OBJECTIVES This article proposes, tests, and explores the potential applications of a model cognitive behavioral steps physicians take when they comply with national clinical practice guidelines. The authors propose that guidelines, must first become aware then intellectually agree them, decide to adopt them in care provide, regularly adhere at appropriate times. METHODS Data used test this address physicians' responses pediatric vaccine recommendations. Questionnaires were mailed 3,014...

Williams, Eric S.; Konrad, Thomas R.; Scheckler, William E.; Pathman, Donald Linzer, Mark; McMurray, Julia Gerrity, Martha; Schwartz, Mark Author Information

Background. Physician job satisfaction has been linked to various patient care and health system outcomes. A survey instrument that concisely measures physicians' with facets can help diverse stakeholders better understand manage these Objective. To document the development validation of a multidimensional physician measure separate global measures. Design. Self-administered questionnaire: Worklife Survey (PWS). Subjects. pilot study employed national American Medical Association Masterfile...

Williams, Eric S.; Konrad, Thomas R.; Scheckler, William E.; Pathman, Donald Linzer, Mark; McMurray, Julia Gerrity, Martha; Schwartz, Mark* Author Information

Background. Changes in the demographic, specialty, and employment sector composition of medicine have altered physicians' jobs, limiting autonomy reducing morale. Because physician job satisfaction has been linked to clinical variables, better measurement might help ameliorate conditions medical disaffection, possibly improving health care. Objective. To document conceptual development, item construction, use content experts designing multidimensional measures global scales for assessing...

<b>PURPOSE</b> Few studies have attempted to link patients' beliefs about racism in the health care system with how they use and experience care. <b>METHODS</b> Using telephone survey data from a national sample of 1,479 whites, 1,189 African Americans, 983 Latinos, we explored racism, their preferences for race ethnicity physician, satisfaction that physician. A scale was developed reflect racism. Race-stratified analyses assessed associations between beliefs, racial physicians, choice...

To study the impact that physician, practice, and patient characteristics have on physician stress, satisfaction, mental, physical health.Based a survey of over 5,000 physicians nationwide. Four waves surveys resulted in 2,325 complete responses. Elimination ineligibles yielded 52 percent response rate; 1,411 responses from primary care were used.A conceptual model was tested by structural equation modeling. Physician job satisfaction stress mediated relationship between as independent...

<i>Introduction:</i> Although correlates of overall medication adherence have been studied, little is known about primary non-adherence—patients' failing to fill a prescription provided by practitioner—and whether it relates how patients view their physician, satisfaction with care, and easy or hard for them travel care. <i>Methods:</i> This study uses telephone survey data from adults in 150 rural counties 8 southeastern states. Bivariate multivariable analyses were used identify factors...

Many states attempt to entice young generalist physicians into rural and medically underserved areas with financial support-for-service programs-scholarships, service-option loans, loan repayment, direct incentives, resident support programs-with little documentation of their effectiveness.The objective this study was assess outcomes states' programs as a group compare the 5 program types.We conducted cross-sectional, primarily descriptive study.We studied all 69 state operating in 1996 that...

<h3>Objective.</h3> —To contrast the retention of physicians serving National Health Service Corps (NHSC) Scholarship Program obligations in rural settings to that non-NHSC working same or similar practices, and identify promising retention-enhancing strategies. <h3>Design.</h3> —Cohort study. <h3>Participants.</h3> —Four hundred twelve primary care initially identified during an earlier study as a national stratified random sample 178 externally subsidized clinics 1981. Thirty-six percent...

Tobacco use is a leading cause of cancer, and continued after cancer diagnosis puts patients at greater risk for adverse health outcomes, including increased recurrence. This study surveyed National Cancer Institute (NCI)–designated Centers to assess the availability tobacco treatment (TUT) services. Directors oncology providers 58 NCI-designated received invitations participate in an online survey. The questionnaire asked about attitudes, awareness, policies, practices related TUT; barriers...

PURPOSE: To identify educational approaches that best prepare physicians for rural work and small-town living, promote longer practice retention. METHOD: In two mail surveys (1991 1996-97), the authors collected data from primary care who had moved to practices nationwide 1987 through 1990. A total of 456 eligible responded both (response rate 69.0%). The identified those features physicians' training correlated with their self-reported preparedness how long they stayed in practices....

