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PubMed1998

An investigation of dental student practice preferences.

This study explored characteristics hypothesized to influence dental student long-range practice preferences. Dental students (N = 264) for this study were selected at random from all dental students in one state who rated practice arrangements they most prefer to be in five years after graduation. The rating instrument was composed of two items measured on 5-point Likert-type scales. The independent variables were student gender, year of dental study, and practice arrangement. The research design was a 2 x 4 x 3 completely randomized, fixed-factor, factorial analysis of variance (ANOVA). The ANOVA model explained 48 percent of the variance in student practice arrangement ratings. Both males and females rated solo ownership as the most favorable practice arrangement. Males rated the solo owner arrangement more favorably than did females, while females had a stronger preference for the employee practice arrangement than did males. Study results have implications for dental educators in their efforts to structure curricula to meet diverse student needs, to assess personnel needs and enhance the accuracy of projections, and to evaluate the effect of practice preferences on the health care system.

Administrative Personnel↗
PubMedDate not supplied

Components necessary in a successful nurse practitioner-physician collaborative practice.

In recent years, collaborative practice has gained much attention from nurse practitioners in primary health care settings. This is because many nurse practitioners feel that nurse practitioners and physicians can complement each other's roles. Together, they can provide more comprehensive, quality primary health care than either profession can provide by itself. Nurse practitioners and physicians working together to care for a common group of patients may have varying degrees of collaboration in their practice. This article discusses some elements and components necessary to maximize the quality and extent of collaboration.

Communication↗
PubMed2003

The best way to bring a dentist into your practice.

Solo practice is the most common practice mode in dentistry. It probably will remain so for a long time to come. However, numerous advantages and some disadvantages are present for those dentists wanting or needing to have another practitioner in their practices. Finding the right employee dentist, associate or partner is a difficult task, but the success of many multidentist practices has shown that it can be done. Also, having another trusted dentist in the practice can facilitate exiting from the practice at retirement, allowing the retiring dentist to turn over his or her patients to the other dentist without the worry or anxiety of selling to an unknown party.

Humans↗
PubMed1993

Sexual practices, sexually transmitted diseases and other risk factors for HIV among injecting drug users.

Data were collected from 814 clients attending anonymously for counselling before tests for human immunodeficiency virus (HIV) infection at the Burnett Clinic in Auckland. Just over 10 per cent of clients (n = 83) reported ever having injected drugs. This group was matched according to age, gender, ethnicity and sexual orientation with an equal sized control group drawn from clients who had not injected drugs. The groups were compared in terms of their sexual practices, sexual partnerships, other drug use, current and past health status and their perception of HIV risk. The injecting drug users reported more sex partners than the nonusers, they were less likely to be in a relationship and they were less likely to be monogamous. Vaginal and oral sex were the most common practices in both groups but anal sex was more common among users than the nonusers. Regular condom use was reported by less than a quarter of each group. The health status of drug users was generally poorer than that of the nonusers. They reported greater use of alcohol and other drugs, more mental health problems, and more symptoms of ill health. They also had experienced more sexually-transmitted diseases. Only 1 per cent of users and 2 per cent of nonusers tested positively for HIV, although users saw themselves and their partners as at greater risk of HIV infection than the nonusers.

AIDS Serodiagnosis↗
PubMed1993

Preliminary evidence on retention rates of primary care physicians in rural and urban areas.

The primary study objectives were to 1) determine how many physicians entered primary care practice in rural and urban counties of North Carolina in the 1981 to 1989 period and 2) estimate their length of tenure in these areas. The secondary objective was to identify the physician's demographic, training, and practice characteristics that influence geographic location of practice and length of tenure. A cohort of 1,947 physicians was identified from the North Carolina Board of Medical Examiners database, which included all active, nonfederal primary care physicians who began their initial practice in North Carolina in 1981 or later. The primary outcome was time in practice in a given rural or urban county. Selected data on physician demographic, training and practice characteristics were also available in the database. Approximately one third of physicians beginning their initial North Carolina practice selected a rural county for the location. Almost half of these primary care physicians were still in the county of their initial practice in 1989. An additional 20% of these physicians had changed practice location within the State, of which half chose a similar type of county to that of their initial practice. Length of tenure was similar across geographic locations of the medical practice, with the average length of tenure being 4.6 and 4.4 years among physicians in rural and urban counties, respectively. The strongest predictors of tenure were practice organizational characteristics with physicians in either an office-based solo practice or partnership having longer tenures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Partnership prophylaxis.

