Assessing the professional development needs of public health professionals.

This article describes the major activities associated with designing and implementing a comprehensive, professional development needs assessment of public health professionals in four states of the South Central region of the United States. The instrumentation, research design, and summary results of the needs assessment described in this article may facilitate similar efforts by interested researchers and program developers to assess the public health professional workforce training needs. Results of needs assessments can be useful in designing and evaluating professional development curricula and activities to strengthen public health services in the United States.

Physician practice variation in assignment of return interval.

BACKGROUND: Recent shifts in reimbursement toward capitation makes appointment availability a significant resource and stimulates us to understand primary care physician (hereafter referred to as "provider") behavior concerning appointment assignment. The results of prior studies suggest significant provider variability in this area. OBJECTIVE: To examine the influences on assigning patient revisit intervals in the ambulatory setting. METHODS: Survey regarding general care issues of hypothetical diabetic and hypertensive patients seen in an ambulatory setting was given to 62 providers in the Internal Medicine Program at the Tulane University Internal Medicine Residency Program and outpatient clinics, New Orleans, La. Measurements evaluated included survey responses for demographics (sex, year of birth, year of graduation from medical school, and level of training) and practice style (decision to change therapy, order tests, and recommended return appointment interval in weeks) variables. RESULTS: The response rate was 89% (56 providers). Most respondents were men (n = 39). Wide variation was noted in assignment of reappointment interval with mean return intervals for the scenarios ranging from 2.2 to 20.5 weeks. Significant influences on provider practice included patient stability (P<.001), the decision to change therapy (P = .001), and the decision to order tests (P = .001). All correlated with an earlier return appointment. Some providers exhibited test-ordering tendencies across scenarios. Sex was a significant provider independent variable and was not influenced by other study variables. Female providers assigned earlier reappointment intervals for their patients. CONCLUSIONS: Wide variation exists among practitioners with similar training background and practice setting. As expected, patient stability was a major determinant of assigned return interval. Test-ordering behaviors may consume appointments inappropriately and may be a productive area for efforts to reduce provider variability. The influence of the provider's sex on scheduling follow-up appointments warrants further investigation.

Double duty: students' perceptions of Tulane's MD-MPH dual degree program.

PURPOSE: Although MD-MPH programs exemplify the initiative for collaboration between schools of medicine and public health and address the expanding requirements for effective medical practice, information on such programs is scant. Perspectives and motivations of students enrolled in a 4-year MD-MPH program are explored to benefit existing and new programs as well as to inspire future research. SUMMARY: A questionnaire, based on previously identified themes, was mailed to all 110 students enrolled in the MD-MPH program at Tulane University. The typical respondent felt prepared for the program, expected to practice medicine full time, and expected to practice internationally up to 3 months annually. Perceived enhancements and barriers to dual degrees are addressed. CONCLUSIONS: Increased awareness of MD-MPH programs at the undergraduate level might be beneficial. Respondents valued the broader perspectives on the doctor-patient-society triad and additional career opportunities gained through their combined studies. Findings of this study can facilitate program planning and improvement elsewhere.