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Eberts, Margaret, and Daniel Capurro. "Patient and Physician Perceptions of the Impact of Electronic Health Records on the Patient–Physician Relationship." Applied Clinical Informatics 10, no. 04 (August 2019): 729–34. http://dx.doi.org/10.1055/s-0039-1696667.
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Abstract Objectives Limited studies have been performed in South America to assess patient and physician perceptions of electronic health record (EHR) usage. We aim to study the perceptions of patients and physicians regarding the impact of EHRs on the patient–physician relationship. Methods We use a survey instrument to assess the physician computer experience and opinions regarding EHR impact on various aspects of patient care. An additional survey is used to assess patient opinions related to their medical visit. Surveys are administered in two outpatient clinics in a private, academic health care network. Results While a majority of physicians believed that EHRs have an overall positive impact on the quality of health care, many physicians had negative perceptions of the impact of EHRs on the patient–physician relationship. A majority of patients felt comfortable with their physician's use of the EHR and felt that their physician was able to maintain good personal contact while using the computer. Conclusion Although physicians believe EHRs have a generally positive impact on the overall quality of care, the EHR's impact on the patient–physician relationship is still of concern. Patients do not perceive a negative interference from the EHR on the patient–physician relationship.
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Allafi, Ahmad R., Fahhad Alajmi, and Ahmad Al-Haifi. "Survey of nutrition knowledge of physicians in Kuwait." Public Health Nutrition 16, no. 7 (July 31, 2012): 1332–36. http://dx.doi.org/10.1017/s1368980012003606.
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AbstractObjectiveThe objective of the present study was to determine whether nutrition knowledge differs between male and female physicians working in Kuwait City, Kuwait.DesignThe study employed a cross-sectional analysis of physician's nutrition knowledge by using a sixteen-item multiple-choice questionnaire.SettingGovernmental hospitals in Kuwait City, Kuwait.SubjectsOne hundred Kuwaiti physicians (fifty males; fifty females) working in Kuwait City, Kuwait.ResultsA response rate of 73 % was achieved (forty males; thirty-three females). The mean percentage of correctly answered questions was 60 %. The male and female physicians averaged 56 % and 65 % of correct responses, respectively (P = 0·042). However, only for two questions did male and female physicians’ scores differ significantly (P < 0·05). The two age groups (<40 years; ≥40 years) had equal mean total correct scores (60 %, P = 0·935). Physicians’ knowledge was greatest for topics that have received a great deal of media coverage in Kuwait. Most (70 %) of the physicians described their nutrition knowledge as ‘moderate’.ConclusionsPhysicians in Kuwait gave inaccurate information regarding common problems in Kuwaitis such as obesity, hypertension and osteoporosis. In view of the public's perception of the role of the physician in providing nutrition advice, it is imperative that nutrition and diet training be part of continuing medical education to bridge these deficiencies in physicians’ knowledge.
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Hickey, Michael, Lauralyn McIntyre, Monica Taljaard, Kasim Abdulaziz, Krishan Yadav, Carly Hickey, and Jeffrey J. Perry. "Effect of prenotification on the response rate of a postal survey of emergency physicians: a randomised, controlled, assessor-blind trial." BMJ Open 11, no. 9 (September 2021): e052843. http://dx.doi.org/10.1136/bmjopen-2021-052843.
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ObjectivesResponse rates to physician surveys are typically low. The objective of this study was to determine the effect of a prenotification letter on the response rate of a postal survey of emergency physicians.DesignThis was a substudy of a national, cross-sectional postal survey sent to emergency physicians in Canada. We randomised participants to either receive a postal prenotification letter prior to the survey, or to no prenotification letter.ParticipantsA random sample of 500 emergency physicians in Canada. Participants were selected from the Canadian Medical Directory, a national medical directory which lists more than 99% of practising physicians in Canada.InterventionsUsing computer-generated randomisation, physicians were randomised in a concealed fashion to receive a prenotification letter approximately 1 week prior to the survey, or to not receive a prenotification letter. All physicians received an unconditional incentive of a $3 coffee card with the survey instrument. In both groups, non-respondents were sent reminder surveys approximately every 14 days and a special contact using Xpresspost during the final contact attempt.OutcomeThe primary outcome was the survey response rate.Results201 of 447 eligible physicians returned the survey (45.0%). Of 231 eligible physicians contacted in the prenotification group, 80 (34.6%) returned the survey and among 237 eligible physicians contacted in the no-prenotification group, 121 (51.1%) returned the survey (absolute difference in proportions 16.5%, 95% CI 2.5 to 30.5, p=0.01).ConclusionInclusion of a prenotification letter resulted in a lower response rate in this postal survey of emergency physicians. Given the added costs, time and effort required to send a prenotification letter, this study suggests that it may be more effective to omit the prenotification letter in physician postal surveys.
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Conroy, Deirdre A., and Matthew R. Ebben. "Referral Practices for Cognitive Behavioral Therapy for Insomnia: A Survey Study." Behavioural Neurology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/819402.
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This study examined referring practices for cognitive behavioral therapy for insomnia (CBTI) by physicians at University of Michigan Hospitals and Weill Cornell Medical College of Cornell University. A five-item questionnaire was sent via email that inquired about the physician’s patient load, number of patients complaining of insomnia, percent referred for CBTI, and impressions of what is the most effective method for improving sleep quality in their patients with insomnia. The questionnaire was completed by 239 physicians. More physicians believed a treatment other than CBTI and/or medication was most effective (N= 83). “Sleep hygiene” was recommended by a third of the sample. The smallest number of physicians felt that CBTI alone was the most effective treatment (N= 22). Additional physician education is needed.
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Ahlers-Schmidt, Carolyn R., Amy Chesser, Traci Hart, Jordan Jones, Katherine S. Williams, and Robert Wittler. "Assessing Physician Response Rate Using a Mixed-Mode Survey." Kansas Journal of Medicine 3, no. 5 (November 24, 2010): 1–6. http://dx.doi.org/10.17161/kjm.v3i5.11322.
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Background. It is important to minimize time and cost of physician surveys while still achieving a reasonable response rate. Mixed-mode survey administration appears to improve response rates and decrease bias. A literature review revealed physician response rates to mixed-mode surveys averaged about 68%. However, no identified studies used the combination of e-mail, fax, and telephone. The purpose of this study was to evaluate physician response rates based on surveys first administered by e-mail, then fax, then telephone. Methods. Surveys initially were administered by e-mail to 149 physicians utilizing SurveyMonkey©. Two follow-up reminder e-mails were sent to non-respondents at two-week intervals. Surveys then were faxed to physicians who had not responded. A follow-up fax was sent to non-respondents one week later. Finally, phone interviews were attempted with physicians who had not responded by e-mail or fax; each physician was called at least twice. Results. Of the 149 eligible physicians, 102 completed the survey for a response rate of 68.5%. Of those who responded, 49 (48%) responded by e-mail, 25 (24.5%) by fax, and 28 (27.5%) by phone. Mode of response did not differ by gender, specialization, or years in practice. In addition, mode of response was not related to the primary study question, physician willingness to use text messaging for immunization reminders. Conclusions. This mix of survey methodologies appeared to be a feasible combination for achieving physician responses and may be more cost effective than other mixed methods.
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Baker, Laurence C., M. Kate Bundorf, Aileen M. Devlin, and Daniel P. Kessler. "Hospital Ownership of Physicians: Hospital Versus Physician Perspectives." Medical Care Research and Review 75, no. 1 (November 2, 2016): 88–99. http://dx.doi.org/10.1177/1077558716676018.
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Although there has been significant interest from health services researchers and policy makers about recent trends in hospitals’ ownership of physician practices, few studies have investigated the strengths and weaknesses of available data sources. In this article, we compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey). We find some areas of agreement, but also some disagreement, between the two surveys. We conclude that full understanding of the causes and consequences of hospital ownership of physicians requires data collected at the both the hospital and the physician level. The appropriate measure of integration depends on the research question being investigated.
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Dalia, Samir, and Fred J. Schiffman. "Who's My Doctor? First-Year Residents and Patient Care: Hospitalized Patients' Perception of Their “Main Physician”." Journal of Graduate Medical Education 2, no. 2 (June 1, 2010): 201–5. http://dx.doi.org/10.4300/jgme-d-09-00082.1.
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Abstract Background Studies have shown that a large portion of patient satisfaction is related to physician care, especially when the patient can identify the role of the physician on the team. Because patients encounter multiple physicians in teaching hospitals, it is often difficult to determine who the patient feels is his or her main caregiver. Surveys evaluating resident physicians would help to improve patient satisfaction but are not currently implemented at most medical institutions. Intervention We created a survey to judge patient satisfaction and to determine who patients believe is their “main physician” on the teaching service. Methods Patients on a medical teaching service at The Miriam Hospital during 20 days in March 2008 were asked to complete the survey. A physician involved in the research project administered the surveys. Surveys included 3 questions that judged patient's perception and identification of their primary physician and 7 questions regarding patient satisfaction. Completed surveys were analyzed using averages. Results Of the 126 patients identified for participation, 102 (81%) completed the survey. Most patients identified the intern (first-year resident) as their main physician. Overall, more than 90% of patients expressed satisfaction with their main physician. Conclusion Most patients on the teaching service perceived the intern as their main physician and were satisfied with their physician's care. One likely reason is that interns spend the greatest amount of time with patients on the teaching service.
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Khokhar, Bilal, Jina Yujin Park, Zippora Kiptanui, Francis Palumbo, Sarah Dutcher, Wenlei Jiang, Françoise Pradel, and Ilene Harris. "Assessing Physician and Patient Perceptions of Generic Drugs via Facebook: A Feasibility Study." Journal of Pharmacy Technology 34, no. 2 (December 14, 2017): 43–47. http://dx.doi.org/10.1177/8755122517747906.
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Background: Social media offer a novel avenue to engage with and recruit research participants. Facebook in particular is a promising option given its popularity and widespread use. Objective: To explore the feasibility of using Facebook to recruit physicians and patients to participate in a survey to assess their perceptions about generic venlafaxine extended release (ER) tablet indicated for depression. Methods: Web-based surveys were developed to gauge physicians’ prescribing experiences with and patients’ perceptions of generic venlafaxine ER tablet. The surveys included questions specific to venlafaxine ER tablets, such as perceived safety and efficacy of the drug and overall comfort level with either prescribing or taking the drug. Survey links were then posted and advertised on Facebook to recruit physicians and patients. Results: Advertisement for physicians reached 1898 Facebook users and advertisement for patients reached 1144 users during a 10-day advertising period. However, only 14 and 35 users clicked on the survey for physicians and patients, respectively. No physician completed the physician survey while 3 patients completed the patient survey. Conclusions: The findings of this study suggest that Facebook may not be an effective method to recruit physicians. Facebook holds promise to recruit patients, but additional recruitment efforts, such as incentives, are needed.
