RESUMO
OBJECTIVE: To investigate whether hospital activities and attitudes toward hospitals of members of an urban family medicine department changed between 1977 and 1997. To explore whether these activities and attitudes are different among fee-for-service (FFS) and non-FFS physicians in 1997. DESIGN: Cross-sectional surveys by interview (1977) and self-administered questionnaire (1997). SETTING: Community-based family practices in Hamilton, Ont. PARTICIPANTS: In 1977, 88 of 89 (98.9%) and, in 1997, 66 of 88 (75.0%) members of the Department of Family Medicine at St Joseph's Hospital in Hamilton. MAIN OUTCOME MEASURES: Perceived reasons for involvement in hospital work; time spent and main activities in hospital; use of hospital privileges; attitudes toward family physicians' role in hospital, hospital work, and the Department of Family Medicine; perceptions of patients', consultants', and hospital administrators' attitudes toward family physicians' role in hospitals. RESULTS: In 1977 and 1997, patient care and continuing education remained key reasons for doing hospital work. In 1997, however, respondents spent a mean of 3 hours less per week in hospital; used the hospital less often for procedures, meetings, and teaching; and assumed less responsibility for their patients' in-hospital care. While perceptions of hospital work changed over the years, most physicians continued to see a need and have a desire to remain involved in hospitals. Fee-for-service and non-FFS physicians held different opinions on the needs of both hospitalized patients and family physicians. CONCLUSION: Although physicians' hospital activities and attitudes changed between 1997 and 1997, most continued to see a need and have a desire to remain involved in hospitals.
Assuntos
Atitude do Pessoal de Saúde , Medicina de Família e Comunidade , Relações Hospital-Médico , Prática Institucional , Continuidade da Assistência ao Paciente , Estudos Transversais , Medicina de Família e Comunidade/economia , Planos de Pagamento por Serviço Prestado , Feminino , Humanos , Masculino , Privilégios do Corpo Clínico , Ontário , Defesa do Paciente , Papel do Médico , Fatores de TempoRESUMO
A questionnaire on the hospital involvement of family doctors was completed by the active staff members of the Department of Family Medicine at St. Joseph's Hospital, Hamilton, in April, 1977. This paper is the second of four; the first dealt with the study's conception, design and methodology.This paper deals with the reasons why family doctors attend hospital, what they do there, how much time they spend there, and the use of hospital privileges, both attending and procedural. A discussion of the study's implications for general understanding of the family doctor's role, and necessary education for this role, concludes this section.Subsequent sections will give more detailed results of the family doctor's involvement in obstetrics and lastly the attitudes of family doctors toward their hospital environment.
RESUMO
This fourth and final part of the report of a survey carried out at St. Joseph's Hospital, Hamilton, Ontario, examines the results from that portion of the questionnaire relating to attitudes of the family physicians surveyed. It was found that family doctors have strong ties to the hospital and see an association between the quality of community and hospital care and the maintenance of these hospital ties. Problems in clarifying and consolidating their role in hospital are identified and discussed, together with some implications concerning training programs in family medicine.
RESUMO
This is the third paper in a series of four on the part played by the family physician in a general hospital.Of 88 family physicians on active staff at St.Joseph's Hospital in Hamilton, 56 did deliveries. Most of those practicing obstetrics did most of their own deliveries. As the procedures became more difficult, fewer doctors performed them. Most of the members were involved with routine prenatal care, and some with high risk prenatal care. The resons for not doing obstetrics varied, but obstetrics till seem to be a very important part of the family physician's activity within the hospital.
RESUMO
Five family doctors at St. Joseph's Hospital in Hamilton, Ontario, completed a comprehensive survey of 88 active, associate and senior members of the Department of Family Medicine, detailing their activities in hospital, their attitudes toward the hospital, their actual and desired roles and their Department of Family Medicine.The study illustrates the changing role in hospital from procedure-orientation to patient advocate, and the resulting problems. These problems were mainly lack of communication skills and feeling impotent in dealing with the hospital power structure. Implications for family medicine training programs, continuing medical education programs and teaching and community hospitals are discussed in a series of four papers.