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Biology of Blood and Marrow... Jan 2018We conducted a study to analyze and report on indicators of hematopoietic cell transplant (HCT) physician time use and HCT center output measures. HCT centers in...
We conducted a study to analyze and report on indicators of hematopoietic cell transplant (HCT) physician time use and HCT center output measures. HCT centers in Australia and New Zealand (A&NZ) were invited to provide demographic and time use details for physicians participating in HCT patient care (HCT physicians). Resource details for adult and pediatric centers were included. From a total of 46 centers that were invited to participate, completed data were received from 37 centers (80%) representing 185 HCT physicians, with a median age of 48 (range, 33 to 72), of whom 31% were women. Just over half of HCT physicians cited prior work experience in large overseas HCT centers (97, 52%) and over one-third (79, 43%) possessed postgraduate qualifications other than specialist training. Total annual mean HCTs per HCT physician full-time equivalent (FTE) were 14.2 for centers performing both allogeneic and autologous HCT, 6.6 for autologous only centers, and 10.6 for all centers. For all HCT physicians surveyed the mean proportion of time spent on HCT related tasks was 31.7%. In A&NZ, for centers that perform both allografts and autografts, there was a mean of 4.0 allogeneic HCT annually per HCT bed, compared with 2.6 for the United States and 7.1 allogeneic HCT annually per HCT physician FTE (United States, 6.3). Projections of the A&NZ HCT physician workforce indicated that the numbers of HCT physicians are likely to stay within the region of 170 to 190 for the next 10 years, whereas HCT activity will likely continue to climb steadily. Healthcare and government authorities should be prepared to enable and support greater HCT activity in A&NZ in the future.
Topics: Adult; Aged; Australia; Female; Health Workforce; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; New Zealand; Physicians; Tertiary Healthcare
PubMed: 28963078
DOI: 10.1016/j.bbmt.2017.09.011 -
Advances in Therapy Feb 2020Appropriate management of patients with Alzheimer's disease (AD) helps preserve their independence and time at home. We explored physician behavior in the management of... (Comparative Study)
Comparative Study
INTRODUCTION
Appropriate management of patients with Alzheimer's disease (AD) helps preserve their independence and time at home. We explored physician behavior in the management of AD, focusing on diagnosis.
METHODS
Online questionnaires and patient record forms (PRFs) were created by an independent market research agency and completed by participating physicians. Physicians were recruited from France, Germany, Japan, the UK, and the USA. A sample of 1086 physicians was recruited, including general practitioners, geriatricians, neurologists, and psychiatrists. Physicians completed an online interview and 2-3 PRFs based on randomly selected records of their patients with AD. Data on triggers and timing of diagnosis were captured. Data were assessed for all countries combined (global) and within each country and physician specialty.
RESULTS
A total of 3346 PRFs were submitted. Approximately half of patients received diagnosis within 6 months. There were large country differences. In France, only 35% of patients were diagnosed within 6 months compared to 65% in Japan. Physicians in France also reported diagnoses taking > 9 months for a substantial number of patients (39%) compared with other countries (16-29%). Caregivers were the main driver toward diagnosis. Physician suspicion of AD was a trigger for diagnosis in only 20% of cases, globally. Overall, referral rates were low (14-23%).
CONCLUSION
This study suggests that detection and timely diagnosis of AD remains suboptimal. This highlights the importance of fostering awareness of early symptoms and education on the benefits of timely diagnosis, a critical step in initiating treatment as early as possible.
Topics: Adult; Aged; Aged, 80 and over; Alzheimer Disease; Attitude of Health Personnel; Female; France; Germany; Humans; Internationality; Japan; Male; Middle Aged; Physicians; Referral and Consultation; Surveys and Questionnaires; United Kingdom; United States
PubMed: 31933051
DOI: 10.1007/s12325-019-01212-0 -
Health Expectations : An International... Mar 2013The physician-patient relationship is a critical component of the integrated approach to excellence in health-care delivery. Although commonly modelled within the... (Review)
Review
BACKGROUND
The physician-patient relationship is a critical component of the integrated approach to excellence in health-care delivery. Although commonly modelled within the boundaries of the agency theory and regarded as synonymous to an agent-principal interaction, there exists only a sparse understanding about the most effective ways of governing it.
