MedWorm: Solo Practices

Trends in Knowledge, Attitudes, and Practices of Travel Risk Groups Toward Prevention of Hepatitis A: Results From the Dutch Schiphol Airport Survey 2002 to 2009

Journal of Travel Medicine — Thu, 08 Dec 2011 05:00:00 +0100

Conclusions. The results of this longitudinal survey in Dutch travelers suggest an annual 5% increase in protection rates against hepatitis A coinciding with an annual 1% decrease in intended risk‐seeking behavior. This improvement may reflect the continuous efforts of travel health advice providers to create awareness and to propagate safe and healthy travel. The KAP profile of travelers visiting friends and relatives (VFR) and solo as well as last‐minute travelers to high‐risk destinations substantially increased their relative risk for hepatitis A. These risk groups should be candidates for targeted interventions. (Source: Journal of Travel Medicine)

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The experience of nursing students in their transition to professional practice: a social phenomenological approach

Texto e Contexto - Enfermagem — Thu, 08 Dec 2011 00:57:17 +0100

This study made it possible to understand the reasons and motives for their actions within the transition process, as well as how a particular social group in a given time and space is integrated into the world of everyday life.Os objetivos deste estudo foram compreender o significado da experiência de aprendizagem de transição do estudante de enfermagem e o significado de suas expectativas de aprendizagem para a futura prática profissional. A abordagem da Fenomenologia Social de Alfred Schutz foi utilizada na condução da pesquisa. Foram entrevistados dez estudantes de internato de enfermagem. A análise compreensiva do tipo vivido permitiu identificar que o estudante sente que, ao assumir responsabilidades, experimenta sofrimento e insegurança devido à falta de conhecimento, não ...

Providing Therapy to Children and Families in Foster Care: A Systemic‐Relational Approach

Family Process — Thu, 01 Dec 2011 05:00:00 +0100

Foster care is a system created to protect children from an unsafe home environment yet multiple foster home placements, conflictual or nonexistent relationships between foster parents and birth parents, long, drawn out court battles, and living in an on‐going state of not knowing when or if they will be going home are just some of the challenges many children in care are expected to manage. This paper presents a guide for therapists working with families involved in foster care. Utilizing ideas from the postmodern therapies and structural family therapy, suggestions will be provided about who needs to talk to whom about what, when to have these necessary conversations, and how to talk to people in a way that mobilizes adults to take action for the children, with the goal of minimizing p...

The practice of neurology, 2000-2010: Report of the AAN Member Research Subcommittee

Neurology — Mon, 21 Nov 2011 05:00:00 +0100

Conclusion: Despite advances in neurologic diagnosis and therapy, there has been little change in practice characteristics of US neurologists. (Source: Neurology)

What Do You Do When The Parent is Impaired?

PediatricEducation.org — Mon, 21 Nov 2011 00:47:49 +0100

Discussion Workplace violence is defined by the Occupational Health and Safety Administration (OSHA) as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.” Social services and health care professionals are at high risk for workplace violence, with the numbers probably higher because of underreporting. In 2000 the Bureau of Labor statistics reported the following rates of injuries from violent acts and assaults. Rates are per 10,000 full-time workers Overall private sector 2 Health services 9.3 Social services 15 Personal care facility 25 The Department of Justice has average annual rates of non-fatal violent crime from 1993-1999. Rates are per 1000 workers All occupations 12.6 Physicians 16.2 Nurse...

Medical Practice Integration: Going Big in Private Practice

Gastrointestinal Endoscopy Clinics of North America — Sat, 19 Nov 2011 09:47:57 +0100

Historically, gastroenterologists entered into solo, small group, or academic practices. The current economic environment and looming regulatory mandates have led to gastroenterologists integrating into large, single-specialty groups to acquire costly practice infrastructure, gain negotiating leverage with health plans, promote high-quality care, and benefit from professional practice management. Individual gastroenterologists must assess whether a large practice will meet their personal goals, financial needs, and professional visions. The decision to integrate into a large practice will also be affected by local practice patterns and regulatory issues. For these and other reasons, gastroenterologists are going big in private practice. (Source: Gastrointestinal Endoscopy Clinics of North ...

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Think ahead when selling your practice

Modern Medicine — Thu, 10 Nov 2011 05:00:00 +0100

Even if you're not ready to retire, it's a good idea to plan for the day when you may want to sell your solo practice or your partnership in a group practice. (Source: Modern Medicine)

An exploration of clinical decision-making among students and newly qualified midwives.

Midwifery — Wed, 09 Nov 2011 05:00:00 +0100

CONCLUSIONS: decision-making was learnt primarily by working alongside midwifery mentors and through situated learning in practice. Decision-making was not necessarily a solo activity, it was common for midwives to use each other as a resource, which established there was a social dimension to midwifery decision-making. Learners had to navigate through workplace culture, which consisted of: the practices shared by some midwives and not others, covert rules of practice, midwifery and institutional authoritarianism. IMPLICATIONS FOR PRACTICE: learners need to work with mentors who actively encourage participation in decision-making and provide discussion and feedback on decision-making abilities. When a staged and active approach to decision-making is not provided this may have negative impl...

Attitudes and practices of obstetrician-gynecologists regarding influenza vaccination in pregnancy.

Obstetrics and Gynecology — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSION: : Although most ob-gyns routinely offered influenza vaccination to pregnant patients, vaccination coverage rates may be improved by addressing logistic and financial challenges of vaccine providers. LEVEL OF EVIDENCE: : III. PMID: 22015875 [PubMed - in process] (Source: Obstetrics and Gynecology)

Solo docs provide top care (and change light bulbs, too).

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Rogers P PMID: 22167857 [PubMed - indexed for MEDLINE] (Source: The Journal of Family Practice)

Residents' desire for hospital employment poses recruiting challenge for practices

American Medical News - BUSINESS — Mon, 24 Oct 2011 12:00:00 +0100

Interest is waning for group practices that don't offer quick paths to partnerships, while the pursuit of solo practice is nearly nonexistent. (Source: American Medical News - BUSINESS)

Medical home standards not met by half of physician practices

Modern Medicine — Sun, 23 Oct 2011 00:57:50 +0100

Nearly half of physician practices do not meet national standards to qualify quality as a Patient-Centered Medical Home, with smaller, single-specialty groups being the least likely to qualify, according to a new study. Ninety percent of Americans receive care from those smaller practices, however. Learn how solo and single-specialty practices can even the playing field to meet medical home standards. (Source: Modern Medicine)

Physician Practices and Readiness for Medical Home Reforms: Policy, Pitfalls, and Possibilities

Health Services Research — Tue, 18 Oct 2011 04:00:00 +0100

Conclusion.Almost half of all practices fail to meet NCQA standards for medical home recognition. (Source: Health Services Research)

Practice of Questioning Normality, Indignation and Resistance

Psicologia USP — Sat, 15 Oct 2011 21:43:18 +0100

O presente texto aponta algumas das importantes contribuições trazidas por Maria Helena Souza Patto para a Psicologia e a Educação em nosso país, em especial através de seu último livro, Exercícios de Indignação. Afirma-se ali não só a pesquisadora competente e cuidadora, a professora requisitada e respeitada, mas também a mulher solidária, amiga, acolhedora e indignada que indaga, estranha e coloca em análise o que vem sendo considerado como natural. São muitas e múltiplas Marias aqui apresentadas por uma de suas alunas da Pós-graduação da USP em 1988. Em especial toma relevo neste texto a prática cotidiana da resistência que os escritos de Maria Helena enfatizam. Resistência não como simples reação, mas como criação, produção de rupturas e afirmação de out...

The right to the humanity

Psicologia USP — Sat, 15 Oct 2011 21:43:18 +0100

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Effective use of physician extenders in an outpatient otolaryngology setting

The Laryngoscope — Wed, 12 Oct 2011 04:00:00 +0100

AbstractPhysician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency. We discuss five different practice models for incorporation of advanced practice providers in an outpatient otolaryngology practice. These models include scribe, collaborative, limited independent, partial independent, and near complete independent practice and are based primarily on the autonomy level of the physician extender. In addito...

Providers' perspectives on the vaginal birth after cesarean guidelines in Florida, United States: a qualitative study

BMC Pregnancy and Childbirth - Latest articles — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions: The current ACOG VBAC guidelines limit US obstetricians' and midwives' ability to provide care for women with a previous cesarean, particularly in community and rural hospitals. Although ACOG has proposed that women be allowed to accept "higher levels of risk" in order to be able to attempt a trial of labor in some settings, access to VBAC is unlikely to increase in Florida as long as systemic barriers and liability risks remain high. (Source: BMC Pregnancy and Childbirth - Latest articles)

The positive deviance/hearth approach to reducing child malnutrition: systematic reviewL’approche ‘Déviance Positive/Foyer’ visant à réduire la malnutrition infantile: Revue systématiqueEl programa de Desviación Positiva/Talleres Hogareños en la reducción de la desnutrición infantil: revisión sistemática

Tropical Medicine and International Health — Sat, 08 Oct 2011 07:29:19 +0100

Conclusions Overall this study shows mixed results in terms of program effectiveness, although some Positive Deviance/Hearth programs have clearly been successful in particular settings. Sibling studies suggest that the Positive Deviance/Hearth approach may have a role in preventing malnutrition, not just rehabilitation. Further research is needed using more robust study designs and larger sample sizes. Issues related to community participation and consistency in reporting results need to be addressed.Objectifs: L’approche ‘Déviance Positive/Foyer’ vise à réhabiliter les enfants malnutris en utilisant les pratiques de celles des mères dans la communauté qui ont bien nourris des enfants, malgré la pauvreté. Cette étude évalue son efficacité dans une série de régions....

