoking: 33% to 44% never help patients plan dates to quit, 68% to 75% never make follow-up appointments with patients primarily about smoking, and 27% to 48% never give smokers self-help pamphlets about quitting. Although they believe that counseling about smoking is worthwhile, internists are not doing as much as they could to help their patients quit.

Attitude of Health Personnel↗
PubMed2005

[Implementation and development of quality management in hospitals and private practice -- present state of the art].

Since 1. 1. 2004 both hospitals and private practices in Germany are required by law to implement a quality management (QM) system within their organization. Different QM systems with a number of advantages and disadvantages are available. It has been well-documented that implementing QM im-proves the quality of both processes and results, thus improving patient care. At present certification of the organization is not yet part of the official requirements, but seems a likely step.

Germany↗
PubMed1977

The effect of career change from private practice to full-time family practice faculty.

This study investigated the timing and extent of the emotional impact of the career change of 33 selected family physicians who, after at least 15 years in private practice, moved into full-time teaching and/or administration in a family practice residency program. Their intrinsic feelings of being enthusiastic, energetic, optimistic, and enjoying associates were all diminished during the first six months, dropped further in the second six months, but began to recover during the second year. Similarly the physicians' perception of their effectiveness in their new work -- confident, competent, and fulfilled -- was relatively low during the first six months, but began to rise during the second six months and again during the second year. A comparison is made between the responses of those who held positions as directors and those who were non-directors. Changes reported were less marked in those who became directors than in those who did not. Possible causes of this phenomenon are explored. Methods to soften the impact of the career change are suggested.

Career Choice↗
PubMed2006

Implementing evidence-based decision making in the private practice setting: the 4-step process.

An important goal of EBDM is to improve outcomes where it matters the most: at the point of care. All dental clinicians need practical tools that facilitate access to the clinical information needed to enable our patients to make better-informed choices. This article provides a 4-step guide for practical implementation of EBDM in the private practice setting. Step 1 is defining your practice purpose. Step 2 describes the use of Ethical Practice Parameters to guide clinical decision-making. Step 3 illustrates how to implement Ethical Practice Parameters. Step 4 describes a simple process for searching for scientific evidence. Online resources are provided and the benefits of the 4-step process are elucidated.

Crowns↗
PubMed1986

[Private practice].

Explore the source record for details and available documents.

Nursing, Private Duty↗
PubMed2003

STD trends and patterns of treatment for STD by physicians in private practice in Peru.

OBJECTIVES: To describe trends in STD visits to physicians in private practice in Peru over a 15 year period and in the patterns of treatments used for STD. METHODS: IMS Health conducts for pharmaceutical marketing purposes surveys of a random cluster sample of 1.63% of practising physicians in Peru, stratified by region and specialty. Physicians record details of diagnoses and treatments for all patients seen during a 7 day period every 6 months. Data collected on selected STD syndromes were retrospectively reviewed over a 15 year period. RESULTS: The number of first visits for pelvic inflammatory disease (PID) and trichomoniasis, and total visits for genital herpes increased from 1983-5 to 1996-7; while first visits for gonorrhoea and total visits for syphilis have changed little in recent years. Treatment for gonorrhoea usually involved the use of spectinomycin or an aminoglycoside only. Treatments offered for PID were remarkably inadequate and for trichomoniasis often involved products not known to be effective for trichomoniasis or other causes of vaginal discharge. CONCLUSIONS: This form of active surveillance provides information potentially useful to guide policies for prevention and management of STDs and HIV infections in developing countries.

Cluster Analysis↗
PubMedDate not supplied

[Physiotherapists in private practice in France].

In France, most of the physiotherapists providing ambulatory care are in private practice: they are paid on a fee-for-service basis by the patients who are reimbursed by the Sickness Insurance Fund. A survey on a sample of 2000 (out of 40,000) private practitioners was undertaken in early 2004. As concerns their workload, only 4% think that it is "not sufficient" whereas 66% estimate it "certainly sufficient". Such a feature is noteworthy, as private practitioners are most often fearful of lack of work. In the coming years, one physiotherapist out of 10 envisages to increase his workload, whereas 27% are in favour of a reduction. Furthermore, the survey shows that more than one third of private physiotherapists plan to offer to patients services which are not listed in the contractual agreement document signed by their profession and the Sickness Insurance Fund. The trend is most noticeable among the young practitioners. As the feeling of medical doctors shortage is currently widespread in France, the public debates are focused on the issue of task delegation. After the survey, 54% private physiotherapists are in favour of task delegation, 24% have an opposite opinion and 22% do not express a clear-cut position. However, an in-depth analysis of the written answers to the question shows that a large majority do not accept to replace medical doctors for performing the tasks which are of a subordinate level, are not significant or are time-consuming (e.g. filling out the administrative forms). The question of vocabulary is fundamental in the matter. Moreover, a process of task delegation implies that certain tasks carried out by an overburdened profession are transferred to an other profession less heavily surcharged. Is it the case of French private physiotherapists whose two thirds declare that "their workload is certainly sufficient"?

Adult↗