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Leigh, R., K. Van Aarsen, L. Foxcroft, and R. Lim. "P012: Does physician burnout differ between urban and rural emergency medicine physicians? A comparison using the Maslach Burnout Inventory tool." CJEM 22, S1 (May 2020): S68—S69. http://dx.doi.org/10.1017/cem.2020.220.
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Introduction: Previous literature suggests that emergency medicine physicians experience high levels of work-related burnout. However, these results are drawn primarily from physicians working in large urban emergency departments. The aim of this study was to compare physician wellness between emergency medicine physicians working in urban versus rural settings. Methods: Emergency medicine physicians were recruited to complete a wellness survey from both urban and rural emergency medicine departments in Southwestern Ontario. The primary outcome measure of interest was physician burnout as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). This survey tool measures physician burnout in the three domains of emotional exhaustion, depersonalization, and personal accomplishment. Descriptive statistics, paired t-tests and Mann-Whitney U tests were used to analyze parametric and non-parametric burnout domain data respectively. Results: Surveys were completed by 67/99 (68%) and 22/66 (33%) of urban and rural emergency medicine physicians, respectively. An emotional exhaustion score ≥27 OR a depersonalization sub-score ≥10 was considered the threshold for burnout and was found in 71.4% (40/56) of urban physicians surveyed and 85.7% (18/21) (P = 0.20) of rural physicians. No statistically significant difference in mean emotional exhaustion, depersonalization, or personal accomplishment was noted between groups. Conclusion: High levels of burnout were noted amongst both urban and rural emergency medicine physicians. No statistically significant differences were noted between groups when compared on the Maslach Burnout Inventory survey tool. Despite many factors differentiating urban from rural practice, rural emergency doctors suffer similar rates of burnout. Thematic qualitative interviews exploring specific burnout factors may offer further insight into the drivers of physician burnout.
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Sobel, Julia, Jessica Bates, Vivienne Ng, Matthew Berkman, Tomas Nuño, Kurt Denninghoff, and Lisa Stoneking. "Effect of Real-Time Surveys on Patient Satisfaction Scores in the Emergency Department." Education Research International 2019 (April 1, 2019): 1–5. http://dx.doi.org/10.1155/2019/6132698.
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Background. Patient satisfaction surveys have become increasingly important as their results help to determine Centers for Medicare and Medicaid Services (CMS) reimbursement. However, these questionnaires have known sources of bias (self-selection, responder, attribution, and nonresponse). Objective. We developed a real-time (RT) survey delivered in the hospital ED to evaluate the effect of implementing RT patient satisfaction surveys on physician behavior and hypothesized that the timing of patient satisfaction survey delivery would significantly impact the results. Method. Data from real-time patient satisfaction surveys were collected in phases from 12/2015 to 5/2017. Hospital-sponsored (HS) surveys were administered after discharge from 12/2015 to 12/2016. Results. For RT surveys, resident physicians were significantly more likely to write their names on the whiteboard (p=0.02) and sit down (p=0.01) with patients. Behavior modifications by attending physicians were not significant. Patient satisfaction measures did not improve significantly between periods for RT or HS surveys; however, RT survey responders were significantly more likely to recommend the ED to others. Conclusion. The timing of survey administration did significantly alter resident physician’s behavior; however, it had no effect on patient satisfaction scores. RT responders were significantly more likely to recommend the emergency department to others.
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Greenblum, Jake, and Ryan K. Hubbard. "Responding to religious patients: why physicians have no business doing theology." Journal of Medical Ethics 45, no. 11 (June 20, 2019): 705–10. http://dx.doi.org/10.1136/medethics-2019-105452.
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A survey of the recent literature suggests that physicians should engage religious patients on religious grounds when the patient cites religious considerations for a medical decision. We offer two arguments that physicians ought to avoid engaging patients in this manner. The first is the Public Reason Argument. We explain why physicians are relevantly akin to public officials. This suggests that it is not the physician’s proper role to engage in religious deliberation. This is because the public character of a physician’s role binds him/her to public reason, which precludes the use of religious considerations. The second argument is the Fiduciary Argument. We show that the patient-physician relationship is a fiduciary relationship, which suggests that the patient has the clinical expectation that physicians limit themselves to medical considerations. Since engaging in religious deliberations lies outside this set of considerations, such engagement undermines trust and therefore damages the patient-physician relationship.
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Coleman-Musser, Lori. "The Physician's Perspective: A Survey of Attitudes toward Organ Donor Management." Journal of Transplant Coordination 7, no. 2 (June 1997): 55–58. http://dx.doi.org/10.1177/090591999700700203.
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The demand for suitable organs in the United States greatly outweighs the supply of transplantable organs. It has been estimated that approximately half of all potential donors do not donate. Preexisting barriers seem to impede donation, and the physician is a vital link in this process. To better understand the physician's perspective and to identify barriers that may produce difficulties in the process, a survey of physicians in northern Ohio was conducted. Respondents identified the following barriers: consensus in tests performed in the diagnosis of death is lacking, ambivalence exists with respect to informing families of the patient's death and offering families the donation option, and physicians do not seem to recognize the importance of decoupling the discussion of brain death from the request for organs. Although physicians surveyed were in favor of donation and transplantation, an effort should be made to increase awareness in personal attitudes that may affect the donation process.
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VanFrank, Brenna K., Sohyun Park, Jennifer L. Foltz, Lisa C. McGuire, and Diane M. Harris. "Physician Characteristics Associated With Sugar-Sweetened Beverage Counseling Practices." American Journal of Health Promotion 32, no. 6 (December 12, 2016): 1365–74. http://dx.doi.org/10.1177/0890117116680472.
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Purpose: Frequent sugar-sweetened beverage (SSB) consumption is associated with chronic disease. Although physician counseling can positively affect patient behavior, physicians’ personal characteristics may influence counseling practices. We explored SSB-related topics physicians discuss when counseling overweight/obese patients and examined associations between physicians’ SSB-related counseling practices and their personal and medical practice characteristics. Design: Cross-sectional survey. Setting: DocStyles survey, 2014. Participants: A total of 1510 practicing US physicians. Measures: Physician’s SSB counseling on calories, added sugars, obesity/weight gain, health effects, consumption frequency, water substitution, and referral. Analysis: Adjusted odds ratios (aORs) were calculated with multivariable logistic regression, adjusting for physician’s personal and medical practice characteristics. Results: Most physicians (98.5%) reported SSB-related counseling. The most reported topic was obesity/weight gain (81.4%); the least reported were added sugars (53.1%) and referral (35.0%). Physicians in adult-focused specialties had lower odds than pediatricians of counseling on several topics (aOR range: 0.26-0.64). Outpatient physicians had higher odds than inpatient physicians of counseling on consumption frequency and water substitution (aOR range: 1.60-2.01). Physicians consuming SSBs ≥1 time/day (15.7%) had lower odds than nonconsumers of counseling on most topics (aOR range: 0.58-0.68). Conclusion: Most physicians reported SSB-related counseling; obesity/weight gain was discussed most frequently. Counseling opportunities remain in other topic areas. Opportunities also exist to strengthen SSB counseling practices in adult-focused specialties, inpatient settings, and among physicians who consume SSBs daily.
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Song, Wenwen, Honghe Li, Ning Ding, Weiyue Zhao, Lin Shi, and Deliang Wen. "Psychometrics properties of the Team Interaction Scale and influencing factors of team interaction of tertiary hospital physicians in China: a cross-sectional study." BMJ Open 9, no. 8 (August 2019): e026162. http://dx.doi.org/10.1136/bmjopen-2018-026162.
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ObjectivesTo administer a cross-cultural adaptation of the Team Interaction Scale (TIS), test its psychometric properties and investigate influencing factors of team interactions in a physician population in Chinese tertiary hospitals.DesignCross-sectional survey.SettingsTwo rounds of surveys, a pilot and a large sampling survey, were conducted in two and nine tertiary hospitals, respectively, in Liaoning Province, China.ParticipantsIn the pilot survey, 363 of 390 physicians sampled were included in the analysis, resulting in an effective response rate of 93.08%. In the large sampling survey, the effective response rate was 89.10% (3653 of 4100 physicians).Outcome measuresThe TIS and a short version of a burn-out scale were administrated to assess the physician’s team interaction and burn-out. Psychometric properties of TIS were tested by confirmatory factor analysis (CFA), exploratory factor analysis (EFA) and internal consistency analysis. Gender, age, discipline, education level, professional title, hospital scale and burn-out were explored as influencing factors with independent samplet-tests, one-way analyses of variance and a correlation analysis.ResultsBased on CFA, a 17-item modified scale was developed following the pilot survey. In the large sampling survey, EFA was conducted with half of the samples, producing six dimensions: ‘Communication’, ‘Coordination’, ‘Mutual help’, ‘Team goals’, ‘Work norms’ and ‘Cohesion and conflict resolution’. Fit of the modified model was confirmed by CFA with the other half of the samples (root mean square error of approximation=0.067, Comparative Fit Index=0.98, Normed Fit Index=0.97, Goodness of Fit Index=0.94, Adjusted Goodness of Fit Index=0.92). A high Cronbach’s α coefficient of 0.98 demonstrated reliability of the modified scale. The Team Interaction Score was significantly lower in younger physicians, in men, in paediatricians and in physicians from larger-scale tertiary hospitals. Team Interaction Scores were negatively associated with burn-out.ConclusionsThe adapted TIS, containing 17 items and six dimensions, was reliable and valid for Chinese tertiary hospital physicians. To address physician burn-out, team interaction should be highlighted.
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Matthews, Juliana J., and Carly Elizabeth Souther. "Factors Associated With Implementation of the POLST Paradigm: Results From a Survey of Florida Physicians." Care Management Journals 14, no. 4 (December 2013): 247–53. http://dx.doi.org/10.1891/1521-0987.14.4.247.