Yield of Practice-Based Depression Screening In VA Primary Care Settings

Journal of General Internal Medicine — Thu, 06 Oct 2011 06:28:30 +0100

Conclusions Practice-wide survey-based depression screening yielded more than twice the positive-screen rate demonstrated through chart-based VA performance measures. The substantial level of comorbid physical and mental illness among PC patients precludes solo management by either PC or mental health (MH) specialists. PC practice- and provider-level guideline adherence is problematic without systems-level solutions supporting adequate MH assessment, PC treatment and, when needed, appropriate MH referral. Content Type Journal ArticleCategory Original ResearchPages 1-8DOI 10.1007/s11606-011-1904-5Authors Elizabeth M. Yano, VA Greater Los Angeles Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Sepulveda, C...

Involvement of gynecologic oncologists in the treatment of patients with a suspicious ovarian mass.

Pain Physician — Sat, 24 Sep 2011 02:16:22 +0100

CONCLUSION: : When presented with a patient with a suspicious ovarian mass, the majority of primary care physicians do not self-report direct referral to a gynecologic oncologist. This may contribute to the high rates of noncomprehensive surgery for ovarian cancer patients in the United States. LEVEL OF EVIDENCE: : II. PMID: 21934449 [PubMed - in process] (Source: Pain Physician)

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Skill Based Mentored Laparoscopy Course Participation Leads to Laparoscopic Practice Expansion and Assists in Transition to Robotic Surgery

The Journal of Urology — Fri, 23 Sep 2011 04:00:00 +0100

Conclusions: Long-term results reveal that the American Urological Association Mentored Laparoscopy Course attendees reported expansion in their laparoscopic practice since taking the course. They described the course as benefiting the transition to robotic surgery. (Source: The Journal of Urology)

Health‐seeking behaviour among adults with prolonged cough in VietnamComportement de recours à la santé chez les adultes présentant une toux prolongée au VietnamComportamiento de búsqueda de salud entre adultos con tos prolongada en Vietnam

Tropical Medicine and International Health — Thu, 15 Sep 2011 13:38:35 +0100

Conclusions In this Vietnamese survey, nearly half of persons with cough for more than 2 weeks had visited a health care provider. The commonest first health facility contacted was the pharmacy. Sputum smears were rarely examined, except in the provincial TB hospital. Our findings highlight the need to improve diagnostic practices by retraining health staff on the performance of sputum examination for TB suspects.Objectif: Evaluer le comportement de recours à la santé chez les adultes présentant une toux prolongée dans un échantillon national représentatif de la population au Vietnam.Méthodes: Enquête transversale menée de septembre 2006 à juillet 2007. Tous les habitants âgés de ≥ 15 ans ont été invités pour le dépistage de la toux, l’historique du traitemen...

The rebirth of the solo family doc.

The Journal of Family Practice — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Susman J PMID: 21901175 [PubMed - in process] (Source: The Journal of Family Practice)

Making it work: characteristics of high-performing hospital-physician networks.

The Journal of Medical Practice Management : MPM — Thu, 01 Sep 2011 04:00:00 +0100

This article examines the stress points that physicians and practice managers face as they find themselves thrust into new but often ill-defined business models. It offers insights and pathways to help them navigate the changes that will be necessary for these business models to survive, evolve, and thrive. PMID: 22111274 [PubMed - in process] (Source: The Journal of Medical Practice Management : MPM)

Career Satisfaction in Primary Care: A Comparison of International and US Medical Graduates

Journal of General Internal Medicine — Thu, 25 Aug 2011 05:45:07 +0100

CONCLUSIONS After adjusting for a number of variables previously shown to have an impact on career satisfaction, we were unable to identify additional factors that could account for or explain differences in career satisfaction between IMGs and USMGs. In light of the central role of IMGs in primary care, the potential impact of poorer satisfaction among IMGs may be substantial. Improved understanding of the causes of this differential satisfaction is important to appropriately support the primary care physician workforce. Content Type Journal ArticleCategory Original ResearchPages 1-6DOI 10.1007/s11606-011-1832-4Authors Peggy G. Chen, Division of Health Policy and Administration, Yale School of Public Health, Room 104, 47 College Street, New Haven, CT 06520-8088, ...

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Challenges in Recruiting Minority-Serving Private Practice Primary Care Physicians to a Quality Improvement Project

American Journal of Medical Quality — Thu, 18 Aug 2011 23:00:00 +0100

The objectives of this study were the following: (1) describe one organization’s experience with recruiting minority-serving private practice primary care physicians to an ambulatory quality improvement (QI) project; (2) compare and contrast physicians who agreed to participate with those who declined; and (3) list incentives and barriers to participation. The authors identified eligible physicians by analyzing Medicare Part B claims data, a publicly available physician database, and office staff responses to telephone inquiries. The recruitment team had difficulty identifying, contacting, and recruiting eligible physicians. Solo practitioners and physicians who had lower scores on certain quality measures were more likely to participate. Barriers to participation were similar in all...

Behavioural sleep treatments and night time crying in infants: Challenging the status quo

Sleep Medicine Reviews — Wed, 17 Aug 2011 20:01:33 +0100

Summary: In Australia, as in many Westernised industrialised nations, the majority of families encourage infants to sleep alone or ‘solo’ from an early age. Sleeping solo can increase night time crying, which in turn disrupts sleep for both parent and infant. Night time waking and crying are frequently culturally constructed as behavioural sleep ‘problems’. The pursuit of solo sleeping is thus achieved through ‘behavioural sleep treatments’ that teach an infant to sleep alone. Some behavioural extinction treatments necessitate a parent leaving an infant to cry for extended periods unattended, a practice reportedly difficult for parents. Despite parent’s anxieties, and the potential (though little studied) stress to the infant, the pursuit of those behavioural sleep treatments...

Harold N. Schwinger

Journal of the American College of Radiology : JACR — Sun, 31 Jul 2011 23:00:00 +0100

, Brooklyn born, raised, practiced, and settled, often said that he spent several thousand days of his career working on volunteer chores for the ACR. His efforts over 40 years led him to the top of College leadership. As a solo practitioner for most of his career, his days serving the ACR meant having to arrange and pay for coverage or else close his office. But despite that cost, he seldom declined to accept any responsibility for representing radiology against hospital leaders, health insurance companies, other specialties, and in debates concerning professional ethics. (Source: Journal of the American College of Radiology : JACR)

Getting the Right Training and Job

Thoracic Surgery Clinics — Sun, 17 Jul 2011 22:01:42 +0100

The authors discuss the factors to be considered in selecting locations in which to train and to practice, and in conducting successful interviews and site visits. The advantages and disadvantages of different types of surgical practice (ie, solo vs group) are also reviewed, as are issues surrounding negotiations related to contracts, benefits, and covenants. (Source: Thoracic Surgery Clinics)

JACR: The upside of bureaucracy

Health Imaging News — Tue, 12 Jul 2011 13:08:29 +0100

As solo physicians become increasingly corralled up by multispecialty practices and larger organizations, medicine faces a growing bureaucratic trend, for patients and physicians. Though the thought of bureaucracy may conjure negative sentiments, radiology can learn and benefit from some important models of bureaucracy, according to the author of an article published in the July issue of the Journal of the American College of Radiology. (Source: Health Imaging News)

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Individual and Practice Characteristics Associated With Physician Provision of Recommended Care for Children With Special Health Care Needs

Clinical Pediatrics — Sat, 02 Jul 2011 23:00:00 +0100

Conclusion. Future studies should examine characteristics of smaller practices that drive implementation of recommended care practices. (Source: Clinical Pediatrics)

Whose piano is it, anyway?

Guardian Unlimited Science — Sat, 02 Jul 2011 08:16:37 +0100

This Caturday morning video smile checks in with Nora the piano-playing cat. In this video, we see that her playing is getting better, but she also is getting more possessive of her instrumentWe've met Nora the Piano-playing cat before, so we're checking in with her this morning to see how she's progressing. This video is a collection of short clips of solo and duet playing, and we see that Nora's piano playing bouts are more frequent and her playing has evolved. You will also notice that Nora is extremely protective of her instrument. Last but certainly not least, this video answers the important question; "What does Nora like to do when not playing the piano?" If you would like to see and read more about Nora, you are invited to watch her practice playing her instrument and to watch he...

What Can Bureaucracies Teach Radiology?

