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PubMed2001

[The physician-patient relationship when the patient is a physician].

BACKGROUND: Though there are several narratives written by doctors who have experienced personal illness and a troublesome patient-role, few have described the particular problems for the doctor who meets a patient who is also a colleague. MATERIAL AND METHODS: Relevant literature that describes this particular doctor-patient relationship is reviewed. RESULTS: Psychological factors that obstruct the doctor's role are often caused by negative counter-transference reactions. Feelings of inferior professional competence, over-identification, and being too sociable are some pitfalls for the caring doctor. Organisational obstacles are "corridor consultations" and deficiencies in occupational health services and primary health care services for patients who are physicians themselves. They are often treated differently from other patients when admitted to hospital. Doctor-patients tend to deny their own symptoms and to be shameful and reluctant to accept the role of patient. They often have fears about confidentiality and may diagnose themselves and also self-prescribe. This may lead to deficient care-seeking. Some practical advice concerning taking care of doctor-patients is given. INTERPRETATION: Doctor-patients should be met in the same way as other patients, but all medical students and doctors should be aware of the particular obstacles and pitfalls in this special doctor-patient relationship.

Clinical Competence↗
PubMed2002

Can the profession of pharmacy serve as a model for health informationist professionals?

Pharmacy could serve as a model for the health informationist profession proposed by Davidoff and Florance in their 2000 editorial in the Annals of Internal Medicine. The current training and practice roles for pharmacists suggest a way to prepare health sciences librarians for work with clinical health care teams. The influences that spurred the transformation of pharmacy parallel in many respects those suggesting the need for more information professionals prepared to practice in clinical health care settings. During the same decades that health sciences librarians have been debating and experimenting with new professional roles such as clinical medical librarians, pharmacy has undergone an intensive review of its core values, mission, practice roles, and educational preparation methods. Until recently, most pharmacists graduated from five-year baccalaureate programs preparing them to understand drug products, sources of supply, and effective ways to dispense them to patients as prescribed by physicians. Today, almost all pharmacy students graduate from six-year doctor of pharmacy programs that prepare them to be the primary providers of what their profession calls "pharmaceutical care." The pharmaceutical care model suggests that health information professionals in clinical settings could be educated and trained to provide what we might call health information care.

Humans↗
PubMed2002

OPL. Myths and legends 101.

Libraries are the topic (and occasional font) or numerous myths and legends. Solos find themselves confronting any number of beliefs firmly held by their constituents as gospel-trye, in spite of evidence to the contrary. Librarians themselves are not immune to this condition. Herewith are some of my favorites, in no particular order.

Librarians↗
PubMedDate not supplied

Accused of misconduct.

Explore the source record for details and available documents.

Employee Discipline↗
PubMed2001

Case manager role. A content analysis of published literature.

The case manager (CM) role is in its third decade of existence. However, there remains a lack of continuity in definition, educational level and qualifications, and the needed experience for role performance. This article presents the results of a content analysis of the published literature, conducted at two points in time, in an attempt to clarify common qualifications and skills needed for role implementation. The results suggest that the CM role requires interpersonal skills, and knowledge of planning, economic and evaluation strategies. Comparison of data for the two measurement times revealed an increased emphasis on the need to work in groups, conduct cost accounting, and facilitate change. Outcome measurement and ongoing evaluation experienced a decline in importance at the time of the second analysis. The ability to critically think, communicate and practice with clinical expertise emerge as inherent qualities of the role. Educational and experiential background remain ill defined in the literature.

Case Management↗
PubMed2002

Community dental service--the first year.

In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists in their first year of placement. A cross-sectional, descriptive study was carried out among 171 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation and living conditions, dental clinic facilities--equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Thirty five per cent of the sample responded. Of the respondents 54% could speak the local language; almost half (45%) felt that the allocation process was not handled efficiently and 40% said that they needed more information; 60% were placed within 20 km of the nearest town; 26% did not have access to telephone or fax and only 52% were provided with accommodation. Twenty six per cent described the condition of the clinics as poor. Almost a quarter of the respondents indicated that they did not have full sets of instruments. Ten per cent did not have an autoclave nor a high-speed handpiece. Fifty seven per cent did not have oxygen and half the clinics did not have any emergency equipment. Fifty per cent reported that equipment broke down often and an equal number that it was not fixed promptly. More than 90% indicated that they needed a short course to help with repairs. Almost two-thirds said that they enjoyed their work environment. Fifty three per cent had supervision, but 30% felt that they did not need supervision. Although 75% felt that their professional competence had been enhanced, more than three-quarters indicated that they had lost some of their clinical competence in one or other area. While 58% felt that there were many opportunities to improve clinical skills, almost two thirds felt that they were over-skilled for the job. Three-quarters of the respondents indicated that the year had been fulfilling and worthwhile. Problem areas centred around the adequacy of the information provided, accommodation and breakdown of equipment. With the next community service placement, it would be useful if the experiences and lessons of the first year could be taken into account.

Achievement↗