A survey of marketing practices by family practice residency programs.

The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.

Problem-based ACLS instruction: a model approach for undergraduate emergency medical education.

The optimal format for teaching advanced cardiac life support (ACLS) to medical students and other groups with little emergency medicine experience has not been studied extensively. We report an ACLS provider course that was taught to sophomore medical students using a self-directed, problem-based learning model. The traditional two-day provider course format was replaced by a series of clinical problems that emphasized various aspects of the ACLS curriculum. Students then met weekly with an ACLS instructor who served as a tutor to discuss the problem. A specific set of learning objectives for the entire ACLS curriculum was developed into a study unit index and given to students at the beginning of the course. Enhanced practice time was offered to students in the form of traditional teaching stations and skills laboratories. Students were tested using standard ACLS criteria. The students in the problem-based course achieved a higher pass rate on the written test and skills stations than senior medical students did in a standard two-day course during the same time period. The problem-based format with enhanced practice time would appear to be an effective alternative for groups that need to acquire the basic skills needed in a resuscitation attempt but have little previous experience in this area.

Endoscopic cleaning and disinfection procedures for preventing iatrogenic spread of human immunodeficiency virus.

With estimates as high as 1.8 million individuals infected with human immunodeficiency virus (HIV) in the United States, the majority asymptomatic, it is crucial that all physicians routinely use adequate disinfection procedures for medical instruments. The protosigmoidoscopic disinfection procedures used by US family physicians were evaluated for adequacy in inactivating HIV. Sixty-seven percent of 1,585 randomly selected American Academy of Family Physicians members completed a mail survey regarding these procedures. Comparing procedures used with those recommended by the Centers for Disease Control or documented to inactivate HIV, 32.4 percent were judged to be appropriate procedures; 54.4 percent of the procedures were not tested or recommended; and 13.2 percent used appropriate solutions but at inadequate concentrations or exposure times. Therefore, a substantial proportion of US family physicians performing endoscopic procedures use disinfection procedures that may not inactivate HIV. The ever-increasing prevalence of HIV demands that standardized adequate disinfection procedures be implemented by all physicians to prevent the potential nosocomial spread of HIV.

Use of rigid and flexible sigmoidoscopy by family physicians in the United States.

To investigate the incidence of use of the flexible and rigid proctosigmoidoscopes by family physicians, a questionnaire was mailed to 1,585 randomly selected members of the American Academy of Family Physicians. Of the total of 1,057 respondents, 48 percent performed sigmoidoscopy, with 30 percent performing flexible sigmoidoscopy, 31 percent performing rigid sigmoidoscopy, and 48 percent performing at least one of the procedures. Younger physicians were found to be more likely to perform flexible sigmoidoscopy, as were physicians who practice in communities of fewer than 500,000 population. Nationwide, more of the flexible procedures are performed in private offices than in the hospital. Physicians in communities of less than 500,000, however, are more likely to use the flexible sigmoidoscope in a hospital setting than are physicians in larger urban areas [corrected]. Board-certified physicians were more likely to perform one or both procedures than were noncertified physicians.