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Objectives: To investigate physicians’ awareness and attitudes regarding the Physician Orders for Life-Sustaining Treatment (POLST) concept and to identify barriers and opportunities for its expansion.Design: Cross-sectional questionnaire, using electronic survey instrument.Setting: Community.Patients: 212 physicians from three Florida medical associations and the Florida State University College of Medicine clinical faculty responded to the survey. Of those, 67.9% were familiar with the concept of POLST.Measurements and Main Results: Data were collected using a web-based survey, completed in June–July 2012, consisting of qualitative and quantitative questions. Most (95.8%) agreed or strongly agreed that it was a physician’s responsibility to discuss end-of-life care and treatment options with patients. Satisfaction with current advanced directives was highly variable. However, a consensus about potential benefits of POLST exists, including assisting the discussion of end-of-life care, decreasing unwanted treatment, and lowering costs. More than 70% of respondents reported they would be more likely to use the POLST form if provided civil and criminal immunity; however, data analysis rendered the apparent association statistically insignificant. Qualitative data were also collected in the form of respondents’ recommendations and additional comments.Conclusions: Physicians vary in their knowledge and opinions regarding the POLST paradigm. Broad opportunities may exist to improve physician knowledge and attitudes toward POLST. Dissemination of educational materials to physicians involved in the end-of-life planning process may increase physician support and use of POLST.
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Brown, Gina R., LaDonna S. Hale, Molly C. Britz, Mindy J. Schrader, Sedera L. Sholtz, and Madalyn J. Unruh. "A Survey of Kansas Physicians' Perceptions of Physician Assistant Education and Qualifications." Kansas Journal of Medicine 8, no. 1 (February 27, 2015): 18–25. http://dx.doi.org/10.17161/kjm.v8i1.11512.
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BACKGROUND: Effective physician-physician assistant (PA) teams improve patient access and satisfaction, and increase productivity and revenue while reducing physician workload. This survey assessed perceptions of Kansas primary care physicians regarding educational requirements and qualifications of PAs, professional and legal regulations, and the most important skills and competencies for PAs to possess. Understanding these perceptions may lead to improved communication and refined expectations of physician-physician assistant teams, thereby increasing their utilization and effectiveness. METHODS: A 20-question survey was emailed to all 1,551 primary care physicians registered with the Kansas Board of Healing Arts in 2012. Descriptive data were reported as frequencies; comparisons between groups were analyzed using Chi-square. RESULTS: The response rate was 9.2% (n = 143). Physicians were highly accurate regarding the program’s generalist/primary care educational model and moderately accurate regarding the degree awarded, average pre-program grade point average, lock-step full-time curriculum, weeks of clinical rotations, recertification and continuing medical education hours, and Medicare PA fee schedule. Physicians had low accuracy regarding program and pharmacology credit hours, strict dismissal policy, pre-program healthcare experience, and co-signatory regulations. Physicians with PA supervisory experience had higher knowledge than those without (p = 0.001). Physicians most commonly selected history taking and performing physical exam as the most important skill (49%) and providing patient care that is patient-centered, efficient, and equitable as the most important competency (42%). CONCLUSIONS: Physicians often underestimated the average PA applicant qualifications, program rigor and intensity, professional regulatory standards, and co-signatory requirements. Correcting misperceptions and improving understanding of which PA skills and competencies are most valued by physicians may optimize PAs as part of the healthcare team.
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Khan, Shamima, Joshua Spooner, and Harlan Spotts. "United States Physician Preferences Regarding Healthcare Financing Options: A Multistate Survey." Pharmacy 6, no. 4 (December 9, 2018): 131. http://dx.doi.org/10.3390/pharmacy6040131.
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Background: Not much is currently known about United States (US) physicians’ opinions about healthcare financing, specifically subsequent to the creation and implementation of the Affordable Care Act (ACA). Objectives: A four state survey of practicing US based physicians’ opinions about healthcare financing following ACA passage and implementation. Methods: Physician leaders practicing in the state of New York, Texas, Colorado and Mississippi were surveyed. Two factor analyses (FA) were conducted to understand the underlying constructs. Results: We determined the final response rate to be 26.7% after adjusting it for a variety of factors. Most physicians favored either a single payer system (43.8%) or individualized insurance coverage using health savings accounts (33.2%). For the single-payer system, FA revealed two underlying constructs: System orientation (how the physicians perceived the impact on the healthcare system or patients) and individual orientation (how the physicians perceived the impact on individual physicians). Subsequently, we found that physicians who were perceived neutral in their attitudes towards physician-patient relationship and patient conflict were also neutral in reference to system orientation and individual orientation. Physicians who were perceived as stronger on the physician-patient relationship were more supportive of a single-payer system. Conclusion: This study brings attention to the paradox of social responsibility (to provide quality healthcare) and professional autonomy (the potential impact of a healthcare financing structure to negatively affect income and workload). Efforts to further reform healthcare financing and delivery in the US may encounter resistance from healthcare providers (physicians, mid-level prescribers, pharmacists, or nurses) if the proposed reform interferes with their professional autonomy.
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Kahale, Pravin, Pijush Kanti Biswas, Sunil George, Sree Ranga P. C., Pankaj Singh, Sanjoy K. Nag, and Soumen Roy. "Preference and practice of Indian physicians towards the use of vasodilator di-hydralazine in the management of resistant hypertension." International Journal of Advances in Medicine 7, no. 12 (November 23, 2020): 1781. http://dx.doi.org/10.18203/2349-3933.ijam20204986.
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Background: The treatment modalities of resistant hypertension (RH) remain a clinical challenge, often requiring secondary/add-on drugs with first-line therapy to control blood pressure (BP). This study was conducted to explore and understand the preferences and practices of Indian physicians towards the use of vasodilator (especially di-hydralazine) in the management of RH.Methods: This was a cross-sectional, observational, web-based physician survey. The study included cardiologist, nephrologist and consultant physicians from different geographical regions of India. A web-based physician survey questionnaire (PSQ) was created in google forms and the link was circulated to the physicians. Responses obtained were analysed.Results: A total of 457 physicians participated in this survey. In majority of the physicians, vasodilators were the treatment choice as secondary or add-on drugs with first line therapy to control BP in RH; especially hydralazine/di-hydralazine preferred the most. Majority of the physicians preferred to combine vasodilator with beta blocker and diuretic in patients with uncontrolled and RH. Cardiac failure, followed by chronic kidney disease (CKD), diabetes, dyslipidaemia, hypertensive emergency and angina were the common patient profile in RH in which majority physicians prescribed vasodilator (di-hydralazine). Majority of the physicians rated vasodilator di-hydralazine as “good-very good” in terms of efficacy, safety, tolerability, patient compliance and patient satisfaction in RH.Conclusions: Overall, vasodilators (hydrazinophthalazine derivatives) are preferred as add-on drugs along with first-line drugs in RH. Physician’s opinion towards the use of di-hydralazine was positive. Di-hydralazine may be preferred as an add-on therapeutic option to control BP in RH, however randomized clinical trials are needed for recommendation in cardio-renal medicine.
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Bhagat, Sagar, Saiprasad Patil, Sagar Panchal, and Hanmant Barkate. "Physicians perception in the management of allergic rhinitis: a Pan-India survey." International Journal of Otorhinolaryngology and Head and Neck Surgery 6, no. 12 (November 24, 2020): 2233. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205065.
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<p class="abstract"><strong>Background: </strong>Allergic rhinitis (AR) affects a wide proportion of the population across all age groups. There are several guidelines and consensus statements in AR management, the effect of this is implicit from a physician's perspective. The present cross-sectional survey was conducted to understand physicians approach to the management algorithm in the treatment of allergic rhinitis and medication choice.</p><p class="abstract"><strong>Methods:</strong> Physicians from diverse specialties such as pulmonologists, consultant physician, paediatricians, Allergists, ENT specialists and general practitioners were invited to participate in the survey, which focused on recognizing the burden of disease, clinical presentation, and management methods.</p><p class="abstract"><strong>Results:</strong> 1,261 Physicians participated in this survey, belonging to different specialties. Oral H1 antihistamine was favoured as a first-line therapy, followed by the combination of oral H1 histamine and leukotriene receptor antagonist. Fexofenadine was the most frequently prescribed. Majority believed, bilastine as antihistamine with the least sedative potential and was identified as the most effective treatment. Bilastine was preferred in patients with mild- moderate hepatic/renal impairment and in patients with persistent allergic rhinitis. Most physicians prefer bilastine in all AR clinical profiles. Aside from AR, bilastine is also use in management of upper respiratory tract infections and urticaria respectively.</p><p class="abstract"><strong>Conclusions: </strong>AR is still a growing challenge in India with majority of physician preferring oral antihistamine either as monotherapy or in combination. Bilastine is a preferred choice in patients with impaired liver and renal function and was also referred as least sedative antihistamine by majority of physicians across India. </p>
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Vargas-Schaffer, Grisell, Suzie Paquet, Andrée Neron, and Jennifer Cogan. "Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey." Journal of Personalized Medicine 10, no. 2 (April 21, 2020): 27. http://dx.doi.org/10.3390/jpm10020027.
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Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.
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Taylor, Tamara, and Anthony Scott. "Do Physicians Prefer to Complete Online or Mail Surveys? Findings From a National Longitudinal Survey." Evaluation & the Health Professions 42, no. 1 (November 1, 2018): 41–70. http://dx.doi.org/10.1177/0163278718807744.
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Survey response rates for physicians are falling generally, and surveys of physicians tend to have lower response rates than those of the general population. To maximize response, respondents are often given a choice of modes in which to respond. The aim of this article is to describe mode response patterns and identify factors related to physicians’ decisions to complete surveys online rather than by mail. The data are from the fifth annual wave of the Medicine in Australia: Balancing Employment and Life longitudinal survey of physicians, in which there was a 43.5% response rate (10,746/24,711) and 33.7% of respondents completed the survey online. Online completion was more likely when the physician had completed the survey online in the previous wave, was a general practitioner rather than other medical specialist or doctor-in-training, worked in a remote location, and was young and male. Free-text spontaneous comments from respondents indicated that mode choice was based on a combination of preference, previous experience, and feasibility. These results provide support for the use of mixed mode survey designs, which can accommodate doctors with different mode preferences and cast doubt over the possibility of tailoring mode based on respondent characteristics.
