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[PMID]:28455311
[Au] Autor:Cairns R; Cairns S
[Ti] Título:Robert John Cairns.
[So] Source:BMJ;357:j2035, 2017 04 28.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Dermatologistas/história
Prática Privada/história
[Mh] Termos MeSH secundário: História do Século XX
Seres Humanos
Reino Unido
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Cairns RJ
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j2035


  2 / 7514 MEDLINE  
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[PMID]:28939195
[Au] Autor:Hovanesyan A; Rubio E; Novak E; Budoff M; Rich MW
[Ad] Endereço:Private Practice, Glendale, California. Electronic address: ahovanes@gmail.com.
[Ti] Título:Comparison of Rate of Utilization of Medicare Services in Private Versus Academic Cardiology Practice.
[So] Source:Am J Cardiol;120(10):1899-1902, 2017 Nov 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiovascular services are the third largest source of Medicare spending. We examined the rate of cardiovascular service utilization in the community of Glendale, CA, compared with the nearest academic medical center, the University of Southern California. Publicly available utilization data released by Medicare for the years 2012 and 2013 were used to identify all inpatient and outpatient cardiology services provided in each practice setting. The analysis included 19 private and 17 academic cardiologists. In unadjusted analysis, academic physicians performed half as many services per Medicare beneficiary per year as those in private practice: 2.3 versus 4.8, p <0.001. Other factors associated with higher utilization included male physician, international (vs US) medical school graduate, interventional (vs general) cardiologist, and more years in practice. Factors independently associated with higher utilization rates by multivariable analysis included private practice setting (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.30 to 2.61, p <0.001), male physician (OR 1.64, 95% CI 1.00 to 2.67, p = 0.049), and international medical school graduate (OR 1.37, 95% CI 1.07 to 1.78, p = 0.014). In conclusion, in this analysis of 2 cardiology practice settings in southern California, medical service utilization per Medicare beneficiary was nearly 2-fold higher in private practice than in the academic setting, suggesting that there may be opportunity for substantially reducing costs of cardiology care in the community setting.
[Mh] Termos MeSH primário: Centros Médicos Acadêmicos/economia
Assistência Ambulatorial/economia
Cardiologia/economia
Gastos em Saúde
Medicare/utilização
Prática Privada/economia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170924
[St] Status:MEDLINE


  3 / 7514 MEDLINE  
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[PMID]:28784330
[Au] Autor:Ehrlich A; Kostecki J; Olkaba H
[Ad] Endereço:Department of Dermatology, George Washington University, Washington, DC.
[Ti] Título:Trends in dermatology practices and the implications for the workforce.
[So] Source:J Am Acad Dermatol;77(4):746-752, 2017 Oct.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The American Academy of Dermatology (AAD) practice profile surveys have been conducted for more than a decade to gauge trends in our workforce supply and demand. OBJECTIVE: To update the trends and current workforce issues for the field of dermatology. METHODS: The AAD Practice Profile Survey is sent by both e-mail and postal mail to a random sample of practicing dermatologists who are AAD members. RESULTS: Shifts are noted in the primary practice setting; fewer dermatologists are in solo practice and more are in group practices than in previous years. Teledermatology use trended upward from 7% to 11% between 2012 and 2014. The implementation of electronic health records increased from 51% in 2011 to 70% in 2014. LIMITATIONS: There is potential for response bias and inaccurate self-reporting. Survey responses collected may not be representative of all geographic areas. CONCLUSION: The demand for dermatology services remains strong. Shifts in the practice setting may be related to increases in overhead costs that are partially associated with the implementation of technology-based medical records. Integration of electronic health records and utilization of telemedicine are increasing.
[Mh] Termos MeSH primário: Dermatologistas/provisão & distribuição
Dermatologia/organização & administração
Registros Eletrônicos de Saúde/utilização
Serviços de Saúde Rural/recursos humanos
Telemedicina/utilização
Serviços Urbanos de Saúde/recursos humanos
[Mh] Termos MeSH secundário: Dermatologia/recursos humanos
Dermatologia/tendências
Feminino
Prática de Grupo/estatística & dados numéricos
Prática de Grupo/tendências
Seres Humanos
Cobertura do Seguro/tendências
Seguro Saúde/tendências
Masculino
Meia-Idade
Profissionais de Enfermagem/estatística & dados numéricos
Assistentes Médicos/estatística & dados numéricos
Prática Privada/estatística & dados numéricos
Prática Privada/tendências
Área de Atuação Profissional
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE


