Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Private 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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,459 records · Page 81Linked to original sources

Confidentiality expectations of patients in teaching hospital clinics versus private practice offices.

Two hundred and fifty patients at a university hospital teaching clinic and 200 patients in a small private medical office were questioned about their expectations for confidentiality. It was found that in general, subjects in both groups had similar expectations of how physicians handle confidential information. This included physician behavior in situations such as discussing cases with other physicians for second opinions, submitting cases to medical journals, and discussing cases at parties or with spouses and friends. The similarity existed despite demographic differences between the two groups and despite marked differences in the two practice settings. A few differences between the groups were noted, however. University clinic patients were more likely than private office patients (54.5% vs 38.5%) to expect that cases are discussed at large physicians' meetings. Private office patients were more likely (77.8% vs 67%) to expect physicians to discuss cases with nurses. Men in both practice settings were more likely than women to believe that physicians commonly submit cases to medical journals (75.8% vs 59.9%), or discuss cases with nurses (81% vs 67%), non-medical friends (10.9% vs 4.4%), spouses (53% vs 36.4%), and at parties with physicians (56.4% vs 39.6%).

Adult↗

A look at the private practice of the future.

Powerful trends that have influenced pediatric care in recent decades will sweep us into the new century. By looking at the major forces at work today, we can predict where we will be 10 years from now. As infectious diseases continue to decline, psychosocial disorders will take a larger share of the pediatrician's efforts. Technology will allow more effective management, but it will require strong commitment to ongoing education. More children with chronic conditions and more young adults will fall under the care of pediatricians. Prevention will retain a central role in practice. Maintaining an independent practice will become more difficult, and a wide range of delivery schemes will emerge. Relationships among pediatricians and relationships with other health care providers will be influenced significantly by these systems, which carry potential for both positive and negative impact on the quality of care and on the lifestyles of pediatricians. It is crucial that pediatricians take an active and committed role in shaping the evolution of care systems, thereby making the future what it should be for children.

Health Services↗

Experience with ACTH and cortisone in private practice.

ACTH and cortisone are highly nonspecific in their action. A fundamental portion of the mechanism of action is the interposition of a blockade between toxin and end organ. This effect can be of great benefit in the management of a variety of acute and chronic diseases.A major hazard constantly to be kept in mind is the potential masking of advancing disease. This consideration makes concomitant chemotherapy mandatory in the presence of specific infections. In chronic diseased states it should be assumed that prolonged therapy will be necessary. Treatment should not be instituted unless such continued therapy is physiologically and economically feasible.

Adrenocorticotropic Hormone↗

Cost-effectiveness of echocardiography: a private practice perspective.

Echocardiography is essential to the modern practice of cardiology. It is a robust, noninvasive technique, with proven effectiveness in the diagnosis of a multitude of cardiac disorders. However, the true costs of echocardiography and the charges, reimbursement, and collection rates, plus the overall economic value of echocardiography relative to other technical and cognitive services provided by cardiologists, are not so clearly understood or established. The purpose of this article is to provoke thought among echocardiographers about these economical issues.

Cost-Benefit Analysis↗

Total parathyroidectomy and forearm autotransplantation for chronic renal failure: a useful tool for the general surgeon in private practice.

We reviewed 12 cases of chronic renal failure in patients with secondary hyperparathyroidism who had total parathyroidectomy and forearm autotransplantation during the years 1978 to 1984. All had elevated parathyroid hormone and calcium levels before the procedure. Using a technique previously described, with relatively large parathyroid grafts in the forearm, calcium levels were effectively reduced and maintained below the upper limit of the normal range (10.5 mg/dl). Only one patient had symptomatic hypocalcemia postoperatively. Phosphorous levels were also significantly reduced to more physiologic values. When necessary, the forearm autografts allowed simplified titration of calcium levels on an outpatient basis.

Adult↗

Prostatectomy in private practice; a review of 589 cases in a five-year period.

Prostatectomy was done in 589 cases in a five-year period. The operation was done transurethrally in 530 cases of benign disease and in 50 cases of malignant lesions. In six cases of malignant disease and three of benign, open procedures were used. Results of transurethral prostatectomy were considered good or excellent in 94.4 per cent of the cases of benign hypertrophy and in 92 per cent of the cases of carcinoma. It was felt that radical perineal prostatectomy was advisable for early operable cases of carcinoma, but that the transurethral procedure was more suitable in almost all cases of benign hypertrophy.

Humans↗

Evaluation of panoramic dental radiographs taken in private practice.

