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Hospital Doctor (hospital + doctor)
Selected AbstractsTraining the ideal hospital doctor: the specialist registrars' perspectiveMEDICAL EDUCATION, Issue 10 2001N Khera Background When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training. Methods This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. Findings A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes. Conclusions SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers. [source] Life is sweet in Fiji: the availability of diabetes healthcare and health education, and diabetes awareness amongst diabetic patients in FijiPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 6 2002Jay Kuruvatti BSc, MB ChB Pre-registration House Officer Abstract During an elective visit to Fiji we assessed the knowledge of diabetes possessed by patients who attended the hospital Diabetic Clinic in Lautoka. All the patients interviewed had type 2 diabetes and 15.4% were treated with insulin, 80.8% with oral therapy and 3.8% with diet alone. Blindness was the commonest complication known to patients but almost a quarter could not describe any diabetic complication. All patients had seen a hospital doctor regarding their diabetes; 17.9% also saw a private general practitioner, 80.8% had seen the diabetes nurse, 60.8% a dietician, and 57.7% a chiropodist. When asked about causative factors 12.8% thought diabetes was caused by overeating, 12.8% thought it was due to too much sugar in the diet, and the remaining 60.3% did not know. The methods by which the ever-increasing financial burden of diabetes in Fiji can be reduced are discussed. We feel that the prevention of diabetes and the early detection of complications would be the most cost-effective methods to improve overall diabetes care in Fiji. However, the whole diabetes care service in Fiji is constrained by the poor economic state of the country and the low profile of diabetes in the healthcare plans of the country. Copyright © 2002 John Wiley & Sons, Ltd. [source] The effects of pay and job satisfaction on the labour supply of hospital consultantsHEALTH ECONOMICS, Issue 12 2007Divine Ikenwilo Abstract There is little evidence about the responsiveness of doctors' labour supply to changes in pay. Given substantial increases in NHS expenditure, new national contracts for hospital doctors and general practitioners that involve increases in pay, and the gradual imposition of a ceiling on hours worked through the European Working Time Directive, knowledge of the size of labour supply elasticities is crucial in examining the effects of these major changes. This paper estimates a modified labour supply model for hospital consultants, using data from a survey of consultants in Scotland. Rigidities in wage setting within the NHS mean that the usual specification of the labour supply model is extended by the inclusion of job quality (job satisfaction) in the equation explaining the optimal number of hours worked. Generalised Method of Moments estimation is used to account for the endogeneity of both earnings and job quality. Our results confirm the importance of pay and non-pay factors on the supply of labour by consultants. The results are sensitive to the exclusion of job quality and show a slight underestimation of the uncompensated earnings elasticity (of 0.09) without controlling for the effect of job quality, and 0.12 when we controlled for job quality. Pay increases in the new contract for consultants will only result in small increases in hours worked. Small and non-significant elasticity estimates at higher quantiles in the distribution of hours suggest that any increases in hours worked are more likely for consultants who work part time. Those currently working above the median number of hours are much less responsive to changes in earnings. Copyright © 2007 John Wiley & Sons, Ltd. [source] Insights into creation and use of prescribing documentation in the hospital medical recordJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2005Mary P. Tully PhD MRPharmS Abstract Rationale, aims and objectives, Extraction of prescribing data from medical records is a common, albeit flawed, research method. Yet little is known about the processes that result in those data. This study explores the creation and use of prescribing documentation in the medical record, from the perspective of the hospital doctors who both create and use it. Methods, Thirty-six hospital doctors were purposively selected for qualitative interviews, giving a maximum variability sample of grades of doctors across the range of major medical specialty areas and medical teams at a large teaching hospital in England. Results, The findings suggest a number of reasons why hospital doctors fail to record prescribing decisions in the medical record. There was no set standard, record keeping was not formally taught and the hurried environment of the ward gave little time for documentation. The doctors also acknowledged that there was no need for completeness, as colleagues would be able to ,fill in the gaps' via an inferential process. ,Assumptions ,were ,made ,and ,although ,this ,was ,not ,seen ,as ,ideal, it was recognized as necessary if work was to be done efficiently. Conclusion, These results reinforce the suggestion that, despite the large number of potential users, the medical record is created for those with the right privileged knowledge. This has profound implications for those without that insider knowledge who are using medical records for research purposes. Funding, This work was funded by a North West Regional National Health Service Postdoctoral Fellowship. [source] Is inequity undermining Australia's ,universal' health care system?AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Socio-economic inequalities in the use of specialist medical, non-medical ambulatory health care Abstract Objectives: To quantify need-adjusted socio-economic inequalities in medical and non-medical ambulatory health care in Australia and to examine the effects of specific interventions, namely concession cards and private health insurance (PHI), on equity. Methods: We used data from a 2004 survey of 10,905 Australian women aged 53 to 58 years. We modelled the association between socio-economic status and health service use , GPs, specialists, hospital doctors, allied and alternative health practitioners, and dentists , adjusting for health status and other confounding variables. We quantified inequalities using the relative index of inequality (RII) using Poisson regression. The contribution of concession cards and PHI in promoting equity/inequity was examined using mediating models. Results: There was equality in the use of GP services, but socio-economically advantaged women were more likely than disadvantaged women to use specialist (RII=1.41, 95% CI:1.26,1.58), allied health (RII=1.21,1.12,1.30), alternative health (RII=1.29,1.13,1.47) and dental services (RII=1.61,1.48,1.75) after adjusting for need, and they were less likely to visit hospital doctors (RII=0.74,0.57,0.96). Concession cards reduced socio-economic inequality in GP but not specialist care. Inequality in dental and allied health services was partly explained by inequalities in PHI. Conclusions and implications: Substantial socio-economic inequity exists in use of specialist and non-medical ambulatory care in Australia. This is likely to exacerbate existing health inequalities, but is potentially amenable to change. [source] | ||||||||||