OBJECTIVE
This article undertakes a selective review of the growing body of research on the governance of the physician-patient relationship to discuss the current state of the knowledge in the field and suggest promising avenues for further exploration.
FINDINGS
On the basis of an extensive analysis of the relevant literature, we identify two emerging streams of inquiry on the trust-based (i.e. trust and ethical oversight) and distrust-based (i.e. patient information-empowerment and decision-making authority) governance mechanisms of the physician-patient relationship and discuss the key findings within each stream.
DISCUSSION
To conciliate the on-going scholarly debate concerning the efficacy of trust- and distrust-based mechanisms, we draw the foundations of a conceptual framework which might serve as a guide for more integrative research endeavours on the governance of the physician-patient relationship.
Topics: Humans; Models, Theoretical; Physician-Patient Relations; Physicians; Power, Psychological; Trust
PubMed: 22882293
DOI: 10.1111/j.1369-7625.2012.00807.x -
American Society of Clinical Oncology... May 2018Throughout the arc of a career in medicine, physicians are universally faced with the difficult decision of when to provide care for a colleague and when to refer to... (Review)
Review
Throughout the arc of a career in medicine, physicians are universally faced with the difficult decision of when to provide care for a colleague and when to refer to another physician. Gauging the magnitude of your relationship, both professionally and personally, and then weighing how to add the roles of physician and patient to your preexisting relationship is complex. We review and discuss care of family and colleagues, address ethical boundaries both firm and flexible, and explore the emotional weight of those relationships.
Topics: Family; Humans; Oncologists; Patient Care; Physician-Patient Relations; Physicians
PubMed: 30231376
DOI: 10.1200/EDBK_201451 -
The Pan African Medical Journal 2018There is paucity of physician-scientists in Africa, resulting in overt dependence of clinical practice on research findings from advanced "first world" countries....
There is paucity of physician-scientists in Africa, resulting in overt dependence of clinical practice on research findings from advanced "first world" countries. Physician-scientists include individuals with a medical degree alone or combined with other advanced degrees (e.g. MD/MBChB and PhD) with a career path in biomedical/ translational and patient-oriented/evaluative science research. The paucity of clinically trained research scientists in Africa could result in dire consequences as exemplified in the recent Ebola virus epidemic in West Africa, where shortage of skilled clinical scientists, played a major role in disease progression and mortality. Here we contextualise the role of physician-scientist in health care management, highlight factors limiting the training of physician-scientist in Africa and proffer implementable recommendations to address these factors.
Topics: Africa; Biomedical Research; Career Choice; Education, Medical; Humans; Physician's Role; Physicians; Translational Research, Biomedical; Workforce
PubMed: 29632630
DOI: 10.11604/pamj.2018.29.8.13239 -
International Journal of Health Policy... Dec 2015Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but...
Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.
Topics: Africa South of the Sahara; Delivery of Health Care; Health Personnel; Humans; Physician's Role; Physicians; Workforce
PubMed: 26927585
DOI: 10.15171/ijhpm.2015.215 -
Israel Journal of Health Policy Research Jun 2020The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and...
BACKGROUND
The issue of patient-physician relationships in general, and particularly the trust of patients in their primary care physician has gained much interest in academia and with practitioners in recent years. Most research on this important topic, however, focused on how patients view the relationship and not how the physicians see it. This research strives to bridge this gap, with the resolution of leading to an improved appreciation of this multifaceted relationship.
