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Results for “Professional Practice Location”

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PubMed2001

Approach to sustainable primary health care service delivery for rural and remote South Australia.

We describe the operation of four University Teaching Practices established by the South Australian Centre for Rural and Remote Health (SACRRH) and the Adelaide University Department of General Practice. These practices were established in response to the acknowledged difficulty in recruiting and retaining GPs in rural South Australia. The practices are co-located with a hospital or accident and emergency service and community based nurses and allied health professionals. They provide integrated health care and multidisciplinary health care student placements in a learning environment where students experience rural multidisciplinary practice and country life. The study found that although the sites differed in significant ways, they all provided integrated care and effective placements for students. This style of health care delivery is flexible and broadly applicable. Sustainability is achieved through financially viability, attracting and retaining health care professionals and the development of electronic information systems, to support integrated practice.

Allied Health Personnel↗
PubMed1995

Graduate medical education and physician practice location. Implications for physician workforce policy.

OBJECTIVE: To determine the relationship between graduate medical education and physician practice location. DESIGN: Cross-sectional analysis of physicians in active practice in 1993, classified by state of graduate medical education and stratified by specialty and professional activity. Logistic regression analysis was used to examine predictors of physicians remaining to practice in the same state in which they trained. SETTING: There were 82,871 allopathic physicians (national random sample) and 15,076 osteopathic physicians (universe) who completed graduate medical education between 1980 and 1992. MAIN OUTCOME MEASURE: Practice location in the same state as graduate medical education. RESULTS: Overall, 51% of physicians are practicing in the state in which they obtained their graduate medical education (range among states, 6% to 71%). Generalist physicians are more likely than specialists to remain in their state of graduate medical education (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.33 to 1.40) There is a weak negative association between the number of physicians in training per capita in a state and the likelihood of a physician remaining in the state to practice (OR, 0.90; 95% CI, 0.90 to 0.91, for an increment in resident supply of 10 per 100,000 population). New York and Massachusetts, the states with the highest numbers of residents per capita, retained 51% and 49%, respectively, of their graduates, placing them near the median among states. CONCLUSIONS: Most physician training and practice locations function as a national market, with physicians dispersing relatively widely after completing graduate medical education. States that produce high numbers of physicians per capita do not appear to play a unique role in training physicians to serve a national market. These findings pose challenges for states attempting to modify their physician supply and specialty mix.

Cross-Sectional Studies↗
PubMed2000

The distribution of rural female generalist physicians in the United States.

Female physicians are underrepresented in rural areas. What impact might the increasing proportion of women in medicine have on the rural physician shortage? To begin addressing this question, we present data describing the geographic distribution of female physicians in the United States. We examine the geographic distribution of all active U.S. allopathic physicians recorded in the October 1996 update of the American Medical Association Physician Masterfile. Percentages and numbers of female physicians by professional activity, specialty type, and geographic location are reported. Findings reveal there were fewer than 7,000 female allopathic physicians practicing in rural America in 1996. The proportion of generalist female physicians who practice in rural settings was significantly lower than the proportion who practice in urban locations. Although members of the most recent 10-year medical school graduation cohort of female generalist physicians were slightly more likely to practice in rural areas than members of earlier cohorts, female physicians remained significantly underrepresented in rural areas. States varied dramatically in rural female generalist underrepresentation. Should female generalists continue to be underrepresented in rural locations, the rural physician shortage will not be resolved quickly. Effective strategies to improve rural female physician placement and retention need to be identified and implemented to improve rural access to physician care.

American Medical Association↗
PubMed2003

Does exposure to medically underserved areas during training influence eventual choice of practice location?

INTRODUCTION: There are an increasing number of communities within the United States that have limited or no access to primary healthcare. In recognition, many medical schools now provide opportunities and activities that offer exposure to these demographic areas in order to increase the presence of and community access to medical care and to promote these locations as practice site choices for graduating students. Evaluation of these enhancements has led to doubts whether this exposure timing is optimal in promoting practice in these settings. The purpose of this study is to identify whether early exposure(s) to medically underserved settings prior to medical school is associated with eventual choice of practice location. METHODS: Utilising a cross-sectional design, 450 US Family Medicine residency programmes were surveyed. From these, 775 participants responded to a standardised self-administered questionnaire on indicators associated with medically underserved area (MUA) exposure. RESULTS: Early MUA exposures combined with medical training experiences in underserved settings have a positive effect on later practice site choice. Identification of these attributes may be useful in considering determinants that impact eventual choice of practice location.

