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  • 1
    Language: English
    In: JAMA, 22 November 2006, Vol.296(20), pp.2467-75
    Description: Whether physicians have a professional responsibility to address health-related issues beyond providing care to individual patients has been vigorously debated. Yet little is known about practicing physicians' attitudes about or the extent to which they participate in public roles, which we defined as community participation, political involvement, and collective advocacy. To determine the importance physicians assign to public roles, their participation in related activities, and sociodemographic and practice factors related to physicians' rated levels of importance and activity. Mail survey conducted between November 2003 and June 2004 of 1662 US physicians engaged in direct patient care selected from primary care specialties (family practice, internal medicine, pediatrics) and 3 non-primary care specialties (anesthesiology, general surgery, cardiology). Rated importance of community participation, political involvement, collective advocacy, and relevant self-reported activities encompassing the previous 3 years; rated importance of physician action on different issues. Community participation, political involvement, and collective advocacy were rated as important by more than 90% of respondents, and a majority rated community participation and collective advocacy as very important. Nutrition, immunization, substance abuse, and road safety issues were rated as very important by more physicians than were access-to-care issues, unemployment, or illiteracy. Two thirds of respondents had participated in at least 1 of the 3 types of activities in the previous 3 years. Factors independently related to high overall rating of importance (civic-mindedness) included age, female sex, underrepresented race/ethnicity, and graduation from a non-US or non-Canadian medical school. Civic mindedness, medical specialty, practice type, underrepresented race/ethnicity, preceptors of physicians in training, rural practice, and graduation from a non-US or non-Canadian medical school were independently related to civic activity. Public roles are definable entities that have widespread support among physicians. Civic-mindedness is associated primarily with sociodemographic factors, but civic action is associated with specialty and practice-based factors.
    Keywords: Community Participation ; Consumer Advocacy ; Physician'S Role ; Politics ; Public Health
    ISSN: 00987484
    E-ISSN: 1538-3598
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  • 2
    In: The New England Journal of Medicine, 2007, Vol.356(17), pp.1742-1750
    Description: Background Relationships between physicians and pharmaceutical, medical device, and other medically related industries have received considerable attention in recent years. We surveyed physicians to collect information about their financial associations with industry and the factors that predict those associations. Methods We conducted a national survey of 3167 physicians in six specialties (anesthesiology, cardiology, family practice, general surgery, internal medicine, and pediatrics) in late 2003 and early 2004. The raw response rate for this probability sample was 52%, and the weighted response rate was 58%. Results Most physicians (94%) reported some type of relationship with the pharmaceutical industry, and most of these relationships involved receiving food in the workplace (83%) or receiving drug samples (78%). More than one third of the respondents (35%) received reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) received payments for consulting, giving lectures, or enrolling patients in trials. Cardiologists were more than twice as likely as family practitioners to receive payments. Family practitioners met more frequently with industry representatives than did physicians in other specialties, and physicians in solo, two-person, or group practices met more frequently with industry representatives than did physicians practicing in hospitals and clinics. Conclusions The results of this national survey indicate that relationships between physicians and industry are common and underscore the variation among such relationships according to specialty, practice type, and professional activities. In this national survey of 3167 physicians, 83% reported receiving food or beverages paid for by a company that makes drugs or other medical products, 78% drug samples, 35% reimbursement for professional meetings, and 28% payments for consulting, speaking, or enrolling patients in clinical trials. Family practitioners met most frequently with industry representatives, and cardiologists were most likely to receive payments. In this national survey of physicians, 83% reported receiving food or beverages paid for by a company that makes drugs or other medical products, 78% drug samples, 35% reimbursement for professional meetings, and 28% payments for consulting, speaking, or enrolling patients in clinical trials. In the past 20 years, physician–industry relationships have received considerable attention.1–12 In 2000, Wazana reviewed 16 studies published between 1982 and 1997 and estimated that, on average, physicians met with industry representatives four times per month and residents accepted six gifts per year from industry representatives.13 A 2001 survey showed that 92% of physicians received drug samples, 61% received meals, tickets to events, or free travel, 13% received financial or other kinds of benefits, and 12% received incentives for participation in clinical trials.14 Many of these previous studies are now somewhat dated or focused on particular specialties or geographic . . .
