Tuberculosis in prisons in countries with high prevalence

BMJ, 2003

Health care technology is continuously moving forward with great advances in all fields of medicine. The way in which health care is delivered has been stuck in a primary care/secondary care model, which is failing to meet patients' needs. Existing structures are inefficient because they do not maximise use of skills. A new way of delivering services is proposed using an intermediate level specialist -a general practitioner with a special clinical interest (GPSCI), to increase access at a location close to the patient while giving support to the wider primary health community. We explore how the role of GPSCI might work using the field of respiratory medicine as an exemplar. The concept is transferable to other therapeutic areas.

Journal of General Internal Medicine, 2004

asked a task force to redefine the domain of general internal medicine. The task force believes that the chaos and dysfunction that characterize today's medical care, and the challenges facing general internal medicine, should spur innovation. These are our recommendations: while remaining true to its core values and competencies, general internal medicine should stay both broad and deep-ranging from uncomplicated primary care to continuous care of patients with multiple, complex, chronic diseases. Postgraduate and continuing education should develop mastery. Wherever they practice, general internists should be able to lead teams and be responsible for the care their teams give, embrace changes in information systems, and aim to provide most of the care their patients require. Current financing of physician services, especially fee-for-service, must be changed to recognize the value of services performed outside the traditional face-to-face visit and give practitioners incentives to improve quality and efficiency, and provide comprehensive, ongoing care. General internal medicine residency training should be reformed to provide both broad and deep medical knowledge, as well as mastery of informatics, management, and team leadership. General internal medicine residents should have options to tailor their final 1 to 2 years to fit their practice goals, often earning a certificate of added qualification (CAQ) in special generalist fields. Research will expand to include practice and operations management, developing more effective shared decision making and transparent medical records, and promoting the close personal connection that both doctors and patients want. We believe these changes constitute a paradigm shift that can benefit patients and the public and reenergize general internal medicine.

2004

ii DECLARATION I, the undersigned, Marietjie René de Villiers, hereby declare that the work contained in this dissertation is my own and that I have not previously in its entirety or in part submitted it at any university for a degree. …………………………………………….. iii SUMMARY District hospitals play a pivotal role in the district health system of the Western Cape and other provinces of South Africa. It is a dual role, supporting both primary health care services and serving as a gateway to higher levels of care.

BMJ Clinical Research

Journal of the Ceylon College of Physicians, 2017

JAMA, 2012

ENERAL INTERNISTS PROVIDE comprehensive and coordinated care for both acute and chronic diseases. General internists are expected to play an increasingly critical role in health care provision as the population ages, the burden of chronic disease grows, and health care reform targets coverage of tens of millions of currently uninsured patients. 1-6 The value of generalist care is well documented. 1-7 With the increasing understanding that the United States faces a severe shortage of generalist physicians, 1-6 the composition of the medical workforce has become a more prominent concern. In the 1970s, internal medicine primary care programs were created to stimulate increased training in general medicine. 8 Early studies reported general medical career plans for up to 90% of primary care program graduates. 8-11 However, these results came in an environment in which more than half of all internal medicine residency graduates pursued general medical careers. 10 More recently, only 20% to 25% of internal medicine residency graduates pursue general medical careers, 12,13 and fewer medical students are For editorial comment see p 2252. CME available online at www.jamaarchivescme.com and questions on p 2286.

Physician, teacher, author and historian, few within Family Medicine are more qualified to tell the story of the specialty than Dr. Nikitas J. Zervanos.

BMJ, 2012

Australian health review : a publication of the Australian Hospital Association, 2017

This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners.This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice.The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work-life balance, scope of practice, connection with patients, training environment and pract...

Radiography