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Mesa, Ruben, Carole B. Miller, Maureen Thyne, James Mangan, Sara Goldberger, Salman Fazal, Xiaomei Ma, et al. "Gaps in Perception Between Patients and Physicians Regarding Symptomatology and Treatment Attitudes for Myeloproliferative Neoplasms: MPN LANDMARK SURVEY." Blood 124, no. 21 (December 6, 2014): 4827. http://dx.doi.org/10.1182/blood.v124.21.4827.4827.
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Abstract Background : Patients diagnosed with myeloproliferative neoplasms (MPNs), including myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET), experience disease burdens that can negatively affect their quality of life. Disconnects between patient and physician perceptions of disease burden or poor patient-physician communication may delay or prevent achievement of treatment goals. The MPN LANDMARK SURVEY is the first large US-based survey designed to evaluate disease burden and patient-physician communication in MPN disease settings. Methods : All eligible patients diagnosed with 1 of the 3 MPNs and physicians treating patients with MPNs that were recruited were surveyed in the US during May-July 2014.The surveys included ≤67 questions (depending on the type of MPN and respondent) and required approximately 20–25 minutes to complete. Descriptive analyses were conducted to identify gaps in perceptions of disease burden and patient-physician communication. Results : The MPN LANDMARK SURVEY was completed by 813 patients (MF=207; PV=380; ET=226) and 457 physicians. Approximately half of the patients were 60–74 years of age (MF, 55%; PV, 51%; ET, 46%), the majority were female (MF, 54%; PV, 62%; ET, 72%) and had a degree from a 4-year college or postgraduate institution (MF, 65%; PV, 65%; ET, 58%), and >98% had health insurance. The majority of physicians graduated from medical school 5–24 years before the survey (67%) and practiced in outpatient settings (single specialty groups, 42%; academic hospitals, 31%). Patient-physician communication gaps were identified in several important areas: (1) Prognostic assessment: most patients did not recall receiving a prognostic risk score, but most physicians reported classifying patients by prognostic risk (Table 1). (2) Symptom assessment: physicians were more likely than patients to report that physicians ask about patients' most important disease-related symptoms or about a full and comprehensive list of symptoms (Table 1). (3) Treatment goals: the most important treatment goals were different in MF (patients: delay disease progression; physicians: improve symptoms) and PV (patients: delay disease progression; physicians: prevent vascular/thrombotic events) settings (Table 2). Patients and physicians in the ET setting both reported that prevention of vascular/thrombotic events was the most important treatment goal. Patients and physicians in the MF and PV settings reported fatigue as the most pressing disease manifestation that patients would like to resolve (MF: patients, 47%; physicians, 65%; PV: patients, 33%; physicians, 31%), whereas patients and physicians differed in the ET setting (patients: fatigue, 33%; physicians: stroke, 29%). Most patients reported a desire to be ≥50% responsible for their treatment decisions (MF, 72%; PV, 71%; ET, 75%). Physicians reported that most patients sometimes or often did not wish to comply with their primary treatment recommendation (MF, 77%; PV, 84%; ET, 79%). (4) Treatment satisfaction: overall, more than one third of patients were somewhat satisfied or dissatisfied with their physician's communication about their condition and treatment (MF, 34%; PV, 43%; ET, 45%) and with their physician's overall management of their disease (MF, 36%; PV, 40%; ET, 42%). Among patients who changed their MPN doctor (MF, 47%; PV, 46%; ET, 56%), dissatisfaction with prior care received was the most frequently reported reason for the change (MF, 40%; PV, 37%; ET, 33%). Approximately one fifth to one fourth of patients included their doctor's office among the most helpful sources of information about their diagnosis (MF, 27%; PV, 22%; ET, 20%), and most patients included the internet among the most helpful sources (MF, 90%; PV, 87%; ET, 89%). Conclusion : Important disconnects exist between patients' and physicians' perceptions in MPN disease settings. In addition, the majority of physicians report classifying patients by prognostic risk, including PV and ET settings, which do not have widely accepted prognostic risk scores. Although physicians generally appreciate the burden that MPNs have on patients, patient management may be enhanced with improved elucidation of patient symptoms and clear communication regarding the goals and potential benefits of interventions. Disclosures Mesa: Incyte Corporation: Research Funding; CTI: Research Funding; Gilead: Research Funding; Genentech: Research Funding; Eli Lilly: Research Funding; Promedior: Research Funding; NS Pharma: Research Funding; Sanofi: Research Funding; Celgene: Research Funding. Miller:Incyte Corporation: Honoraria, Research Funding. Thyne:Incyte Corporation: Speakers Bureau. Mangan:Incyte Corporation: Membership on an entity's Board of Directors or advisory committees; Alexion Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. Goldberger:Incyte Corporation: Membership on an entity's Board of Directors or advisory committees. Fazal:Incyte Corporation: Consultancy, Research Funding, Speakers Bureau; Gilead: Research Funding, Speakers Bureau. Ma:Incyte Corporation: Consultancy. Wilson:Incyte Corporation: Honoraria. Dubinski:Incyte Corporation: Employment, Equity Ownership. Boyle:ICF International: Employment, Equity Ownership. Mascarenhas:Novartis Pharmaceuticals: Research Funding; Incyte Corporation: Consultancy, Research Funding.
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Chang, I.-Chiu, Kuei-Chen Cheng, Hui-Mei Hsu, and David C. Yen. "Factors Influencing Physicians’ Continuous Blogging: A Survey." Healthcare 9, no. 8 (July 29, 2021): 958. http://dx.doi.org/10.3390/healthcare9080958.
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Background: Health information can be more easily transmitted and diffused through the Internet, but questionable online health information often misinforms patients. Physicians have a duty to inform patients how to achieve positive health outcomes. Many physicians often write blogs to provide patients with the right health information. However, most articles available on this subject only describe the blog phenomena without providing a theoretical background and an empirical analysis of doctors using blogs. Methods: This study based on social cognitive theory (SCT) explores the factors influencing physicians’ intention of continuously blogging. A total of 887 physician bloggers were invited to participate in an online survey and 128 valid responses were received. Results: The SCT was proven to be useful in explaining 36.8% of the variation in physicians’ continuous intention to blog. Conclusions: We provide references for platform developers with different strategies to motivate doctors to blog, and the implications and limitations of this study are discussed.
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Hamelin, A., J. Yan, and I. G. Stiell. "LO067: Emergency department management of diabetic ketoacidosis and hyperosmolar hyperglycemic state: national survey of attitudes and practice." CJEM 18, S1 (May 2016): S53. http://dx.doi.org/10.1017/cem.2016.104.
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Introduction: The 2011 Canadian Diabetes Association (CDA) Clinical Practice Guidelines were developed in order to help physicians manage hyperglycemic emergencies in the emergency department (ED), including diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). The goal of this study was to determine physician attitudes towards these guidelines and to identify potential barriers to their implementation in the ED. Methods: We distributed an online, cross sectional survey to 500 randomly selected members of the Canadian Association of Emergency Physicians (CAEP) who were currently practicing physicians. A total of 3 email notifications were distributed on days 1, 7 and 14. The survey consisted of 23 questions relating to physician management of DKA and HHS in the ED. The primary outcome was overall physician familiarity and usage of the guidelines using a 7-point Likert scale. Secondary outcomes included physician attitudes towards the guidelines as well as any perceived barriers to their implementation in the ED. Simple descriptive statistics were used to illustrate the survey results. Results: The survey response rate was 62.2% (311/500) with the following participant characteristics: male (62.6%), CCFP(EM) training (46.1%) and working in major academic centers (50.5%). The overall awareness rate of the CDA guidelines was 22.9% (95% CI = 18.3%, 27.5%). 58.9% (95% CI = 53.3%, 64.3%) reported the CDA guidelines being useful. The most frequently reported barriers to CDA guideline implementation were concerns about education issues (56.0%), lack of time and disruption of flow (23.9%), staffing and human resource issues (26.7%) and poor policy adherence (25.5%). Physician’s ideal changes to optimize the management of these patients included improved coordination for follow-up with family physicians (79.9%), increased diabetes education for patients (73.9%) and increased availability to diabetes specialists (47.5%). Conclusion: In this study, although Canadian ED physicians were generally supportive of the CDA guidelines, many were unaware that these guidelines existed and barriers to their implementation were reported. Future research should focus on strategies to standardize DKA and HHS management by ensuring physician awareness and education to ensure the highest quality of patient care.
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Kugasia, A., N. Sehgal, M. Dollear, W. Sequeira, J. A. Block, and M. Jolly. "Practice patterns in longitudinal lupus care provision: patient and physician perspectives." Lupus 26, no. 14 (June 28, 2017): 1556–61. http://dx.doi.org/10.1177/0961203317716788.
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Background/purpose To plan a quality improvement project, we need to understand the practice patterns of physicians. We undertook an online survey of systemic lupus erythematosus (SLE) patients and physicians providing care to SLE patients to determine the patterns of medical care provided to SLE patients. Materials and methods Two self-report surveys were developed. A 12-item survey for the patients and a 13-item survey for physicians enquired about longitudinal care for SLE. Surveys were administered online to physicians providing care to SLE patients, and to patients who self-identified as having SLE, through the Lupus Society of Illinois. Patient and physician data were analyzed for physician practice patterns for SLE care, using chi square tests and t tests. A P value of 0.05 or less was considered significant on two-tailed tests. Results A total of 283 patients completed the survey. Mean (SD) age and disease duration of patients were 45.9 (13.2) and 12.7 (9.7) years. Half of the participants were being seen at 3–4-month intervals. More than 70% of patients reported being tested for antinuclear antibody (ANA), and 20–30% anti-ENA antibody and Sjögren’s (SSA/SSB) antibodies, respectively, at each follow-up visit. Eighty-six rheumatologists completed the surveys. Mean (SD) age was 55 (12) years and 56% were men. More than half (54%) provided care only in a private practice setting. More than 80% of physicians reported seeing their SLE patients at 3–4-month interval. Only 2% reported performing ANA tests at each visit, while 4–5% performed anti-ENA and anti-SSA/SSB antibody tests at each visit for their SLE patients. More than 75% of physicians in private practice also ordered sedimentation rate at each visit for their SLE patients. Conclusions Unnecessary laboratory investigations may be being ordered routinely for patients at every visit. These results indicate a need for physician education on indications and utility of some of the laboratory tests such as ANA.
