Physician Work Research Articles

The Psychological Outcomes of COVID-19 Pandemic on the Family Healthcare Physicians Working in Universal Health Insurance, Port Said Governorate

The Psychological Outcomes of COVID-19 Pandemic on the Family Healthcare Physicians Working in Universal Health Insurance, Port Said Governorate

Pregnancy, obstetrical and neonatal outcomes in women exposed to physician-related occupational hazards: a scoping review

ObjectiveEvidence is needed to guide organisational decision making about workplace accommodations for pregnant physicians. Our objective was to characterise the strengths and limitations of current research examining the association between...

Telemedicine Usage of Physicians and Views on Telemedicine

Background: With the Covid-19 pandemic, those who care about working online from home office, computer and / or phone. it is aimed to pay attention to the use of telemedicine in the field of health and the attitudes of specialist physicians.
 Methods: 85 specialist physicians participated in our research. The collected selection analysis was performed with the SPSS 22.0 program.
 Results: Physicians working in internal sciences constituted 76.47% (n=65) of the study group. Among the matched branches, 24% (n=16) of clinical sciences consisted of pediatricians and their sub-branch physicians. 84.70% (n=72) of the physicians participating in the study did not perform video examination with telemedicine. Since it was only reviewed with telemedicine during working hours; 90.58% (n=77) of our study group stated that patients with at least 29 and below can be treated. During both face-to-face and telemedicine visual examinations, 83.52% (n=71) of our study group stated that a maximum of 9 patients could be treated by telemedicine. 85.88% of our study (percussion, palpation, auscultation) thought that telemedicine might be insufficient in evaluating the inspection user physical examination components. As for what precautions should be taken before telemedicine applications are popularized by the public, 83% of our physicians were supporters of the insurance company that wanted to intervene in helping the malpractice police. It should be considered as 76.47% (n=65) of our study group.
 Conclusions: It is thought that telemedicine will facilitate the work of specialist physicians. However, more studies and data are needed before it can be used.

Recognition and Treatment of Eye Diseases in Andalusia

Muslim ophthalmologists have made significant achievements in the field of ophthalmology in all Islamic lands and territories, especially in Andalusia. Andalusian scientists have written several works related to medicine and ophthalmology that introduce us to their activities in this field. The main purpose of this study is to review the activities performed in Andalusia regarding ophthalmology. Using the review method of libraries and referring to the sources and written works of Andalusian physicians and ophthalmologists, their most important activities in this field have been studied. A study of medical and ophthalmological works in Andalusia showed that Andalusian ophthalmologists created special innovations, the most important of which are the invention and manufacture of various drugs, various surgeries, understanding the anatomy of the eye, and use of various tools for treatment and surgery.

Sassanids and Their Attitude to Medical Knowledge

The Sassanid Empire ruled in Iran between 224 AD and 651 AD. The founder of this dynasty, Ardashir I (241-224 AD), a Zoroastrian cleric, took two very important steps in the beginning; One was the creation of a central government and the other was the formalization of the religion of Zoroaster. The homogeneity and alignment of government and religion in the Sassanid administration had very important effects on the growth and development of science and knowledge, especially medical science, which began in the Achaemenid Empire (330 559 AD). The under-consideration question in this research is that despite the class system and the monopoly of learning science and knowledge in the privileged classes of society, what was the status of medical science in the Sassanid period? This study showed that medical science had the highest position in the teachings of Zoroastrian religion; Because with that, they took care of their health and performed their religious duties well, and with it, they overcame the devil. In Zoroastrian religious texts, the duties and characteristics of the physician, the types of diseases and how to treat and the rules related to ‘Tebabat’(medicine) are discussed. In addition to this, the encouragement policy of kings and Sassanid government, including; Expanding cultural and scientific relations with India, Greece and Rome, translating the works of foreign physicians into Pahlavi and archiving them along with the formation of a large library, inviting foreign physicians to work at ‘GondiShapur’ University and sending Iranian physicians abroad in order to acquire more medical knowledge and experience, they were very influential in the growth and development of medical science. The current study has been conducted in a historical method with reference to library sources and archaeological sources as well as new researches have been used to complete the topics. It seems that due to the spread of Iranian civilization in the Sassanid era and paying attention to science and knowledge as well as the creation of a medical city in the Sassanid period, medical knowledge had a great importance in this period and this knowledge was researching professionally.

