Asthma ; drug therapy ; Humans ; Practice Patterns, Physicians' ; statistics & numerical data

Asthma ; drug therapy ; Humans ; Practice Patterns, Physicians' ; statistics & numerical data

Urologists perform the majority of vasectomies in the United States; however, family medicine physicians (FMPs) perform up to 35%. We hypothesized that differences exist in practice patterns and outcomes between urologists and FMPs. Patients who underwent a vasectomy from 2010 to 2016 were identified. Postvasectomy semen analysis (PVSA) practices were compared between urologists and FMPs, before and after release of the 2012 AUA vasectomy guidelines. From 2010 to 2016, FMPs performed 1435 (35.1%) of all vasectomies. PVSA follow-up rates were similar between the two groups (63.4% vs 64.8%, P = 0.18). Of the patients with follow-up, the median number of PVSAs obtained was 1 (range 1-6) in both groups (P = 0.22). Following the release of guidelines, fewer urologists obtained multiple PVSAs (69.8% vs 28.9% pre- and post-2012, P < 0.01). FMPs had a significant but lesser change in the use of multiple PVSAs (47.5% vs 38.4%, P < 0.01). Both groups made appropriate changes in the timing of the first PVSA, but FMPs continued to obtain PVSAs before 8 weeks (15.0% vs 6.5%, P < 0.01). FMPs had a higher rate of positive results in PVSAs obtained after 8 weeks, the earliest recommended by the AUA guidelines (4.1% vs 1.3%, P < 0.01). Significant differences in PVSA utilization between FMPs and urologists were identified and were impacted by the release of AUA guidelines in 2012. In summary, FMPs obtained multiple PVSAs more frequently and continued to obtain PVSAs prior to the 8-week recommendation, suggesting less penetration of AUA guidelines to nonurology specialties. Furthermore, FMPs had more positive results on PVSAs obtained within the recommended window.
Adult ; Humans ; Male ; Physicians, Family/statistics & numerical data* ; Practice Patterns, Physicians'/statistics & numerical data* ; Retrospective Studies ; Urologists/statistics & numerical data* ; Vasectomy/statistics & numerical data* ; Wisconsin

China ; Humans ; Poverty ; Practice Patterns, Physicians' ; statistics & numerical data ; Rural Health Services ; statistics & numerical data

Adult ; China ; epidemiology ; Death, Sudden ; epidemiology ; Female ; Hospitals ; statistics & numerical data ; Humans ; Male ; Physicians ; statistics & numerical data

OBJECTIVETo understand the use of lipidemia related assistant examinations and lipid-lowering agents, the clinical ability among physicians in district and community hospitals in Beijing, and to evaluate the capability of dislipidemia diagnosis and treatment in these hospitals.

METHODSA survey was carried out in 42 hospitals in Chaoyang and Haidian district, including 9 district level hospitals, and the rest were at the community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals. A total number of 632 physicians in those hospitals were investigated, using a close book examination.

RESULTS100% of the hospitals could perform TC and TG tests; 87.5% and 72.5% of the hospitals had medications as statins and bile acid, respectively; 100% of the hospitals could test ALT and 40.0% of the hospitals could test CK. The correct rates of selecting treatment strategy and determining the appropriate treatment goals were 53.7% and 17.6%, respectively.

CONCLUSIONThe hardware condition of community hospitals seem to have satisfied the implicit requirements of dyslipidemia evaluation and treatment but it was essential to improve the knowledge and ability among physicians in community hospitals.

At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.
Altitude ; Biomedical Research ; education ; manpower ; trends ; Humans ; Physicians ; psychology ; statistics & numerical data

The brief history of acupuncture, its current situation, locations for acupuncture practitioners, the manipulation and indications of acupuncture in Jordan are introduced in this paper. The acupuncture treatment in Jordan started in the early 1990s. Now there are more than 20 private acupuncture clinics in different size, most in the capital city of Amman. Acupuncture practitioners are western doctors who studied acupuncture techniques in China. The indications of acupuncture in Jordan are pain and nervous system diseases. Acupuncture therapy can be applied single or combined with physical therapy.
Acupuncture Therapy ; trends ; Humans ; Jordan ; Moxibustion ; trends ; Practice Patterns, Physicians' ; statistics & numerical data ; trends

Objective To investigate doctors' feelings when providing medical care to end-stage patients, and their understanding as well as reflection about theoretical concepts of palliative medicine. Methods Questionnaires were delivered through a social networking platform to 1500 clinicians of different specialties in 10 proviences of China. It covered issues of background information, self-assessment of familiarity to palliative care, prior training history, emotional attitude toward end-stage patients, and the reflections on clinical practice. Logistic regression analysis and chi-square test were used to analyse the categorical variables. Results There were 379 clinicians who completed the questionnaires and submitted successfully. Among them, 66.8% (253/379) had attended palliative care training courses more than twice; 66.8% (253/379) clinicians percieved powerless feeling when facing end-stage patients. We found that the education on palliative medicine was significantly associated to doctors' better comprehension on the concept of palliative care (OR=6.923, P=0.002). Doctors who were more familiar with palliative medicine were less likely to perceive powerless feelings (χ =13.015, P<0.001), and would be more likely to concern about patients and their family members in their clinical work (χ =28.754, P<0.001, χ =24.406, P<0.001). Conclusion The powerless feeling is prevalent in Chinese doctors when facing end-stage patients. Palliative care help them overcome the negative feelings and act more caring in clinic. More careful designed educational strategies that adapt to Chinese actual situation are needed to improve doctors' cognition on palliative care.
China ; Female ; Humans ; Male ; Palliative Care ; methods ; statistics & numerical data ; Physicians ; Surveys and Questionnaires

OBJECTIVE: To describe consultation practice patterns of an otolaryngology chief resident in China. METHOD: The pattern and frequency of patient encounters during the Xijing Hospital of the Fourth Military Medical University otolaryngology residency program for one chief resident were retrospectively analyzed. RESULT: A total of 1062 new inpatients were consulted during a 10-month period of otolaryngology residency, including emergency consultation for 467 cases (43.97%) and routine consultation for 595 cases (56.03%). The chief resident consulted an average of 28 new patients perweek. The most common diagnosis for an emergency consultation was epistaxis (279 cases, 59.72% of emergency consultation), characterized by disturbances of blood coagulation, hypertension, renal failure or liver failure, iatrogenic factors. The second cause was laryngeal obstruction and tracheotomy (113 cases, 24.19% of emergency consultation). There were 43 cases with foreign body in bronchus . For routine consultation on general internal medicine, chronic rhinitis and sinusitis (169 cases) was the most common disorder, followed by chronic pharyngitis, acute or chronic tonsillitis. For consultation on surgery, most cases were concerned about preoperative evaluations (67 cases) of the chronic otolaryngological disorders. CONCLUSION Consultation is an inimitable clinical practice and a challenge to otolaryngology residents. The chief residents should be prepared for the consultation practice. Accumulation of related data from consultation is necessary and helpful for chief residents.
Humans ; Otolaryngology ; Otorhinolaryngologic Diseases ; diagnosis ; therapy ; Physicians ; Referral and Consultation ; statistics & numerical data ; Retrospective Studies ; Workforce