Humans↗
PubMedDate not supplied

Family practice residents' decision making regarding future practice of obstetrics.

BACKGROUND: This study assesses the attitudes of family practice residents toward their future practice of obstetrics. The decline of family practice obstetrics has resulted in problems of access to care for many areas. METHODS: Questionnaires were sent to 30 family practice residency programs and were distributed to 353 2nd- and 3rd-year residents; the overall response rate was 85 percent. Respondents were asked to describe factors contributing to their decision whether to practice obstetrics. RESULTS: Seventy-two percent of the respondents indicated plans for future obstetrics practice. Reasons for choosing to practice obstetrics included personal interest, believing that obstetrics is an important part of family health care, and desire for diversity in practice. Primary concerns included interference with personal life, fear of lawsuits, and insurance premiums. Those deciding not to practice obstetrics cited interference with personal or professional life and desire for limited practice as deterrents. Important demographic variables predicting future practice included female sex, geographic location, and type of practice desired. CONCLUSION: This study portrays a resurgence in the percentage of family practice residents planning to practice obstetrics and discusses aspects of the training system that merit support to increase the number of family physicians providing obstetric care.

Attitude of Health Personnel↗
PubMed2002

Preparing social workers to address HIV/AIDS prevention and detection: implications for professional training and education.

The social work profession remains an untapped resource within the community for addressing HIV/AIDS prevention and early detection. This study investigated social workers' knowledge and practices relating to HIV prevention education, risk assessment, and case finding. A six page questionnaire was mailed to a random sample of 600 licensed social workers and licensed clinical social workers in Illinois. The sample was drawn from a list provided by the state department of professional regulation, stratified by geographic location. The final response rate for the survey was 51.3% (N = 308). Social work knowledge concerning HIV and AIDS was significantly related to the variables of age, geographic location, and practice setting. Respondents scored lower on knowledge items pertaining to their ability to perform a comprehensive sexual and drug risk assessment and to appropriately advise clients on HIV antibody testing. Most of the social workers in the sample provided minimal to no HIV-related services in their clinical practice. HIV-related behaviors were also significantly related to the variables of age, geographic location, and practice setting. Multiple logistic regression was used to test whether prior HIV/AIDS training predicted the presence of HIV-related practice behaviors, controlling for potential confounding factors. Both prior HIV-related training and education and prior work experience with HIV-infected clients were statistically significant and independent predictors of current HIV-related practice behaviors reported by social workers.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Physician location survey: self-reported and census-defined rural/urban locations.

Using a survey of New York State Residence-Trained Family Physicians and the 1990 census data, this paper assesses the relative importance and consistency of factors associated with physician practice locations when different definitions of community size are used. By matching the zip code information with 434 physicians' practice locations, physician respondents' self-reported communities are linked to census-defined communities. It was found that the significant level of some variables could be affected when community classifications were based on survey responses rather than census data. It concludes that caution should be taken for interpreting rural-urban differences when data are solely based on self-reported practice locations.

Attitude of Health Personnel↗
PubMed1999

Maintaining treatment boundaries in small communities and rural areas.

Psychiatrists and other mental health professionals practicing in small communities and rural areas encounter unique situations and customs that may complicate the task of maintaining treatment boundaries. Boundary adjustments are frequently required that do not disturb the psychiatrist-patient relationship. The authors discuss specific boundary problems that arise in maintaining the psychiatrist's neutrality; fostering the psychological separateness of the patient; protecting confidentiality; ensuring that the psychiatrist has no previous, current, or future personal relationship with the patient; preserving anonymity of the psychiatrist; and establishing a stable fee policy. Four vignettes illustrate boundary issues that may be encountered in psychiatric practice in small communities. The authors suggest that applying the rule of abstinence, which states that the therapist must abstain from obtaining personal gratification at the expense of the patient, can help therapists distinguish between boundary issues, crossings, and violations.

Adult↗
PubMedDate not supplied

Selecting a location for the practice of pediatric dentistry.

A series of state-by-state correlation procedures was carried out, involving pediatric dentist-to-population ratios and a number of economic and social variables. This was the first step in developing an understanding of the decision process carried out by pediatric dentists as they select practice locations. Suggestions are offered for further directions to be taken.

Child↗