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At least 19 recordsLinked to original sources
PubMed1978

New dimensions: the dietitian in private practice.

Private practice is coming to the fore in the profession of dietetics. It can serve as a much needed arm of the health care delivery system in the area of nutrition. Institutions need to re-evaluate and expand their opportunities to sue private practioners, thus releasing more employee time for short-term remedial counseling and education. Referral processes need to be designed and implemented to open new opportunities for consumers to choose and obtain continuing services. Private practice must be included in funding methods, such as third-party payment. Educationl institutions must design programs to prepare persons for private practice. The profession must solve the problem of obtaining community recognition of properly qualified professional authority. The profession must also support the concept of a lifetime career in direct private practice and plan career tracks to keep the most able practioners available to consumers.

Community Health Services↗
PubMedDate not supplied

Private practice.

Private practice can both enrich clinical work in hospital and aid the teaching of medical students, but care must be taken not to abuse it. The final article in this series is designed to help those considering embarking on private practice.

Consultants↗
PubMed2005

Organizational characteristics and preventive service delivery in private practices: a peek inside the "black box" of private practices caring for children.

OBJECTIVE: Although privately owned practices provide the majority of primary care for children, little is known about the organizational characteristics of these practices or how these characteristics affect the quality of care for children. The purpose of this study was to describe selected organizational characteristics and preventive service delivery features that might affect the quality of primary care for children in private practices. METHODS: A cross-sectional study of 44 private pediatric and family medicine practices in 2 regions of North Carolina was performed. Preventive service performance was assessed through chart abstraction for 60 randomly selected children between 24 and 30 months of age, for evaluation of immunizations and anemia, tuberculosis, and lead screening delivery by 2 years of age. Organizational characteristics were determined through surveys of all physicians and staff members. We used descriptive statistics and scatter plots to describe variations in organizational characteristics and preventive services. RESULTS: Overall, practices demonstrated low levels of preventive service performance, with substantial variation among practices. Only 39% of children received 3 of the 4 recommended preventive services measured (practice range: 2-88%). Few practices demonstrated evidence of a systematic approach to prevention. For example, only 12 (27%) of the 44 practices used >1 of 5 recommended preventive service delivery strategies. Furthermore, practices varied greatly with respect to many of the measured organizational characteristics, which were consistent with organizational stress in some cases. For example, turnover of clinicians and staff members was remarkably high, with practices losing an average of 27% of their clinicians every 4 years (range: 0-170%) and 39% of their office staff members every 2 years (range: 0-170%). CONCLUSIONS: Private practices caring for children in North Carolina demonstrated low overall performance for the 4 recommended preventive services examined, with large variations among practices. Few practices had evidence of comprehensive systems for prevention. There was also evidence of substantial variation in many organizational characteristics. Some organizational characteristics were at levels that might impede delivery of high-quality primary care for children. These findings suggest a growing need for research that examines the impact of organizational characteristics on the quality of care in private practices.

Adolescent↗
PubMedDate not supplied

Prosthodontics as a specialty private practice: net income of private practitioners.

PURPOSE: The aim of this study was to use data from a survey of prosthodontists in the US to examine average net earnings of prosthodontists in private practice. MATERIALS AND METHODS: A survey of 2500 prosthodontists in the US was used to estimate the net earnings of practicing prosthodontists. The national average net earnings of prosthodontists in private practice was estimated along with average earnings for subgroups of prosthodontists. Estimates for private practitioners by age, gender, size of practice, full-time/part-time status, practice ownership, and by type of treatment procedures rendered by the practitioner were also included. RESULTS: Average earnings for prosthodontists in private practice on a primary or secondary basis were estimated to be $215,300 and for prosthodontists who own or share in the ownership of a private practice, $233,920. Reported earnings estimates ranged from $96,160 for non-owners of a private practice and $103,350 for part-time private practitioners to $233,920 for practice owners and $275,170 for prosthodontists in practice with two prosthodontists. The average earnings of prosthodontists who are practice owners were estimated to be 35% higher than the corresponding general practitioners. CONCLUSION: Average net earnings are often used to examine the current economic health of a profession. The average net earnings of prosthodontists in private practice exceed the average net income reported by the American Dental Association for all dentists and all general practitioners and they are competitive with earnings among all specialty groups. This evaluation of the net earnings of prosthodontists shows that prosthodontics offers a competitive career opportunity for the general dentist with a personal desire to pursue advanced dental education in a specialty as a profession.

