Patient reports of lifestyle advice in primary care.
ABSTRACT Purpose: Patients' perceptions of preventive lifestyle in primary care practice were examined. Methods: Practice was assessed with a modified version of the Primary Care Assessment Survey (PCAS). This was mailed to random samples of patients twice, using practice mailing lists from three Ontario Family Health Networks (FHNs). Family Health Networks are physician-based group practices, with additional nurse-led telephone advisory services to provide care 24 hours a day, seven days a week. The PCAS questionnaire consisted of nine scales (ranging from 0 to 100). For preventive counselling, additional questions on diet and exercise counselling were included to determine how the physician delivered the intervention. Results: Of the 2184 survey questionnaires mailed to patients, 22% were undeliverable. The response rate was 62% at valid addresses (49% of all mailed questionnaires). Of the nine scales, scores (± standard deviation) for preventive counselling were lowest at 33 ± 25. In particular, rates of diet (37%) and exercise (24%) counselling were low in the FHNs. For most other aspects of primary care services, patients generally rated FHNs highly. The majority of patients advised about diet and exercise were given verbal advice or pamphlets. Conclusions: In these primary health care organizations, considerable room exists for increased preventive counselling, especially about diet and exercise.
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ABSTRACT: Many physicians have been reluctant to embrace physician evaluation websites (PEWs) due to the overwhelming number of PEWs and concerns about negative anonymous feedback. This article provides perspective for the vast array of PEWs, website features and user characteristics, and identifies the most notable websites which merit attention from physicians concerned about their online reputations. 35 PEWs met criteria for inclusion in the analysis. Each website was studied to assess its geographic focus, detailed features of physician profiles, nature of patient-generated reviews, number of monthly site visitors, and other points including user demographics and characteristics. Most PEWs provide their services free-of-charge, and physicians are usually allowed to create and enhance online profiles without payment. Anonymous posting of reviews is an almost universal feature of PEWs, but most reviews are positive. A few websites allow physicians to respond publicly or privately to negative patient reviews. These and other notable websites are identified. Physician evaluation websites have tremendous potential to help doctors and patients. With this review as a guide, physicians should collaborate with PEWs to harness their potential, to improve clinical practices, and to attract new patients. As physicians increasingly interact with the most "doctor-friendly" PEWs, this collaboration could motivate other websites to implement changes that give physicians greater control over their online reputations. The era of doctors avoiding online evaluations is closing, and in the future, physicians who embrace PEWs are most likely to succeed.The American Journal of Gastroenterology 11/2013; 108(11):1676-85. DOI:10.1038/ajg.2013.112 · 9.21 Impact Factor