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Ritchie, David J., Robert F. Manchester, Michael W. Rich, Mary M. Rockwell, and Paul M. Stein. "Acceptance of a Pharmacy-Based, Physician-Edited Hospital Pharmacy and Therapeutics Committee Newsletter." Annals of Pharmacotherapy 26, no. 7-8 (July 1992): 886–89. http://dx.doi.org/10.1177/106002809202600703.
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OBJECTIVE: To assess the level of physician acceptance and perceived usefulness of a pharmacy-prepared, physician-edited pharmacy and therapeutics (P&T) committee newsletter. DESIGN: Two separate surveys conducted after 7 and 24 months of publication, respectively. SETTING: 500-bed, university-affiliated, tertiary-care hospital. MAIN OUTCOME MEASURES: The initial survey was mailed to physicians after 7 months of publication and they were requested to rate various aspects of the newsletter, including timeliness of articles, usefulness of articles, quality of writing and design, and overall value of the publication on a scale of 1–4: (1 = excellent, 2 = good, 3 = fair, 4 = poor). Physicians were also asked to rank different categories of articles (articles on new drugs, drug-class reviews, topical reviews, formulary news, and articles providing P&T committee information) and were encouraged to provide comments. A separate follow-up survey conducted at 24 months asked physicians to indicate whether they (1) regularly received the newsletter, (2) regularly read the newsletter, (3) found the information in the newsletter to be useful, and (4) desired to continue receiving the newsletter. RESULTS: Initial survey results yielded mean newsletter quality scores ranging from 1.54 to 1.66. Respondents preferred, in descending order, articles on new drugs, drug-class reviews, topical reviews, formulary news, and P&T committee information. The 24-month survey revealed that 96 percent of the physicians regularly receiving and reading the newsletter found the information useful and 97 percent felt that the newsletter should continue to be published. Favorable comments were also received from several prominent physicians. CONCLUSIONS: The results indicate strong physician acceptance of a pharmacy-prepared, physician-edited newsletter and provide information about the types of articles preferred by physicians in a university hospital setting.
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Berry-Stoelzle, Maresi, Kim Parang, and Jeanette Daly. "Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors." Health Services Research and Managerial Epidemiology 6 (January 1, 2019): 233339281882291. http://dx.doi.org/10.1177/2333392818822914.
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Background: A cancer diagnosis is a monumental event in a patient’s life and with the number of cancer survivors increasing; most of these patients will be taken care of by a primary care provider at some point after their cancer therapy. The purpose of this study is to identify primary care physician’s needs to care for a patient who has had cancer. Methods: A cross-sectional survey of the physician members of the Iowa Research Network was conducted. The survey was designed to measure physician confidence in cancer survivor’s care, office strategies regarding cancer survivorship care, and resources available for patients with cancer. Two hundred seventy-four Iowa Research Network members were invited to participate in this survey. Results: Eighty-two physicians (30%) completed the questionnaire with 96% reporting that they are aware of their patient’s cancer survivorship status. Seventy-one physicians reported they were aware of cancer survivorship status by an oncologist sending a note to the office, 68 being diagnosed in their office, 61 by the patient keeping the office apprised, and 15 receiving a survivorship care plan. Physicians reported the top changes in a cancer survivor’s physical health as fatigue (81%) and pain (59%). Sixty-two physicians reported not feeling confident for managing chemobrain, cardiotoxicity (71%), and skin changes (35%). Male physicians were significantly more confident managing patients’ skin changes ( P = .049) and musculoskeletal disturbances than female physicians ( P = .027), while female physicians were significantly more confident managing early-onset menopause than male physicians ( P = .027). Conclusion: Most respondents are aware of their patients who are cancer survivors and are mostly confident in the care they provide for them related to long-term effects and side effects of cancer therapies with limited receipt of cancer survivorship care plans.
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Soin, Amol. "The Effect of COVID-19 on Interventional Pain Management Practices: A Physician Burnout Survey." Pain Physician 4S;23, no. 8;4S (August 14, 2020): S271—S282. http://dx.doi.org/10.36076/ppj.2020/23/s271.
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Background: Burnout has been a commonly discussed issue for the past ten years among physicians and other health care workers. A survey of interventional pain physicians published in 2016 reported high levels of emotional exhaustion, often considered the most taxing aspect of burnout. Job dissatisfaction appeared to be the leading agent in the development of burnout in pain medicine physicians in the United States. The COVID-19 pandemic has drastically affected the entire health care workforce and interventional pain management, with other surgical specialties, has been affected significantly. The COVID-19 pandemic has placed several physical and emotional stressors on interventional pain management physicians and this may lead to increased physician burnout. Objective: To assess the presence of burnout specific to COVID-19 pandemic among practicing interventional pain physicians. Methods: American Society of Interventional Pain Physicians (ASIPP) administered a 32 question survey to their members by contacting them via commercially available online marketing company platform. The survey was completed on www.constantcontact.com. Results: Of 179 surveys sent, 100 responses were obtained. The data from the survey demonstrated that 98% of physician practices were affected by COVID and 91% of physicians felt it had a significant financial impact. Sixty seven percent of the physicians responded that inhouse billing was responsible for their increased level of burnout, whereas 73% responded that electronic medical records (EMRs) were one of the causes. Overall, 78% were very concerned. Almost all respondents have been affected with a reduction in interventional procedures. 60% had a negative opinion about the future of their practice, whereas 66% were negative about the entire health care industry. Limitations: The survey included only a small number of member physicians. Consequently, it may not be generalized for other specialties or even pain medicine. However, it does represent the sentiment and present status of interventional pain management. Conclusion: The COVID-19 pandemic has put interventional pain practices throughout the United States under considerable financial and psychological stress. It is essential to quantify the extent of economic loss, offer strategies to actively manage provider practice/wellbeing, and minimize risk to personnel to keep patients safe. Key Words: Interventional pain management, burnout, interventional pain physician, corona COVID-19, financial stress, anxiety, depression
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Rubin, David, Charles Sninsky, Britta Siegmund, Miquel Sans, Ailsa Hart, Brian Bressler, Yoram Bouhnik, Alessandro Armuzzi, and Anita Afzali. "P169 DEFINITION OF REMISSION IN INFLAMMATORY BOWEL DISEASE: ASSESSMENT OF PATIENT AND PHYSICIAN PERSPECTIVES." Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S77. http://dx.doi.org/10.1093/ibd/zaa010.191.
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Abstract Background A primary goal in IBD management is achieving disease remission; however, patient (pt)-physician alignment on this goal is unclear. International online surveys were conducted to gain insights into pts’ and physicians’ perspectives on real-world management of IBD. Herein, we report survey findings pertaining to their understanding and perceptions of disease remission in IBD. Methods Surveys were completed online by pts and physicians in Canada, France, Germany, Italy, Spain, UK, and US. Using a mixed-recruitment method, pts were identified by physicians, pt advocacy groups, and panels, while physicians were identified by recruitment agencies and panels. Eligible pts were aged ≥18 y who were diagnosed with and received treatment for Crohn’s disease (CD) or ulcerative colitis (UC) and had not undergone surgery for UC. Eligible physicians were gastroenterologists who had treated pts with CD or UC (≥12 each) in the last month, were responsible for treatment decisions of their IBD pts, and for whom ≥30% of their IBD pts had moderate or severe disease per prespecified clinical criteria. A 1:1 CD:UC ratio was targeted for the pt survey. Alignment between pts and physicians on remission definitions and pt-physician communication about remission was assessed. Physicians’ estimates of remission rates in their moderate/severe IBD pts receiving biologic therapy and their satisfaction (1=very dissatisfied to 7=very satisfied) with remission rates with current IBD treatments also were reported. Results A total of 2398 IBD pts (1368 CD [40% male], 1030 UC [45% male]) and 654 physicians completed the surveys. Mean pt age was 42 y (CD) and 44 y (UC). Physicians had mean monthly caseloads of 42.9 (CD) and 43.3 (UC). The most common primary care settings were university/teaching hospitals (41%), private practices (31%), and regional/community hospitals (20%). Nearly one quarter of pts reported never having discussed remission with their physician; only 7% of physicians reported that they typically did not discuss remission with their pts. Pts most commonly defined remission as symptom resolution (45%), whereas most physicians defined remission through test results (64% CD, 70% UC), including colonoscopies (56% CD, 58% UC), biopsies (36%, 37%), and biochemical tests (8%, 6%). Most pts (62% CD, 64% UC) had never heard of the term “mucosal healing.” Despite low physician-reported remission rates (CD: 37%–54%; UC: 37%–55%), 25% and 36% of physicians reported high satisfaction (score ≥6) with CD and UC remission rates, respectively. Conclusions This international survey demonstrated differences in pts’ and physicians’ definitions of IBD remission and in their understanding of the role of histologic remission in IBD. The findings highlight the need for improved pt-physician communication and education regarding remission, which may improve adherence and outcomes.
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Manning, Blaine T., Daniel D. Bohl, Charles P. Hannon, Michael L. Redondo, David R. Christian, Brian Forsythe, Shane J. Nho, and Bernard R. Bach. "Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine." Orthopaedic Journal of Sports Medicine 6, no. 4 (April 1, 2018): 232596711876687. http://dx.doi.org/10.1177/2325967118766873.
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Background: Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. Purpose: To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician’s midlevel provider to patients when initially selecting a physician. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Results: Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician’s midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. Conclusion: As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient satisfaction. Physicians may consider these data in clinical workforce planning, as patients preferred specific services to be physician or midlevel provided. It may be worthwhile to consider midlevel providers in marketing efforts, given that patients considered the credentials of the physician’s midlevel provider when initially selecting a new physician. Patients lacked consensus regarding reimbursement equity between physicians and midlevel providers, despite responding that the physician provides a higher-quality consultation. Our findings are important for understanding the midlevel workforce as it continues to grow in response to the increasing demand for orthopaedic sports care.
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Lockyer, Jocelyn M., Claudio Violato, Herta Fidler, and Pauline Alakija. "The Assessment of Pathologists/Laboratory Medicine Physicians Through a Multisource Feedback Tool." Archives of Pathology & Laboratory Medicine 133, no. 8 (August 1, 2009): 1301–8. http://dx.doi.org/10.5858/133.8.1301.