Journal of the American College of Radiology : JACR — Thu, 30 Jun 2011 23:00:00 +0100

The practice of medicine is becoming increasingly bureaucratic. Solo medical practice is becoming less common, and an increasing proportion of physicians are working in single-specialty group practices, in multispecialty group practices, and as employees of hospitals and other health care organizations. The sizes of the organizations with which physicians deal on a regular basis, including hospitals and insurance companies, are also increasing. With greater organizational size comes an inevitable tendency toward more bureaucratic forms of organization. (Source: Journal of the American College of Radiology : JACR)

Primary care physician compliance with colorectal cancer screening guidelines

Cancer Causes and Control — Mon, 27 Jun 2011 17:51:28 +0100

Conclusions PCPs are not adequately following CRC screening guidelines. Further studies are needed to clarify the reasons for this lack of compliance, especially as guidelines become more complex. Content Type Journal ArticlePages 1-11DOI 10.1007/s10552-011-9801-0Authors Jesse N. Nodora, Arizona Cancer Center, University of Arizona, PO Box 245024, Tucson, AZ 85724, USAWilliam D. Martz, University Physicians Healthcare, Tucson, AZ, USAErin L. Ashbeck, Arizona Cancer Center, University of Arizona, PO Box 245024, Tucson, AZ 85724, USAElizabeth T. Jacobs, Arizona Cancer Center, University of Arizona, PO Box 245024, Tucson, AZ 85724, USAPatricia A. Thompson, Arizona Cancer Center, University of Arizona, PO Box 245024, Tucson, AZ 85724, USAMaría Elena Martínez, Arizona C...

Balancing Business, Service, and Life

Physicians Practice — Mon, 27 Jun 2011 12:00:00 +0100

One of the reasons that I left my former practice to go into solo private practice was my desire for autonomy. I wanted to set my hours, my days off, my schedule. How silly I was to think getting those things would be easy. (Source: Physicians Practice)

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Three solo doctors offer tips on meaningful use

Healthcare IT News — Fri, 24 Jun 2011 15:02:08 +0100

Healthcare IT News interviewed three solo practitioners who have met Stage 1 meaningful use guidelines, and asked what advice they might have for other solo practitioners or small practices. Donald Moore, MD, a primary care physician who practices in Brooklyn, N.Y., has been using his Sage Intergy EHR for about five years. read more (Source: Healthcare IT News)

Helping Small Practices Survive Health System Change

As We See It: Voices From the AAFP — Tue, 21 Jun 2011 23:05:00 +0100

This is a tough time for family physicians in many small or solo practices. They're working as hard as they can, struggling to keep their doors open while the health care system shifts and changes beneath their feet. Many are wondering how to transform their practices into patient-centered medical homes, or PCMHs, with the limited resources they have at hand. And now, to top it off, they're worried about the advent of accountable care organizations, or ACOs, and whether practices like theirs will be able to participate or be left behind. Faced with these challenges, many simply don't know what to do. If this describes you, I want you to know the AAFP hasn't forgotten you -- not in the programs and services we offer, and definitely not in the national debate about health care reform and ACO...

Be prepared: a hospital is likely to come knocking

Modern Medicine — Tue, 21 Jun 2011 23:00:00 +0100

Are the days of solo and small physician practices numbered? Very likely for most practices, according to two recent surveys that indicate the trend of hospitals employing physicians is continuing unabated and raising new issues for all parties. Make sure you know how to protect your interests in negotiations with a future hospital employer. (Source: Modern Medicine)

Docs tell government panel EHR tales of woe

Healthcare IT News — Fri, 03 Jun 2011 13:46:36 +0100

The cost, physician practice size, and lack of technical resources still present barriers for small healthcare providers in adopting electronic health records and participating in the meaningful use incentive program. Solo practitioners and small practices find it difficult to locate a lender willing to offer them an unsecured loan, said Sasha Kramer, MD, a solo practitioner dermatologist in Olympia, Wash. Others who try to finance their electronic health record system with the vendor have no leverage in negotiating terms because of their limited market share. read more (Source: Healthcare IT News)

Can Psychiatry Cross the Quality Chasm? Improving the Quality of Health Care For Mental and Substance Use Conditions [INFLUENTIAL PUBLICATIONS]

FOCUS — Thu, 02 Jun 2011 23:00:00 +0100

This article summarizes the Institute of Medicine's analysis of these issues and recommendations for improving mental and substance use health care and discusses the implications for psychiatric practice and related advocacy efforts of psychiatrists, psychiatric organizations, and other leaders in mental and substance use health care. (Reprinted with permission from American Journal of Psychiatry 2007; 164:712–719) (Source: FOCUS)

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Electronic Health Records and Clinical Decision Support Systems: Impact on National Ambulatory Care Quality [Original Investigation]

Archives of Internal Medicine — Sun, 22 May 2011 23:00:00 +0100

Conclusions Our findings indicate no consistent association between EHRs and CDS and better quality. These results raise concerns about the ability of health information technology to fundamentally alter outpatient care quality. (Source: Archives of Internal Medicine)

What Could Help Oncologists in Small Practices?

Medscape Today Headlines — Tue, 17 May 2011 14:17:00 +0100

Many oncologists in small or solo practices are struggling financially, and the situation is likely to become worse. Here's one possible solution. Medscape Business of Medicine (Source: Medscape Today Headlines)

Doc uptake of EMRs grows across California

Healthcare IT News — Wed, 11 May 2011 14:28:36 +0100

While nearly half of all physicians in California use an electronic medical record, according to a new report from the California HealthCare Foundation, uptake is still slow among solo and small physician practices. For example, only 20 percent of solo practices, and less than 40 percent of small group practices (two to five MDs), have implemented electronic health records (EHRs) in their practices. With retirements and practice consolidation, these smaller physician groups are becoming less prevalent in California and across the nation. read more (Source: Healthcare IT News)

Gaining insight into benzodiazepine prescribing in General Practice in France: a data-based study

BMC Family Practice — Tue, 10 May 2011 23:00:00 +0100

Conclusions: The present study showed the persistence of high rates of BZD prescription by GPs, particularly in women and older patients, which highlights the difficulties of implementing effective public policies and the necessity of using new approaches enabling doctors and patients to understand the true relative advantages, disadvantages, and consequences of using these drugs and of non-pharmaceutical treatments. (Source: BMC Family Practice)

Electronic health records in small physician practices: availability, use, and perceived benefits.

Journal of the American Medical Informatics Association — Sat, 30 Apr 2011 23:00:00 +0100

Conclusion Our study found that physicians in small practices have lower levels of EHR adoption and that these providers were less likely to use these systems. Ensuring that unique barriers are addressed will be critical to the widespread meaningful use of EHR systems among small practices. PMID: 21486885 [PubMed - in process] (Source: Journal of the American Medical Informatics Association)

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Is Private Practice Dead?

Consultant Live — Tue, 26 Apr 2011 18:30:02 +0100

And if solo practice if going away, does that really mean human connection is getting lost, too? (Source: Consultant Live)

Doctors INC.: Family Physician Can’t Give Away Solo Practice

NYT Health — Sat, 23 Apr 2011 01:36:38 +0100

Dr. Ronald Sroka has been in practice for 32 years, and has a roster of 4,000 patients, but with costs going up and reimbursements going down he is looking for an out. (Source: NYT Health)

Physician Practices Embrace Tablets

ICMCC: The International Council on Medical and Care Compunetics — Wed, 20 Apr 2011 08:51:10 +0100

Source: Marisa Torrieri, Physicians Practice Content: “Several times a day, Frank Adams, a solo pulmonologist in New York City, uses his Apple iPad to access his practice’s EHR, to review charts and prescribe medication, and to pick up e-mail messages from his staff. Only nine months since he purchased the device, he can’t imagine his [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Patient complexity and GPS' income under mixed remuneration

Health Economics — Wed, 13 Apr 2011 02:55:51 +0100

The objective is to assess how patient heterogeneity affects list size, income and total utility of GPs operating under a mixed remuneration scheme. We adapt the model by Iversen (2004) as a theoretical framework for analysing the consequences of patient heterogeneity in a mixed remuneration system. We use a data set of Danish solo practitioners to analyse the effect of patient complexity on list size and income. From the theoretical model we find that higher levels of patient complexity lead GPs to choose a lower list size, whereas the effect on income is ambiguous. The effect on total utility (income and leisure) is, however, shown to be negative. Using empirical data from 1039 solo practices we find that patient complexity reduces both list size and income and conclude that a mixed per ...

What's the Best Size for a Practice?

Medscape Cardiology Headlines — Fri, 01 Apr 2011 16:00:00 +0100

Each size practice -- solo, small, medium, large -- has its own pros and cons. Choosing which works for an individual doctor depends on his or her own desires and goals. UnCommon Sense® (Source: Medscape Cardiology Headlines)

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iPad helps podiatrist deliver better care

ICMCC: The International Council on Medical and Care Compunetics — Fri, 01 Apr 2011 08:39:34 +0100

Source: Molly Merrill, Healthcare IT News Content: “A podiatrist in private practice in Birmingham, Ala., says using an iPad has improved his workflow and given him more time with his patients. Todd Falls, DPM, a solo provider at Montclair Podiatry and an attending physician in the Department of Podiatric Surgery at St. Vincent’s Hospital, is an [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Global health: Cambodia days 7-8

Thrive, Children's Hospital Boston — Wed, 30 Mar 2011 15:16:07 +0100

Since December 2009, a group of nurses, physicians and therapists from Children’s Hospital Boston has dedicated themselves to setting up a “Sister PICU” (pediatric intensive care unit) program between Children’s and the National Pediatric Hospital (NPH) in Phnom Penh, Cambodia. Read about the C4C team–named for their Cans for Care fundraising efforts–here, then read the first in a series of posts from Maureen Hillier and Kim Cox, two Children’s nurses who are spending the next two weeks 9,000 miles away, in Phnom Penh. Last week we shared the the middle of their journey, here is their final installment. Day 7: With only two clinical days remaining at NPH, we’ve got to redirect our efforts if we’re going to accomplish all our goals for this mission. We finally com...

