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At least 19 recordsLinked to original sources
PubMed1997

[The role of the Swiss Medical Association (FMH) in health care of migrants].

The structure and function of the Swiss Medical Association (FMH) are summarized and important aspects of the medical care for the migrant population are presented. The relationship between the FMH and the Federal Office for Refugees (BFF) is highlighted. The FMH aims to facilitate the introduction of a confidential medical officer service which can be approached in particular circumstances. This function should be integrated in the asylum law.

Delivery of Health Care↗
PubMed2006

Patients' satisfaction with the preoperative informed consent procedure: a multicenter questionnaire survey in Switzerland.

OBJECTIVE: To assess patients' satisfaction with the preoperative informed consent procedure in obstetrics and gynecology. PATIENTS AND METHODS: Between March 2001 and April 2002, patients from 11 Swiss hospitals, representing 3 linguistic areas of Switzerland, were given a questionnaire and a standardized operation-specific leaflet and engaged in a structured conversation. The questionnaire and operation-specific leaflet were designed in collaboration with the Swiss Patient Organization, the judiciary service of the Swiss Medical Association, and the Swiss Society of Obstetrics and Gynecology. RESULTS: A total of 3888 (56%) of 6970 women received the questionnaire and were enrolled in the study. Most of the patients considered the written and oral information to be good or excellent, and more than 80% did not desire further written information. Forty-five percent would have preferred to receive this structured Information the same day the decision to undergo an invasive procedure was made, and mere than half of the patients were reassured by the information provided. However, in 7% anxiety increased. In the multivariate analysis, Turkish (odds ratio [OR], 6.7; 95% confidence Interval [CI], 2.0-22.4; P=-.002) and Serbo-Croat (OR, 8.0; 95% CI, 2.4-27.4; P=.001) language and a poor rating of the written description of the planned operation (OR, 3.1; 95% CI, 1.1-9.0; P=-.03) were the only variables significantly associated with discontent. CONCLUSIONS: The combined written and oral preoperative information presented is well adapted to patients' Informative wishes and needs; it allows for a structured conversation, facilitates documentation, and offers valid legal proof that adequate information has been provided. Therefore, close collaboration between the national patient organization and the expert Judiciary and medical societies of the corresponding country is strongly recommended to Improve the Informed consent procedure.

Adolescent↗
PubMed1993

[Campaign against smoking and the general practitioner. Evaluation of a simple method allowing immediate measurement of compliance with smoking cessation in the physicians office].

Recently, the Swiss Medical Association and the Swiss Federal Office for Public Health started a campaign against smoking. Portable carbon monoxide (CO) devices measuring alveolar CO concentration are now available. It is important to know how accurate they are in discriminating smokers (S) from nonsmokers (NS) in different environmental conditions. We administered a smoking questionnaire and measured alveolar CO concentration in 241 people living in an urban area (PU) and 112 people living in a mountain area (PM). Smoking prevalence was 39% in PU and 17% in PM. Alveolar CO concentration was significantly higher in S than in NS (27 +/- 11, 11 to 60, vs. 14 +/- 9, 4 to 52, p < 0.01 in PU and 23 +/- 13, 4 to 48, vs. 9 +/- 7, 4 to 46, p < 0.01 in PM). We found significantly higher CO-values in NF of PU than PM (p < 0.01). This test has a sensitivity of 80%, a specificity of 78%/79% (PU/PM) and a predictive positive value of 74%/80% (PU/PM). The cut-off point has to be adapted depending on the environmental exposure (PU: 15 ppm, PM: 10 ppm CO). Alveolar CO measurement is a cheap accurate method whose results are immediately available to the general practitioner in his fight against smoking. This method merits higher application.

Adolescent↗
PubMed2005

[From the concept of guilt to the value-free notification of errors in medicine. Risks, errors and patient safety].

The number of liability cases but also the size of individual claims due to alleged treatment errors are increasing steadily. Spectacular sentences, especially in the USA, encourage this trend. Wherever human beings work, errors happen. The health care system is particularly susceptible and shows a high potential for errors. Therefore risk management has to be given top priority in hospitals. Preparing the introduction of critical incident reporting (CIR) as the means to notify errors is time-consuming and calls for a change in attitude because in many places the necessary base of trust has to be created first. CIR is not made to find the guilty and punish them but to uncover the origins of errors in order to eliminate them. The Department of Anesthesiology of the University Hospital of Basel has developed an electronic error notification system, which, in collaboration with the Swiss Medical Association, allows each specialist society to participate electronically in a CIR system (CIRS) in order to create the largest database possible and thereby to allow statements concerning the extent and type of error sources in medicine. After a pilot project in 2000-2004, the Swiss Society of Gynecology and Obstetrics is now progressively introducing the 'CIRS Medical' of the Swiss Medical Association. In our country, such programs are vulnerable to judicial intervention due to the lack of explicit legal guarantees of protection. High-quality data registration and skillful counseling are all the more important. Hospital directors and managers are called upon to examine those incidents which are based on errors inherent in the system.

