Multiple factors influence family physicians' practice scope

Drivers of scope of practice in family medicine: A conceptual model

2021-05-11

(Press-News.org) Although new family medicine graduates intend to provide a broader scope of practice than their senior counterparts, individual family physicians' scope of practice has been decreasing, with fewer family physicians providing basic primary care services, such pediatric and prenatal care. Russell et al conducted a study to explore family medicine graduates' attitudes and perspectives on modifiable and non-modifiable factors that influenced their scope of practice and career choices. The authors conducted five focus group discussions with 32 family physicians and explored their attitudes and perspectives on their desired and actual scope of practice. Using a conceptual framework to understand the influences on practice scope, the authors found that personal factors played a role on desired scope while workplace, environmental and population factors influenced actual practice scope. Stressors that occurred in these four categories often caused family physicians to narrow their scope of practice. Understanding personal, environmental, workplace and population factors that influence practice scope can inform specific interventions that create desirable jobs for family physicians and improve their ability to meet changing population needs. Supportive factors of a broader-scope practice include training and access to additional medical education after training; access to mentors; strong organizational leadership; and team-based care.

INFORMATION:

Drivers of Scope of Practice in Family Medicine: A Conceptual Model
Amy Russell, MD, et al
University of North Carolina Health Sciences at Mountain Area Health Education Center and HCA Healthcare, Asheville, North Carolina
https://www.annfammed.org/content/19/3/217

ELSE PRESS RELEASES FROM THIS DATE:

Gene editing expands to new types of immune cells

2021-05-11

In the decade since the advent of CRISPR-Cas9 gene editing, researchers have used the technology to delete or change genes in a growing number of cell types. Now, researchers at Gladstone Institutes and UC San Francisco (UCSF) have added human monocytes--white blood cells that play key roles in the immune system--to that list. The team has adapted CRISPR-Cas9 for use in monocytes and shown the potential utility of the technology for understanding how the human immune system fights viruses and microbes. Their results were published online today in the journal Cell Reports. "These experiments set the stage for many more studies on the interactions between major infectious diseases and human immune cells," says senior author Alex Marson, MD, PhD, director of the Gladstone-UCSF Institute ...

Pregnant women hospitalized for COVID-19 infection do not face increased risk of death

2021-05-11

Pregnant women who develop severe COVID-19 infections that require hospitalization for pneumonia and other complications may not be more likely to die from these infections than non-pregnant women. In fact, they may have significantly lower death rates than their non-pregnant counterparts. That is the finding of a new study published today in the Annals of Internal Medicine conducted by researchers at the University of Maryland School of Medicine (UMSOM). The study examined medical records from nearly 1,100 pregnant women and more than 9,800 non-pregnant patients aged 15 to 45 who were hospitalized with COVID-19 and pneumonia. Slightly less than 1 percent of the pregnant patients died from COVID-19 compared to 3.5 percent of non-pregnant patients, according to the study findings. There ...

Tiny, wireless, injectable chips use ultrasound to monitor body processes

2021-05-11

New York, NY--May 11, 2021--Widely used to monitor and map biological signals, to support and enhance physiological functions, and to treat diseases, implantable medical devices are transforming healthcare and improving the quality of life for millions of people. Researchers are increasingly interested in designing wireless, miniaturized implantable medical devices for in vivo and in situ physiological monitoring. These devices could be used to monitor physiological conditions, such as temperature, blood pressure, glucose, and respiration for both diagnostic and therapeutic ...

History of giants in the gene: Scientists use DNA to trace the origins of giant viruses

2021-05-11

2003 was a big year for virologists. The first giant virus was discovered in this year, which shook the virology scene, revising what was thought to be an established understanding of this elusive group and expanding the virus world from simple, small agents to forms that are as complex as some bacteria. Because of their link to disease and the difficulties in defining them--they are biological entities but do not fit comfortably in the existing tree of life--viruses incite the curiosity of many people. Scientists have long been interested in how viruses evolved, especially when it comes to giant viruses that can produce new viruses with very little help from the host--in contrast to most small viruses, which utilize the host's machinery to replicate. ...