The most common association of veterinarians in private practice is that of partnership. Some such relationships are not happy and may not endure. The concept of partnership is examined and suggestions are made which will minimise dissension.

Partnership Practice↗
PubMed2005

The keys to successful associateships.

When a practice is running at a high volume and stress is increasing, dentists often feel that it might be time to add an associate. This can be a good decision if the practice has the right data-driven systems in place. Conversely, if the scheduling system is inefficient and not managed properly, adding an associate will only increase the practice stress levels. Once the right systems are in place, hiring an associate still requires excellent communication and training skills on the part of the dentist.

Dental Staff↗
PubMed1995

Gender and the transition into practice.

Since 1990, over half the enrollees in advanced education pediatric dentistry programs have been women. The higher proportion of women in pediatric dentistry should permit examination of the practice patterns of groups of men and women at similar stages in their careers. In 1991 the American Academy of Pediatric Dentistry surveyed 4,950 dentists about a variety of issues related to practice patterns and demographics, obtaining 2,362 responses. This study conducted a secondary analysis of the survey data by developing three age-matched graduation cohorts based on gender and years since graduation: 1 to 5 years, 6 to 10 years, and over 10 years. Four areas were investigated: practice patterns, practice arrangements, distribution of time, and income. The overall differences in practice patterns between males and females were statistically significant for the Early Career Group (1 to 5 years). More males were in private practice and a higher proportion of them were practice owners. More women were dental school faculty or in private practice as an employee or contractor. The differences in practice patterns for males and females were not statistically significant for the Intermediate Career Group (6 to 10 years). In the Established Career group (over 10 years), the differences were again statistically significant, with more males as practice owners and shareholders and more women in solo practices. Analysis of time distribution showed that, in the two earlier career groups, women spend about twice as much time as men in child care. These findings may help to explain why many women in the early stages of their careers might prefer the flexibility of working for someone else. When the effects of gender and employment status on income were tested, significant differences were found for the Intermediate and Established groups, with males and practice owners having higher income levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

The meaning of public health nursing: creating 24 hour care in a community in Japan.

This case study describes the strategies and activities of public health nurses to increase the availability of services in a municipality of 36,000 and to transform community attitudes so that those needing services would feel free to use them. Strategies and activities are seen in the context of Japan, Minakuchi Town and the leadership of the chief public health nurse. Practicing in partnership with members of the community, strategies of public health nurses include technical activities (conducting needs assessment and framing program alternatives) and information sharing and health education (e.g. 75 meetings organized with health promoters for residents in the districts of the town). On the basis of the results of Minakuchi Town, viewed as an example of expert public health nursing practice, a general model for public health nursing practice is presented.

Adult↗
PubMed2005

Physician dual practice.

Physicians employed in government clinics and hospitals also frequently have private practices. The economic theory of such dual practice is relatively limited and recent. We provide a summary and comparison of five models of dual practice, including one we have developed based on total compensation theory and contracting limitations. We also discuss whether theoretical predictions are consistent with empirical evidence from developed and developing countries. We argue that the social trade-off between the benefits and costs of dual practice hinge on the quality of a country's contracting institutions. The conclusion outlines a proposed research agenda for better understanding this widespread phenomenon in the health sector and in other segments of society.

Humans↗
PubMedDate not supplied

The clinical nurse specialist and psychiatrist in joint practice.

The authors describe a joint practice model between a clinical nurse specialist and psychiatrist. The authors address factors to consider in establishing a joint practice--negotiation of roles and benefits as well as clinical supervision. In addition, specific clinical responsibilities for the nurse specialist, as well as potential expanded duties, are outlined.

Humans↗
PubMed2001

Do single handed practices offer poorer care? Cross sectional survey of processes and outcomes.