METHODS
A survey of 328 actively practicing physicians from all four health maintenance organizations (HMOs) in Israel resulted in a hierarchical formation of components, indicating both the relative as well as absolute importance of each component in the formation of the patient-physician relationship. The sample conducted was a convenience one. Methodologically, we used two different complementary methods of analysis, with the primary emphasis on the Analytic Hierarchical Processing (AHP), a unique and advanced statistical method.
RESULTS
The results provide a detailed picture of physicians' attitudes toward the patient-physician relationship. Research indicates that physicians tend to consider the relationship with the patient in a rather pragmatic manner. To date, this attitude was mostly referred to intuitively, without the required rigorous investigation provided by this paper. Specifically, the results indicate that physicians tend to consider the relationship with the patient in a rather pragmatic manner. Namely, while fairness, reliability, devotion, and serviceability received high scores from physicians, social interaction, friendship, familial, as well as appreciation received the lowest scores, indicating low priority for warmth and sociability in the trust relationship from the physician's perspective. The results showed good consistency between the AHP results and the ANOVA comparable analyses.
CONCLUSIONS
In contrast to patients who traditionally stress the importance of interpersonal skills, physicians stress the significance of the technical expertise and knowledge of health providers, emphasizing the role of competence and performance. Physicians evaluate the relationship on the basis of their ability to solve problems through devotion, serviceability, reliability, and trustworthiness and disregard the "softer" interpersonal aspects such as caring, appreciation, and empathy that have been found to be important to their patients. This illustrates a mismatch in the important components of relationship building that can lead to a loss of trust, satisfaction, and repeat purchase.
POLICY IMPLICATIONS
We study the impact physicians' incentives have on the tangible relationship and discuss the significance of physician-patient relationship on satisfaction with the health service given. As a result policies leading to a more dynamic role must be given to the patient, who being well informed by the physician, can help in the decision making process. Policy schemes need to be implemented as a way of changing physicians' behavior, forcing them to better construct and utilize this dyadic relationship.
Topics: Adult; Analysis of Variance; Attitude of Health Personnel; Female; Humans; Israel; Male; Middle Aged; Physician-Patient Relations; Physicians; Surveys and Questionnaires; Trust
PubMed: 32605635
DOI: 10.1186/s13584-020-00375-4 -
Tidsskrift For Den Norske Laegeforening... May 2018
Topics: Coercion; Driving Under the Influence; Humans; Informed Consent; Physician's Role; Physicians
PubMed: 29737751
DOI: 10.4045/tidsskr.18.0361 -
Health Expectations : An International... Apr 2021This study examined the influence of physicians' recommendations and gender on the decision-making process in a preference-sensitive situation. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study examined the influence of physicians' recommendations and gender on the decision-making process in a preference-sensitive situation.
METHODS
N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision and attitude towards the treatment options. Then, participants watched a video that differed regarding physician's recommendation (surgery vs physiotherapy) and physician's gender (female vs male voice and picture). Afterwards, they indicated again their treatment preference, certainty, satisfaction and attitude, as well as the physician's professional and social competence.
RESULTS
Participants changed their treatment preferences in the direction of the physician's recommendation (P < .001). Decision certainty (P < .001) and satisfaction (P < .001) increased more strongly if the physician's recommendation was congruent with the participant's prior attitude than if the recommendation was contrary to the participant's prior attitude. Finally, participants' attitudes towards the recommended treatment became more positive (surgery recommendation: P < .001; physiotherapy recommendation: P < .001). We found no influence of the physician's gender on participants' decisions, attitudes, or competence assessments.
CONCLUSION
This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient's preferences.
Topics: Attitude; Decision Making; Female; Humans; Male; Physician-Patient Relations; Physicians; Research Design
PubMed: 33274816
DOI: 10.1111/hex.13161 -
Canadian Family Physician Medecin de... Apr 2019
Topics: Female; Humans; Internship and Residency; Male; Physician's Role; Physicians, Family
PubMed: 30979746
DOI: No ID Found