Anesthesiology↗
PubMed2003

[A short history of the Swiss Society of Anaesthesiology and Reanimation (SSAR)].

In common with most continental countries, anaesthesia in post-World War II Switzerland was clearly in arrears in comparison to the Anglo-American and Scandinavian countries. As early as in 1947, however, motivated young physicians left Switzerland for England, Scandinavia and the USA to familiarise themselves with the advances made in modern anaesthesia. In March, 1951, three of these pioneers, Ch. Bovay (Lausanne), W. Hügin (Basel), and K. Zeller (Winterthur), founded the Professional Association of Swiss Anaesthesiologists, thus preparing the ground for the Swiss Society of Anaesthesiology which was founded on July 5 th, 1952, on the occasion of the annual meeting of the Swiss Society of Surgery held in Zurich. Members of the first Executive Committee were Ch. Bovay, K. Zimmermann (Zurich), and W. Hügin. In 1963, the latter was appointed first Professor of Anaesthesiology in Switzerland by the University of Basel. Looking back, the 18 physicians involved in the foundation of the Society were indeed most courageous. This step towards independence is all the more admirable since the Swiss Society of Surgery, by founding a Section of Anaesthesiology, attempted to retain sovereignty over this small and new group of specialists. Only in 1954 anaesthesiology was recognised by the Swiss Medical Association as a medical specialty in its own right. In 1967 the name was changed to Swiss Society of Anaesthesiology and Reanimation (SSAR). Since coming into existence, the Society has grown more than 40-fold, with a total membership approaching 800 by 2002 end. In recent years, the SSAR took a particular interest in promoting both the training and CME of anaesthesiologists, in supporting research by its young members and in improving the quality and safety of anaesthesia.

Anesthesiology↗
PubMed1995

[Free from tobacco. Counseling of smokers in medical practice--experiences from the Swiss campaign].

Physicians can help patients quit smoking by offering advice and counselling. Towards this end, the Swiss Medical Association (FMH) together with the Federal Office of Public Health developed a programme aimed at improving physicians' counselling skills. The programme offers a systematic approach to patient counselling. Between 1990 and 1993, on three consecutive occasions Swiss doctors (12,000) were mailed an invitation to join the campaign and order their free copies of the counselling package. An optional 3 hours training session on how to make effect use of the package was also offered. Course participants were routinely questioned (pre and post course, and six months after completing the course), about their knowledge, attitude and behaviour towards smoking and counselling. In 1991 an evaluation of the overall programme was conducted. A representative sample of 450 physicians was used for the survey. It was divided into 3 groups with 150 physicians each. Group I included those, who both had ordered the package and attended the training, group II had the package only, while group III had neither. The overall response rate was 80%: For groups I and II it was 93% and for the control group it was 76%. 92% of respondents reported having heard of the campaign. 51% stated having used one or more of the materials included in the package in their daily work. 63% reported an increased frequency of intervention activity and 55% stated that their counselling had been more successful. Relevant statements amongst the control-group were significantly lower -26% with regard to success and 38% with respect to increased frequency of interventions (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1999

[Manual therapy in lumbo-vertebral syndromes].

Based upon the shortly presented survey among the members of the Swiss Medical Association for Manual Medicine, the low back pain problems are approached by the means of manual therapy on average 805 times per year and physician. On average each case with low back pain is treated 1,4 times by a general practitioner with experience in manual medicine while specialists who are dealing with more complex cases on average 4 to 5 times. The functional disorders of the lumbar spine treated by manual therapy are superior to the physiotherapy approach or in comparison with a "placebo group" (information by general practitioner about low back pain and application of medication). An appropriate indication for manual therapy is relevant to avoid or reduce the possible risk of the treatment procedure. The physician who performs the manual therapy has to know the limits of the method. Also the knowledge of contraindications for manual therapy will reduce the incidence of possible complication. However based upon the survey among the swiss association the side effects and complications due to manual therapy of the lumbal spine are extremely seldom.

Humans↗
PubMed2003

Training needs in adolescent medicine of practising doctors: a Swiss national survey of six disciplines.

OBJECTIVE: To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. DESIGN: Cross-sectional postal survey. SETTING: Switzerland. PARTICIPANTS: National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. MAIN OUTCOME MEASURES: Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. RESULTS: A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. CONCLUSIONS: Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).

Adolescent↗
PubMed2005

Swiss primary care physicians reporting of utility and use of recommended vaccinations for adults.

