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At least 19 recordsLinked to original sources
PubMed1975

Intellectual and attitudinal characteristics of medical students selecting family practice.

Family practice residents were compared with residents in internal medicine, surgery, obstetrics-gynecology, and pediatrics in terms of cognitive and non-cognitive characteristics. Family practice residents were in most instances significantly different from the other four groups. On non-cognitive measures they scored higher on affiliation need and lower on aggression and materialism. Their scores on several cognitive measures were among the highest of the five groups. These results were contrary to others from earlier studies. However, if the trend reported here is confirmed on other samples, it is the more intellectually gifted and idealistic physician who is currently being attracted to the practice of family medicine.

Attitude of Health Personnel↗
PubMed1975

Toward clarification of objectives for family practice and family medicine.

This paper analyzes the social boundaries derived from an adequate definition of family practice and family medicine and explores the social dynamics between them and other social institutions and disciplines, More precise objectives for family practice and family medicine are delineated using a model which specifies social targets, methods, and purpose of intervention. Implication for further research in family medicine are discussed as well as their future effect on family practice.

Delivery of Health Care↗
PubMed1977

The family as the object of care in family practice.

Family practice as a specialty is based upon the continuing and comprehensive care of families. Much emphasis has been placed upon care of the "whole-person" and the family, but actual practice still reflects a predominant focus on the individual, rather than the family, as the object care. There is an important conceptual and practical difference between caring for the individual in the context of the family and caring for the family itself as the patient. Both approaches are required for family medicine to realize its potential in the ongoing care of families. This paper outlines some useful concepts and principles which can help to increase the capability of family physicians to deal with the common problems of individuals and their families.

Behavioral Sciences↗
PubMed1977

The content of family practice: a family medicine resident's 2 1/2-year experience with the E-book.

The purpose of this paper is to present the content of office family practice problems seen over a 2 1/2-year residency period and to afford comparison with the well-known Virginia Study. It illustrates the usefulness of the diagnostic E-Book, with which all the data were collected and preserved. Over a 2 1/2-year period, the author cared for 592 patients in the family practice office. The ratio of one physician to 592 patients compares to the Virginia Study's one physician to approximately 745 patients. A total of 1,640 problems were coded in the E-Book. In this study 55 problems/physician/month were seen, whereas in the Virginia Study approximately 177 problems/physician/month were noted. Respiratory illnesses were the most common diagnostic category in both studies. Among specific problems, obesity ranked first at Hershey, with afebrile colds second, hypertension and Beta streptococcal pharyngitis third, and smoking fourth. Obesity and smoking were ranked considerably lower in the Virginia Study, whereas "health maintenance examinations" were ranked number one. Finally, for age-sex practice profiles, the present data revealed two peak age groups for both sexes, whereas the Virginia work noted only one peak age range.

Acute Disease↗
PubMed1978

Quantitative assessment of the quality of medical care provided in five family practices before and after attachment of a family practice nurse.

The standards of patient care were maintained in five urban medical practices after the introduction of family practice nurses. Evaluations were achieved before and after their appointment by the indicator condition method. Minimal explicit criteria for the management of patients with 12 indicator conditions and by the use of 14 drugs were approved by an ad hoc peer group of community physicians. These cirteria were applied to the five practices by the use of a single-blind design and the abstraction of unaltered medical records. A standardized score for each practic e permitted comparison of scores for the management of indicator conditions and for the clinical use of drugs before and after attachment of the family practice nurses. For each of the indicator conditions and the drugs assessed in the five practices similar levels of adequacy were observed in the two study periods. These explicit (objective) audit resutls agreed with the implicit (subjective) assessments of the family practice nurses by their physician colleagues.

Drug Therapy↗
PubMed1975

Continuity of care in family practice. Part 4: implementing continuity in a family practice residency program.

Although continuity of care is an important goal of family practice residency programs, there are many factors which inevitably prevent its full achievement by individual residents in any program. Each resident is frequently faced with conflicting responsibilities involving the Family Practice Center, inpatient clinical services, and other parts of the residency training program. This paper explores this dilemma and suggests a variety of positive approaches to resolve the issue. All family practice residents must necessarily be intimately involved in providing continuity of patient care and develop the requisite skills and attitudes. However, full continuity of care must ultimately be provided on a program and group level, not exclusively by the individual resident.

Comprehensive Health Care↗
PubMed1978

Organizational complexity in family practice: a sociological model of a family practice group.

The growth of a family practice goup is presented as a case study. Enlarging size and increasing functions require organizational change--from solo to collegial to bureaucratic to political systems. Organizational theory distinguishes between the characteristics and functions of individual, collegial, bureaucratic, and political organizations. Different styles and strategies are appropriate at different stages.