  4 / 7514 MEDLINE  
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[PMID]:28765463
[Au] Autor:Gesko DS; Bailit HL
[Ad] Endereço:Dr. Gesko is Dental Director and Senior Vice President, HealthPartners, South Bloomington, MN; and Dr. Bailit is Professor Emeritus, Department of Community Medicine, School of Medicine, University of Connecticut.
[Ti] Título:Dental Group Practice and the Need for Dentists.
[So] Source:J Dent Educ;81(8):eS120-eS125, 2017 Aug.
[Is] ISSN:1930-7837
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study compared the number of patients treated per year by general dentists and dental hygienists in solo practice and by those employed by a large group practice. Information on the annual number of patient visits to solo general dental practitioners comes from the 2013 American Dental Association (ADA) Survey of Dental Practice. Patient visits were divided by 2.5 to estimate the number of patients treated annually. The data on group practices come from HealthPartners (HP) of Minnesota, a large not-for-profit medical and dental Health Maintenance Organization that accepts insurance contracts based on global budgets and is financially at risk. In 2013, solo general dentists averaged 1,350 patients, while the average HP general dentist treated 2,052 patients. HP general dentists thus treated over 700 more patients annually than did solo practitioners. This large difference has major implications for the future of the dental delivery system and dental education. This article was written as part of the project "Advancing Dental Education in the 21 Century."
[Mh] Termos MeSH primário: Odontologia Geral/estatística & dados numéricos
Prática Odontológica de Grupo/estatística & dados numéricos
Prática Privada/estatística & dados numéricos
[Mh] Termos MeSH secundário: Higienistas Dentários/estatística & dados numéricos
Odontologia Geral/recursos humanos
Seres Humanos
Masculino
Minnesota
Administração da Prática Odontológica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.21815/JDE.017.018


  5 / 7514 MEDLINE  
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[PMID]:28749922
[Au] Autor:Ross K; Mehr J; Carothers B; Greeley R; Benowitz I; McHugh L; Henry D; DiFedele L; Adler E; Naqvi S; Lifshitz E; Tan C; Montana B
[Ti] Título:Outbreak of Septic Arthritis Associated with Intra-Articular Injections at an Outpatient Practice - New Jersey, 2017.
[So] Source:MMWR Morb Mortal Wkly Rep;66(29):777-779, 2017 Jul 28.
[Is] ISSN:1545-861X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:On March 6, 2017, the New Jersey Department of Health (NJDOH) was notified of three cases of septic arthritis in patients who had received intra-articular injections for osteoarthritic knee pain at a private outpatient practice. The practice voluntarily closed the next day. NJDOH, in conjunction with the local health department and the New Jersey Board of Medical Examiners, conducted an investigation and identified 41 cases of septic arthritis associated with intra-articular injections administered during 250 patient visits at the same practice, including 30 (73%) patients who required surgery. Bacterial cultures of synovial fluid or tissue from 15 (37%) patients were positive; all recovered organisms were oral flora. An infection prevention assessment of the practice identified multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, inappropriate use of pharmacy bulk packaged (PBP) products as multiple-dose containers and handling PBP products outside of required pharmacy conditions, and preparation of syringes up to 4 days in advance of their intended use. No additional septic arthritis cases were identified after infection prevention recommendations were implemented within the practice.
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial
Artrite Infecciosa/epidemiologia
Surtos de Doenças
Injeções Intra-Articulares/efeitos adversos
[Mh] Termos MeSH secundário: Seres Humanos
New Jersey/epidemiologia
Osteoartrite do Joelho/complicações
Dor/tratamento farmacológico
Dor/etiologia
Prática Privada
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.15585/mmwr.mm6629a3