A smart IoMT based architecture for E-healthcare patient monitoring system using artificial intelligence algorithms.

Generally, cloud computing is integrated with wireless sensor network to enable the monitoring systems and it improves the quality of service. The sensed patient data are monitored with biosensors without considering the patient datatype and this minimizes the work of hospitals and physicians. Wearable sensor devices and the Internet of Medical Things (IoMT) have changed the health service, resulting in faster monitoring, prediction, diagnosis, and treatment. Nevertheless, there have been difficulties that need to be resolved by the use of AI methods. The primary goal of this study is to introduce an AI-powered, IoMT telemedicine infrastructure for E-healthcare. In this paper, initially the data collection from the patient body is made using the sensed devices and the information are transmitted through the gateway/Wi-Fi and is stored in IoMT cloud repository. The stored information is then acquired, preprocessed to refine the collected data. The features from preprocessed data are extracted by means of high dimensional Linear Discriminant analysis (LDA) and the best optimal features are selected using reconfigured multi-objective cuckoo search algorithm (CSA). The prediction of abnormal/normal data is made by using Hybrid ResNet 18 and GoogleNet classifier (HRGC). The decision is then made whether to send alert to hospitals/healthcare personnel or not. If the expected results are satisfactory, the participant information is saved in the internet for later use. At last, the performance analysis is carried so as to validate the efficiency of proposed mechanism.

Primary Care Aspects in the German Coalition Agreement 2021

Despite statewide rising numbers of family physicians during the last legislative period, their overall health care providing capacity has declined, mainly due to their working part-time. In the legislative period starting in 2021, this trend appears likely to continue. The German Health System Advisory Council foresees the number of general practitioners (GPs) who will have to be replaced by the next federal election in 2025 as exceeding 26,000. This results in a need for political action to sustain the primary care workforce. We conducted a content analysis of the coalition agreement 2021 between SPD, Greens and FDP with regard to explicit and related topics of GP care. A mixed inductive-deductive classification of the included text passages was used to thematically structure the results. A total of 34 relevant text passages were identified between pages 8 to 139 of the coalition agreement. Family physician care was explicitly addressed only once, when the planned abolition of budgeting was discussed. Other proposals which affect family physicians work included reduction of bureaucracy, prevention, or easier access to medical care for disadvantaged groups. Other passages of the coalition agreement regarding security of medical supply, included demand planning, innovative healthcare models, and cross-sectoral care. One focus of the coalition agreement was on digitalization. It mentions e. g., a digitization strategy for the healthcare sector, telemedicine services, and the electronic medical record, including opt-out possibility. Other assessed passages included projects to facilitate research or climate change and health. Despite the lack of mention of family physicians in the coalition agreement, many projects relate to the work of family physicians. Some of the ideas mentioned have also already been written down by the German Society for General Practice and Family Medicine (DEGAM) in its positions on the future of general practice, digitization or climate change and health. The planned projects in the coalition agreement have the potential to strengthen health care by family doctors and also make it more attractive for young doctors. However, further measures may be necessary to maintain GP care in the short and long term.