Decision Making↗
PubMed1976

The Adlerian approach: a practical psychology for family practice.

A systematic approach to understanding the patient's personality and helping him cope with common life problems is found in Adlerian Psychology. It is uniquely appropriate to family practice because it stresses the interpersonal purposes of behavior and symptoms and the influence of family constellation on the development of the individual life-style. By obtaining a small amount of data about the patient's present life situation and his family of origin, the physician can gain a basis for understanding how the patient developed his unique way of acting and reacting to the physical and social stresses of life. Interpretation of two or three early recollections reveals what the patient expects of himself, others, and life. The insight thus gained is used as the basis for a holistic assessment of the problem; a directive, supportive, action-oriented plan for treatment; and an ongoing doctor-patient relationship of mutual respect.

Adolescent↗
PubMed1978

Toward the evaluation of family practice: development of a family utilization index.

This paper describes a research project that establishes criteria for utilization patterns of a family practice that could be used to develop evaluation techniques for family practice as a method of delivering primary medical care. The criteria are summarized in a Family Utilization Index, which measures the utilization patterns of a family unit. Changes in the Utilization Index are compared over a five-year period. Changes in attitudes and opinions about family practice in general and the specific Family Medicine Clinic are also compared over time and related to changes in the Family Utilization Index. Utilization patterns have significantly shifted over a five-year period, with more total visits to the clinic due to an increase in the number of family members per family unit using the clinic. Both the utilization patterns and attitudes toward the role of the family physician have shifted, indicating an increased acceptance of family practice.

Adolescent↗
PubMed1979

Differences in morbidity patterns among rural, urban, and teaching family practices: a one-year study of twelve Colorado family practices.

An analysis of one year's data from family practices in Colorado tested the hypothesis that there are no significant differences in the proportion of patients with problems in each of the 18 major International Classification of Health Problems in Primary Care (ICHPPC) categories among visiting patients in rural, urban, and teaching family practices. Four rural, three urban, and five residency practices participated in the study from January 1, 1978, through December 31, 1978. Transient patients were excluded. There were 25,525 patients included in the study. Each setting was compared with the other two settings in each of the 18 ICHPPC categories. More than half of the comparisons differed at the .001 significance level, and the setting with a significantly greater proportion of visiting patients with diseases in a given category was identified. These differences may have implications for disease surveillance, the planning for delivery of primary health care in different settings, and the preparation of health care providers for practice.

Adolescent↗
PubMed1976

Importance of obstetrics in a comprehensive family practice.

Four family practices in the San Francisco Bay Area, two of which did not include obstetrics and two of which did, were examined with reference to their patient populations and to the number of families for which they provided comprehensive, continuous family care. The groups practicing without obstetrics were found to do acute care primarily and, to a lesser extent, long-term care internal medicine, with very little pediatrics or gynecology. The groups practicing with obstetrics did significantly more minor surgery, gynecology, pediatrics, and psychotherapy. During the six-week study, the group practicing with obstetrics saw five times as many patients who were members of families receiving continuous, comprehensive care from the practice under observation. Psychotherapy done by the group including obstetrics was primarily family therapy; for the other group, individual therapy. If larger studies support these findings, then important implications are suggested for training programs in family practice and for the resident deciding to enter practice.

Adult↗
PubMed1978

Exploring the doctor-patient relationship: a sociocultural pilot study in a family practice residency.

Family physicians' growing attention to the nature of their patients' live should include the social and cultural factors that influence patient health and illness behavior. Patient visits to a family practice residency program were found to be influenced by the patients' beliefs about symptoms and the beliefs of their significant others, and symptom interference with valued activities. Data from physician-patient encounters suggest that physician attention to such sociocultural information as occupation and family structure may have positively influenced rapport. Results from this pilot study confirm the feasibility of observational research by physician-behavioral scientist teams in a primary care setting.

Adult↗
PubMed1977

Temporary transvenous cardiac pacemaking in rural family practice.

Interested family physicians with proper training and minimal extra equipment can now employ transvenous pacemaking. Some cardiac centers have developed training programs for general internists and family physicians. We believe that this valuable procedure can, with proper physician training, be offered to patients in rural areas as well as in cardiac centers. While the number of patients in this rural family practice who require this procedure has not been great (ten patients in four years), the need is often urgent when it does occur. Use of this treatment modality with consultation in a 44-bed hospital was found to be safe and practical, although sometimes technically difficult. This paper describes the training, techniques used, results, and complications in a rural community in southeastern Nebraska. It is suggested that every hospital caring for seriously ill cardiac patients should have at least one physician trained to perform this emergency procedure.

Aged↗