    Keywords: Anesthesiology–Statistics & Numerical Data ; Cardiology–Statistics & Numerical Data ; Data Collection–Statistics & Numerical Data ; Drug Industry–Statistics & Numerical Data ; Equipment & Supplies–Statistics & Numerical Data ; Family Practice–Statistics & Numerical Data ; Female–Statistics & Numerical Data ; General Surgery–Statistics & Numerical Data ; Gift Giving–Statistics & Numerical Data ; Humans–Statistics & Numerical Data ; Industry–Statistics & Numerical Data ; Internal Medicine–Statistics & Numerical Data ; Interprofessional Relations–Statistics & Numerical Data ; Logistic Models–Statistics & Numerical Data ; Male–Statistics & Numerical Data ; Marketing–Statistics & Numerical Data ; Multivariate Analysis–Statistics & Numerical Data ; Pediatrics–Statistics & Numerical Data ; Physicians–Statistics & Numerical Data ; United States–Statistics & Numerical Data ; United States–Us ; Acquisitions & Mergers ; Meetings ; Health Facilities ; American Medical Association ; Pharmaceutical Research & Manufacturers of America;
    ISSN: 0028-4793
    E-ISSN: 1533-4406
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  • 3
    In: Journal of General Internal Medicine, November 2006, Vol.21(11), pp.1150-1155
    Description: Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. To determine current prevalence of non‐electronic health record (EHR) IT use by a national sample of U.S. physicians, and to identify associated physician, practice, and patient panel characteristics. Survey conducted in early 2004 of 1,662 U.S. physicians engaged in direct patient care selected from 3 primary care specialties (family practice, internal medicine, pediatrics) and 3 nonprimary care specialties (anesthesiology, general surgery, cardiology). Self‐reported frequency of e‐mail communication with patients or other clinicians, online access to continuing medical education or professional journals, and use of any computerized decision support (CDS) during clinical care. Survey results were weighted by specialty and linked via practice zip codes to measures of area income and urbanization. Response rate was 52.5%. Respondents spent 49 (±19) (mean [±standard deviation]) hours per week in direct patient care and graduated from medical school 23 (±11) years earlier. “Frequent” use was highest for CDS (40.8%) and online professional journal access (39.0%), and lowest for e‐mail communication with patients (3.4%). Ten percent of physicians never used any of the 5 IT tools. In separate logistic regression analyses predicting usage of each of the 5 IT tools, the strongest associations with IT use were primary care practice (adjusted odds ratios [aORs] ranging from 1.34 to 2.26) and academic practice setting (aORs 2.17 to 5.41). Years since medical school graduation (aOR 0.85 to 0.87 for every 5 years after graduation) and solo/2‐person practice setting (aORs 0.21 to 0.55) were negatively associated with IT use. Practice location and patient panel characteristics were not independently associated with IT use. In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice‐level barriers to adoption.
    Keywords: Information Technology ; Physician Practice Patterns ; Primary Care ; Academic Medicine
    ISSN: 0884-8734
    E-ISSN: 1525-1497
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  • 4
    Language: English
    In: Annals of internal medicine, 04 December 2007, Vol.147(11), pp.795-802
    Description: The prospect of improving care through increasing professionalism has been gaining momentum among physician organizations. Although there have been efforts to define and promote professionalism, few data are available on physician attitudes toward and conformance with professional norms. To ascertain the extent to which practicing physicians agree with and act consistently with norms of professionalism. National survey using a stratified random sample. Medical care in the United States. 3504 practicing physicians in internal medicine, family practice, pediatrics, surgery, anesthesiology, and cardiology. Attitudes and behaviors were assessed by using indicators for each domain of professionalism developed by the American College of Physicians and the American Board of Internal Medicine. Of the eligible sampled physicians, 1662 responded, yielding a 58% weighted response rate (adjusting for noneligible physicians). Ninety percent or more of the respondents agreed with specific statements about principles of fair distribution of finite resources, improving access to and quality of care, managing conflicts of interest, and professional self-regulation. Twenty-four percent disagreed that periodic recertification was desirable. Physician behavior did not always reflect the standards they endorsed. For example, although 96% of respondents agreed that physicians should report impaired or incompetent colleagues to relevant authorities, 45% of respondents who encountered such colleagues had not reported them. Our measures of behavior did not capture all activities that may reflect on the norms in question. Furthermore, behaviors were self-reported, and the results may not be generalizable to physicians in specialties not included in the study. Physicians agreed with standards of professional behavior promulgated by professional societies. Reported behavior, however, did not always conform to those norms.
    Keywords: Attitude of Health Personnel ; Quality of Health Care ; Physicians -- Standards ; Professional Practice -- Standards
    ISSN: 00034819
    E-ISSN: 1539-3704
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  • 5
    Language: English
    In: New England Journal of Medicine Audio, April 26, 2007, Vol.356(17), p.1742(9)
    Keywords: Physicians -- Surveys ; Physicians -- Public Relations ; Health Care Industry -- Surveys ; Health Care Industry -- Public Relations
    Source: Cengage Learning, Inc.
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  • 6
    Language: English
    In: New England Journal of Medicine Audio, April 26, 2007, Vol.356(17), p.1742(9)
    Keywords: Physicians -- Surveys ; Physicians -- Public Relations ; Health Care Industry -- Surveys ; Health Care Industry -- Public Relations
    Source: Cengage Learning, Inc.
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