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Review Article

Variables in the projection of physician demand and supply in primary care
Dae Hyun Kim, Yoonseo Lee
Korean J Fam Med 2025;46(1):4-11.   Published online December 24, 2024
DOI: https://doi.org/10.4082/kjfm.24.0153
Primary care services improve healthcare outcomes and limit unnecessary specialty care. Thus, it is essential to monitor primary care physician demand and supply projections to suggest evidence-based healthcare reforms and promote better healthcare delivery. This study evaluates 28 demand variables, 50 supply variables, and 26 additional variables associated with the demand and supply projections of physicians by reviewing scenarios from other countries, including Taiwan, Singapore, Japan, and the United States of America. The results indicate that Korea uses less diverse demand and supply indicators and suggest the need to implement variables used in the other four countries to improve projection modeling.

Citations

Citations to this article as recorded by  
  • What is the optimal number of physicians for a sustainable healthcare system?
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(1): 1.     CrossRef
  • 2,090 View
  • 75 Download
  • 1 Web of Science
  • 1 Crossref

Original Articles

The Effect of Access to Primary Care Physicians on Avoidable Hospitalizations: A Time Series Study in Rural Areas of Tehran Province, Iran
Arash Rashidian, Sedigheh Salavati, Hanan Hajimahmoodi
Korean J Fam Med 2020;41(5):282-290.   Published online May 29, 2020
DOI: https://doi.org/10.4082/kjfm.19.0028
Background
Avoidable hospitalizations (AHs) are defined as hospitalizations that could have been prevented through timely and effective services. AHs are, therefore, an indicator used to evaluate the access and effectiveness of primary health care services.
Methods
A retrospective time-series study spanning 8 years (2006–2013) was conducted to determine the relationship between AHs and gender, age, and access to primary health care physicians in rural areas in Tehran province, the capital of Iran. The total number of avoidable hospitalizations was 22,570; logistic regression was estimated for each year separately.
Results
Total hospitalizations and AHs increased during the study period, especially during the first 3 years of the study. AHs, as a percentage of total hospitalizations, did not change significantly throughout the study years. This value was 22.3% during the first year of study and varied between 17% and 19.6% from 2007 to 2013. No statistically significant relationship was seen between AH occurrence and access to a physician during the study years.
Conclusion
Increasing access to primary health care physicians cannot necessarily result in decreased AHs. Considering the factors influencing AHs while designing and implementing the family physicians program is important to achieve the expected results regarding the effectiveness of primary health care services.

Citations

Citations to this article as recorded by  
  • Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation
    Shehla Zaidi, Jai K Das, Wafa Jamal, Ammarah Ali, Faareha Siddiqui, Aya Thabet, Hassan Salah, Awad Mataria
    BMJ Open.2023; 13(2): e063327.     CrossRef
  • 4,100 View
  • 77 Download
  • 1 Web of Science
  • 1 Crossref
Analysis of the Time Interval between the Physician Order for Life-Sustaining Treatment Completion and Death
Sung Yoon Joung, Chung-woo Lee, Youn Seon Choi, Seon Mee Kim, Seok Won Park, Eun Shik Mo, Jae Hyun Park, Jean Shin, Hyun Jin Lee, Hong Seok Park
Korean J Fam Med 2020;41(6):392-397.   Published online May 20, 2020
DOI: https://doi.org/10.4082/kjfm.19.0077
Background
This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing.
Methods
A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher’s exact test was also used to compare cancer versus non-cancer groups.
Results
More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336).
Conclusion
Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.

Citations

Citations to this article as recorded by  
  • An Integrative Review of the State of POLST Science: What Do We Know and Where Do We Go?
    Elizabeth E. Umberfield, Matthew C. Fields, Rachel Lenko, Teryn P. Morgan, Elissa Schuler Adair, Erik K. Fromme, Hillary D. Lum, Alvin H. Moss, Neil S. Wenger, Rebecca L. Sudore, Susan E. Hickman
    Journal of the American Medical Directors Association.2024; 25(4): 557.     CrossRef
  • Discussing POLST-facilitated hospice care enrollment in patients with terminal cancer
    Ho Jung An, Hyun Jeong Jeon, Sang Hoon Chun, Hyun Ae Jung, Hee Kyung Ahn, Kyung Hee Lee, Min-ho Kim, Ju Hee Kim, Jaekyung Cheon, Su-Jin Koh
    Supportive Care in Cancer.2022; 30(9): 7431.     CrossRef
  • The Medical Orders for Scope of Treatment (MOST) form completion: a retrospective study
    Anastasia A. Mallidou, Coby Tschanz, Elisabeth Antifeau, Kyoung Young Lee, Jenipher Kayuni Mtambo, Holly Heckl
    BMC Health Services Research.2022;[Epub]     CrossRef
  • 4,777 View
  • 90 Download
  • 2 Web of Science
  • 3 Crossref