OBJECTIVES: To determine whether there are important differences in performance between group practices and singlehanded general practitioners and the extent to which any differences are explained by practice characteristics such as deprivation. DESIGN: Cross sectional survey. SETTING: 206 singlehanded practices and 606 partnerships in Trent region, United Kingdom. METHOD: Comparison of process and outcome measures derived from routinely collected data on hospital admissions and target payments for singlehanded practices and partnerships. Multivariate analysis was used to adjust for the confounding effects of general practice characteristics-deprivation (Townsend score), percentage of Asian residents, percentage of black residents, proportion of men over 75 years, proportion of women over 75 years, rurality, presence of a female general practitioner, and vocational training status. RESULTS: Differences in achievement of immunisation and cytology targets apparent on univariate analysis were not seen after adjustment for other general practice characteristics. Similarly, significant differences (>15%; P<0.01) for three types of hospital admission seen on univariate analysis were not present after adjustment for other practice characteristics. CONCLUSIONS: This study provides no evidence that singlehanded general practitioners are underperforming clinically. Our results offer insight into the structural difference between the two types of practice and underline the importance of the effect of other practice characteristics on process and outcome measures.

Cross-Sectional Studies↗
PubMed2006

Accessing research participants in schools: a case study of a UK adolescent sexual health survey.

While methods and results of school-based studies have been reported widely in the literature, little published information exists on the practical aspects of recruiting schools and students into a study. This paper reflects on the experiences of a UK-based sexual health survey among 3007 students aged 15-18 years. The survey explored beliefs, attitudes and behaviours in relation to sexual health. This case study highlights significant aspects of planning and conducting successful large-scale research in schools, focusing on the process of conducting the research rather than outcomes. As such, the paper will benefit those intending to sample a school-based population. The key features of effective and feasible research in schools are outlined in four areas: (i) adopting suitable research tools, (ii) selecting and contacting schools, (iii) selecting students within schools and (iv) the importance of fieldworkers. On-site and post-data collection feedback from teachers are incorporated into the discussion of good practice in partnership working with schools and students in research. We conclude by discussing fieldwork experiences and outlining key recommendations for researchers across disciplines engaging in school-based studies.

Adolescent↗
PubMed2005

[From health promoting school perspectives to discuss the building of school-community partnership].

In the wake of the WHO's health promotion campaign health promotion schools have gained currency in Europe and the United States. The Department of Education in Taiwan has proposed a "school health promotion program" and the Department of Health a "program to build healthy schools" The goal of these programs was to create a holistic environment for school health and put the concepts of "school-family-community partnership" into practice. Although difficulties, such as school-centered perspectives, ambiguous definitions of "community" and shortage of funding, human resources and long-term planning impeded the program, this article, based on literature and practical experience, presents the "school-community model" and the strategies that it applied to organize the school-community health promotion committee to plan long-term programs and to assess the needs and resources of schools and communities on a collaborative basis. It contends, furthermore, that integrating community services into curriculums in order to enable students to appreciate the meaning of partnership, and involving the community in the planning process, can achieve the goal of effectively promoting the health of both the school and the community.

Community-Institutional Relations↗
PubMed1975

Establishing a private practice in neurological surgery; preparations, problems and pitfalls.

In summary, the young neurosurgeon entering private practice will find he will have to make many non-medical decisions for which he has had little or no preparation during the course of his lengthy training. Just as one spends time planning a careful curriculum in leading to the specialty of neurological surgery, he must also dedicate many hours to establishing a private practice in that specialty. The time spent in investigating these problems in advance will minimize the frustrations in attaining the goal which we are all striving to achieve-personal satisfaction in the delivery of excellent health care.

Neurosurgery↗
PubMed2000

Management of asthma exacerbations: home treatment.

Asthma is a major cause of morbidity in children. Delays in care and inappropriate home management practices can contribute to morbidity and mortality. Guidelines for the diagnosis and management of asthma were developed in 1991 and revised in 1997 by The National Heart, Lung and Blood Institute. In this article we review the recommended pharmacological protocol for home treatment of asthma exacerbations, and then discuss in more detail behavioral components of asthma management, including monitoring of symptoms, seeking medical care, developing clinician-patient partnerships, and practical issues in equipment and medication usage. Discrepancies between guideline recommendations and current management practices are also discussed.

Administration, Inhalation↗
PubMed1983

Associated practice: a case for professional collaboration.

The establishment of a successful nurse-physician associated practice requires planning, patience, and a willingness to take calculated risks. The nurse executive can lend credibility and support to the nurse in associated practice by understanding the concept, providing a climate for acceptance of such practices, and by clarifying the role of the nurse associate in relation to other professionals in the organization. In this article the authors describe models for associated practice, as well as the measures necessary to ensure peer and patient acceptance and effective health care delivery.

Chicago↗