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      Personal health care of internal medicine residents

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          Abstract

          Introduction

          Medical residents, as part of their job to balance the demands of their work with caring for themselves so as to be mentally, emotionally, and physically sound to stay clinically competent. While regulatory and legislative attempts at limiting medical resident work hours have materialized but have yet to attain passage, there are fairly little data looking into how residents cope up with their demands and yet attend to their own personal health.

          Design

          Anonymous mailed survey.

          Subjects

          Three hundred and thirty-seven residents from all internal medicine residency programs within United States.

          Methods

          We conducted a survey in the form of a questionnaire that was sent by e-mail to the program directors of various internal medicine residency programs within the United States, and responses were collected between May 19 and June 21, 2009. Response was well appreciated with total number of participants of 337 with even demographical distribution in gender, residency year, AMG/IMG, age group. Seventy-one percent of the residents felt that they would prefer getting admitted to their own hospital for any acute medical or surgical condition. Of the 216 residents who have had received health care in the past, almost half of them chose their own hospital because of the proximity, while 45% did not choose their own hospital despite proximity. Two out of three residents missed their doctors appointments or cancelled them due to demands of medical training. Only half of the residents have a primary care physician and almost 80% of them did not have their yearly health checkup. Close to 30% held back information regarding their social and sexual history from their provider because of privacy and confidentiality concerns. Eighty percent of residents never received information about barriers that physicians may face in obtaining care for their socially embarrassing conditions. Seventy percent felt that their performance then was suboptimal because of that health condition and also felt sick but did not drop the call. Half of the residents had concerns that they might be having a psychiatric illness, but only 5% of them received a formal evaluation at their own hospital and 23 (12.4%) at an outside hospital.

          Conclusions

          It is very important to have more studies to emphasize on resident's physical and mental health and encourage them to have a primary care physician. There are several reasons preventing residents from getting a formal evaluation, confidentiality reasons, lack of time – schedule constraints, fear of being labeled, and social repercussions are few of them. Program directors should encourage the residents to not only care of the health of their patients but also be enthusiastic about their personal health issues for upgraded, revised patient care, and ultimately for their overall well-being.

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          Most cited references14

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          Does having regular care by a family physician improve preventive care?

          To assess whether regular care from a family physician is associated with receiving preventive services. Secondary analysis of the 1994 National Population Health Survey. Cross-sectional sample of the Canadian population. A total of 15,731 non-institutionalized adults. Reported visits to general practitioners and specialists in the previous year and reports of having had blood pressure measurements, mammography, and Pap smears. A graded relationship was observed between level of regular care by a family physician in the previous year (none, some, regular) and receiving preventive services. Those without regular doctors and those reporting only some care by a family physician were less likely to have ever had their blood pressure checked than adults receiving ongoing care from a regular family physician. Women reporting some or no care were less likely to have had mammography within 2 years or to have ever had Pap smears. Adults who receive regular care from a family physician are more likely to receive recommended preventive services.
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            Health and health care among housestaff in four U.S. internal medicine residency programs.

            Although there have been many studies of the health care services that resident physicians provide, little is known about the health care services they receive. To describe residents' perceptions of the health care they receive. Anonymous mailed survey. All 389 residents in four U.S. categorical internal medicine training programs. Three hundred sixteen residents responded (83%). In aggregate, 116 (37%) reported having no primary care physician, and 36 (12%) reported that they are their own primary care physician. These figures varied substantially across the four programs. Most residents reported receiving basic screening and preventive services; however, their attitudes toward their health and health care differed across postgraduate level, gender, and program. Many residents reported that their long and unpredictable hours interfered with their ability to schedule clinician visits, that their health had declined because of residency, that programs and other residents were unsupportive of residents' health care needs, and that residency raised special issues of privacy that limited access to health care. Despite high rates of receipt of preventive services, these internal medicine residents identified several barriers that limited their access to health care. Program directors should explore these barriers and, at the same time, reevaluate the messages being sent to resident physicians about maintaining their health and health care.
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              Doctors as patients: postal survey examining consultants and general practitioners adherence to guidelines.

              To examine the adherence by senior NHS medical staff to the BMA guidelines on the ethical responsibilities of doctors towards themselves and their families. Postal semistructured questionnaire. Four randomly selected NHS trusts and three local medical committees in South Thames region. Consultants and principals in general practice. Personal use of health services. The response rate was 64% (724) for general practitioners and 72% (427) for consultants after three mailings. Most (1106, 96%) respondents were registered with a general practitioner, although little use was made of their services. 159 (26%) general practitioners were registered with a general practitioner in their own practice and 80 (11%) admitted to looking after members of their family. 73 (24%) consultants would never see their general practitioner before obtaining consultant advice. Most consultants and general practitioners admitted to prescribing for themselves and their family. Responses to vignettes for different health problems indicated a general reluctance to take time off, but there were differences between consultants and general practitioners and by sex. Views on improvements needed included the possibility of a "doctor's doctor," access to out of area secondary care, an occupational health service for general practitioners, and regular health check ups. The guidelines are largely not being followed, perhaps because of the difficulties of obtaining access to general practitioners outside working hours. The occupational health service should be expanded and a general practitioner service for NHS staff piloted.
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                Author and article information

                Journal
                J Community Hosp Intern Med Perspect
                J Community Hosp Intern Med Perspect
                JCHIMP
                Journal of Community Hospital Internal Medicine Perspectives
                Co-Action Publishing
                2000-9666
                26 January 2012
                2011
                : 1
                : 4
                : 10.3402/jchimp.v1i4.8864
                Affiliations
                Greater Baltimore Medical Center, Towson, MD, USA
                Author notes
                [* ] Venkataraman Palabindala, Chief Medical Resident, Greater Baltimore Medical Center, Internal Medicine Residency, Towson, MD 21204. Email: palabindala@ 123456gmail.com
                Article
                8864
                10.3402/jchimp.v1i4.8864
                3714053
                23882347
                d4c0735d-e10a-4d22-9e3b-a2e4dae6f92f
                © 2011 Venkataraman Palabindala et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 August 2011
                : 23 November 2011
                : 07 December 2011
                Categories
                Research Article

                mailed questionnaire,confidentiality,primary care,health access

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