Epocrates launches beta EHR

Healthcare IT News — Wed, 30 Mar 2011 15:04:28 +0100

Epocrates announced Wednesday that its mobile and Web-based electronic health record has entered beta and is now being tested by solo and small group physician offices across the country. The firm also announced an agreement with Burlington, Mass.-based Nuance Communications to integrate its speech recognition technology as a component of its Epocrates EHR. read more (Source: Healthcare IT News)

Epocrates EHR for Small Group and Solo Physician Practices Enters Beta

Medical News (via PRIMEZONE) — Wed, 30 Mar 2011 10:00:00 +0100

SAN MATEO, Calif., March 30, 2011 (GLOBE NEWSWIRE) -- Epocrates, Inc. (Nasdaq:EPOC), today announced its mobile and web-based electronic health record (EHR) solution has entered beta and is now being tested by solo and small group physician offices across the country. The company also announced an agreement with Nuance Communications, Inc. (Nasdaq:NUAN) to leverage the Nuance Healthcare Development Platform (NHDP) to integrate Nuance's cloud-based, medical speech recognition technology as a component of its Epocrates EHR(tm) solution. (Source: Medical News (via PRIMEZONE))

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Discussions About Prostate Cancer Screening Between U.S. Primary Care Physicians and Their Patients

Journal of General Internal Medicine — Fri, 18 Mar 2011 01:53:02 +0100

Conclusions Both individual and practice-related factors of PCPs were associated with the use of prostate cancer screening discussions by U.S. PCPs. Results from this study may prove valuable to researchers and clinicians and help guide the development and implementation of future prostate cancer screening interventions in the U.S. Content Type Journal ArticlePages 1-7DOI 10.1007/s11606-011-1682-0Authors Ingrid J. Hall, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USAYhenneko J. Taylor, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC USALouie E. Ross, Ross-Holmes Group LLC, Raleigh, NC USALisa C. Richardson, Division of Cancer Prevention and Control, Centers f...

How are symptoms of ovarian cancer managed?

Cancer — Wed, 16 Mar 2011 00:00:00 +0100

CONCLUSIONS:On the basis of a vignette in which a woman reported symptoms associated with ovarian cancer, the majority of primary care physicians and gynecologists would not recommend CA125, but would recommend imaging of the pelvis. Gynecologists, physicians involved with clinical teaching, and those in group practices were significantly more likely to recommend testing that could lead to an ovarian cancer diagnosis. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

A solo practice that bucks conventions

Medical Economics - Malpractice — Thu, 10 Mar 2011 00:00:00 +0100

Bernd Wollschlaeger, MD, has always sought a unique path in life; the same holds true for his career path in medicine. (Source: Medical Economics - Malpractice)

My First Solo Weekend on Call

Physicians Practice — Tue, 08 Mar 2011 12:00:00 +0100

This past weekend, for the first time ever, I was on call completely by myself. Since it was only me, I had to make some tough decisions. (Source: Physicians Practice)

More Than Four In Five Office-Based Physicians Could Qualify For Federal Electronic Health Record Incentives [Health Information Technology]

Health Affairs — Mon, 07 Mar 2011 00:00:00 +0100

Our analyses of federal survey data show that more than four in five office-based physicians could qualify for new federal incentive payments to encourage the adoption and "meaningful use" of electronic health records, based on the numbers of Medicare or Medicaid patients they see. The incentives are thus likely to accelerate the spread of electronic health records. However, our analyses also indicate that eligibility for the incentives is likely to vary by specialty: 90.6 percent of physicians working in general or family practice or internal medicine could qualify for incentives, but fewer than two-thirds of pediatricians, obstetrician-gynecologists, and psychiatrists may qualify. Eligibility and use will also vary by factors such as size and type of practice; physicians in solo pra...

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“Hay Que Ponerse en los Zapatos del Joven”: Adaptive Parenting of Adolescent Children Among Mexican‐American Parents Residing in a Dangerous Neighborhood

Family Process — Tue, 01 Mar 2011 00:00:00 +0100

We examined parenting of adolescents with Consensual Qualitative Research analyses of five 90‐minute focus groups with 45 Mexican immigrant parents residing in a high‐crime and low‐income neighborhood. Parents identified gangs as their major challenge in parenting. Relatedly, they endorsed control‐oriented practices to ensure the safety of their adolescents. In addition, parents used practices that aimed to build strong, trusting relationships with their adolescents. The co‐occurrence of parenting strategies that promote strong parent–adolescent bonds along with strict monitoring highlights the need to conceptualize parenting with both controlling as well as supportive dimensions. Moreover, the parents' narratives pertaining to the dangers in their neighborhood suggest that int...

Survival of solo practitioners and small group practices in today's challenging marketplace: setting the ground work now--Part II.

The Journal of Medical Practice Management : MPM — Tue, 01 Mar 2011 00:00:00 +0100

This article provides guidelines to empower physicians and their staff with proven practice management tools and techniques that have stood the test of time. PMID: 21595382 [PubMed - in process] (Source: The Journal of Medical Practice Management : MPM)

Self‐perceived preparedness for dental practice amongst graduates of The University of Hong Kong’s integrated PBL dental curriculum

European Journal of Dental Education — Thu, 17 Feb 2011 00:00:00 +0100

Conclusions: Dental graduates of HKU’s integrated PBL curriculum felt well prepared for the most fundamental aspects of dental practice. However, apparent deficiencies of training in orthodontics and oral and maxillofacial surgery will need to be addressed by continuing education, postgraduate training and planning for the new 6‐year undergraduate curriculum in 2012. (Source: European Journal of Dental Education)

Leadership structures in emergency care settings: A study of two trauma centers

International Journal of Medical Informatics — Thu, 10 Feb 2011 00:00:00 +0100

Conclusion: Most important weaknesses of different leadership structures are manifested in inefficient teamwork or inappropriate patient care. These inefficiencies are particularly problematic when leadership is shared between physicians from different disciplines with different levels of experience, which often leads to conflict, reduces teamwork efficiency and lowers the quality of care. We discuss practical implications for technology design. (Source: International Journal of Medical Informatics)

CRNA prescribing practices: the Washington State experience.

AANA Journal — Tue, 01 Feb 2011 00:00:00 +0100

Authors: Kaplan L, Brown MA, Simonson D One year after implementation of a 2005 Washington State law that granted Certified Registered Nurse Anesthetists (CRNAs) authority to prescribe schedule II through IV controlled substances, only 30% of CRNAs held prescriptive authority. The purpose of this study was to describe Washington State CRNA prescribing practices and workforce and practice characteristics. A questionnaire was mailed in 2006 to CRNAs licensed in Washington with addresses in Washington, Oregon, and Idaho. A typical respondent was 51 years old, white, and equally likely to be male or female, with 19 years of experience. More than half (52.2%) of the CRNAs were employed by hospitals, and 22% were in solo practice. Forty-one percent of the sample had prescriptive authority; h...

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Masturbation: Not Just Monkey Business

Psychology Today Sex Center — Mon, 31 Jan 2011 13:07:56 +0100

I first discovered the Proboscis Monkey during graduate school when I happened upon a picture of this large-nosed creature. Having a similarly prominent organ in the center of my face, as well as being married to a like-faced fellow, I felt instant kinship with this unique creature. However, it is only recently that I learned about the masturbation habits of this endangered primate.My daughter came home from high school, announcing that she had actually learned something interesting in Human Geography that day. She informed me that when they feel stressed, Proboscis Monkeys masturbate. Although I couldn't verify this information about what motivates monkey masturbation, multiple searches informed me many animals masturbate- both when partners are available and when they are not. Many sourc...

Electronic Health Records and Clinical Decision Support Systems: Impact on National Ambulatory Care Quality [Original Investigation]

Archives of Internal Medicine — Mon, 24 Jan 2011 00:00:00 +0100

The Making—and Fueling—of Stereotypes

Psychology Today Parenting Center — Thu, 20 Jan 2011 02:30:07 +0100

The enormous flak over Amy Chua's book, "Battle Hymn of the Tiger Mother," serves to fuel, not only a debate, but also the stereotype of immigrant parenting. As a staunch defender of only children and their parents who are maligned with regularity, I am not surprised.Incomplete or misinformation "travels" faster than light, leaving a residue which labels a group, often erroneously. I am not defending Chua's parenting methods; they have been rehashed and argued endlessly. Instead, I am examining the collateral damage left in its wake-the stereotype of the relentless, strict, deprecating, depriving Chinese/immigrant parent.As in only children labeling, the attention paid to and the misinterpretation of her book, particularly in an early Wall Street Journal article, will be its only remnant. ...

All of Us

Journal of Oral and Maxillofacial Surgery — Wed, 19 Jan 2011 15:59:09 +0100

How much we have in common! We are all oral and maxillofacial surgeons. We have a common background of education, experience, training, and certification. We have a similar set of goals: care for patients, provide for families, and advancement of the profession we are fortunate enough to serve. Regardless of the training and academic initials we sign after our names (DDS or DMD; MS or MD; PhD or MPH); regardless of practice environment (academic surgeon, solo-private practitioner, academic educator or researcher, military surgeon or small- or large-group practice, federal services or contract employee), and regardless of whether you do teeth and titanium or oncological surgery, reconstructive or esthetic surgery, orthognathic or trauma surgery, temporomandibular disorder management or clin...

