Annals of family medicine
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Annals of family medicine · Jan 2008
Influence of patients' socioeconomic status on clinical management decisions: a qualitative study.
Little is known about how patients' socioeconomic status (SES) influences physicians' clinical management decisions, although this information may have important implications for understanding inequities in health care quality. We investigated physician perspectives on how patients' SES influences care. ⋯ Physicians indicated that patient SES did affect their clinical management decisions. As a result, physicians commonly undertook changes to their management plan in an effort to enhance patient outcomes, but they experienced numerous strains when trying to balance what they believed was feasible for the patient with what they perceived as established standards of care.
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Annals of family medicine · Jan 2008
Influence of obstetric practice on workload and practice patterns of family physicians and obstetrician-gynecologists.
Obstetric practice among family physicians has declined in recent years. This study compared the practice patterns of family physicians and obstetrician-gynecologists with and without obstetric practices to provide objective information on one potential reason for this decline--the impact of obstetrics on physician lifestyle. ⋯ Practicing obstetrics is associated with an increased workload for family physicians. Organizing practices to decrease the impact on lifestyle may support family physicians in practicing obstetrics.
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The reservation was a littered muddy wasteland, and its population endured poor health, not unlike a third world country. Native American patients suffered from conditions of squalor, alcoholism, diabetes, and drug abuse. ⋯ Rescuing a teenage girl in labor with a footling breech brought my cultural incompetence to a head. I searched for validation of my service and meaningful purpose in my efforts.