QUESTION: To determine how recommended vaccinations in adults are perceived and used by primary care physicians in Switzerland. METHODS: A cross-sectional mail survey of primary care physicians randomly selected from the register of the Swiss medical association was conducted, including specific items measuring perceived utility and reported use for fourteen recommended vaccinations for adults. The answers were standardized to have a minimum of 0 and a maximum of 100. Other items assessed socio-demographic and work characteristics, opinion regarding the use of vaccinations, sources of recommendations used for vaccinations, and patient and organisational barriers. Frequency tables and crosstabulations were used to describe differences in perceived utility and reported use across these characteristics. RESULTS: After three reminders, 1166 physicians participated in the survey (response rate 64%). Perceived utility was the highest for rubella immunisation in young women (93.6; 95% CI: 92.8 to 94.3) and hepatitis B immunisation in high-risk adults (91.9; 95% CI: 91.0 to 92.7); it was the lowest for immunisations against measles (56.7; 95% CI: 55.3 to 58.2) and pneumococcal diseases (55.2; 95% CI: 53.8 to 56.7). The highest levels of use were reported for diphtheria-tetanus booster after a wound (91.7; 95% CI: 90.7 to 92.7) and poliomyelitis immunisation of travelers (89.5; 95% CI: 88.4 to 90.6); the lowest for immunisations against measles (40.3; 95% CI: 38.5 to 42.1) and pneumococcal diseases (33.3; 95% CI: 31.8 to 34.8). Lower reported use was associated with reports of physicians not having the time to verify vaccination status and convince a patient to be immunised, and other logistic issues related to physician's practice, but not with reports of patient's refusal of immunisation. CONCLUSION: There are several avenues to strengthen promotion programs aiming at improving immunisation use by Swiss primary care physicians in adults, among which a high better recognition of time spent for health promotion activities should have priority.

Adult↗
PubMed2005

Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671].

BACKGROUND: Acute respiratory tract infections (ARTI) are among the most frequent reasons for consultations in primary care. Although predominantly viral in origin, ARTI often lead to the prescription of antibiotics for ambulatory patients, mainly because it is difficult to distinguish between viral and bacterial infections. Unnecessary antibiotic use, however, is associated with increased drug expenditure, side effects and antibiotic resistance. A novel approach is to guide antibiotic therapy by procalcitonin (ProCT), since serum levels of ProCT are elevated in bacterial infections but remain lower in viral infections and inflammatory diseases. The aim of this trial is to compare a ProCT-guided antibiotic therapy with a standard approach based on evidence-based guidelines for patients with ARTI in primary care. METHODS/DESIGN: This is a randomised controlled trial in primary care with an open intervention. Adult patients judged by their general practitioner (GP) to need antibiotics for ARTI are randomised in equal numbers either to standard antibiotic therapy or to ProCT-guided antibiotic therapy. Patients are followed-up after 1 week by their GP and after 2 and 4 weeks by phone interviews carried out by medical students blinded to the goal of the trial. Exclusion criteria for patients are antibiotic use in the previous 28 days, psychiatric disorders or inability to give written informed consent, not being fluent in German, severe immunosuppression, intravenous drug use, cystic fibrosis, active tuberculosis, or need for immediate hospitalisation. The primary endpoint is days with restrictions from ARTI within 14 days after randomisation. Secondary outcomes are antibiotic use in terms of antibiotic prescription rate and duration of antibiotic treatment in days, days off work and days with side-effects from medication within 14 days, and relapse rate from the infection within 28 days after randomisation. DISCUSSION: We aim to include 600 patients from 50 general practices in the Northwest of Switzerland. Data from the registry of the Swiss Medical Association suggests that our recruited GPs are representative of all eligible GPs with respect to age, proportion of female physicians, specialisation, years of postgraduate training and years in private practice.

Adult↗
PubMed2001

Quality programmes, accreditation and certification in Switzerland.

PURPOSE: To report on current quality initiatives in health care in the context of accreditation and certification in Switzerland. SOURCE OF INFORMATION: A review from the Swiss Accreditation Service, the Swiss Medical Association and the University of Zurich. SETTING: In Switzerland, health care providers and health insurers are obliged by law to sign contracts on quality of care. The law texts and related ordinances do not state explicitly the content and format of quality contracts between providers and costs payers. Finding adequate practical solutions is the responsibility of the partners involved. Six different possibilities of quality initiatives are studied and discussed in this report. These include initiatives to create independent certification or inspection bodies for health care organizations accredited by the national accreditation body. FINDINGS: So far, there is only one established standardized system with clear requirements. This accreditation and certification model is an adaptation of the International Standards Organization but so far it has not been used often in the public domain. Each of the other five approaches are more frequently applied but none of them lead to full external peer review certification including medical outcome yet. CONCLUSIONS: A lot of harmonization work still has to be done and clear branch specific requirements need to be agreed upon. Practicability and validity of external peer review schemes may also need further evaluation and improvement to reach the goals of health care systems in the future.

