Knowledge of vaccination of allergic children among Italian primary care pediatricians, hospital pediatricians and pediatric residents.
Vaccine. 2010 Aug 27;
Authors: Esposito S, Azzari C, Bartolozzi G, Fara GM, Giovanetti F, Giudice ML, Galeone C, Atti MC,
A cross-sectional survey of Italian pediatricians and pediatric residents was carried out between 15 September and 18 October 2008 in order to evaluate their knowledge concerning the administration of vaccines to children with suspected or proved allergies. Of the 750 physicians who accepted to participate (620 pediatricians and 130 residents), 630 (84.0%; 407 females; mean age 43.5+/-11.2 years) returned completed questionnaires: 268 primary care pediatricians (42.5%), 244 hospital pediatricians (38.8%), and 118 pediatric residents (18.7%). Knowledge concerning the vaccination of children with suspected or proved allergies was far from optimal, with the poorest knowledge being shown by the pediatric residents and no difference between the primary care and hospital pediatricians. Since pediatricians are the main parents’ advisors regarding vaccinations, these results indicate an urgent need for educational programmes (especially for residents) and evidence-based guidelines concerning vaccinations in children with suspected or proved allergies.
20804803
– Knowledge of vaccination of allergic children among Italian primary care pediatricians, hospital pediatricians and pediatric…
The reality of subclinical hypothyroidism in general practice.
J Prim Health Care. 2009 Sep;1(3):215-21
Authors: Cibbons V, Lillis S, Conaglen J, Lawrenson R
INTRODUCTION: Subclinical hypothyroidism (SCH) is common, reported to affect 4-10% of the adult population. Recommendations for treatment of SCH are contentious, with protagonists even disagreeing over the rationale for medical intervention. How general practitioners (GPs) manage patients with elevated thyroid stimulating hormone (TSH) and normal thyroid hormone results are unknown. This study aimed to explore how GPs think about diagnosing and managing SCH. METHODS: A qualitative study using focus groups conducted between December 2007 and March 2008 to understand how GPs perceive SCH and their diagnostic and management process. FINDINGS: Thirteen GPs in three focus groups in Waikato, New Zealand participated. There is wide variability in how GPs perceive SCH and their knowledge of the disease. A patient-centred approach to diagnosis and management was commonly reported. Consideration of overt pathology and medicolegal issues also influenced perceptions of SCH, but lack of evidence regarding outcomes of treatment made such issues complex. CONCLUSION: SCH remains a complex entity because of ambiguity regarding symptoms, uncertainty regarding prognosis and variation in advice regarding treatment. This complexity is reflected in the disparate responses by GPs to the diagnosis and management of SCH.
20690385
– The reality of subclinical hypothyroidism in general practice.
Physicians’ perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues.
JAMA. 2010 Jul 14;304(2):187-93
Authors: Desroches CM, Rao SR, Fromson JA, Birnbaum RJ, Iezzoni L, Vogeli C, Campbell EG
CONTEXT: Peer monitoring and reporting are the primary mechanisms for identifying physicians who are impaired or otherwise incompetent to practice, but data suggest that the rate of such reporting is lower than it should be. OBJECTIVE: To understand physicians’ beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative survey of 2938 eligible physicians practicing in the United States in 2009 in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Overall, 1891 physicians (64.4%) responded. MAIN OUTCOME MEASURES: Beliefs about and preparedness for reporting and experiences with colleagues who practice medicine while impaired or who are incompetent in their medical practice. RESULTS: Sixty-four percent (n = 1120) of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice. Nonetheless, only 69% (n = 1208) of physicians reported being prepared to effectively deal with impaired colleagues in their medical practice, and 64% (n = 1126) reported being so prepared to deal with incompetent colleagues. Seventeen percent (n = 309) of physicians had direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. Of those with this knowledge, 67% (n = 204) reported this colleague to the relevant authority. Underrepresented minorities and graduates of non-US medical schools were less likely than their counterparts to report, and physicians working in hospitals or medical schools were most likely to report. The most frequently cited reason for taking no action was the belief that someone else was taking care of the problem (19% [n = 58]), followed by the belief that nothing would happen as a result of the report (15% [n = 46]) and fear of retribution (12% [n = 36]). CONCLUSION: Overall, physicians support the professional commitment to report all instances of impaired or incompetent colleagues in their medical practice to a relevant authority; however, when faced with these situations, many do not report.
20628132
…more