Flinching from the Tiger Mom

Psychology Today Parenting Center — Sat, 15 Jan 2011 01:53:33 +0100

I have studied parenting in the US, Japan, the Philippines, Chile, Italy, and Uganda. I have studied differences in parenting in the US, comparing Blacks, Whites, Latinos, and Asian-Americans. I am comfortable with thinking about cultural differences.But the excerpts I've read from Tiger Moms still make me flinch.Battle Hymn of the Tiger Moms is a new book written by Amy Chua, a Chinese-American law professor from Yale, talking about her parenting and why Chinese kids - or any kid whose mom act like Chinese moms - excel. In her Wall Street Journal description of her parenting, Why Chinese Mothers Are Superior, Chua talks about not letting her daughters watch TV, forcing them to play the piano and/or violin, not letting them be in school plays, and refusing to let them have...

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Do we live in a culture of violence?

Psychology Today Work Center — Wed, 12 Jan 2011 17:47:17 +0100

The recent shooting of a Congresswoman in Arizona, and killing and wounding of many more innocent bystanders has opened up wounds in our psyche. Some have attempted to politicize the event as symptomatic of the immorality of the people and media with conservative political or social views while others seek to minimize the importance by seeing the event as another "deranged lone gunman" episode. Neither explanation may be close to the truth. The reality may be that American culture has become a culture of violence, which is now exemplified in many forms. Geneva Graduate Institute of International Studies study of list of countries by number of guns divided by number of residents in 2007, listed the U.S. as number 1, with Yemen second. The U.S. had 90 guns per 100 residents, while Yemen had ...

Prevalence and self‐reported health consequences of vaginal practices in KwaZulu‐Natal, South Africa: findings from a household surveyPrévalence et conséquences sur la santé des pratiques vaginale auto‐rapportées dans le KwaZulu‐Natal, Afrique du Sud: résultats d’une enquête auprès des ménagesPrevalencia y consecuencias autorreportadas sobre la salud de las prácticas vaginales en KwaZulu‐Natal, Sudáfrica: hallazgos de una encuesta realizada en el hogar

Tropical Medicine and International Health — Tue, 11 Jan 2011 14:45:03 +0100

Conclusions Vaginal practices are common in KwaZulu‐Natal. Although self‐reported health problems with current practices are rare, high lifetime risk of adverse events and potential for asymptomatic but clinically important damage make continued research important.Objectifs: Examiner la prévalence à l’échelle de la population des pratiques vaginales, leur fréquence et leurs conséquences auto‐rapportées sur la santé dans le KwaZulu‐Natal, en Afrique du Sud.Méthodes: Une enquête sur les ménages utilisant l’échantillonnage en grappes à plusieurs niveaux a été réalisée en 2007. Les femmes âgées de 18 à 60 ans (n = 867) ont été interrogées sur les caractéristiques démographiques, les comportements sexuels et les pratiques vaginales, en se concent...

Letter: Readers comment on Medical Economics stories

Modern Medicine — Mon, 10 Jan 2011 00:00:00 +0100

Letters discuss social networking and practicing solo. (Source: Modern Medicine)

Survival of solo practitioners and small group practices in today's challenging marketplace: setting the ground work now--part I.

The Journal of Medical Practice Management : MPM — Sat, 01 Jan 2011 00:00:00 +0100

Authors: Cascardo D Today's healthcare changes have been driven by harsh economic realities. Hospitals and physicians have competed intensely for patients. The current economy, increased practice operational costs, and deep cuts in federal and state funding have created the need for practices to tighten up the business side and work efficiently without losing their patient-centric outlook. The new Patient Protection and Affordable Care Act of 2010, which calls for a quality-based healthcare delivery system, will require physicians to shift their thinking and pattern of practicing medicine to focus on quality-based medicine rather than volume-based medicine. Taking small incremental steps today can position you for success in the future. PMID: 21506463 [PubMed - in process] (Source:...

Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study

Comprehensive Psychiatry — Fri, 03 Dec 2010 00:00:00 +0100

Conclusions: Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. (Source: Comprehensive Psychiatry)

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EMRs as a barrier to patient-doctor relationship

ICMCC: The International Council on Medical and Care Compunetics — Mon, 29 Nov 2010 11:25:27 +0100

Source: Patty Enrado, EHRWatch Content: “There’s an interesting article in a recent issue of the Connecticut Mirror about the impact of EMRs on the patient-doctor relationship. It starts out with one patient telling a solo-practicing general surgeon that she’s glad the surgeon doesn’t have an EMR because the physicians spend more time on the computer [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Dental capitation insurance provider compensation: a fair deal?

The American Journal of Managed Care — Wed, 24 Nov 2010 19:15:02 +0100

CONCLUSIONS: Solo general dentists with office overhead costs greater than or equal to the national mean likely find that the capitation amounts paid by insurance companies are an unfair compensation or are incompatible with their income objectives. Participation by solo general practitioners in capitation plans with such compensation levels would be problematic or unlikely. PMID: 21087073 [PubMed - as supplied by publisher] (Source: The American Journal of Managed Care)

Setting a Fair Performance Standard for Physicians’ Quality of Patient Care

Journal of General Internal Medicine — Tue, 23 Nov 2010 07:00:37 +0100

Conclusions The standard-setting method yielded a credible, defensible performance standard for diabetes care based on informed judgment that resulted in a reasonable, reproducible outcome. Our method represents one approach to identifying outlier physicians for intervention to protect patients. Content Type Journal ArticleDOI 10.1007/s11606-010-1572-xAuthors Brian J. Hess, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106, USAWeifeng Weng, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106, USALorna A. Lynn, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106, USAEric S. Holmboe, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, ...

No Longer a Solo Doc

Physicians Practice — Mon, 15 Nov 2010 12:00:00 +0100

In many ways the transition from solo to group (albeit a group of two) has been seamless. It helps that there were plenty of exam rooms to go around, enough computers, and a steady flow of patients. It also helps that she is fresh out of fellowship and is flexible in her ways. And the fact that I’ve known her for more than five years helps, too. (Source: Physicians Practice)

Vaccines provided by family physicians.

Annals of Family Medicine — Mon, 01 Nov 2010 00:00:00 +0100

CONCLUSIONS: Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study. PMID: 21060120 [PubMed - in process] (Source: Annals of Family Medicine)

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Learning Curve and Surgical Outcome for Robotic-Assisted Hysterectomy with Lymphadenectomy: Case-Matched Controlled Comparison with Laparoscopy and Laparotomy for Treatment of Endometrial Cancer

The Journal of Minimally Invasive Gynecology — Sun, 24 Oct 2010 06:47:33 +0100

Conclusion: The learning curve for robotic-assisted hysterectomy with lymph node dissection seems to be easier compared with that for laparoscopic hysterectomy with lymph node dissection for surgical management of endometrial cancer. (Source: The Journal of Minimally Invasive Gynecology)

The Performance of Outside Readings by Radiology Practices

American Journal of Roentgenology — Wed, 20 Oct 2010 23:00:00 +0100

CONCLUSION. Outside readings were a common activity among radiology practices in 2007. There was substantial variability among practice types, sizes, and locations in whether practices performed outside readings and, if so, how much outside reading they did. (Source: American Journal of Roentgenology)

Can E-Health Improve Aboriginal And Torres Strait Islander Health Outcomes? Australia

Health News from Medical News Today — Fri, 08 Oct 2010 08:00:00 +0100

E-health has the capacity to enhance the health outcomes of Aboriginal and Torres Strait Islander people, according to Dr Brad Murphy, an Aboriginal man from the Kamilaroi people of northwest New South Wales and a solo GP in Eidsvold (central Queensland). Dr Murphy is also the Inaugural Chair of the Royal Australian College of General Practitioners (RACGP) National Faculty of Aboriginal and Torres Strait Islander Health... (Source: Health News from Medical News Today)

Self-reported use of complementary and alternative medicine (CAM) products in topical treatment of diabetic foot disorders by diabetic patients in Jeddah, Western Saudi Arabia

BMC Research Notes — Tue, 05 Oct 2010 23:00:00 +0100

Conclusions: The use of CAM products in topical treatment of diabetic foot disorders is fairly common among Saudi diabetic patients. Honey headed the list as a solo topical preparation or in combination with other herbs namely black seeds and myrrh. The efficacy of the most common products needs further research. (Source: BMC Research Notes)

News & Notes

Journal of Allergy and Clinical Immunology — Thu, 30 Sep 2010 23:00:00 +0100

This month, we interviewed another of the three newly elected members of the Board of Directors. Michael H. Clayton, MD, MPH, FAAAAI, is a solo private practitioner and Clinical Faculty, University of New Mexico Department of Pediatrics. (Source: Journal of Allergy and Clinical Immunology)

Research interests and funding of members of the American Pediatric Surgical Association: report from 2010 American Pediatric Surgical Association Outcomes and Clinical Trials Committee

Journal of Pediatric Surgery — Thu, 30 Sep 2010 23:00:00 +0100

Conclusions: Research activities are common among APSA members and encompass a wide range of pediatric surgery topics. Strikingly, the overall financial support of these efforts is limited, predominantly supported by the surgeons themselves. Funded respondents attained grants through Public Health Service grants, departmental grants, or private institutions. (Source: Journal of Pediatric Surgery)

A Simple Vista en Este Número

Ophthalmology — Thu, 30 Sep 2010 17:24:27 +0100

Tejedor y otros (p. 1883) propusieron la hipótesis de que se practicaría menos cirugía de estrabismo al usar anestesia tópica en pacientes que cooperen, en vez de los métodos clásicos de anestesia con la dosis quirúrgica preestablecida. Los investigadores se basaron en la cantidad total de cirugía, como resultado primario sustituto, señalando las posibles ventajas de practicar una menor cantidad de cirugía así como de reducir la frecuencia de las complicaciones. Por ejemplo, practicar una cantidad menor de cirugía puede evitar llegar muy cerca de la curva de longitud-tensión, donde pequeños cambios en la retroposición del recto interno pueden tener consecuencias impredecibles en la corrección de la desviación. Para probar su hipótesis, los investigadores asignaron 28 paci...