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Abstract Context.—There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies. Objective.—To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians. Design.—Surveys with 39, 30, and 22 items were developed to assess individual physicians by 8 peers, 8 referring physicians, and 8 coworkers (eg, technologists, secretaries), respectively, using 5-point scales and an unable-to-assess category. Physicians completed a self-assessment survey. Items addressed key competencies related to clinical competence, collaboration, professionalism, and communication. Results.—Data from 101 pathologists and laboratory medicine physicians were analyzed. The mean number of respondents per physician was 7.6, 7.4, and 7.6 for peers, referring physicians, and coworkers, respectively. The reliability of the internal consistency, measured by Cronbach α, was ≥.95 for the full scale of all instruments. Analysis indicated that the medical peer, referring physician, and coworker instruments achieved a generalizability coefficient of .78, .81, and .81, respectively. Factor analysis showed 4 factors on the peer questionnaire accounted for 68.8% of the total variance: reports and clinical competency, collaboration, educational leadership, and professional behavior. For the referring physician survey, 3 factors accounted for 66.9% of the variance: professionalism, reports, and clinical competency. Two factors on the coworker questionnaire accounted for 59.9% of the total variance: communication and professionalism. Conclusions.—It is feasible to assess this group of physicians using multisource feedback with instruments that are reliable.
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Gallagher, R., P. Hawley, and W. Yeomans. "A Survey of Cancer Pain Management Knowledge and Attitudes of British Columbian Physicians." Pain Research and Management 9, no. 4 (2004): 188–94. http://dx.doi.org/10.1155/2004/748685.
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INTRODUCTION:There are many potential barriers to adequate cancer pain management, including lack of physician education and prescription monitoring programs. The authors surveyed physicians about their specific knowledge of pain management and the effects of the regulation of opioids on their prescribing practices.METHODS:A questionnaire was mailed out to British Columbia physicians who were likely to encounter cancer patients. The survey asked for physicians' opinions about College of Physicians and Surgeons of British Columbia regulation and other issues related to their prescribing practices, and assessed basic knowledge of cancer pain management.RESULTS:There was a 69% return rate with a total of 4618 evaluable responses. There was a significant difference among medical disciplines, years in practice, number of chronic pain patients seen and size of community of practice. The highest knowledge scores were achieved by oncologists and the lowest scores were from surgeons. Those who practiced in smaller communities had a higher average knowledge score. Those who felt their knowledge about cancer pain was inadequate scored lower than those who felt their knowledge was adequate. The questions most frequently answered incorrectly (or by 'don't know') were those about equianalgesic dosing (68%) and adequate breakthrough dosing (45%), revealing knowledge deficiencies that would significantly impair a physician's ability to manage cancer pain.CONCLUSIONS:The details of opioid prescribing are crucial areas to target education for cancer pain management. The surveyed physicians accepted the need for regulation of opioid prescribing with very few being fearful of scrutiny from the College of Physicians and Surgeons of British Columbia. However, the inconvenience of the triplicate prescription pad was more of a barrier to prescribing, it being of concern to 20% of respondents, particularly surgeons and medical specialists.
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Lensing, Shelly Y., Stephen R. Gillaspy, Pippa M. Simpson, Stacie M. Jones, John M. James, and Juneal M. Smith. "Encouraging Physicians to Respond to Surveys through the Use of Fax Technology." Evaluation & the Health Professions 23, no. 3 (September 2000): 348–59. http://dx.doi.org/10.1177/01632780022034642.
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High response rates to surveys of physicians are difficult to achieve. One possible strategy to improve physicians’ survey participation is to offer the option of receiving and returning the survey by fax. This study describes the success of the option of fax communication in a survey of general practitioners, family physicians, and pediatricians in Arkansas with regard to pediatric asthma. Eligible physicians were given the choice of receiving the survey by telephone, mail, or fax. In this observational study, physicians’ preferences, response rates, and biases for surveys administered by fax were compared with mail and telephone surveys. The overall survey response rate was 59%. For the 96 physicians completing an eligibility screener survey, the largest percentage requested to be surveyed by fax (47%) rather than by telephone (28%) or mail (25%). Faxing may be one strategy to add to the arsenal of tools to increase response rates in surveying physicians.
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Siembida, Elizabeth J., Archana Radhakrishnan, Sarah A. Nowak, Andrew M. Parker, and Craig Evan Pollack. "Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey." JCO Clinical Cancer Informatics, no. 1 (November 2017): 1–10. http://dx.doi.org/10.1200/cci.17.00090.
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Purpose Physician reminders have successfully increased rates of mammography. However, considering recent changes to breast cancer screening guidelines that disagree on the optimal age to start and stop mammography screening, we sought to examine the extent to which reminders have been deployed for breast cancer screening targeting younger and older patients. Methods A mailed survey was sent to a national sample of 2,000 primary care physicians between May and September 2016. Physicians were asked whether they received reminders to screen women in various age groups (40 to 44, 45 to 49, and ≥ 75 years), the organizational screening guidelines they trusted most, and whether they recommended routine breast cancer screening to average-risk women in the different age groups. Using regression models, we assessed the association between reminders and physician screening recommendations, controlling for physician and practice characteristics, and evaluated whether the association varied by the guidelines they trusted. Results A total of 871 physicians responded (adjusted response rate, 52.3%). Overall, 28.9% of physicians reported receiving reminders for patient ages 40 to 44 years, 32.5% for patient ages 45 to 49 years, and 16.5% for patient ages ≥ 75 years. Receiving reminders significantly increased the likelihood of physicians recommending mammography screening. In adjusted analyses, 84% (95% CI, 77% to 90%) of physicians who received reminders recommended screening for women ages ≥ 75 versus 65% (95% CI, 62% to 69%) of those who did not receive reminders. The associations between reminders and screening recommendations remained consistent regardless of which guidelines physicians reported trusting. Conclusion Reminders were significantly associated with increases in physician screening recommendations for mammography, underscoring the need for careful implementation in scenarios where guidelines are discordant.
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Sarkar, Sudip. "Use of tamsulosin and dutasteride combination for the management of benign prostatic hyperplasia: a real world practice survey (VELTAM survey)." International Journal of Advances in Medicine 8, no. 8 (July 23, 2021): 1183. http://dx.doi.org/10.18203/2349-3933.ijam20212864.
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Background: Benign prostatic hyperplasia has high prevalence ranging from 8-80% affecting male population. Dutasteride and tamsulosin combination has been found to be more effective as compared to individual monotherapy. However, evidence on real world clinical experience on this combination is lacking. Aim and Objective of current study was to gather the evidence on real world clinical experience from the physicians using the combination of tamsulosin and dutasteride for the management of BPH.Methods: Responses from 1571 physicians who were the current prescribers of tamsulosin with dutasteride combination for the management of BPH were collected in a questioner containing a set of nine questions having multiple choice answers. All the data is expressed as number and percentage.Results: Majority of the physicians considered tamsulosin with dutasteride combination as the gold standard therapy for the treatment of BPH (88.86%). Most common co-morbidities which physician takes in to consideration was cardiovascular (62.61%) followed by asthma (23.04%). While treating BPH patients with cardiovascular co-morbidities, majority of the physician consider drug-drug interaction as significant criteria to decide the therapy (87.83%).Conclusions: Physicians considered tamsulosin and dutasteride combination as the gold standard for the management of BPH with cardiovascular co-morbidity. Tamsulosin and dutasteride combination is the first line choice for the management of BPH in real world practice.
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Elsous, Aymen, Mahmoud Radwan, and Samah Mohsen. "Nurses and Physicians Attitudes toward Nurse-Physician Collaboration: A Survey from Gaza Strip, Palestine." Nursing Research and Practice 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/7406278.
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Interprofessional collaboration and teamwork between nurses and physicians is essential for improving patient outcomes and quality of health services. This study examined the attitudes of nurses and physicians toward nurse-physician collaboration. A cross-sectional study was conducted among nurses and physicians (n=414) in two main referral public hospitals in the Gaza Strip using the Arabic Jefferson Scale of Attitude toward Physician-Nurse Collaboration. Descriptive statistics and difference of means, proportions, and correlations were examined using Student’st-test, one-way ANOVA, and Pearson correlation andp<0.05was considered as statistical significant. Response rate was 42.8% (75.6% for nurses and 24.4% for physicians). Nurses expressed more positives attitudes toward collaboration than physicians (M ± SD on four-point scale:3.40±0.30and3.01±0.35, resp.) and experience duration was not proved to have an interesting influence. Teamwork approach in the professional practice should be recognized taking into consideration that the relationship between physicians and nurses is complementary and nurses are partners in patient care.
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Garvin, Dennis, James Worthington, Shaun McGuire, Stephanie Burgetz, Alan J. Forster, Andrea Patey, Caroline Gerin-Lajoie, Jeffrey Turnbull, and Virginia Roth. "Physician performance feedback in a Canadian academic center." Leadership in Health Services 30, no. 4 (October 2, 2017): 457–74. http://dx.doi.org/10.1108/lhs-08-2016-0037.
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Purpose This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization. Design/methodology/approach A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions. Findings This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met. Originality/value This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.
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Lindblad, Anna, Rurik Löfmark, and Niels Lynöe. "Physician-assisted suicide: a survey of attitudes among Swedish physicians." Scandinavian Journal of Public Health 36, no. 7 (August 6, 2008): 720–27. http://dx.doi.org/10.1177/1403494808090163.
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Hale, Michael K. P., Ian G. Stiell, and Catherine M. Clement. "Emergency Department Management of Heart Failure and COPD: A National Survey of Attitudes and Practice." CJEM 18, no. 6 (March 29, 2016): 429–36. http://dx.doi.org/10.1017/cem.2016.24.
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AbstractObjectivesThe Ottawa Heart Failure Risk Scale (OHFRS) and the Ottawa COPD Risk Scale (OCRS) were developed in order to estimate medical risk and to help guide disposition decisions for patients presenting to the ED with acute exacerbations of heart failure (HF) and COPD. We sought to determine physician attitudes towards these two new risk scales and to identify potential barriers to their ED implementation.MethodsTwo self-administered online surveys were distributed to the Canadian Association of Emergency Physicians. The surveys each consisted of 16 questions relating to the OHFRS and OCRS. The primary outcome measures were the overall physician rating of the two risk scales. Secondary outcome measures assessed the likelihood of risk scale implementation into Canadian EDs, as well as the perceived barriers to such implementation. Descriptive statistics were used.ResultsFor the OHFRS survey, we received responses from 195 emergency physicians (35.7%). Overall, 74.4% approved of the risk scale based on a Likert rating of 4 or 5 and 66.7% believed that the risk scale would be implemented at their hospital. For the OCRS survey, we received responses from 208 emergency physicians (38.1%). Overall, 76.9% approved of the risk scale based on a Likert rating of 4 or 5 and 70.2% believed that the risk scale would be implemented at their hospital.ConclusionsCanadian emergency physicians are very supportive of the new OHFRS and OCRS. We believe these risk scales will assist physicians with making safe and efficient disposition decisions and improve outcomes for patients suffering from HF and COPD.