Five hundred panoramic radiographs submitted to Delta Dental Plan of Michigan for preauthorization or claim processing were evaluated for frequency of occurrence of 15 categories of technical errors in patient positioning, film processing, and general film handling. Only one radiograph showed no errors. The average radiograph contained 2.2 positioning errors, 1.0 processing errors, and 1.5 miscellaneous errors, for a total of 4.7 errors. Of the 500 radiographs, 467 had positioning errors, 441 had processing errors, and 424 had miscellaneous errors. Diagnostic quality was judged to be adequate in 365 radiographs, inadequate in 91 radiographs and marginal in 44 radiographs. The severity of error was of more importance than the number of errors in the determination of diagnostic adequacy.

Diagnostic Errors↗

[Physicians' work load. A comparison between company physicians and general practitioners in private practice].

The authors describe and compare the work load of 26 general practitioners and 17 company doctors. All of them worked full time. The information was collected by means of a structured telephone interview. The results indicate a higher work load among general practitioners than among company doctors. Despite this, the general practitioners plan to remain working longer than the company doctors do. In both groups of doctors there were some who believed they risked developing the "burn-out syndrome". This problem was found among the youngest doctors, female doctors and doctors with a large number of consultations daily.

Burnout, Professional↗

Long-term therapy with lithium in a private practice clinic: a naturalistic study.

OBJECTIVE: To document the effectiveness and vicissitudes of treating 14 bipolar patients with lithium carbonate over a combined 300 years, and an average of 21 years/patient. METHODS: Chart review of the narrative and laboratory studies of these 14 patients ranging in duration from 12 to 29 years. RESULTS: Lithium stabilized these bipolar patients over these periods. Only three patients required hospitalization, one because lithium was slowly tapered at her request after 6 years of mood stability, another because of non-compliance, and a third because of co-morbid alcohol abuse. One patient attempted suicide after lithium was tapered off. However, in some patients, there were serious side-effects necessitating lithium discontinuation. CONCLUSIONS: Controlled studies in psychopharmacology are obviously preferred to open-label or naturalistic case studies. However, controlled studies are rarely conducted over long periods, and practice-related naturalistic research can be of value, albeit anecdotal and without the use of structured rating scales. In this paper, we are reporting on 14 patients seen consistently by one psychiatrist. These patients were functional and productive at work and in family life. The patients suffered brief hypomanic or depressive episodes. Although several patients experienced serious side-effects, lithium was continued with stable mood, while the side-effects were managed in collaboration with other specialists.

Adult↗

[Factors of significance for short or prolonged duration of physiotherapeutic treatment from private practicing physiotherapists].

The aim of the study was to determine factors of importance for the duration of treatment of physiotherapy patients. A material of 363 patients answered questions about personal and social data and their disease. The following was related to prolonged treatment (greater than 47 days): 1) young, unmarried students. There was twice as many boys as girls. 2) Patients with psychosomatic disease. The ratio between men and women was 1, and the main symptom was headache. 3) Patients with generalized disease. This study did not reveal whether prolonged treatment is due to an ineffective treatment or whether other factors are of importance. However, we doubt the effect of physiotherapy in patients with psychosomatic disease.

Adolescent↗

[Consumers view of treatment by dental hygienists in private practice].

Questionnaires were sent to 22 dental practitioners. Each dentist was sent two types of questionnaires, one to be completed by the hygienist and the other one by the patients. The sampling was done by selecting at random approximately every sixth clinic employing a dental hygienist. Of 1100 questionnaires 710 were completed and returned. The investigation illustrates the patients opinion on different aspects of the dental hygienist's technical and social skills and of the cost of care. There was an overwhelming consumer satisfaction regarding the quality, as well as the cost, of dental care performed by a hygienist. Therefore, a broad use of well qualified dental hygienists as an auxilliary to a dentist is one way to lower the cost of dental health care in the future.

Consumer Behavior↗

Dietary protein restriction in renal insufficiency in private practice.

About 50% of patients in an ambulatory setting with different stages of renal insufficiency are suitable candidates for protein-restricted diets. This is due to contraindications and, more important, noncompliance of patients. The German health insurance system does not reimburse for dietitians' consultations. Institution and execution of any diet as well as controls of patients' adherence are issues of physicians' work. Protein restriction prescribed varies between 60 and 30 g protein/day. As soon as 40 g/day has been reached, supplementation by essential amino acids is started. Metabolic control is confined to evaluations of BUN/creatinine serum concentration and the reciprocal serum creatinine concentration. Patients' general state of well-being and weight are also followed. For more detailed investigations there is also no reimbursement.

Dietary Proteins↗

The clinical picture of bipolar II outpatient depression in private practice.

