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Canadian Journal of Rural Medicine :... 2022This study seeks to explore influential factors leading to physician turnover in designated Rural Northern Physician Group Agreement (RNPGA) communities in Northern...
INTRODUCTION
This study seeks to explore influential factors leading to physician turnover in designated Rural Northern Physician Group Agreement (RNPGA) communities in Northern Ontario, as well as physician's perceptions of the RNPGA contract and effects of the Northern Ontario School of Medicine (NOSM) on physician retention in these communities.
METHODS
Twelve qualitative semi-structured interviews were completed with rural physicians who had RNPGA contracts within the past 5 years but had left their practice community. Data collected from recorded interviews were analysed using a thematic analysis approach in order to identify common themes.
RESULTS
A range of factors influencing physician's decisions to leave were identified including lack of partner career prospects, burnout and lack of opportunities and amenities. Common challenges were sometimes also perceived as rewards of rural practice. The concern of lack of flexibility of the RNPGA contract was identified, as well as a perceived lack of presence of NOSM graduates in RNPGA communities.
CONCLUSION
A variety of factors influence physician turnover in RNPGA communities. These may be considered by communities hoping to inform recruitment and retention policy. Renewal of the RNPGA contract may require consideration for availability of part-time positions, increasing the number of physicians funded and incentivising physician wellness. NOSM may consider mandatory postgraduate programme placements in RNPGA communities and further development of infrastructure in these communities to improve learner, graduate and institutional engagement.
Topics: Humans; Personnel Turnover; Physicians; Rural Health Services; Rural Population; Schools, Medical
PubMed: 34975113
DOI: 10.4103/cjrm.cjrm_2_21 -
Journal of the Royal Society of Medicine Jun 2009
Topics: Age Factors; Forecasting; Humans; Physician's Role; Physicians; Prejudice; Sex Factors
PubMed: 19531612
DOI: 10.1258/jrsm.2009.09k032 -
AMA Journal of Ethics Sep 2019Changes made in 2017 to the World Medical Association Physician's Pledge strive to keep in step with geopolitical trends by addressing respect for patients' dignity and...
Changes made in 2017 to the World Medical Association Physician's Pledge strive to keep in step with geopolitical trends by addressing respect for patients' dignity and autonomy and respect among colleagues. Health professions students should continue to proactively insist on patient care, research, and advocacy efforts that uphold human rights and the principles of beneficence, nonmaleficence, justice, and respect for autonomy regardless of a patient's origins or locale. US students should enter clinical encounters, both domestically and abroad, with cultural humility but should hold institutions accountable for ethical violations committed or observed during immersion experiences. As part of global and cultural humility, students should also remain cognizant of their privileged position as international observers.
Topics: Humans; Personal Autonomy; Personhood; Physician-Patient Relations; Physicians; Respect; Social Responsibility; Societies, Medical; United States
PubMed: 31550228
DOI: 10.1001/amajethics.2019.796 -
The Western Journal of Medicine Jan 1975The mid-level practitioner movement is no longer experimental; nurse practitioners and physician's assistants in California have proved to fill a necessary and viable... (Review)
Review
The mid-level practitioner movement is no longer experimental; nurse practitioners and physician's assistants in California have proved to fill a necessary and viable professional role in the delivery of primary health care. The physician's assistant law (AB2109) and the Experimental Manpower Act (AB1503) have facilitated the training and functioning of these new health care professionals; more comprehensive laws are still needed to permit optimal utilization. National agencies for approval of teaching programs and testing of individual graduates will play an increasing role in the accreditation and certification procedures. Professional role difficulties, issues of sex and questions of delegation of responsibility are being resolved and it is hoped that a more equitable and patient-oriented system is evolving.
Topics: American Medical Association; California; Certification; Communication; Economics, Nursing; Female; Hospitals, Teaching; Legislation, Medical; Legislation, Nursing; Male; Nurse Practitioners; Patient Care Team; Physician Assistants; Physicians; Primary Health Care; Sex Factors; United States; Workforce
PubMed: 234011
DOI: No ID Found -
BMC Medical Education Sep 2014Despite significant differences in terms of medical training and health care context, the phenomenon of medical students' declining interest in family medicine has been... (Review)
Review
BACKGROUND
Despite significant differences in terms of medical training and health care context, the phenomenon of medical students' declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians' professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management.
METHODS/DESIGN
The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the "case" is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed.
DISCUSSION
This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians' professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies.
Topics: Faculty, Medical; Humans; Identification, Psychological; Internal-External Control; Interview, Psychological; Physician's Role; Physicians, Family; Social Identification; Social Perception
PubMed: 25193544
DOI: 10.1186/1472-6920-14-184 -
Missouri Medicine 2021
Topics: Humans; Physicians
PubMed: 34149067
DOI: No ID Found -
Journal of Medical Internet Research Aug 2020Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not...
BACKGROUND
Previous research internationally has only analyzed publicly available feedback on physician rating websites (PRWs). However, it appears that many PRWs are not publishing all the feedback they receive. Analysis of this rejected feedback could provide a better understanding of the types of feedback that are currently not published and whether this is appropriate.
