Family Medicine Update

Perceived difficulties in managing ethical problems in family practice in slovenia: cross-sectional study.

Croat Med J. 2008 Dec;49(6):799-806

Authors: Klemenc-Ketis Z, Kersnik J, Ojstersek J

Aim. To determine the prevalence of difficulties in managing ethical dilemmas in family practice. Methods. The study included a random sample of 259 family medicine physicians, representing 30% of the population of family physicians in Slovenia. Participants were given a self-administered questionnaire on perceived ethical dilemmas in their practice, with responses on a 5-point scale and a maximum score of 100. The main outcome measure was the percentage of family physicians reporting difficulties in solving perceived ethical dilemmas. Results. The response rate was 55%. Physicians reported having difficulties in solving ethical dilemmas often or very often (mean score+/-standard deviation, 56.1+/-12.1). The most difficult ethical issue included abandoned and unattended patients and patients with insufficient means of support (48.6%), followed by suspicion of physical abuse, sexual abuse, or other criminal behavior (40.9%), and use of limited health care resources (21.1%). Female physicians reported greater difficulties in solving ethical dilemmas than male physicians (57.7+/-10.6 vs 53.0+/-14.1, P=0.036, t test). Older physicians solved ethical issues more easily than younger ones (53.9+/-12.6 vs 58.2+/-11.2, P=0.043, t test). Specialists and residents in family medicine considered solving ethical dilemmas to be more difficult than general practitioners without specialization (57.3+/-11.6 vs 47.1+/-11.8, P=0.001, t test). Multivariate regression analysis of physician and practice characteristics did not yield any significant model to explain the differences in the perceived level of difficulties in solving ethical dilemmas. Conclusion. Although managing ethical dilemmas is an important part of daily work of family physicians in Slovenia, it is perceived as a considerable burden in their work. Family physicians need more training in addressing and managing ethical issues.

PMID: 19090605 [PubMed - in process]

More: continued here

Dermatologic disease in family medicine.

Fam Med. 2008 Jul-Aug;40(7):507-11

Authors: Awadalla F, Rosenbaum DA, Camacho F, Fleischer AB, Feldman SR

BACKGROUND AND OBJECTIVES: Because dermatologic complaints are encountered frequently in primary care, the education of family physicians about skin disorders is important. Data are needed to help define areas of dermatology that deserve the most time and emphasis. This study determined what types of skin problems and medications family physicians most commonly diagnose and prescribe. METHODS: Study researchers analyzed the National Ambulatory Medical Care Survey data from 2002 to 2005 for dermatologic diagnoses and most common prescriptions by family physicians. The data from 2002-2005 were compared to data from 1990-1994. RESULTS: Skin conditions accounted for 8% of all visits to family physicians in 2002-2005. The five most common skin disorders diagnosed by family physicians were dermatitis, pyoderma, tinea, benign neoplasms, and candida. The top 20 diagnoses accounted for 70% of the visits. The three most commonly prescribed medication classes for skin problems from 2002-2005 were antihistamines, topical anti-infectives, and adrenal corticosteroids. Between 1990-1994 and 2002-2005, family physicians increased the number of less common dermatologic diagnoses they make by 10% and have concurrently increased the prescribing of medications they use to treat these disorders. CONCLUSIONS: Family physicians diagnose a wide range of skin disorders and prescribe drugs to treat them. Family physicians make more dermatologic diagnoses and prescribe more treatments than previously.

PMID: 18928078 [PubMed - in process]

More: continued here

Related Articles

Asia Pacific Family Medicine: The rebirth of a not-so-young child.

Asia Pac Fam Med. 2008 Sep 29;7(1):1

Authors: Clearihan L, Lam TP, Leopando Z

ABSTRACT: N/A.

PMID: 18973647 [PubMed - as supplied by publisher]

More: continued here