Fulfillment is Playing and Listening to Beethoven!

Psychology Today Personality Center — Tue, 21 Sep 2010 20:38:59 +0100

"Chamber music" refers to what Beethoven wrote for solo, duet, or small groups: sonatas, trios, string quartets, etc. This afternoon, my friend Tessa and I played Beethoven's tenth and last violin/piano sonata, opus 96. Sometimes the piano part jumps around the keyboard so fast I have trouble getting my fingers there on time. For our next session, two principles I'll use when practicing will be: 1. "She who plays slowest longest plays fastest soonest." This is for playing a piece the first few times. 2. "Isolate the smallest possible problem areas and work mainly on those." My favorite piano teacher, Bernhard Abramowitsch, nicknamed the "King of Rubato," taught me this. (Rubato means playing the rhythm with flexibility-not strictly as written-in order to express the music beautifully.)Beet...

Secret messages written into fabric of our world

Guardian Unlimited Science — Fri, 17 Sep 2010 11:30:56 +0100

A girl playing noughts and crosses, a Playboy centrefold, Sky satellite dishes, the trill of a modem – all have hidden meaningsFrank Swain blogs at http://scienceblogs.com/sciencepunk/Even if you don't watch much TV, you've probably come across Carole Hersee. Her TV career has spanned over forty years, clocking up around 70,000 hours of on-screen time with her faithful co-star Bubbles. She's appeared on a host of BBC channels, typically in the early hours, but has yet to land a speaking role. If you hadn't guessed already, I am of course referring to the eternally youthful subject of the BBC test cards, who has graced our screens since 1967.I like the BBC test card, because it's a wonderful example of how practical industrial design can develop into an enigmatic work of art. But even bet...

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AAFP Questions Claims That Health Care Reform Will Reduce Role of Solo, Small Practices

AAFP Government and Medicine — Wed, 15 Sep 2010 21:35:00 +0100

The AAFP has sent a letter to the White House regarding an article in the Annals of Internal Medicine written by top White House officials that gives the impression that health care reform will accelerate the establishment of larger group practices at the expense of solo and small physician group practices. (Source: AAFP Government and Medicine)

Cognitive Behavioral Therapy With a Paranoid Schizophrenic Patient

Clinical Case Studies — Mon, 13 Sep 2010 12:07:13 +0100

This case study describes the cognitive-behavioral therapy (CBT) of a married adult male diagnosed with paranoid schizophrenia. "Michael" was initially oriented to CBT for psychosis (CBTp) in a partial hospital program at McLean Hospital in Belmont, Massachusetts. Michael was then followed as an outpatient over 30 weekly sessions of CBTp. Over the course of treatment, Michael remained paranoid. However, his self-reported levels of conviction and preoccupation decreased measurably, and he experienced improvements in mood and psychosocial functioning. These results support a growing body of research demonstrating effectiveness of CBTp with schizophrenia and have implications for solo practitioners facing pressure to utilize evidence-based treatments. Further research is needed on the effecti...

Most Regional Extension Centers still in planning stages

Healthcare IT News — Fri, 10 Sep 2010 14:07:14 +0100

Most health IT Regional Extension Centers, funded by the federal government to jump start the adoption of EHRs by physicians in solo and small practices, remain in the planning phase, according to a new survey by eHealth Initiative. (Source: Healthcare IT News)

NPR: Some Primary Care Doctors Remain In Solo Practice

Health News from Medical News Today — Fri, 27 Aug 2010 11:00:00 +0100

In the first of a three-part series on primary care, NPR reports on doctors who choose to stay in solo practice. "Conventional wisdom is that the age-old model of a single doctor serving patients out of a small office is rapidly going extinct. Doctors need to evolve or die. That means fancy new computerized medical systems and bigger groups to handle the overhead. But Cathy Crute wants to get one thing straight from the get-go: She is not a dinosaur." Crute practices in Portland, Maine, and formed her solo practice 10 years ago after years in group practice... (Source: Health News from Medical News Today)

Bucking The Trend: Primary Care Doc Practices Solo

News stories via the Rural Assistance Center — Thu, 26 Aug 2010 06:00:00 +0100

NPR article profiles Dr. Cathy Crute, who has her own practice in Maine, and says she brings a personal touch to primary care. (Source: News stories via the Rural Assistance Center)

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Going Solo: Primary Care Doctor Bucks The Trend

NPR Health and Science — Wed, 25 Aug 2010 19:00:00 +0100

There's a catastrophic shortage of primary care doctors who provide basic health care. And the need is expected to grow as more people receive coverage as a result of the new health law. Dr. Cathy Crute is one doctor who is holding onto her solo practice in Maine.» E-Mail This » Add to Del.icio.us (Source: NPR Health and Science)

Bucking The Trend: Primary Care Doc Practices Solo

NPR Health and Science — Wed, 25 Aug 2010 19:00:00 +0100

There's a catastrophic shortage of primary care doctors who provide basic health care. And the need is expected to grow as more people receive coverage under the new health law. Dr. Cathy Crute is one doctor who is holding on to her solo practice in Maine.» E-Mail This » Add to Del.icio.us (Source: NPR Health and Science)

Tax Credit Designed to Help Small Businesses Provide Health Insurance

AAFP Practice Management — Wed, 11 Aug 2010 22:55:00 +0100

As small-business owners, many family physicians who own solo or small practices struggle to provide health insurance for their employees. However, thanks to the recently enacted health care reform legislation, these physicians now may be eligible for a tax credit that they can use to help purchase this health insurance. The Patient Protection and Affordable Care Act contains various provisions to help small businesses purchase health insurance for their workers, including a measure that offers a tax credit for small employers (i.e., businesses with fewer than 25 workers and average wages of less than $50,000 per worker) who provide health insurance for their employees. (Source: AAFP Practice Management)

Can I Be Burning Out Already?

Physicians Practice — Tue, 10 Aug 2010 10:00:02 +0100

It hasn’t even been a year. I can’t even really say my schedule is overwhelming. After all, I made it. But the day in, day out demands of solo private practice are starting to get to me. (Source: Physicians Practice)

Doctors and Hospitals Team Up for Payment Reform

News stories via the Rural Assistance Center — Tue, 10 Aug 2010 06:00:00 +0100

Kaiser Health News tells how across Texas, hospital systems are scooping up physician groups and solo practitioners, scrambling to create the kinds of coordinated medical teams that federal health care reform puts a premium on. (Source: News stories via the Rural Assistance Center)

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After health care reform, physicians and small hospitals race to merge into larger, more efficient organizations

bizjournals.com Health Care:Health Insurance headlines — Mon, 02 Aug 2010 04:00:00 +0100

The Norman Rockwellian ideal of American medicine — the solo practitioner and the nearby community hospital — is already on life support, and Congress’ federal health care overhaul may finally pull the plug.Health care providers have followed a path of steady consolidation for two decades, with hospitals turning into “health care systems” and physician group practices growing far beyond their humble beginnings. Until now, doctors and hospitals wanting to hunker down as independents often could. But many practicing physicians and experts predict that option will become untenable by the time the law is fully implemented in 2018. (Source: bizjournals.com Health Care:Health Insurance headlines)

Factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors.

Med J Aust — Sun, 01 Aug 2010 23:00:00 +0100

CONCLUSIONS: The mental health of medical practitioners is crucial to the quality of care their patients receive. Doctors should reflect on their hours of work and need for holidays. Involvement with medicolegal processes, such as lawsuits, complaints and inquiries, is a stressful part of medical practice today. Doctors need to be educated about these processes and understand how the experience may affect their health, work and loved ones. PMID: 20678045 [PubMed - in process] (Source: Med J Aust)

The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice

Asia Pacific Family Medicine — Wed, 28 Jul 2010 23:00:00 +0100

Background: ObjectiveTo evaluate the usefulness of a clinical scorecard in managing sore throat in general practice.DesignValidation study of scorecard for sore throat with a throat swab culture used as the 'gold standard'.Setting: A solo family practice in rural New South Wales, AustraliaParticipants: Patients attending with sore throat.MethodPatients from the age of 5 years and above presenting with the main symptom of a sore throat, and who have not had any antibiotic treatment in the previous two weeks, were invited to participate in the study. The doctor completed a scorecard for each patient participating and took a throat swab for culture. Adult patients (>16yrs) were asked to complete a patient satisfaction questionnaire, while guardians accompanying children (5yr to (Source: Asia ...