  6 / 7514 MEDLINE  
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[PMID]:28637069
[Au] Autor:Ziegler S; van den Bussche H; Römer F; Krause-Solberg L; Scherer M
[Ti] Título:[Preference Changes Regarding Future Work Area and Intended Position Among German Residents after Four Years of Residency].
[Ti] Título:Berufliche Präferenzen bezüglich Versorgungssektor und Position von Ärztinnen und Ärzten nach vier jähriger fachärztlicher Weiterbildung..
[So] Source:Dtsch Med Wochenschr;142(12):e74-e82, 2017 Jun.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:We investigated the preferences of medical residents in Germany with regard to future working place (hospital or private practice) and position (employment/self-employment in private practice; resp. specialist/senior or chief physician in the hospital). This is analysed in a gender comparative perspective, including the influence of parenthood. Annual postal surveys among graduates of seven medical faculties in Germany from their last year ("Practical Year") until after four years of postgraduate training. The return rate at baseline was 48 % and the four surveys after reached rates from 85 % up. In all samples about two thirds were women, which corresponds to the actual gender differentiation in under- and postgraduate training. Descriptive statistics and regression analyses were performed. Compared to private practice the hospital is clearly preferred, although the attraction of hospital jobs decreased over the years. The decision for or against the hospital is connected to the discipline. Working in private practice is seen as possibility for part time work. Men prefer self-employment whereas women prefer to work under an employment contract. In the hospital, male doctors prefer to work in leading positions. Those positions are associated with full-time work. Leadership training especially takes place in university hospitals. Three trends are recognized: Reluctance against leading positions, growing interest for part time work and rising popularity of work as an employee in private practice. Those trends can be understood as a rejection of traditional professional role models. The realization of these preferences is easily feasible because of the current labour market situation. Therefore, emerging problems have to be faced in another way. A change of gender-typical role models was rarely detected.
[Mh] Termos MeSH primário: Escolha da Profissão
Medicina Geral/educação
Intenção
Internato e Residência
[Mh] Termos MeSH secundário: Adulto
Mobilidade Ocupacional
Estudos de Coortes
Educação de Pós-Graduação em Medicina
Feminino
Alemanha
Hospitais Universitários
Seres Humanos
Liderança
Masculino
Corpo Clínico Hospitalar/educação
Medicina
Pais
Prática Privada
Fatores Sexuais
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-101860


  7 / 7514 MEDLINE  
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[PMID]:28481380
[Au] Autor:Voltmer E; Spahn C; Frank E
[Ad] Endereço:Friedensau Adventist University, Möckern-Friedensau, Germany (Department of Health and Behavioral Sciences). edgar.voltmer@thh-friedensau.de.
[Ti] Título:Factors for and against establishing and working in private practice correlated with work-related behavior and experience patterns of Ferman physicians in Schleswig-Holstein: A 2-year longitudinal study.
[So] Source:Int J Occup Med Environ Health;30(3):485-498, 2017 May 08.
[Is] ISSN:1896-494X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To identify factors in favor of or against establishing and working in private practice, to determine the quality of life and work-related behavior and experience patterns of German physicians working in private practice, and to analyze the correlation of those factors. MATERIAL AND METHODS: A representative sample of physicians in private practice in Schleswig-Holstein, Germany, was surveyed according to a 2-year longitudinal design (T1 - 2008, N = 549 and T2 - 2010, N = 414). The study included 22 items regarding the attractiveness of establishing and working in private practice, and the questionnaires: the Short Form-12 Health Survey (SF-12), and Work-related Behavior and Experience Pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster - AVEM). RESULTS: Job satisfaction among those private practitioners decreased over time but their willingness to choose the profession once again remained unchanged. Patient care and the continuity of physician-patient relationship encouraged establishing and working in private practice; state regulation, financial risk, and administrative effort weighed against it. At both T1 and T2, physicians scored significantly lower for mental health than general population. About 20% of physicians showed a healthy behavior and experience pattern but 40% of them showed the pattern of reduced working motivation. About 20% of participants were at elevated risk for overexertion and for burnout. Physical and mental health as well as the total distribution of patterns did not change significantly during the 2-year observation period. Physicians at higher burnout risk rated tasks related to patient care considerably less positively than those with healthy pattern. CONCLUSIONS: In order to improve job satisfaction and quality of life, and to make private practice more attractive, those German physicians require a) improved legislation, b) educational programs that promote the attractiveness of private practice, and c) highly accessible counseling services for the prevention and treatment of stress, overexertion, and burnout. Int J Occup Med Environ Health 2017;30(3):485-498.
[Mh] Termos MeSH primário: Satisfação no Emprego
Médicos/psicologia
Prática Privada
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Esgotamento Profissional/epidemiologia
Esgotamento Profissional/prevenção & controle
Feminino
Alemanha
Seres Humanos
Estudos Longitudinais
Masculino
Saúde Mental
Meia-Idade
Saúde do Trabalhador
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