Ovos mendici medici. Criticism of medical doctors by Johannes Gregor Macer Szepsius (ca.1530-after 1579)

A relationship between literature and medicine has existed since antiquity. A physician often appears in the literary genre of satire as the representative of medicine and is the object of the satire. The barely known humanistic author Johannes Gregor Macer Szepsius (ca.1530-nach 1579) was a humanist who sharply criticized the work and behavior of physicians. We have read, translated and analyzed the satirical verses from his comprehensive poetical work De vera gloria, On the true glory, with respect to content, structure and sources. According to this, physicians are characterized by conceit, ignorance and laziness and therapeutic ineptitude. The comparison with other satirical works shows that much of that which he accuses physicians of is repeated in the history of medicine. Some places are similar to the proverbs from Walter's collection of proverbs from the Middle Ages and others are similar to the invectives of Petrarch. Macer also levels criticism against physicians in his poem about the family tree of his friend Anton Schneeberger that appears in Schneeberger's work De bona valetudine militum conservanda liber.

Comparative Ethics of Modern Payment Models

Comparative Ethics of Modern Payment Models

Implementation of a digital health module for undergraduate medical students: A comparative study on knowledge and attitudes.

Digital competencies are more and more required in everyday work, and training future healthcare professionals in digital health is highly important. Aim of this study was to assess medical students' gain of knowledge by participation in a teaching module "Digital Health", and to evaluate their attitudes towards digital health and its role in medical education. Students of the module were asked to complete a questionnaire and a multiple-choice-test before and after completing the classes. Students of the same educational level in different modules served as reference group. 34 students took part (n= 17 "Digital Health group"; n= 17 "reference group"). There was no significant difference in pre-existing knowledge between the groups. After having completed the module, participants reached significantly higher scores, compared to their preexisting knowledge (p< 0.05) and the reference group (p< 0.05). Most students found that digital medicine is not sufficiently represented in undergraduate medical education, but will influence everyday work of physicians in the next five years. Students showed a high awareness for the impact of digital health on physicians' work. The results suggest that the format can sufficiently transfer knowledge about digital health. Teaching of digital knowledge and competencies should be firmly implemented into medical education to form digitally competent future doctors.

Formação inicial do médico que atua na atenção primária à saúde mental

Abstract: Introduction: The trajectory of medical schools towards the transformation of the traditional training model to an innovative and advanced perspective of training, including in the field of mental health, has been observed since the implementation of the Family Health Strategy. Objective: The present study sought to understand the initial medical training in mental health, from the perspective of the physician working in Primary Health Care (PHC). Method: For this purpose, a qualitative, exploratory, descriptive approach was adopted, in which data were obtained through interviews with physicians working in the PHC of a municipality in the Northeast of Brazil, whose corpus was treated based on the application of the thematic content analysis. Data collection for the study took place between June 2020 and June 2021, when medical professionals working in the municipal Family Health Strategy (FHS) were invited to participate. It is, therefore, an intentional, non-probabilistic sample. Of the seven physicians working in the municipal health network at the FHS level, five were included in the study. Results: The study results indicate that medical training in mental health is still related to a biomedical vision, in which the hospital scenario is valued as a space for practices and PHC is underutilized in the development of professional skills and abilities, producing gaps that affect performance in the context of mental health care in PHC. The speeches also show deficiencies in the training related to the appreciation of issues related to medicalization and the difficulty in granting autonomy in mental health care. Conclusion: Medical training in mental health should approach the reality of the general practitioner’s work, in order to prepare them for the demands they will face in their daily routine in PHC.

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events.

"Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.

Money talks: performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden.

The study aimed to investigate in which way performance-based reimbursement (PBR) systems in Swedish healthcare services (1) subjectively impacted physicians' work and patient care and (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians. The study applied a mixed-method design. Data were collected from a representative sample of Swedish physicians. In the questionnaire, respondents were asked to answer an open-ended question regarding their reflections on PBR. The answers to the open-ended question were analysed using thematic analysis. Respondents were also asked to rate the impact of PBR on their work. The association between PBR and self-rated stress-induced exhaustion disease was analysed with logistic regressions. Stress-induced exhaustion disorder was measured using the Burnout Assessment Scale. Thematic analysis resulted in four themes: (1) Money talks, (2) Patients are affected, (3) Medical morals are challenged, and (4) PBR increase the quantity of illegitimate tasks. Logistic regressions showed that physicians who experienced PBR had an impact on their work and had a two-fold higher risk of stress-induced exhaustion disorder. Our findings suggest that current reimbursement systems in Sweden play an essential role in Swedish healthcare and negatively influence physicians' work and health. Also, current PBR impact patients negatively. No previous study has explored the potentially harmful impact of PBR on how physicians perceive work, health and patient care. Results indicate that policymakers should be encouraged to deeply review PBR systems and focus on ways that they can limit the negative impact on physicians' work and health while meeting future challenges.

