The value of a professional practice.
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Seventy five advertisements placed in five consecutive issues of the BMJ by general practices for vacancies for doctors were analysed for the amount of information given. Fifteen pieces of information were sought and scored. The maximum score was 20, and one advertisement had no indication of how to reply.
BACKGROUND: Community-oriented primary care (COPC) is an increasingly attractive paradigm for primary care delivery. Further work is needed, however, to implement COPC in busy practice settings. This study reports a feasible method for linking practice and community health data for use in COPC. METHODS: Using one practice and its community as an example of the process, we sought data related to five common cancers. Data from readily accessible community sources were combined with practice morbidity data using commonly available computer hardware and software. RESULTS: We developed a user-friendly database and maps showing rates and distribution of the example diseases. We also developed strategies to obtain complete case identification and to address confidentiality and proprietary concerns. CONCLUSIONS: Understanding patterns of disease expression in the practice and the community is critical to the COPC process. Rapid, inexpensive methods for displaying these patterns, such as the database and maps described, must be accessible to clinicians if COPC is to move from theory into practice. Partnerships between health care providers and institutions can also help get this capability into the hands of clinicians.
Implications for practice and education include recognition of the value of clinical outcome studies to clinicians and administrators in clinical agencies, as well as to nursing education. This project provides an example of the opportunity for mutually beneficial education and practice partnerships. Faculty, staff, and students demonstrated their ability to use the basic model for outcome studies developed by the United Way of America (1996). Teams of staff, faculty, and students were able to design small scale outcome studies that provided valuable information for clinicians and administrators about evaluating and improving the quality of clinical services, as well as for seeking continued funding. It is anticipated that further benefits may be discovered when faculty work with agencies to target program outcomes that will yield the most powerful effect for these agencies.
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Last month the authors diagnosed the condition of the hospital-based pathologist and prescribed a large dose of competitive activities to improve security and financial well-being. In this concluding article the complications of this treatment are examined, highlighting the issues that pathologists must resolve as they venture forth into a new practice environment.
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OBJECTIVE: To obtain data on sexual contact between general practitioners (GPs) and their patients and to determine the relationship between sexual abuse and GP characteristics. DESIGN: Cross-sectional. METHOD: In February-May 2002, anonymous questionnaires were mailed to a randomized sample of 1250 general practitioners in the Netherlands. RESULTS: A total of 977 general practitioners responded (response: 80%). This number included relatively large numbers of women and GPs aged > or = 50. Out of the 977 GPs, 32 had had sexual contact with a patient at some time: 30/695 (4.3%) of the male GPs and 2/247 (0.8%) of the female GPs Coitus was reported by 24 (75%) of them. Of the 32 perpetrators 11 (34%) had had sexual contact with 2 or more patients. Of the 30 male GPs who engaged in sexual contact with patients, 20 (67%) afterwards felt positive about the sexual encounter for himself and 22 (73%) for the patient. Sexual contact with a patient occurred more often among men who at the time of the survey were aged < or = 50 [corrected]. The incidence was not related to the degree of urbanisation of the practice area or to the size of the practice partnership. CONCLUSION: Sexual contacts between general practitioners and their patients are not just incidents. It is not enough to be conscious of one's own sexual feelings towards patients. Implementation of a clear policy is needed.
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