  8 / 7514 MEDLINE  
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[PMID]:28418824
[Au] Autor:Rubin GD; Patel BN
[Ad] Endereço:From the Department of Radiology, Duke University School of Medicine, 2424 Erwin Rd, Suite 301, Duke Mail Box 2702, Durham, NC 27705.
[Ti] Título:Financial Forecasting and Stochastic Modeling: Predicting the Impact of Business Decisions.
[So] Source:Radiology;283(2):342-358, 2017 May.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In health care organizations, effective investment of precious resources is critical to assure that the organization delivers high-quality and sustainable patient care within a supportive environment for patients, their families, and the health care providers. This holds true for organizations independent of size, from small practices to large health systems. For radiologists whose role is to oversee the delivery of imaging services and the interpretation, communication, and curation of imaging-informed information, business decisions influence where and how they practice, the tools available for image acquisition and interpretation, and ultimately their professional satisfaction. With so much at stake, physicians must understand and embrace the methods necessary to develop and interpret robust financial analyses so they effectively participate in and better understand decision making. This review discusses the financial drivers upon which health care organizations base investment decisions and the central role that stochastic financial modeling should play in support of strategically aligned capital investments. Given a health care industry that has been slow to embrace advanced financial analytics, a fundamental message of this review is that the skills and analytical tools are readily attainable and well worth the effort to implement in the interest of informed decision making. RSNA, 2017 Online supplemental material is available for this article.
[Mh] Termos MeSH primário: Tomada de Decisões Gerenciais
Modelos Econômicos
Modelos Estatísticos
Técnicas de Planejamento
Gerenciamento da Prática Profissional/economia
Prática Privada/economia
[Mh] Termos MeSH secundário: Simulação por Computador
Previsões
Processos Estocásticos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170421
[Lr] Data última revisão:
170421
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017161800


  9 / 7514 MEDLINE  
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[PMID]:28301616
[Au] Autor:Correa-Selm LM; Alamgir M; Rao BK
[Ad] Endereço:M3059.
[Ti] Título:Use of Biologics in Private Practice: Nine Years of Lessons and Learning.
[So] Source:J Drugs Dermatol;16(3):215-217, 2017 Mar 01.
[Is] ISSN:1545-9616
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:

Over a decade ago, the FDA approved biologics for psoriasis, which changed how the disease is treated and, in most cases, has a significant positive impact on the lives of patients. Side effects primarily identified during the investigational and research phase led to the development of specific guidelines for treatment. The treatment guidelines have been amended to incorporate better understandings of side-effects over the years that the disease has been treated. In this study, we focused on a chart review that included assessing the current guidelines and their alignment with modern patient management and the recent side effects presented. This life-cycle evaluation included over 100 patients, management of their treatment, laboratory abnormalities, criteria for choosing or changing to a different biologic, and the effects of the treatments management throughout the years. The review identified some recommended changes in the application and treatment of psoriasis with biologics. To further evidence our findings, we hope to expand this study to a larger scale with more patients.

J Drugs Dermatol. 2017;16(3):215-217.

.
[Mh] Termos MeSH primário: Produtos Biológicos/uso terapêutico
Prática Privada/tendências
Psoríase/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Produtos Biológicos/administração & dosagem
Produtos Biológicos/efeitos adversos
Criança
Feminino
Seres Humanos
Masculino
Meia-Idade
Guias de Prática Clínica como Assunto
Psoríase/sangue
Qualidade de Vida
Estudos Retrospectivos
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biological Products)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE


  10 / 7514 MEDLINE  
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[PMID]:28291041
[Au] Autor:Rachid F
[Ad] Endereço:RACHID: Private Practice, Geneva, Switzerland.
[Ti] Título:Treatment of a Patient With Depersonalization Disorder With Low Frequency Repetitive Transcranial Magnetic Stimulation of the Right Temporo-Parietal Junction in a Private Practice Setting.
[So] Source:J Psychiatr Pract;23(2):145-147, 2017 Mar.
[Is] ISSN:1538-1145
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Depersonalization disorder (DPD) is a debilitating dissociative condition with no proven treatments. Although the pathophysiology of DPD is poorly understood, there are reports of increased excitability of the prefrontal cortex in patients with this condition. The temporo-parietal junction may also play a major role in the conscious experience of the spatial unity of the normal self and body. Repetitive transcranial magnetic stimulation has been shown in some case studies to effectively treat this condition. This report describes an additional such case, a 26-year-old man with a 6-month history of DPD who responded safely and significantly to repetitive transcranial magnetic stimulation to the right temporo-parietal junction.
[Mh] Termos MeSH primário: Despersonalização/terapia
Lobo Parietal
Lobo Temporal
Estimulação Magnética Transcraniana/métodos
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Prática Privada
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170315
[St] Status:MEDLINE
[do] DOI:10.1097/PRA.0000000000000214



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