Good time to go solo?

Modern Medicine — Thu, 22 Jul 2010 23:00:00 +0100

Weighing the best time to leave a practice. (Source: Modern Medicine)

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All Medicare, (almost) all the time...and loving it

Modern Medicine — Thu, 22 Jul 2010 23:00:00 +0100

The 21 percent cut to Medicare physician reimbursement rates averted last month affected few physicians more than internist and geriatrician Nevada A. Lee, MD, who runs a solo practice in Raytown, Mo. (Source: Modern Medicine)

Doctor, Nurse Roles Considered As Shortages Take Hold

Health News from Medical News Today — Wed, 21 Jul 2010 11:00:00 +0100

"The private doctor's practice - long considered a mainstay of American medicine - could be going the way of the independent bookstore and locally owned pharmacy," The Detroit News reports. "Crushed by mounting economic pressures, more midcareer physicians in Michigan and across the country are giving up their solo practices and joining large and better-financed hospital systems as salaried employees. And an increasing number of young doctors graduating from medical school are forgoing private practice in favor of hospital jobs with steady paychecks and regular hours. ... (Source: Health News from Medical News Today)

The structure of observed learning outcome (SOLO) taxonomy: a model to promote dental students' learning

European Journal of Dental Education — Sat, 17 Jul 2010 23:00:00 +0100

Selective memorising of isolated facts or reproducing what is thought to be required [ndash] the surface approach to learning [ndash] is not the desired outcome for a dental student or a dentist in practice. The preferred outcome is a deep approach as defined by an intention to seek understanding, develop expertise and relate information and knowledge into a coherent whole. The aim of this study was to investigate whether the structure of observed learning outcome (SOLO) taxonomy could be used as a model to assist and promote the dental students to develop a deep approach to learning assessed as learning outcomes in a summative assessment. Thirty-two students, participating in course eight in 2007 at the Faculty of Odontology at Malmö University, were introduced to the SOLO taxonomy and c...

Small physician practices inch closer to adopting electronic health records

bizjournals.com Health Care:Health Insurance headlines — Mon, 28 Jun 2010 04:00:00 +0100

After dismissing it as too expensive for years, doctors in small or solo practices are now closely evaluating their options to buy sophisticated electronic medical record-keeping systems due to a combination of government pressures and new products in the market. (Source: bizjournals.com Health Care:Health Insurance headlines)

Gender and Sexuality Competence: Visions for the Future Treatment of Sexual Minority Youth

Thrive, Children's Hospital Boston — Thu, 10 Jun 2010 14:54:35 +0100

June marks Lesbian, Gay, Bisexual, and Transgender Pride Month. In honor of this event Thrive is pleased have Scott Leibowitz, MD, of Children’s Hospital Boston’s department of psychiatry, as a guest poster, blogging about a soon-to-be launched gender and sexuality psychosocial pilot program he has coordinated at Children’s, which will be the first of its kind in the United States. Scott Leibowitz, MD Imagine growing up in a constant state of turmoil, being pushed and pulled by two opposing forces: where your internal sense of self tells you to feel one way, but what seems like the rest of the world, and sometimes even your own body, says you should feel another way. For sexual minority youth—children and adolescents who grow up outside conventional norms appli...

001 New Kid on the Block

Psychology Today Parenting Center — Sat, 05 Jun 2010 12:53:05 +0100

Sense and Nonsense in Autistic Spectrum DisordersGreetings, dear reader!As the newest blogger in this space, let me introduce myself, and (hopefully) give you reason to return to this spot on a regular basis.By training, I'm what is known as a "developmental pediatrician." This means that in addition to being trained as a general pediatrician, I completed two years of training learning how to care for children with developmental disorders, such as learning disabilities, attention deficit hyperactivity disorder, developmental language disorder, mental retardation, cerebral palsy, and autism. I hold sub-specialty certification in Developmental-Behavioral Pediatrics from the American Board of Pediatrics (ABP), and in Neurodevelopmental Disabilities (awarded jointly by the ABP and the American...

Rational treatment of fibromyalgia for a solo practitioner

Best Practice and Research. Clinical Rheumatology — Mon, 31 May 2010 14:23:05 +0100

Fibromyalgia (FM) is a challenging condition, but the management of patients with FM is becoming facilitated by new medications that act in what are thought to be some of most important pathophysiological features in this syndrome. However, it is of pivotal importance that an interdisciplinary approach is used to improve pain, fatigue, sleep and other domains to improve quality of life. Here, we present elements of management that the solo practitioner can tackle, focussing in the formally approved drugs for FM and other drugs commonly used in this condition. Further, the elements of an ideal multidisciplinary team are presented, and on how to incorporate their recommendations for the treatment of FM. (Source: Best Practice and Research. Clinical Rheumatology)

TransforMED Rolls Out New Product to Support Solo, Small Practices

AAFP Practice Management — Wed, 26 May 2010 21:50:00 +0100

TransforMED, a wholly owned subsidiary of the AAFP, has launched a new service that offers small primary care practices the help they need to implement the patient-center medical home, or PCMH, model of care. (Source: AAFP Practice Management)

Why SaaS EHR systems appeal to small group practices, solo physicians

ICMCC: The International Council on Medical and Care Compunetics — Fri, 21 May 2010 16:22:42 +0100

“Electronic health record (EHR) vendors and health IT industry pundits will tell you that there are nuanced technical distinctions among application service provider (ASP) EHR, Software as a Service (SaaS) EHR and cloud EHR systems. For solo doctors and small group practices struggling to meet deadlines to get federal stimulus money under the HITECH Act, [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Taking IT to the field

ICMCC: The International Council on Medical and Care Compunetics — Thu, 13 May 2010 17:36:04 +0100

“It was a stroke of genius and practicality at once that created the health information technology extension program. The program, a product of the Office of the National Coordinator for Health Information Technology, the program has established 60 Health Information Technology Regional Extension Centers across the country. The idea is to help solo practitioners and small physician [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

How Teams Work--Or Don't--In Primary Care: A Field Study On Internal Medicine Practices [Workforce & Teams]

Health Affairs — Mon, 03 May 2010 20:01:39 +0100

We conducted a field study in three primary care practices representing different practice types: a solo practice; a certified patient-centered medical home; and a multiphysician, multispecialty practice connected to a local university. All three practices shared a common culture in the way that practice members related to each other. In each instance, the practice team operated in separate social "silos," isolating physicians from each other and from the rest of the practice staff. We concluded that current practice structures are primarily focused on supporting physicians’ hectic routines and have trouble accommodating the diversity of patients’ needs. For practices to succeed in managing diverse patients and in helping them understand and manage their own health, it will be ...

The Chiropractic Care of Children With Attention-Deficit/Hyperactivity Disorder: A Retrospective Case Series

Explore — Fri, 30 Apr 2010 23:00:00 +0100

Conclusion: A retrospective case series of ADHD patients under chiropractic care is described. This provides supporting evidence on the benefits of chiropractic spinal manipulative therapy. We encourage further research in this area. (Source: Explore)

More Family Physicians Seek Alternatives to Solo Practice

Family Practice News — Fri, 30 Apr 2010 23:00:00 +0100

Dr. Saria Carter Saccocio loved her solo family practice in Fort Lauderdale, but with two young children and an active role in her medical society, she just couldn't keep it going. (Source: Family Practice News)

The Internet Will Lift All Clinical Boats

Modern Medicine — Mon, 26 Apr 2010 23:00:00 +0100

Dr Pion discusses the use of the Internet and telecommunications to help doctors in solo or small group practice succeed in this interview with ModernMedicine's Richard Reece, MD. (Source: Modern Medicine)

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Benchmarking the Neurology Practice

Neurologic Clinics — Sat, 10 Apr 2010 13:43:29 +0100

A medical practice, whether operated by a solo physician or by a group, is a business. For a neurology practice to be successful, it must meet performance measures that ensure its viability. The best method of doing this is to benchmark the practice, both against itself over time and against other practices. Crucial medical practice metrics that should be measured are financial performance, staffing efficiency, physician productivity, and patient access. Such measures assist a physician or practice in achieving the goals and objectives that each determines are important to providing quality health care to patients. (Source: Neurologic Clinics)

Health IT and Solo Practice: A Love-Hate Relationship

The Journal of Law, Medicine and Ethics — Fri, 26 Mar 2010 00:00:00 +0100

A small town solo gynecologist describes the process of starting a practice based on health information technology, how catastrophic it can be to lose data, how difficult it can be to try to exchange information, and yet how rewarding it can be to accomplish a "paperless" experience. (Source: The Journal of Law, Medicine and Ethics)

EMR use still low at solo and small practices

American Medical News - BUSINESS — Thu, 11 Mar 2010 12:59:41 +0100

But adoption rates at practices with more than 10 physicians have grown significantly since 2009. (Source: American Medical News - BUSINESS)

Bundled payments might cut hospital costs without reducing quality of care

Wash Post Health — Tue, 09 Mar 2010 05:00:00 +0100

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, "Let's see you back in three months." I was eager to fill clinic slots; also, because of my lack of experience, I felt safer seeing my patients more often. (Source: Wash Post Health)