Greater presence of family docs, midwives may decrease rates of cesarean birth

2021-05-11

Surgical cesarean births can expose new mothers to a range of health complications, including infection, blood clots and hemorrhage. As part of Healthy People 2020 and other maternal health objectives, the state of California exerted pressure to reduce cesarean deliveries, and statewide organizations established quality initiatives in partnership with those goals. In this study, researchers from Stanford University and the University of Chicago examined unit culture and provider mix differences on hospital and delivery units to identify characteristics of units that successfully reduced their cesarean delivery rates. The mixed-methods study surveyed ...

Novel circuitry solves a myriad of computationally intensive problems with minimum energy

2021-05-11

From the branching pattern of leaf veins to the variety of interconnected pathways that spread the coronavirus, nature thrives on networks -- grids that link the different components of complex systems. Networks underlie such real-life problems as determining the most efficient route for a trucking company to deliver life-saving drugs and calculating the smallest number of mutations required to transform one string of DNA into another. Instead of relying on software to tackle these computationally intensive puzzles, researchers at the National Institute of Standards and Technology ...

Combination of psychotherapy and pharmacotherapy more effective in treating depression

2021-05-11

Most patients with depression are treated in primary care, however, relatively few clinical trials for treating depression have focused on primary care. Researchers at the Vrije University Amsterdam examined the effects of the two major approaches to treating depression: psychotherapy and pharmacotherapy, as well as combined treatment and care-as-usual. The study integrated the results of 58 randomized controlled trials with a total of 9,301 patients. Results concluded that both psychotherapy and pharmacotherapy were significantly more effective than care-as-usual or waitlist control. However, they found no significant difference between psychotherapy and pharmacotherapy as stand-alone treatments. Combined treatment, particularly in studies that included ...

Newer class of fluoroquinolone antibiotics may present reduced risk of tendon ruptures

2021-05-11

It's widely understood that people taking a common class of antibiotics, like ciprofloxacin and levofloxacin, run the risk of tendonitis and tendon ruptures. However, a new analysis sheds light on newer, third-generation fluoroquinolones and suggests they may have a lower risk of Achilles tendon rupture. Researchers from Jichi Medical University in Tochigi, Japan, used health care administrative data to identify 504 patient cases of Achilles tendon ruptures with co-occurrence of antibiotics. They found that third-generation fluoroquinolones were not associated with an increase in Achilles tendon rupture. First- ...

Focus on outliers creates flawed snap judgments

2021-05-11

DURHAM, N.C. -- You enter a room and quickly scan the crowd to gain a sense of who's there - how many men versus women. How reliable is your estimate? Not very, according to new research from Duke University. In an experimental study, researchers found that participants consistently erred in estimating the proportion of men and women in a group. And participants erred in a particular way: They overestimated whichever group was in the minority. "Our attention is drawn to outliers," said Mel W. Khaw, a postdoctoral research associate at Duke and the study's lead author. "We tend to overestimate people who stand out in a crowd." For the study, which appears ...

Shared medical appointments help patients with prediabetes

2021-05-11

Researchers from the Cleveland Clinic and Takeda Pharmaceutical Company conducted a study to evaluate the effectiveness of shared medical appointments for people with pre-diabetes compared with a group of patients receiving usual care. Shared medical appointments are typically delivered in a medical clinic by physicians and other health care providers. Within the context of this study, shared medical appointments consisted of patients consulting with their doctors one-on-one and then joining a group of similar patients to set goals and review lab results with the same family ...

LAST 30 PRESS RELEASES:

Study shows psychedelic drug psilocybin gives comparable long-term antidepressant effects to standard antidepressants, but may offer additional benefits

Study finds symptoms of depression during pregnancy linked to specific brain activity: scientists hope to develop test for “baby blues” risk

UK study shows there is less stigma against LGBTQ people than you might think, but people with mental health problems continue to experience higher levels of stigma