Uncertainties exist about whether depressive episodes differ phenomenologically in unipolar and bipolar II patients. The aim of the present study was to better define the clinical picture and course of bipolar II depression. Three hundred and ninety-nine consecutive outpatients, presenting for treatment of unipolar and bipolar II depression, were interviewed with the Structured Clinical Interview for DSM-IV, the Montgomery-Asberg Depression Rating Scale and the Global Assessment of Functioning Scale. Bipolar II depression had significantly lower age at onset, more recurrences and more patients with DSM-IV atypical features. Gender, duration of illness, psychosis, chronicity, severity, axis I comorbidity, melancholic features, individual atypical symptoms and other symptoms of depression were not significantly different. The presence of DSM-IV atypical features predicted bipolar II diagnosis with 63% probability.

Adult↗

Frequency of ICD-10 factitious disorder: survey of senior hospital consultants and physicians in private practice.

The authors surveyed physicians for frequency estimates of factitious disorder among their patients. Twenty-six physicians in independent practice and 83 senior hospital consultants in internal medicine, surgery, neurology, and dermatology participated. They completed a questionnaire including the estimated 1-year prevalence of factitious disorder among their patients. Frequency estimates averaged 1.3% (0.0001%-15%). The number of patients treated correlated negatively with frequency estimates. Dermatologists and neurologists gave the highest estimations. One-third of the physicians rated themselves as insufficiently informed. Frequency estimations did not differ by information level. The estimated frequency is substantial and comparable to earlier findings. Authors discuss clinical implications.

Cross-Sectional Studies↗

PACS in private practice--effect on profits and productivity.

Picture archiving and communication systems (PACS) must be cost effective and productive to be successful. Referring physician and radiologist surveys, return on investment, and change in technical FTE productivity is evaluated. Referring physicians nearly unanimously prefer PACS over film, with productivity improvements claimed by 91%. Radiologists glean nearly 100% increased efficiency for computed tomography (CT), ultrasound, and Magnetic resonance imaging, and 50% for special procedures. Technologist productivity increased by 58% for MRI, 30% for CT, and 41% for ultrasound. Four-year experience with PACS reveals great success, with phase I return on investment after 3.5 years and more than $500,000 saved annually thereafter. There was instant conversion to 100% filmless interpretation and archive for all modalities on connection to PACS.

Attitude of Health Personnel↗

[Perspectives of psychiatric care in Leipzig--deinstitutionalization from the viewpoint of neurologist/psychiatrist in private practice and the work of consortium of community psychiatric services].

Two perspectives of mental health care in Leipzig are outlined. Critical aspects of deinstitutionalization are discussed from the point of view of an office-based Nervenarzt (neurologist and psychiatrist). The limitations of office-based practice in providing care for the severely mentally ill (SMI) are described, i.e. lack of a multidisciplinary community mental health team, community psychiatric nursing and social work back-up in particular. Residential service and nursing homes are often under-staffed and ill-prepared for caring for people with SMI. A second view-point describes the Verbund Gemeindenahe Psychiatrie, a community psychiatric service for the just under 500,000 population of Leipzig in seven community mental health centers each combining day hospital, out-patient clinics and multidisciplinary community psychiatric care. This service is unique in Saxony and well accepted by service users and professionals.

Community Mental Health Services↗

[The clientele of physiotherapists in private practice].

The aim of the study was to describe sociomedical characteristics of physiotherapy patients. A material of 466 patients answered questions about personal and social data and their disease. Women were significantly more frequent in the material than men (p less than 0.001). The following groups were underrepresented compared to the background population calculated by X2: 1) boys 0-9 years, 2) girls 0-19 years, 3) women more than 80 years old, 4) officials, 5) unskilled workers and 6) unemployed. The following groups were overrepresented: 1) women 30-39 years, 2) women 60-79 years, 3) pensioners and persons receiving public assistance and 4) students. More than half of the symptoms were located to the head-neck or back-thorax-loin. The cause was most often primarily somatic (46%), while 25% had an occupational genesis.

Adolescent↗

Implementing continuous quality improvement: a private practice's experience.

The "golden rules" of CQI, from our experience, could be summarized as follows: 1. Create the appropriate environment first by teaching the Deming principles. 2. Establish effective methods of group communication. 3. Do not focus on individual error. Focus on processes and your system of care. Make certain that case presentations do not spotlight individuals. 4. Look for the common causes of problems. 5. Use statistical methods appropriately. Identify what is clinically important. Make any data collection effort meaningful, and make sure that all members understand why the data is being collected. 6. If an error is identified, ensure that the practitioners involved are active participants in the analysis. 7. Recognize good performance. If something is done well, have the provider present the case to the group. This step is particularly worthwhile if the case illustrates a new process that will remedy a problem other members of the department have experienced.

Anesthesia Department, Hospital↗