Associateships: a practice arrangement that can incorporate dollars and sense!
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Employment↗
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Results for “Partnership 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.
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Top 10 tips for selling a dental practice (even if you're not ready to sell it yet).
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Consultants↗
What you always needed to know about selling your practice and didn't know you had to ask.
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Humans↗
Therapeutic partnership. A model for clinical practice.
The illness of a relative disturbs family equilibrium and creates a stressor of significant magnitude. Thus, interpretations of individual or family functioning must be placed in this context. The Therapeutic Partnership model is adept at reinforcing shared responsibility, accountability, and decision making. It conveys a culture of hope and appears to achieve its desired goals. Therapeutic Partnership stands in direct contrast to the notion of lifetime advocacy and other more traditional treatment approaches. It is a highly intense, time-limited, goal-directed involvement.
Adult↗
[The importance of integrated health care for private hospital owners].
About 60 to 70% of hospital services are non-urgent, elective procedures. At least in those indications, insurance companies can deliberately choose their partners among the providers. This forces hospital owners and other providers to enhance their performance, to sharpen their profile and to improve their image in the emerging market. Image in the market of health care is only acceptable as a race for improved quality and evidence-based clinical pathways with defined steps with full disclosure of the agreed indications. The next step will lead to management corporations as a link between partners, who will take over responsibility for reimbursement, reinsurance and all management tasks. Integrated Health Care is a promising first step.
Delivery of Health Care, Integrated↗
Variations in the range of services provided by general practitioners.
The debate about the future role of the general practitioner includes discussion about the range of services which should be on offer in addition to general medical services. Drawing on evidence from a nationally representative sample of 1419 general practitioners this paper examines the reality of what is currently being provided in general practice in the UK. The analyses produce figures that are compatible with the hypothesis that there is a form of creeping specialization taking place with general practitioners tending to provide one type of service at the exclusion of the others. Doctors appeared to cluster into three distinct groups--opportunistic health educators, minor surgeons and those who provide services for women. The implications of these and other findings are discussed.
Family Practice↗
The general practitioner and the community.
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Africa, Southern↗
Today's New dentists face professional challenges and opportunities.
The substantial debt load of new dentists is part of the recent trend toward beginning practice as an associate, in a postdoctoral general dentistry program, or in the military. Other reasons include an opportunity to build clinical speed, learning practice management skills, and earning a guaranteed income. While today's new dentists value the same goals of quality, service, and autonomy that motivate established practitioners, they bring new dimensions to the profession. Diversity and a desire for a balanced lifestyle (among both men and women) affect practice decisions and participation in organized dentistry. The new dentist will look for flexibility and responsiveness to personal and social challenges.
Cultural Diversity↗
Family practice and internal medicine office fees: an analysis of charge differences.
BACKGROUND: This study applies the concept of economic efficiency to primary health care physicians. Comparisons of charges made by family physicians and general internists would provide evidence of "optimal" health care delivery of primary care services. METHODS: A list of all active licensed primary care physicians was obtained from the office of the Oregon State Board of Medical Examiners. Two thousand eight hundred forty-three questionnaires were sent to Oregon primary care physicians. Of the 1365 responses, 484 were family physicians and 341 were general internists. RESULTS: The study found that family physicians had significantly lower mean office visit fees than general internists, while both groups had essentially similar patient mixes. This difference in fees could not be explained by patient case mix. CONCLUSIONS: The findings of this study and the body of literature available support the concept that family practice physicians provide economically efficient primary health care. If two similarly trained physicians provide a comparable level of medical care, with the same or similar outcome (or output), the physician who provides the care for the lowest cost should be used.
Diagnosis-Related Groups↗
Management factors influencing practice performance.
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Accounting↗
Nurse-physician collaborative practice: the clinical nurse specialist in a radiation oncology private practice.
The role of the clinical nurse specialist (CNS) has been established and described in some detail. The majority of these specialists practice in academic centers or large hospitals, often in concert with a group of their peers and with strong administrative support for the advanced practice role. Changes in the healthcare system, particularly the recent trend toward the establishment of freestanding cancer centers, have opened new practice opportunities for advanced nursing practitioners. This article describes the transition of a radiation oncology CNS from a university hospital to a collaborative practice in a private radiation oncology setting. The CNS describes important steps in this process, including negotiation of role functions and benefits, maintenance of professional commitments, and collaborative practice issues. Comments from the radiation oncologist, along with speculation on the future of the practice, also are included.
Communication↗
Information exchange between general practitioner and nursing home physician in The Netherlands.