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Wojcik, Barbara E., Catherine R. Stein, Kenzi Guerrero, Brandon J. Hosek, Rebecca J. Humphrey, and Douglas W. Soderdahl. "Army Physician Career Satisfaction Based on a Medical Corps Survey." Military Medicine 185, no. 7-8 (April 1, 2020): e1200-e1208. http://dx.doi.org/10.1093/milmed/usz480.
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Abstract Introduction It is critical the U.S. Army retains skilled physicians in the Medical Corps (MC) to ensure direct support to military operations and medical readiness. The purpose of this study was to examine U.S. Army physicians’ opinions concerning: readiness to perform required duties, work environment, support and recognition they receive, military career intentions, and how these factors may relate to Army physician job satisfaction. Materials and Methods A cross-sectional study of Army physicians was conducted using a 45-item web-based survey tool, “Army Medicine Medical Corps (MC) Engagement/Satisfaction Survey 2018.” The survey used a combination of multiple choice (Likert-scaled and categorical) and open text statements and questions. Satisfaction with their Army physician career was measured using a 5-point unipolar Likert scale response on level of satisfaction. Chi-square tests of independence were conducted on all demographic characteristics to examine if levels of satisfaction with Army physician career were associated with a particular demographic profile. Agreement opinions expressed on 20 statements about professional readiness, work environment, and job recognition were summarized and rank-ordered by percentage of “strongly agree” responses. Categorical responses to several questions related to career intentions were summarized overall and by career satisfaction level. Multivariate logistic regression was performed to identify demographic factors, which may influence career satisfaction as an Army physician. Results Approximately 47% (2,050/4,334) of U.S. Army physicians participated in the MC 2018 survey. Career satisfaction percentages overall were: “extremely satisfied” (10.0%), “quite satisfied” (24.8%), “moderately satisfied” (33.9%), “slightly satisfied” (22.6%), and “not at all satisfied” (8.3%). Respondents were in least agreement to statements about sufficient administrative support and recognition of doing good work. Logistic regression results showed military rank as a significant predictor of negative career satisfaction as an Army physician. For Captains, the odds for being “not at all satisfied” with their military career were almost nine times that of Colonels. Also, compared to their baseline group, physicians who completed their graduate medical education training, mission critical surgeons, and physicians who worked in military treatment facilities that were either a hospital (not a medical center) or a clinic-ambulatory surgery center had a greater risk of being “not at all satisfied” with their career as an Army physician. Conclusions There is significant room for improvement in MC officer career satisfaction. The drivers of satisfaction are multiple and apply differently among MC officers of varied ranks and experience. Senior officers are the ones who are the most satisfied with their military career. Results of this novel MC officer study may serve as an impetus to identify existing shortcomings and make necessary changes to retain skilled Army physicians. Army leaders should invest resources to develop and sustain initiatives that improve military career satisfaction and retention of MC officers.
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Diprose, William K., Nicholas Buist, Ning Hua, Quentin Thurier, George Shand, and Reece Robinson. "Physician understanding, explainability, and trust in a hypothetical machine learning risk calculator." Journal of the American Medical Informatics Association 27, no. 4 (February 27, 2020): 592–600. http://dx.doi.org/10.1093/jamia/ocz229.
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Abstract Objective Implementation of machine learning (ML) may be limited by patients’ right to “meaningful information about the logic involved” when ML influences healthcare decisions. Given the complexity of healthcare decisions, it is likely that ML outputs will need to be understood and trusted by physicians, and then explained to patients. We therefore investigated the association between physician understanding of ML outputs, their ability to explain these to patients, and their willingness to trust the ML outputs, using various ML explainability methods. Materials and Methods We designed a survey for physicians with a diagnostic dilemma that could be resolved by an ML risk calculator. Physicians were asked to rate their understanding, explainability, and trust in response to 3 different ML outputs. One ML output had no explanation of its logic (the control) and 2 ML outputs used different model-agnostic explainability methods. The relationships among understanding, explainability, and trust were assessed using Cochran-Mantel-Haenszel tests of association. Results The survey was sent to 1315 physicians, and 170 (13%) provided completed surveys. There were significant associations between physician understanding and explainability (P < .001), between physician understanding and trust (P < .001), and between explainability and trust (P < .001). ML outputs that used model-agnostic explainability methods were preferred by 88% of physicians when compared with the control condition; however, no particular ML explainability method had a greater influence on intended physician behavior. Conclusions Physician understanding, explainability, and trust in ML risk calculators are related. Physicians preferred ML outputs accompanied by model-agnostic explanations but the explainability method did not alter intended physician behavior.
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Walia, Bhavneet, Anshu Shridhar, Pratap Arasu, and Gursimar Kaur Singh. "US Physicians’ Perspective on the Sudden Shift to Telehealth: Survey Study." JMIR Human Factors 8, no. 3 (August 12, 2021): e26336. http://dx.doi.org/10.2196/26336.
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Background Given the sudden shift to telemedicine during the early COVID-19 pandemic, we conducted a survey of practicing physicians’ experience with telehealth during the prepandemic and early pandemic periods. Our survey estimates that most patient visits in the United States during the early COVID-19 pandemic period were conducted via telehealth. Given this magnitude and the potential benefits and challenges of telehealth for the US health care system, in this paper, we obtain, summarize, and analyze telehealth views and experiences of US-based practicing-physicians. Objective The aim of this study was to examine the extent of shift toward telehealth training and care provision during the early pandemic from the US-based practicing physicians’ perspective. We also sought to determine the short- and long-term implications of this shift on the quality, access, and mode of US health care delivery. Methods We conducted a purposive, snowball-sampled survey of US practicing-physicians. A total of 148 physician completed the survey. Data were collected from July 17, 2020, through September 4, 2020. Results Sample training intensity scaled 21-fold during the early pandemic period, and patient-care visits conducted via telehealth increased, on average, from 13.1% directly before the pandemic to 59.7% during the early pandemic period. Surveyed physician respondents reported that telehealth patient visits and face-to-face patient visits are comparable in quality. The difference was not statistically significant based on a nonparametric sign test (P=.11). Moreover, physicians feel that telehealth care should continue to play a larger role (44.9% of total visits) in postpandemic health care in the United States. Our survey findings suggest a high market concentration in telehealth software, which is a market structural characteristic that may have implications on the cost and access of telehealth. The results varied markedly by physician employer type. Conclusions During the shift toward telehealth, there has been a considerable discovery among physicians regarding US telehealth physicians. Physicians are now better prepared to undertake telehealth care from a training perspective. They are favorable toward a permanently expanded telehealth role, with potential for enhanced health care access, and the realization of enhanced access may depend on market structural characteristics of telehealth software platforms.
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Harvey, Felicia. "Physician Burnout Quality of Life/ Wellness Resource Pilot Program." Journal of Medical Research and Health Sciences 3, no. 2 (February 20, 2020): 886–912. http://dx.doi.org/10.15520/jmrhs.v3i2.160.
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Burnout is a syndrome of emotional exhaustion, depersonalization, and a sense of low personal accomplishment that leads to decreased effectiveness at work (American Journal of Medicine, 2003). Despite the efforts to combat burnout, the number of U.S. physicians who experience burnout rose from 45 percent to over 50 percent between 2011 and 2014 (National Center for Biotechnology Information, 2015).
The purpose of this quality improvement evidence-based capstone project was to determine whether a physician wellness pilot program can reduce and or eliminate burnout and stress for practicing physicians at an acute care healthcare institution in the Chicago metropolitan area. The capstone project consisted of a pre-intervention survey, an intervention and a post intervention survey. The participants targeted for this evidence-based project were practicing physicians in Illinois that span across all specialty groups.
The physician burnout wellness pilot program was implemented during a two-week period of time during which participants were provided with resources to reduce and or eliminate symptoms of burnout. The implementation of the physician wellness pilot program capstone project showed the physicians at this organization were less stressed and more satisfied with their job at (0.555) percent compared to pre intervention survey results that faired (0.77) and that of the national average of (0.80). Additionally, the post intervention survey results showed the physicians at this organization are experiencing a lower level of burnout (0.44) percent compared to pre intervention survey results that faired (0.53), but a higher level of burnout compared to the national average (0.29).
Physician burnout is an epidemic that requires immediate attention because it not only effects the physicians, but it effects the healthcare system. As such, regardless of the specialty and demographics of the physicians, organizations and physicians alike must do their part in assessing if burnout exists. The findings showed the importance of physicians being able to recognize the warning signs of burnout, encourage them to seek help when they are stressed, and take active steps towards ridding or reducing burnout. The findings were compatible with evidence-based research that supports building physician resilience by way of the development of a wellness program.
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Nasser, Soumana C., Jeanette G. Nassif, and Aline Hanna Saad. "Physicians’ Attitudes to Clinical Pain Management and Education: Survey from a Middle Eastern Country." Pain Research and Management 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/1358593.
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Despite promising initiatives to advance the practice of pain management in Middle Eastern countries, their pain care lags behind developed countries. The objectives of this study are to evaluate physicians’ assessment of their own competency in pain management, to assess physicians’ practice related to pain management, and to identify physician-related barriers to effective pain control. A cross-sectional survey was conducted in 3 teaching medical centers in Lebanon targeting the above-mentioned outcomes and assessing the impact of physicians’ years in practice on the studied end-points. A total of 69 physicians were surveyed. Fifty-seven percent reported “very good to excellent” pain management skills; only 25% of them described the need for continuing professional development. When treating patients with pain, 52% of physicians refer to updated international guidelines, whereas 43% rely on their own judgment. Physicians were more likely to consult with another physician (65%) rather than a pharmacist (12%) when treating patients with pain. Fear of adverse effects of analgesics was the most commonly reported barrier (45%) to pain control among physicians from different career stages. Based on these survey findings, national pain management and practice policies are needed to optimize this area of deficiency in patient care.