Prior studies have reported relatively low job satisfaction for general internists. We used data from a large US physician survey to assess correlates of internists.The Physician Worklife Survey was mailed national random stratified sample 5704 physicians. General internists were assessed their satisfaction, training, patient mix, work hours, the likelihood recommending specialty medical students, and stability. then compared them with specialist (internal medicine subspecialists [IMSSs])...

Objectives. We tested the assumption that average job retention duration is shorter for physicians in rural health professional shortage areas (HPSAs) than non-HPSAs. Methods. In 1991, we surveyed nationally representative samples of primary care who recently had moved to HPSAs and non-HPSAs were without service obligations. resurveyed these 1996 1997 learn any changes. Results. Physicians (n=308) demonstrated similar non-HPSA cohort (n=197) (hazard ratio leaving=1.28; 95% confidence...

Abstract: This study uses survey data to identify areas of satisfaction and dissatisfaction for primary care physicians working in rural across the country. It also identifies specific associated with longer retention within a given practice, as well characteristics individuals, practices, jobs, communities that predict retention. Study subjects comprised sample 1,600 who moved nonmetropolitan counties nationwide during years 1987 through 1990, oversampling those federally designated health...

The Centers for Disease Control and Prevention have recommended routinely testing patients (aged 13-64) HIV since 2006. However, many physicians do not test. From January 2011 to March 2012, we conducted 18 in-depth individual interviews explored primary care physicians' perceptions of barriers facilitators implementing routine in North Carolina. Physicians' comments were categorized thematically fell into 5 groups: policy, community, practice, physician, patient. Lack universal...

To determine demographic and health care system factors associated with children receiving an adequate number of well-child visits (WCVs).Information on 4385 their families was obtained via birth certificates, parent interviews, chart review outpatient sites care, insurance records.Only 77% received at least five WCVs by age 2. In regression analysis, the most strongly children's total were delay in initiation prenatal (odds ratio = 0.6) receipt all private physician offices 4.2 to 5.6)....

Objective. To examine how access to outpatient medical care varies with local primary physician densities across service areas (PCSAs) in the rural Southeast, for adults as a whole and separately elderly poor. Data Sources. Access data from 2002 2003 telephone survey of 4,311 living 298 PCSAs within 150 counties eight Southeastern states were linked geographically practice location American Medical Osteopathic Associations population U.S. Census. Study Design. In cross‐sectional study...

In the mid-1980s, states expanded their initiatives of scholarships, loan repayment programs, and similar incentives to recruit primary care practitioners into underserved areas. With no national coordination or mandate publicize these efforts, little is known about state programs recent growth.To identify describe that provide financial support physicians midlevel in exchange for a period service areas, begin assess magnitude contributions US health safety net.Cross-sectional, descriptive...

Abstract Background Physicians and patients highly value continuity in health care. Continuity can be measured several ways but few studies have examined the specific association between duration of patient-doctor relationship patient outcomes. This study (1) examines characteristics rural adults who had longer relationships with their physicians (2) assesses if length is associated patients' satisfaction likelihood receiving recommended preventive services. Methods Cross-sectional telephone...

To learn from physicians in the National Health Service Corps (referred to as NHSC or Corps) scholarship program about their experiences rural health professional shortage areas (HPSAs), contrast with those of other working HPSAs, and how physicians' retention is associated quality experiences.Cohort study.Two groups primary care who moved HPSAs nationwide 1987 through 1990 were surveyed 1991: group 1 consisted all 675 program, 2 a stratified random sample 1000 non-Corps physicians. Response...

Purpose To measure overall satisfaction of community-based preceptors, their anticipated likelihood continuing to teach, professional satisfaction, influence having students, motivation for teaching, with practice, and value incentives, compare results those a similar 2005 statewide survey. Method In 2011, the authors distributed 25-item survey all 2,359 primary care preceptors (physicians, pharmacists, advanced practice nurses, physician assistants) served by North Carolina Area Health...