Bundled Payments Might Cut Hospital Costs Without Reducing Quality of Care

RWJF News Digest - Quality/Equality — Tue, 09 Mar 2010 05:00:00 +0100

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, "Let's see you back in three months." (Source: RWJF News Digest - Quality/Equality)

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Bundled payments might cut hospital costs without reducing quality of care

washingtonpost.com - Health — Tue, 09 Mar 2010 05:00:00 +0100

HIMSS: Fully functional EMR can equal more patients, more revenues

Cardiovascular Business News — Wed, 03 Mar 2010 21:24:39 +0100

ATLANTA – During an education session this afternoon at HIMSS10, Gregory Oliver, DO, primary physician at Oliver Family Healthcare, shared his insight into how to implement a fully functional EMR in a solo practice and raise profits by 25 percent annually through efficiency and the laddering of technologies. (Source: Cardiovascular Business News)

Private Practice of Prosthodontists: Current Conditions of Practice in the United States

Journal of Prosthodontics — Thu, 25 Feb 2010 00:00:00 +0100

Conclusion: In 2007, prosthodontists in private practice paid out about $1.4 billion in practice expenses to provide $2.2 billion dollars in prosthodontic care. Based on survey results from 2007 and the previous 6 years, specialization in prosthodontic care continues to be an economically attractive and productive healthcare profession in the United States. (Source: Journal of Prosthodontics)

Physician's Focus: Many Small Practices Evolve in Direction of Boutique Medicine

Modern Medicine — Thu, 25 Feb 2010 00:00:00 +0100

A growing number of physicians dedicated to keeping the small practice model alive are succeeding with innovations like the cash-only practice, concierge medicine, the open-access office, and the micropractice. Independence seems to be the main attraction, as a solo practice--or even a group of 2, 3, or 4 physicians—makes it easier for doctors to be their own boss, set their own hours, choose their own staff, and be the captain (at least partially) of their own destinies. (Source: Modern Medicine)

Physician's Focus: Make Your Small Practice Successful

Modern Medicine Medical Economics — Thu, 25 Feb 2010 00:00:00 +0100

A growing number of physicians are dedicated to keeping the small practice model alive and are succeeding with innovations like the cash-only practice, concierge medicine, the open-access office, and the micropractice. Independence is the main attraction, as a solo practice—or even a small group of physicians—makes it easier for doctors to be their own boss, set their own hours, choose their own staff, and be the captain (at least partially) of their own destinies. (Source: Modern Medicine Medical Economics)

Pathways Between Marriage and Parenting for Wives and Husbands: The Role of Coparenting

Family Process — Thu, 11 Feb 2010 00:00:00 +0100

This study used model-fitting analyses to include both wives and husbands in a test of these two alternative models of the role of coparenting in the family system. Our data suggested that both the traditional indirect model (marital health to coparenting to parenting practices), and the alternative predictor model where coparenting alliance directly and simultaneously predicts marital health and parenting practices, fit for both spouses. This suggests that dynamic and multiple roles may be played by coparenting in the overall family system, and raises important practical implications for family clinicians. A medida que las investigaciones sobre sistemas familiares se han expandido, también lo han hecho las investigaciones de cómo los compañeros conyugales comparten la crianza de sus hi...

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International health policy survey in 11 countries: assessment of non-response bias in the Norwegian sample

BMC Health Services Research — Wed, 10 Feb 2010 00:00:00 +0100

The objective of this study was to assess the effects of non-response in the Norwegian part of the Commonwealth Fund international health policy survey in 2009. Methods: As part of an international health policy survey in 2009 a cross-sectional survey was conducted in Norway among a representative sample of Norwegian general practitioners. 1 400 randomly selected GPs were sent a postal questionnaire including questions about the Norwegian health care system, the quality of the GPs' own practice and the cooperation with specialist health care. The survey included three postal reminders and a telephone follow-up of postal non-respondents. The main outcome measures were increase in response rate for each reminder, the effects of demographic and practice variables on response, the effects of n...

Suboptimal quality of type 2 diabetes care discovered through electronic feedback led to increased nurse–GP cooperation. A qualitative study

Primary Care Diabetes — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion: EFS used at an overall level provided an overview of the diabetes population which made GPs aware of the need to improve the quality of diabetes care. The EFS influenced partnership practices, but not solo practices, to hire nurses and allocate parts of diabetes care to them. The findings are important in the interpretation of the effect of EFS. (Source: Primary Care Diabetes)

Care management tools for patients with chronic conditions not always used

American Medical News - PROFESSION — Thu, 07 Jan 2010 13:03:32 +0100

Solo and smaller group practices are the least likely to have the staff and other resources needed to use those tools, a recent study says. (Source: American Medical News - PROFESSION)

Better Now Than Later: Get Involved in Reimbursement Issues

Clinical Neurology News — Fri, 01 Jan 2010 00:00:00 +0100

DR. JONES is cochair of the AAN's Government Regulatory Committee and has a solo private practice in Bristol, R.I. As many are now aware, there are a variety of changes to the Medicare fee payment schedule for 2010. (Source: Clinical Neurology News)

Z - Score an Important Clue to Diagnosis of Co-Morbidities and Fracture Risk

Journal of Clinical Densitometry — Fri, 01 Jan 2010 00:00:00 +0100

This study reviews the presence of low Z - scores and relevance to diagnosis, risk of fracture and therapeutic implications for evaluation of patients in a solo rheumatology practice. (Source: Journal of Clinical Densitometry)

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Book: Declarations of a Dinosaur

Sound Medicine — Sun, 20 Dec 2009 00:00:00 +0100

Reports on Primary Health Care topics are sponsored by Wishard Health Services. Lucy Hornstein, MD, is a member of dying breed: the solo practicing family doctor. Today she chats with Sound Medicine's Dr. David Crabb about her book, Declarations of a Dinosaur. Dr. Hornstein offers up rules she's learned treating patients. And she muses about the uncertain future of the family practice docto.... (Source: Sound Medicine)

Rural surgery: the Australian experience.

The Surgical Clinics of North America — Tue, 01 Dec 2009 00:00:00 +0100

This article outlines the past and current state of medical care in rural areas, highlighting models used in Port Augusta, Mount Gambier, and Port Lincoln. It concludes that these models are successful and should be further developed. PMID: 19944815 [PubMed - in process] (Source: The Surgical Clinics of North America)

HITECH Imposes New EHR Security Measures: Federal penalties for breaches of personal health information are significant and will be enforced.

Rheumatology News — Tue, 01 Dec 2009 00:00:00 +0100

DENVER — If federal stimulus money to the tune of $44,000 per physician has warmed more solo and small group practices to the idea of adopting electronic health record systems, the new Health Information Technology for Economic and Clinical Health Act could cool their enthusiasm. (Source: Rheumatology News)

New Security Regs Could Short Circuit EHRs: Potential for violation of the HITECH law could be exacerbated by information technology.

Caring for the Ages — Tue, 01 Dec 2009 00:00:00 +0100

Erik L. Goldman is a freelance writer in New York. DENVER — If federal stimulus money to the tune of $44,000 per physician has warmed more solo and small group practices to the idea of adopting electronic health record systems, the new Health Information Technology for Economic and Clinical Health Act could throw a wet blanket on their enthusiasm. (Source: Caring for the Ages)

HITECH Will Tighten Data Security Rules in 2010

Internal Medicine News — Tue, 01 Dec 2009 00:00:00 +0100

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The Psychiatric Medical Record, HIPAA, and the Use of Electronic Medical Records

Child and Adolescent Psychiatric Clinics of North America — Mon, 30 Nov 2009 16:55:54 +0100

This article addresses the practical and legal issues related to the psychiatric medical record, with an emphasis on the issues related to confidentiality. Implications of HIPAA (Health Insurance Portability and Accountability Act) legislation for the practice of child and adolescent psychiatry are addressed. The advantages and disadvantages of electronic medical records are reviewed, with guidelines for selecting software for solo and group practices. (Source: Child and Adolescent Psychiatric Clinics of North America)

Preface

Child and Adolescent Psychiatric Clinics of North America — Mon, 30 Nov 2009 16:55:53 +0100

Management is doing things right; leadership is doing the right things.—Peter F. Drucker Much of the medical literature in child and adolescent psychiatry is correctly focused on the nature of the illnesses that afflict our patients and the technical aspects of their treatment. Yet, in the real world within which we all work and practice following residency, our patients rely on well-functioning systems for the delivery of our services. These systems do not run themselves, and for optimal functioning, require the involvement of child and adolescent psychiatrists with substantial leadership and management skills, as well as a thorough understanding of the business and management of health care services. Indeed, it is often these areas that produce the greatest anxiety for not only the ne...

Design of an Equine Ambulatory Practice

Veterinary Clinics of North America: Equine Practice — Mon, 30 Nov 2009 16:41:11 +0100

In this article, the author discusses the design of an equine ambulatory practice. He suggests a more systematic approach to the design of an ambulatory practice that should answer the needs of group and solo practices. Today's practitioners must actively manage their practices so that their resources can be leveraged in such a fashion that a return can be realized on their capital investment and the hours spent in practice. (Source: Veterinary Clinics of North America: Equine Practice)

Rural Surgery: The Australian Experience

Surgical Clinics of North America — Mon, 30 Nov 2009 15:49:15 +0100