Accreditation↗
PubMed2006

Complementary and conventional medicine in Switzerland: comparing characteristics of general practitioners.

OBJECTIVES: Do structural characteristics of general practitioners (GPs) who practice complementary medicine (CAM) differ from those GPs who do not? Assessed characteristics included experience and professional integration of general practitioners (GPs), workload, medical activities, and personal and technical resources of practices. The investigated CAM disciplines were anthroposophic medicine, homoeopathy, traditional Chinese medicine, neural therapy and herbal medicine. MATERIAL AND METHODS: We designed a cross-sectional study with convenience and stratified samples of GPs providing conventional (COM) and/or complementary primary care in Switzerland. The samples were taken from the database of the Swiss medical association (FMH) and from CAM societies. Data were collected using a postal questionnaire. RESULTS: Of the 650 practitioners who were included in the study, 191 were COM, 167 noncertified CAM and 292 certified CAM physicians. The proportion of females was higher in the population of CAM physicians. Gender-adjusted age did not differ between CAM and COM physicians. Nearly twice as many CAM physicians work part-time. Differences were also seen for the majority of structural characteristics such as qualification of physicians, type of practice, type of staff, and presence of technical equipment. CONCLUSION: The study results show that structural characteristics of primary health care do differ between CAM and COM practitioners. We assumed that the activities of GPs are defined essentially by analyzed structures. The results are to be considered for evaluations in primary health care, particularly when quality of health care is assessed.

Complementary Therapies↗
PubMed1999

[Extrajudicial expert assessment--what is the basis for complaints against internists?].

In 1981, the Swiss Medical Association (FMH) set up an expert medical evidence office, from which patients or their dependents could request an extra-judicial expert report in cases of suspected error in diagnosis or treatment. Up to the year 1995, this office issued a total of 1675 expert reports, of which 109 were for the specialty of Internal Medicine. Since the office was founded, the number of expert witnesses called upon has continued to increase. The most common accusation was "failure to investigate or delay in investigation" (41 times, 48.2%) followed by the accusation of a "diagnostic error" (35 times, 41.2%). In 13 cases (20%) the expert report confirmed there had been a medical error, 46 (70.8%) negated such a finding, and no firm conclusion was reached in 6 expert reports (9.2%). Expert reports are very often requested by patients with malignant neoplasms, particularly if the disease is first diagnosed at an advanced stage, and these are associated with the most frequent accusation of delayed investigation. Communication problems between doctor and patient are a recurrent theme throughout the expert reports and this shows the importance of taking the patient's concerns seriously, of a well-founded explanation, and of being ready to discuss matters.

Expert Testimony↗
PubMed2000

[Is there a role for infectious disease specialists in private practice?].

For the last 20 years infectious diseases have gained increasing importance for hospital medicine. As a specialty, infectious diseases have been recognized only recently by the Swiss medical association. However, the precise role of infectious disease specialist operating in private practice remain to be defined. The medical community faces many challenges for which infectious disease specialist must provide answers. Knowledge in microbiology has progressed enormously and many very sophisticated and, partly, expensive diagnostic techniques are widely available. New treatment options are introduced while numerous microbial species demonstrate increasing resistance to antimicrobial agents. The intervention of infectious disease specialist could thus contribute to optimize treatment and limit the use of economic resources. Infectious disease specialist in private practice are also facing new activities such as parenteral outpatient treatment for severe infections and HIV infection, which clearly require a specialized professional approach. Infectious disease specialist in private practice will need great care to find a responsible equilibrium between clinical consultation and telephone consultation.

Communicable Diseases↗
PubMed1979

[Training of general surgeons as perceived from private practice].

A recent Swiss opinion poll has revealed that the medical profession is still enjoying a high prestige. The large majority of the surgeons in free practice has an optimistic view of the future of private medicine. Abdominal and peripheral vascular surgery as well as the surgery of the extremities belong also in smaller hospitals. About 75% of the surgeons feel that 10 years of postgraduate training is sufficient. A theoretical final examination is rejected. For further professional training, lectures, various courses and congresses are very popular. Compulsory examinations by the Swiss Medical Association (FMH) are undesirable.

General Surgery↗
PubMed1993

[50 years of Swiss Academy of Medical Sciences].

The Swiss Academy of Medical Sciences is a foundation under private law, which was founded September 24, 1943, by the Medical and Veterinary Faculties of the Swiss universities and the Swiss Medical Association. It devotes its resources to the advancement of the medical sciences and awards research grants, scholarships and scientific prizes. Its other services include a scientific documentation service (DOKDI), the medical-ethical evaluation of research projects and the publication of guidelines and recommendations for physicians, particularly concerning ethical standards of behaviour. The 50 years' existence of the institution will be commemorated at a ceremony to be held in Berne September 23, 1993.

Academies and Institutes↗