A Study on the Work of Primary Care Physicians in Chongqing during the COVID-19 Epidemic

A Study on the Work of Primary Care Physicians in Chongqing during the COVID-19 Epidemic

Artificial intelligence in medical practice: current status and future perspectives

Artificial intelligence in medical practice: current status and future perspectives

Acceptability of a cross-sectoral hospital pharmacist intervention for patients in transition between hospital and general practice: a mixed methods study.

Drug-related problems (DRPs) are often seen when a patient is transitioning from one healthcare sector to another, for example, when a patient moves from the hospital to a General Practice (GP) setting. This transition creates an opportunity for information on medication changes and follow-up plans to be lost. A cross-sectoral hospital pharmacist intervention was developed and pilot-tested in a large GP clinic. The intervention included medication history, medication reconciliation, medication review, follow-up telephone calls, identification of possible DRPs and communication with the GP. It is unknown whether the intervention is transferable to other GP clinics. The aim of the study was to explore similarities and differences between GP clinics in descriptive data and intervention acceptability. A convergent mixed methods study design was used. The intervention was tested in four GP clinics with differing characteristics. Quantitative data on the GP clinics, patients and pharmacist activities were collected. Qualitative data on the acceptability were collected through focus group interviews with general practitioners, nurses and pharmacists. The Theoretical Framework of Acceptability was used. Overall, the intervention was found acceptable and relevant by all. There were differences between the GP clinics in terms of size, daily physician work form and their use of pharmacists for ad hoc tasks. There were similarities in patient characteristics across GP clinics. Therefore, the intervention was found equally relevant for all of the clinics. Shared employment with unique access to health records in both sectors was important in the identification and resolution of DRPs. Economy was a barrier for further implementation. The intervention was found acceptable and relevant by all; therefore, it was considered transferable to other GP clinics. Hospital pharmacists were perceived to be relevant healthcare professionals to be utilized in GP, in hospitals and in the cross-sectoral transition of patients.

Trends in Physician Work Schedules in Japan: Employed Physician Surveys of the Japan Medical Association in 2009, 2015, and 2021.

Trends in Physician Work Schedules in Japan: Employed Physician Surveys of the Japan Medical Association in 2009, 2015, and 2021.

THE WORK OF AN ALLERGIST AND SCIENTIST DURING THE FULL-SCALE WAR IN UKRAINE

The article provides a brief description of the heroic work of Ukrainian physicians- volunteers, including allergists, during Russia's brutal war against Ukraine. Examples of the evacuation of Ukrainian residents, including patients with bronchial asthma, respiratory allergies, COVID-19 and other diseases that worsened under the influence of stress, are given. It is briefly described about the destroyed hospitals throughout the territory of Ukraine. In such a critical situation, Ukrainian doctors continue to provide assistance to patients, improve their scientific level, each in his place does everything to Victory. The light will defeat the darkness!

Women's Perceptions of Medication Use During Pregnancy and Breastfeeding in Saudi Arabia.