Review Articles

Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management
Amir Mari, Mahmud Mahamid, Hana Amara, Fadi Abu Baker, Afif Yaccob
Korean J Fam Med 2020;41(3):139-145.   Published online February 17, 2020
DOI: https://doi.org/10.4082/kjfm.18.0182
Chronic constipation (CC) is a common disorder in the elderly population globally and is associated with comorbidities and negative implications on the quality of life. Constipation prevalence varies in different studies, primarily owing to the nonuniformity of the diagnostic criteria. However, 15%–30% of individuals aged >60 years are diagnosed with CC. Primary care physicians are the main healthcare providers that manage constipation in elderly patients in parallel with increased population aging and increased prevalence of constipation. Physical inactivity, polypharmacy, chronic medical conditions, rectal hyposensitivity, and defecatory disorders all play a role in the pathogenesis of CC in elderly patients. Detailed anamnesis, particularly history related to chronic medication use, with digital rectal examination may assist in identifying constipation causes. Additionally, blood tests and colonoscopy may identify organic causes of CC. Physiologic tests (i.e., anorectal manometry, colonic transit time with radiopaque markers, and defecography) can evaluate the physiologic function of the colon, rectum, and anus. However, generally, there are several causes of constipation in older patients, and an individualized approach is recommended. Treatment of chronic idiopathic constipation is empiric, based on the stepwise approach. Lifestyle advice, adjustment of chronic medications, and prescription of laxatives are the first steps of management. Several laxatives are available, and the treatment is evolving in the last decade. Biofeedback is an effective therapy especially for defecatory disorders. This review aimed to summarize the most updated knowledge for primary care physicians in the approach and management of CC in elderly patients.

