Dunn LB, Moutier CY, Green Hammond KA, Lehrmann J, Roberts LW. Personal health care of residents: Preferences for care outside of the training institution
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. Academic Psychiatry
(Impact Factor: 0.81).
02/2008; 32(1):20-30. DOI: 10.1176/appi.ap.32.1.20
The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy.
A self-report survey was distributed in 2000-2001 to advanced residents at the University of New Mexico Health Sciences Center. Questions related to personal health and health care attitudes, behaviors, preferences, and experiences, and vignettes related to personal illness and treatment. Here the authors report findings regarding preferences for obtaining health care "at" versus "outside" of one's training institution.
Data from 141 residents are presented. A substantial minority of residents had obtained care outside of their institution in the preceding year. Residents expressed concerns about their medical privacy and confidentiality related to obtaining care within their own institution, including concerns about being seen by other residents or by past or future attendings. Women expressed more concern than did men on numerous issues, as did residents in primary care versus specialty training. Residents expressed a preference for care outside the training institution when taking into account confidentiality and prevention of embarrassment; care at their own institution was preferred when considering expense and scheduling. Outside care was more strongly preferred for more stigmatizing illnesses (e.g., mental health-related). Most residents felt poorly informed regarding their personal health care confidentiality rights and did not know whether their institution had confidentiality policies regarding residents who develop physical or mental health problems.
Residents worry about confidentiality and privacy when deciding where to obtain personal medical care. Trainees' concerns are relevant to crafting policies on resident health care. Programs should strive to inform residents thoroughly about policies and rights pertaining to personal health care.
Available from: PubMed Central
- "There was a non-significant tendency toward self-identified Asian women being more likely to report not feeling comfortable having a Pap smear at her workplace institution, which may be a marker for differential desire for privacy or discomfort around sexuality, a predictor of cervical and breast cancer screening. Prior research has suggested that post-graduate residents may not be comfortable receiving care at their institution, but no research has identified racial/ethnic differences in discomfort "
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ABSTRACT: Racial and ethnic disparities in cervical cancer screening have been attributed to socioeconomic, insurance, and cultural differences. Our objective was to explore racial and ethnic differences in adherence to cervical cancer screening recommendations among female post-graduate physicians.
We conducted a cross-sectional survey at one university hospital among a convenience sample of 204 female post-graduate physicians (52% of all potential participants), examining adherence to United States Preventive Services Task Force cervical cancer screening recommendations, perception of adherence to recommendations, and barriers to obtaining care.
Overall, 83% of women were adherent to screening recommendations and 84% accurately perceived adherence or non-adherence. Women who self-identified as Asian were significantly less adherent when compared with women who self-identified as white (69% vs. 87%; Relative Risk [RR]=0.79, 95% Confidence Interval [CI], 0.64-0.97; P<0.01). Women who self-identified as East Indian were significantly less likely to accurately perceive adherence or non-adherence when compared to women who self-identified as white (64% vs. 88%; RR=0.73, 95% CI, 0.49-1.09, P=0.04). Women who self-identified as Asian were significantly more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 35%; RR=1.75, 95% CI, 1.24-2.47; P=0.001) and there was a non-significant tendency toward women who self-identified as East Indian being more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 34%; RR=1.74, 95% CI, 1.06-2.83; P=0.06).
Among a small group of insured, highly-educated physicians who have access to health care, we found racial and ethnic differences in adherence to cervical cancer screening recommendations, suggesting that culture may play a role in cervical cancer screening.
BMC Public Health 10/2008; 8(1):378. DOI:10.1186/1471-2458-8-378 · 2.26 Impact Factor
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ABSTRACT: e all know them—the chief surgery resident receiv- ing fluid boluses in an empty hospital room after vomiting throughout his call shift; the physician maintain- ing a busy clinic schedule despite a fever of 103F; the faculty geriatrician working at his usual pace while his own elderly parent dies of cancer states away; thewidowedphy- sician returning to see patients to "keep her mind off things" following the death of her husband only 2 weeks before; the cardiac surgeon ignoring his own symptoms, which he would be quick to recognizeinoneofhispatients. Despite our ability to care so diligentlyforothers,toexpect that the health and well-being of our patients come before anything else, we as health careprofessionalsarenotorious for being horrible patients. Many factors are thought to play a role in this pattern. Stress, for one, has taken a large portion of the blame. Most surgical or medical residents use their time away from the hospital to maintain their marriages, spend time with their families, and repent for all the hours they have been away. Taking time for self-care seems almost laugh- able. The drive to and from the hospital may be the only time they get to themselves. The hectic pace of the phy- sician life style, the emotional and physical stress of resi-
Academic Psychiatry 02/2008; 32(1):1-2. DOI:10.1176/appi.ap.32.1.1 · 0.81 Impact Factor
Available from: Raymundo Soares Azevedo
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ABSTRACT: To define the profile of medical residents assisted by a mental health care service, aiming to contribute to the understanding of this group's needs.
Observational study, retrospective cohort design. Data were collected from the medical records of a series of residents assisted by the group of psychological care for students of the Sao Paulo University School of Medicine , during the period 1998-2002; and from the institution's general register of residents. Proportions of residents assisted according to time, year of residency, gender , age, specialty, graduation school and distance from family home are described and differences between proportions of these variables categories are analyzed.
The total of residents included was 2,131 with a follow-up time of 4,727 resident-years. Among them, computing first episode of care only, there were 104 residents assisted (4.9% residents assisted, or 2.2 residents assisted per 100 resident-years of follow-up). Their most frequent characteristics were: first year of residency (4.5%), age under 26 years (6.1%), female (6.9%), graduates from other schools (5.9%), and residents of cognitive specialties (6.7%). Psychiatric assistance in this sample shows an association with gender and factors related to a crisis of adaptation. The proportion of residents assisted has not increased during the period analyzed.
Revista da Associação Médica Brasileira 12/2008; 55(6):684-91. · 0.93 Impact Factor
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