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Tajirian, Tania, Vicky Stergiopoulos, Gillian Strudwick, Lydia Sequeira, Marcos Sanches, Jessica Kemp, Karishini Ramamoorthi, Timothy Zhang, and Damian Jankowicz. "The Influence of Electronic Health Record Use on Physician Burnout: Cross-Sectional Survey." Journal of Medical Internet Research 22, no. 7 (July 15, 2020): e19274. http://dx.doi.org/10.2196/19274.
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Background Physician burnout has a direct impact on the delivery of high-quality health care, with health information technology tools such as electronic health records (EHRs) adding to the burden of practice inefficiencies. Objective The aim of this study was to determine the extent of burnout among physicians and learners (residents and fellows); identify significant EHR-related contributors of physician burnout; and explore the differences between physicians and learners with regard to EHR-related factors such as time spent in EHR, documentation styles, proficiency, training, and perceived usefulness. In addition, the study aimed to address gaps in the EHR-related burnout research methodologies by determining physicians’ patterns of EHR use through usage logs. Methods This study used a cross-sectional survey methodology and a review of administrative data for back-end log measures of survey respondents’ EHR use, which was conducted at a large Canadian academic mental health hospital. Chi-square and Fisher exact tests were used to examine the association of EHR-related factors with general physician burnout. The survey was sent out to 474 individuals between May and June 2019, including physicians (n=407), residents (n=53), and fellows (n=14), and we measured physician burnout and perceptions of EHR stressors (along with demographic and practice characteristics). Results Our survey included 208 respondents, including physicians (n=176) and learners (n=32). The response rate was 43.2% for physicians (full-time: 156/208, 75.0%; part-time: 20/199, 10.1%), and 48% (32/67) for learners. A total of 25.6% (45/176) of practicing physicians and 19% (6/32) of learners reported having one or more symptoms of burnout, and 74.5% (155/208) of all respondents who reported burnout symptoms identified the EHR as a contributor. Lower satisfaction and higher frustration with the EHRs were significantly associated with perceptions of EHR contributing toward burnout. Physicians’ and learners’ experiences with the EHR, gathered through open-ended survey responses, identified challenges around the intuitiveness and usability of the technology as well as workflow issues. Metrics gathered from back-end usage logs demonstrated a 13.6-min overestimation in time spent on EHRs per patient and a 5.63-hour overestimation of after-hours EHR time, when compared with self-reported survey data. Conclusions This study suggests that the use of EHRs is a perceived contributor to physician burnout. There should be a focus on combating physician burnout by reducing the unnecessary administrative burdens of EHRs through efficient implementation of systems and effective postimplementation strategies.
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Perera, S., D. A. Nace, C. M. Culley, S. M. Handler, and R. D. Boyce. "A Survey of Nursing Home Physicians to Determine Laboratory Monitoring Adverse Drug Event Alert Preferences." Applied Clinical Informatics 05, no. 04 (2014): 895–906. http://dx.doi.org/10.4338/aci-2014-06-ra-0053.
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SummaryObjective: We conducted a survey of nursing home physicians to learn about (1) the laboratory value thresholds that clinical event monitors should use to generate alerts about potential adverse drug events (ADEs); (2) the specific information to be included in the alerts; and (3) the communication modality that should be used for communicating them.Methods: Nursing home physician attendees of the 2010 Conference of AMDA: The Society for Post-Acute and Long-Term Care Medicine.Results: A total of 800 surveys were distributed; 565 completed surveys were returned and seven surveys were excluded due to inability to verify that the respondents were physicians (a 70% net valid response rate). Alerting threshold preferences were identified for eight laboratory tests. For example, the majority of respondents selected thresholds of ≥ 5.5 mEq/L for hyperkalemia (63%) and ≤ 3.5 without symptoms for hypokalemia (54%). The majority of surveyed physicians thought alerts should include the complete active medication list, current vital signs, previous value of the triggering lab, medication change in the past 30 days, and medication allergies. Most surveyed physicians felt the best way to communicate an ADE alert was by direct phone/voice communication (64%), followed by email to a mobile device (59%).Conclusions: This survey of nursing home physicians suggests that the majority prefer alerting thresholds that would generally lead to fewer alerts than if widely accepted standardized laboratory ranges were used. It also suggests a subset of information items to include in alerts, and the physicians’ preferred communication modalities. This information might improve the acceptance of clinical event monitoring systems to detect ADEs in the nursing home setting.Citation: Boyce RD, Perera S, Nace DA, Culley CM, Handler SM. A survey of nursing home physicians to determine laboratory monitoring adverse drug event alert preferences. Appl Clin Inf 2014; 5: 895–906http://dx.doi.org/10.4338/ACI-2014-06-RA-0053
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Vandersteegen, Tom, Wim Marneffe, Irina Cleemput, Dominique Vandijck, and Lode Vereeck. "The determinants of defensive medicine practices in Belgium." Health Economics, Policy and Law 12, no. 3 (November 22, 2016): 363–86. http://dx.doi.org/10.1017/s174413311600030x.
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AbstractIn 2010 the Belgian government introduced a low cost administrative procedure for compensating medical injuries to overcome the major shortcomings of the existing tort system. This paper examines, for the first time, to what extent this reform had an impact on physician specialists’ defensive practices and what are the relevant determinants affecting physicians’ clinical decision making. Based on a survey of 508 physicians, we find evidence of a relatively modest increase in defensive practices among physicians in various specialties. In general, 14% of the respondents, who were aware of the reform, reported to have increased their overall defensive behaviour, while respectively 18 and 13% altered their assurance and avoidance behaviour. Commonly used physician characteristics, such as claims experience and gender, have a similar impact on defensive medicine as documented in existing literature. Furthermore, the determinant physician’s access to an incident reporting system is found to have a significant impact on most of the defensive medicine measures. Health care institutions may therefore play an important role in controlling and reducing physicians’ defensive practices.
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Chan, Randolph C. H., Winnie W. S. Mak, Ingrid H. Y. Pang, Samuel Y. S. Wong, Wai Kwong Tang, Joseph T. F. Lau, Jean Woo, Diana T. F. Lee, and Fanny M. Cheung. "Utility and Cost-effectiveness of Motivational Messaging to Increase Survey Response in Physicians." Field Methods 30, no. 1 (November 27, 2017): 37–55. http://dx.doi.org/10.1177/1525822x17732010.
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The present study examined whether, when, and how motivational messaging can boost the response rate of postal surveys for physicians based on Higgin’s regulatory focus theory, accounting for its cost-effectiveness. A three-arm, blinded, randomized controlled design was used. A total of 3,270 doctors were randomly selected from the registration list. Results showed that motivational messaging was effective in boosting response rate among younger physicians at relatively low cost when the messages were sent during the delivery of generic invitation letter and questionnaire. However, message framing had no significant impact on postal surveys’ response rate. Future postal surveys can consider using motivational messaging to maximize survey participation in physician population without incurring much extra cost.
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Wangmo, Choni, Sunkyung Kim, Thupten Palzang, and Robert Quick. "A cross-sectional job satisfaction survey of physicians in Bhutan to address the problem of retention." Bhutan Health Journal 5, no. 2 (November 13, 2019): 28–36. http://dx.doi.org/10.47811/bhj.86.
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Introduction: A persistent shortage of physicians and relatively high attrition (>10% over 7 years) have been longstanding challenges for Bhutan despite efforts at improvement. Little is known about physicians’ job satisfaction. The study was done to assess level of job satisfaction amongst physicians in Bhutan and identify factors affecting it, thereby be able to better understand factors affecting physician retention. Methods: A national, cross-sectional study on job satisfaction of all Bhutanese physicians was conducted in 2016. Physicians were defined as satisfied if they answered yes to >50% of general survey questions about job satisfaction and and associations between demographic or job characteristics (e.g., married vs. unmarried, clinical vs. non- clinical) and job satisfaction were examined. Physicians were also queried about specific elements of their jobs (e.g., pay, working conditions) and explored associations between demographic or job characteristics and job elements. Results: Of 147 physicians who completed the job survey, 94 (64%) were classified as satisfied. There were significant differences in job satisfaction between married and unmarried physicians (72% vs 49%, p=0·01), specialists and generalists (73% vs 55%, p=0·04), nonclinical and clinical physicians (89% vs 61%, p=0·02), and physicians in referral and district hospitals (75% vs 48%, p <0·01). Across all demographic and job characteristics, salary satisfaction was low (11%). In multivariable analysis, non-clinicians had significantly greater satisfaction than clinicians with salary, annual leave, and work-family balance. Physicians in referral hospitals had significantly greater satisfaction than physicians in district facilities with work hours and working conditions. Conclusion: Survey findings suggest that, although job satisfaction appeared high, improved physician retention may require increased pay, opportunities for promotion to desired settings and job categories, and improved staffing and work conditions in district healthcare facilities.
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Watson, Jacqueline A., and Deniz Soyer. "A State Medical Board's Assessment of its Physician Workforce Capacity: Purpose, Process, Perspective and Lessons Learned." Journal of Medical Regulation 99, no. 4 (December 1, 2013): 10–19. http://dx.doi.org/10.30770/2572-1852-99.4.10.
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ABSTRACT The District of Columbia Board of Medicine (D.C. Board), a division within the District of Columbia Department of Health, Health Regulation and Licensing Administration, regulates more than 12,000 health care professionals — physicians, physician assistants, acupuncturists, anesthesiologist assistants, naturopathic physicians, polysomnographers, and surgical assistants — licensed in the District of Columbia. Recognizing that the licensure renewal period, conducted every two years on even numbered years, presented a unique opportunity to collect data for workforce research and analysis, the D.C. Board embarked in 2010 upon a three-phased project designed to collect demographic and practice characteristic information on licensed physicians and physician assistants under the Board's purview. A multidisciplinary workforce workgroup was assembled by the D.C. Board and tasked with developing survey questions and a method of data collection. The Health Resources and Services Administration's National Center for Workforce Analysis Minimum Data Set was used as a guide in developing the survey. The surveys were voluntary, and elicited a 78% response rate and a 58% response rate for physicians in 2010 and 2012, respectively. This article summarizes the results of the District's Physician Workforce Reports, focusing on the physician data collected. The article outlines the process the D.C. Board used in compiling the reports, and offers perspective on the project for other state medical boards as they consider launching their own workforce data-gathering efforts. The article does not examine or draw conclusions about data for physician assistants.