Background Pregnancy is a unique physiological condition in which medication intake offers a challenge and a worry due to changed drug pharmacokinetics and drugs potentially crossing the placenta, such as beta blockers and benzodiazepines. As a result, medication safety during pregnancy has gained global interest, attracting attention from doctors and pregnant women, little of which has been documented regarding the Saudi population. Therefore, this study aimed to assess medication use and perceptions of medication use during pregnancy and breastfeeding among women in Saudi Arabia. Methods This study is a questionnaire-based, cross-sectional study. Data was collected through an online self-administered questionnaire from different regions of Saudi Arabia. Data was then entered and analyzed using SPSS 24.0 version (IBM Inc., Chicago, USA) statistical software. Results A total of 1831 participants were included in the current study. About 835 (45.6%) of the participants were within the age group of 26-35 years old. A total of 602 (32.9%) were using medications on a daily basis or several times a week during pregnancy or breastfeeding. About 1476 (80.6%) participants agreed on medication use during pregnancy. About 66.4% of women would be worried about fetal malformations if they were supposed to take medications during pregnancy. About 940 (51.3%) women think that medication use during early pregnancy is harmful, and 500 (27.3%) think that medication use during breastfeeding trimesters is harmful. Regarding pregnant women's perception of herbal medicines, about (65.4%) of those with low educational levels think that herbal medicines are harmful in early pregnancy. Most participants (63%) within the age group of ≥36 years old think that medications and herbal medicines are harmful in early pregnancy. The vast majority (91%) of the participants would ask the physician working on antenatal care if they had concerns about using certain medications during pregnancy. Conclusion The average use of medication and herbal medicines among pregnant women was noted, although many women had negative beliefs about taking certain medications. Continued effort is essential to support and encourage women to seek out reliable information sources regarding medication use during pregnancy. In addition, healthcare practitioners should be mindful of women's attitudes when counseling them to take medication during pregnancy.

Changes in Physician Work Hours and Implications for Workforce Capacity and Work-Life Balance, 2001-2021

Physician work hours are an underexplored facet of the physician workforce that can inform policy for the rapidly changing health care labor market. To examine trends in individual physician work hours and their contribution to clinical workforce changes over a 20-year period. This cross-sectional study focused on active US physicians between January 2001 and December 2021 who were included in the Current Population Survey. Outcomes for physicians, advanced practice professionals (APPs), and nonphysician holders of doctoral degrees were compared, and generalized linear models were used to estimate differences in time trends for weekly work hours across subgroups. Physician and APP workforce size, defined as the number of active clinicians, 3-year moving averages of weekly work hours by individual physicians, and weekly hours contributed by the physician and APP workforce per 100 000 US residents. A total of 87 297 monthly surveys of physicians from 17 599 unique households were included in the analysis. The number of active physicians grew 32.9% from 2001 to 2021, peaking in 2019 at 989 684, then falling 6.7% to 923 419 by 2021, with disproportionate loss of physicians in rural areas. Average weekly work hours for individual physicians declined by 7.6% (95% CI, -9.1% to -6.1%), from 52.6 to 48.6 hours per week from 2001 to 2021. The downward trend was driven by decreasing hours among male physicians, particularly fathers (11.9% decline in work hours), rural physicians (-9.7%), and physicians aged 45 to 54 years (-9.8%). Physician mothers were the only examined subgroup to experience a statistically significant increase in work hours (3.0%). Total weekly hours contributed by the physician workforce per 10 000 US residents increased by 7.0%, from 13 006 hours in 2001 to 2003 to 13 920 hours in 2019 to 2021, compared with 16.6% growth in the US population over that time period. Weekly hours contributed by the APP workforce per 100 000 US residents grew 71.2% from 2010 through 2012 to 2019 through 2021. This cross-sectional study showed that physician work hours consistently declined in the past 20 years, such that physician workforce hours per capita lagged behind US population growth. This trend was offset by rapid growth in hours contributed by the APP workforce. The gap in physician work hours between men and women narrowed considerably, with diverging potential implications for gender equity. Increasing physician retirement combined with a drop in active physicians during the COVID-19 pandemic may further slow growth in physician workforce hours per capita in the US.