OBJECTIVE
The aim of this study was to examine (1) the number of patient feedback rejected from the Swiss PRW Medicosearch, (2) the evaluation tendencies of the rejected patient feedback, and (3) the types of issues raised in the rejected narrative comments.
METHODS
The Swiss PRW Medicosearch provided all the feedback that had been rejected between September 16, 2008, and September 22, 2017. The feedback were analyzed and classified according to a theoretical categorization framework of physician-, staff-, and practice-related issues.
RESULTS
Between September 16, 2008, and September 22, 2017, Medicosearch rejected a total of 2352 patient feedback. The majority of feedback rejected (1754/2352, 74.6%) had narrative comments in the German language. However, 11.9% (279/2352) of the rejected feedback only provided a quantitative rating with no narrative comment. Overall, 25% (588/2352) of the rejected feedback were positive, 18.7% (440/2352) were neutral, and 56% (1316/2352) were negative. The average rating of the rejected feedback was 2.8 (SD 1.4). In total, 44 subcategories addressing the physician (n=20), staff (n=9), and practice (n=15) were identified. In total, 3804 distinct issues were identified within the 44 subcategories of the categorization framework; 75% (2854/3804) of the issues were related to the physician, 6.4% (242/3804) were related to the staff, and 18.6% (708/3804) were related to the practice. Frequently mentioned issues identified from the rejected feedback included (1) satisfaction with treatment (533/1903, 28%); (2) the overall assessment of the physician (392/1903, 20.6%); (3) recommending the physician (345/1903, 18.1%); (4) the physician's communication (261/1903, 13.7%); (5) the physician's caring attitude (220/1903, 11.6%); and (6) the physician's friendliness (203/1903, 10.6%).
CONCLUSIONS
It is unclear why the majority of the feedback were rejected. This is problematic and raises concerns that online patient feedback are being inappropriately manipulated. If online patient feedback is going to be collected, there needs to be clear policies and practices about how this is handled. It cannot be left to the whims of PRWs, who may have financial incentives to suppress negative feedback, to decide which feedback is or is not published online. Further research is needed to examine how many PRWs are using criteria for determining which feedback is published or not, what those criteria are, and what measures PRWs are using to address the manipulation of online patient feedback.
Topics: Feedback; Female; History, 21st Century; Humans; Internet; Male; Patient Satisfaction; Physicians; Switzerland
PubMed: 32687479
DOI: 10.2196/18374 -
Tidsskrift For Den Norske Laegeforening... May 2011
Topics: Clinical Competence; History, 19th Century; History, 20th Century; Humans; Norway; Physician's Role; Physicians; Societies, Medical
PubMed: 21606979
DOI: 10.4045/tidsskr.11.09E1 -
American Society of Clinical Oncology... 2014Obligations are derived from one's core values-those fundamental, enduring, deeply held beliefs that guide one's everyday actions. Gandhi stated it more eloquently than... (Review)
Review
Obligations are derived from one's core values-those fundamental, enduring, deeply held beliefs that guide one's everyday actions. Gandhi stated it more eloquently than I ever could: "Your beliefs become your thoughts, your thoughts become your words, your words become your actions, your actions become your habits, your habits become your values, your values become your destiny." So what are the obligations of the academic oncologist and clinician? I believe there are a few indubitable and fundamental obligations: professionalism, patient care, stewardship, maintenance of knowledge, productivity, and mentorship). I might add that I do not see these obligations as unique to the academician but rather applicable to all physicians.
Topics: Academies and Institutes; Attitude of Health Personnel; Biomedical Research; Clinical Competence; Efficiency; Health Knowledge, Attitudes, Practice; History, 20th Century; History, 21st Century; Humans; Medical Oncology; Mentors; Patient Care; Physician's Role; Physicians; Research Personnel
PubMed: 24857063
DOI: 10.14694/EdBook_AM.2014.34.78 -
Mayo Clinic Proceedings Jun 2024This second installment in a 3-part series about physicians as patients explores challenges in communication and role definition while managing their care and safe... (Review)
Review
This second installment in a 3-part series about physicians as patients explores challenges in communication and role definition while managing their care and safe return to work. In the first article of the series, authors reviewed unique characteristics that make physicians different as patients, with some general guidance about how to approach their care. Although most treating physicians receive little occupational training, health issues commonly have an impact on work with imperative to address work issues promptly for best outcome. This paper demystifies the challenge of managing work status and discusses navigating common physical and cognitive issues while maintaining role clarity. The treating clinician reading this paper will learn to avoid common pitfalls and be better equipped to provide initial assessments and interventions to keep physicians working safely, keeping in mind licensure issues and reporting requirements. Part Three of the series will focus on the most common mental health issues seen in physicians.
Topics: Humans; Return to Work; Physician-Patient Relations; Physician's Role; Physicians
PubMed: 38839190
DOI: 10.1016/j.mayocp.2023.10.017