Family practice research journal
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Burnout and career-choice regret among physicians in early practice may contribute to physician impairment and attrition as well as patient dissatisfaction. ⋯ This sample of physicians in early practice reported slightly less burnout and less specialty-choice regret than a comparable sample of family practice residents, suggesting possible attenuation of burnout with the transition from training to practice. Nonetheless, the importance of overwhelming time demands as a precipitant of exhaustion and potential physician impairment is noted.
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This study assesses the prevalence and characteristics of sexual assault among women patients attending two family medicine residency training clinics. ⋯ Family physicians should be aware of the prevalence of sexual assault in their practices and should understand proper questioning, management, counseling, and referral of patients.
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Comparative Study
Factors chosen by department chairs as important to family medicine.
Family medicine faces significant challenges and opportunities in the next 20 years. This study was conducted to determine the importance of departmental factors to the discipline as perceived by the departmental chairs. ⋯ Although responding departmental chairs felt that many of the items were important, teaching and faculty issues were ranked as the most important areas to the discipline while fellowships was ranked least important.
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Epidural analgesia offers excellent relief from the pain of uterine contractions during labor. It is well tolerated by both mother and baby. ⋯ No significant differences were found in birth weights, Apgar scores, cesarean section rate, or complications. Forceps use was greatly increased, from 13% to 37% (p < 0.01).
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To evaluate if physician specialty is a factor in determining whether cesarean sections are performed, a retrospective review of all obstetrical records was performed at a rural hospital in northeastern Kentucky. Review of 1522 patients who delivered between January 1, 1987, and June 30, 1989, showed that staff obstetricians had a 10.8% cesarean rate compared with 8.9% for family physicians. Analysis of the diagnoses that led to cesarean delivery showed no difference between the specialties for cesarean sections performed for fetal distress, preeclampsia, or other high-risk problems, but obstetricians had an increased cesarean section rate for cephalopelvic disproportion (10.7% of all deliveries vs 6.3% for family physicians, P less than 0.001). These results suggest that physician specialty may influence cesarean section rates, although other factors could also contribute to these results.