Adult↗
PubMed1975

New organizations out of old ones: teaching group practices out of private practice and outpatient departments.

A private group practice and a traditional hospital medical clinic are joined together as a teaching group practice for primary care (Internal Medical Associates). Responsible for revenues as well as costs, the practice is administered by a board of managers composed of physicians, nurses, and administrators in the practice. This decentralization of practice from the clinical department and hospital administration has resulted in (1) a reduction in the numbers of physicians needed for the practice, (2) a greater visit census with increased physician productivity, and (3) a reduced operating deficit and better understanding of transient and educational costs. The matrix organization of the board of managers has resulted in better communication and a commitment of the staff to common goals. Public demand for a single standard of care for patients of all backgrounds, professional aspirations to work in groups, and educators' interest in training outside the hospital converge to make such reorganizations of practical necessity.

Ambulatory Care↗
PubMed1983

[Diabetes in private practice. Data of the INSERM national survey on private practice (1974-1975)].

Data from a national survey of private medicine in France were used to estimate the frequency of diabetes in primary care and to analyse both patient characteristics and therapeutic management. An approach was made to 2012 physicians who were requested to complete a questionnaire for each patient they saw during the course of a single day; 1103 responded and completed more than 20000 questionnaires. An additional investigation looked into the nature of the non responders. Diabetics represent 2,2% of patients in private medicine. Each year about 5,5 million consultations in private practice in France are for diabetes alone or for diabetes in association with other illnesses. 89% of diabetic patients are over 45 years of age and more than 48% older than 65. In most cases (80%), diabetes is associated with other medical problems, half of them being consequences of diabetes (cardio-vascular diseases, ocular and renal diseases). In 85% of cases, diabetics receive their basic care from a general practitioner. Therapeutic management is based mainly on drugs; diet or advice about life style are mentioned in barely one third of cases. Using linkage with social security data, it was possible to make a crude estimate of the number of diabetics in France. It was estimated at about 1 million for 52,6 million inhabitants.

Adult↗
PubMed2006

Ethics in clinical drug trial research in private practice.

INTRODUCTION: Private clinics and clinicians have been involved in clinical drug trials for approximately two decades. This paper reviews the ethical consideration inherent in this process. METHODS: Involvement of a single community based, private, Australian neurological clinic in the conduct of trials was audited. Changes in ethical considerations were analysed. RESULTS: The clinic previously audited its clinical trial involvement, starting with pharmaceutical company orchestrated trials. These were vetted by hospital based ethics committees (ECs) which then refused to review private research. A private EC accommodating NH & MRC standards was formed to assess private research. Indemnity concerns forced return to institutional ECs with government guaranteed indemnification. Trials evolved to investigator initiated, company sponsored studies thence a company asking the clinic to devise, sponsor and manage a trial. The latter relegated trial co-ordination to the clinic which would control publication thereby creating new ethical standards. DISCUSSION: Private practice trial involvement evolved from reluctant inclusion to a pivotal role in privately sponsored studies. Access to ECs is government endorsed and publication is independent for investigator-sponsored trials. There has been modification of standard operating procedures and enhanced ethical standards.

Australia↗
PubMed1993

Nuclear medicine in private practice.

The private practice of nuclear medicine has evolved over the past decade. Federal and state regulatory agencies, reduction in reimbursement, and a shortage of qualified physicians and technologists will affect the practice of nuclear medicine in the 1990s and beyond. Only by being proactive and able to provide credible clinical information to our referring physicians can nuclear medicine position itself for the next decade. We must continue to educate referring physicians about the cost-effectiveness and functional and physiological nature of nuclear medicine. We need to encourage medical students and physicians in training to consider nuclear medicine as a career path, and we need to provide meaningful clinical information to our referral base. In addition to these challenges, we should also remember that nuclear medicine cannot survive in a vacuum. We must support our professional societies and have ongoing representation at all levels of government. Membership in the American Medical Association, the Society of Nuclear Medicine, the American College of Nuclear Physicians, the American College of Radiology, and the Radiological Society of North America all help strengthen our voice at the state and national levels. We must continue to effectively present our specialty's positions to the various state and federal agencies that regulate our practice. We must demand high quality studies from our peers and continue to be advocates for our patients.

Cost Control↗