BACKGROUND: In response to the specific characteristics of nursing home residents, the Netherlands has become the only country to develop the specialty of nursing home medicine. The "nursing home physician" has attained independent status. This development has, however, created a division between medical care in the community and medical care in nursing homes, which challenges the quality of the transitional processes taking place when a patient is admitted to or discharged from nursing home care. OBJECTIVES: To give insight into the type of medical information exchanged between general practitioners (GPs) and nursing home physicians (NHPs) at the time of admission, while a patient is under care of the NHP, and at the time of discharge. METHODS: Questionnaires were sent to a sample of 780 GPs, who were selected using a 2-phase sample strategy. Three hypothetical patient vignettes, involving the admission of a patient to a nursing home, to day care, and to an outreaching nursing home care project, were constructed and presented in the questionnaire. GPs were asked to answer questions about the information exchanged during the care of a patient illustrated in each vignette only if they were really familiar with a patient such as presented. The advantage of hypothetical patient vignettes is that each physician reacts to a standardized situation. RESULTS: In the case of admitting a patient to or discharging a patient from the nursing home, results indicate that the continuity of care at those moments will be better ensured if GPs have more frequent personal contacts with NHPs. In the case of day care patients, the study also reveals that GPs who have frequent personal contact with NHPs will share relevant patient information significantly more often at the start of the day care program, both during day care and also when intercurrent medical problems occur. Similar findings can be expected in patients receiving outreaching nursing home care. CONCLUSIONS: The findings indicate the advantages of personal contacts between different medical professionals in exchanging specific patient information. It can be expected that this will lead to more tailor-made medical care for the patient. Adequate exchange of relevant information is an important aspect of mutual collaboration between professionals. Recommendations as to how to achieve more personal contact and a better collaboration among medical professionals are proposed.
Aged↗
Organisational development in general practice: lessons from practice and professional development plans (PPDPs).
BACKGROUND: Improving the quality and effectiveness of clinical practice is becoming a key task within all health services. Primary medical care, as organised in the UK is composed of clinicians who work in independent partnerships (general practices) that collaborate with other health care professionals. Although many practices have successfully introduced innovations, there are no organisational development structures in place that support the evolution of primary medical care towards integrated care processes. Providing incentives for attendance at passive educational events and promoting 'teamwork' without first identifying organisational priorities are interventions that have proved to be ineffective at changing clinical processes. A practice and professional development plan feasibility study was evaluated in Wales and provided the experiential basis for a summary of the lessons learnt on how best to guide organisational development systems for primary medical care. RESULTS: Practice and professional development plans are hybrids produced by the combination of ideas from management (the applied behavioural science of organisational development) and education (self-directed adult learning theories) and, in conceptual terms, address the lack of effectiveness of passive educational strategies by making interventions relevant to identified system wide needs. In the intervention, each practice participated in a series of multidisciplinary workshops (minimum 4) where the process outcome was the production of a practice development plan and a set of personal portfolios, and the final outcome was a realised organisational change. It was apparent during the project that organisational admission to a process of developmental planning needed to be a stepwise process, where initial interest can lead to a fuller understanding, which subsequently develops into motivation and ownership, sufficient to complete the exercise. The advantages of introducing expert external facilitation were clear: evaluations of internal group processes were possible, strategic issues could be raised and explored and financial probity ensured. These areas are much more difficult to examine when only internal stakeholders are engaged in a planning process. CONCLUSIONS: It is not possible to introduce practice and professional development plans (organisational development and organisational learning projects) in a publicly funded health care system without first addressing existing educational and management structures. Existing systems are based on educational credits for attendance and emerging accountability frameworks (criteria checklists) for clinical governance. Moving to systems that are less summative and more formative, and based on the philosophies of continual quality improvement, require changes to be made in the relevant support systems in order achieve policy proposals.
Evidence-Based Medicine↗
Hospitals and the educational institution: an innovative partnership for nursing specialty education.
Rapid technological and economic change require that educational institutions respond efficiently and effectively to the needs of the health care industry. Nurses demand education that is accessible, affordable, and relevant, and demand recognition for educational achievement in terms of credentials and financial rewards. This article describes a partnership between British Columbia Institute of Technology (which is driven by and responds to industry) and The School of Health Science (which prepares nurses for specialty practice). The partnership permits a proactive relationship that utilizes the best qualities of both the health care and educational institutions. Although this alliance has been used extensively to prepare nurses for specialty areas, this partnership model could be implemented by a variety of institutions to meet educational needs in many health care professions.
British Columbia↗
The young physician: types of practice.
An inquiry was conducted into the type of practice (whether solo, group or salaried) entered by young physicians graduating from Canadian medical schools in 1970. Twenty-one percent entered solo practice, 57% joined a group practice or partnership, and 22% became salaried physicians in a number of different categories. Surgeons and psychiatrists, more than other types of specialist, were inclined to select solo practice. Group practice was more popular in the western provinces and in rural than in urban areas. More than half of the physicians recently established in urban solo practice complained of having too few patients. Lack of patients was a lesser problem in smaller towns and rural areas.
Adult↗
Ophthalmic practice of Charles H. Mayo, M.D.
With no formal training in ophthalmology, Dr. Charles H. Mayo (the younger Mayo brother) undertook the unwanted task of diagnosing ocular disease and managing patients with such disorders in rural southeastern Minnesota during the 20-year period 1889 through 1908. This endeavor was ancillary to a busy general practice in partnership with his father and older brother. A series of his office ledgers provides a daily panorama of the foibles, remedies, and diagnoses associated with an ophthalmic practice during that era.
History, 19th Century↗
Collaborative relationships in general practice projects.
This article reports on a national study of collaborative relationships between general practitioners and other health care providers in 20 Division of General Practice projects. It argues that health care organisations will need to collaborate with others in the future and that much can be learnt from the literature on collaborative networks in business and community organisations. Successful collaborations between general practitioners and others were found to be consistent with a model of collaboration in 'under-organised domains', where pre-existing links between organisations are weak. Lessons are identified from the study to assist future collaborative ventures involving general practitioners.
Australia↗