Citations

Citations to this article as recorded by  
  • Rehabilitation for Chronic Constipation: Integrative Approaches to Diagnosis and Treatment
    Luana Alexandrescu, Ionut Eduard Iordache, Alina Mihaela Stanigut, Laura Maria Condur, Doina Ecaterina Tofolean, Razvan Catalin Popescu, Andreea Nelson Twakor, Eugen Dumitru, Andrei Dumitru, Cristina Tocia, Alexandra Herlo, Ionut Tiberiu Tofolean
    Gastrointestinal Disorders.2025; 7(1): 11.     CrossRef
  • Life’s Simple 7 and its impact on chronic bowel disorders: a study on constipation and diarrhea in the U.S. adult population
    Hongzhi Sun, Lei Qi, Yiwei Ming, Weichen Wang, Maoneng Hu
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Attenuation of intestinal peristalsis with age is attributed to decreased sensitivity of receptors in the enteric nervous system
    Tsukasa Kobayashi, Yuko Takeba, Masanori Ootaki, Yuki Ohta, Keisuke Kida, Taroh Iiri, Naoki Matsumoto
    Cell and Tissue Research.2025; 400(3): 303.     CrossRef
  • Health multidimensional evaluation of institutionalized older adults according to cognitive performance
    Beatriz Cintra Martins, Lilian Barbosa Ramos, Anna Karla Carneiro Roriz, Henrique Salmazo da Silva
    Dementia & Neuropsychologia.2025;[Epub]     CrossRef
  • Advancements in the application of botulinum toxin type a in the treatment of anorectal disorders
    Xiaojuan Chen
    Toxicon.2025; 260: 108346.     CrossRef
  • Probiotics and prebiotics in the treatment of functional constipation in the elderly individuals
    Li Xu, Jian-Tang Guo, Jing Zhao, Ming-He Liu, Chen Mo
    World Journal of Gastrointestinal Pharmacology and Therapeutics.2025;[Epub]     CrossRef
  • Evaluation of nutritional and functional characteristics of noodles formulated with chickpea flour and moringa leaf powder
    Tanjum Kabir Khuku, Sanaullah Mazumdar, Borhan Uddin, Md. Syduzzaman
    Applied Food Research.2025; 5(1): 101062.     CrossRef
  • A Low FODMAP Diet Supplemented with L-Tryptophan Reduces the Symptoms of Functional Constipation in Elderly Patients
    Cezary Chojnacki, Marta Mędrek-Socha, Aleksandra Błońska, Janusz Błasiak, Tomasz Popławski, Jan Chojnacki, Anita Gąsiorowska
    Nutrients.2024; 16(7): 1027.     CrossRef
  • Predictors of inadequate bowel preparation in older patients undergoing colonoscopy: A systematic review and meta-analysis
    Yuanyuan Zhang, Lining Wang, Wenbi Wu, Shi Zhang, Min Zhang, Wenjing She, Qianqian Cheng, Nana Chen, Pengxia Fan, Yuxin Du, Haiyan Song, Xianyu Hu, Jiajie Zhang, Caiyan Ding
    International Journal of Nursing Studies.2024; 149: 104631.     CrossRef
  • Laxatives in Geriatric Practice: From Preoperative Bowel Preparation to Correction of Chronic Constipation
    V. S. Ostapenko
    Russian Journal of Geriatric Medicine.2024; 16(4): 289.     CrossRef
  • Development and validation of a nomogram to predict the risk of constipation after lumbar interbody fusion surgery
    Mingxin Chen, Si Cheng, Dian Zhong, Tao Hu, Xin Wang, Zhongliang Deng, Qingshuai Yu, Zhengjian Yan
    Archives of Orthopaedic and Trauma Surgery.2024; 144(5): 1907.     CrossRef
  • A survey on functional constipation and its risk factors in older people in Shahreza, Iran
    Mina Amiri, Akbar Hassanzadeh, Majid Rahimi
    Journal of Education and Health Promotion.2024;[Epub]     CrossRef
  • Efficacy and mechanism of acupuncture for functional constipation in older adults: study protocol for a randomized controlled trial
    Yisheng Huai, Qian Fan, Yiyue Dong, Xu Li, Junwei Hu, Lumin Liu, Yuelai Chen, Ping Yin
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • An abdominal vibration combined with walking exercise (AVCWE) program for older patients with constipation: Development and feasibility study
    Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
    Saudi Journal of Gastroenterology.2024; 30(3): 173.     CrossRef
  • Chronic constipation: current options of pathogenetic therapy
    M. D. Ardatskaya, L. I. Butorova, A. A. Anuchkin, I. N. Gaivoronsky, A. I. Pavlov, O. Yu. Patsenko
    Meditsinskiy sovet = Medical Council.2024; (8): 145.     CrossRef
  • Insights into the current state of knowledge, practice, and attitudes of physicians regarding gastrointestinal motility disorders in Egypt
    Enaam Ali Al Mowafy, Marwa M. AboKresha, Sally Waheed Elkhadry, Mohamed Bassam Hashem, Ahmed Elganzory, Sayed Ahmed Sayed, Mohammad Almohamady Khaskia
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • Case Report: Toxic megacolon secondary to chronic constipation and cocaine consumption
    Bertha Dimas, Guillermo Hernández, Ivonne Peralta, Ansony Godinez, Gabriela Gutierrez, Fernando Cruz
    Frontiers in Surgery.2024;[Epub]     CrossRef
  • Efficacy of Whole System Approach Ayurveda Interventions in Vibhanda W. S. R. Old Age Constipation – A Randomized Control Clinical Trial
    Ramesh Shivappa Killedar, Savita Angadi, Uma Shetti, Meghana Patil, Pradeep S. Shindhe, Sheetal Kumar Bolaj
    Journal of Ayurveda.2024; 18(3): 181.     CrossRef
  • The problem of constipation in the practice of an outpatient doctor
    I. G. Pakhomova, A. A. Lelyakova
    Meditsinskiy sovet = Medical Council.2024; (15): 158.     CrossRef
  • Pathological and functional significance of aging mouse kidneys: clinical implications to reduce the risk of hyper- or hypokalemia in the elderly
    Itsuro Kazama
    Kidney Research and Clinical Practice.2024; 43(6): 703.     CrossRef
  • DESIGN, DEVELOPMENT AND EVALUATION OF HERBAL LOZENGES FOR LAXATIVE ACTIVITY
    Ravali K. Battula, Aswani Borrigorla, Sivani Macha, Maddhu L. Palisetty, Sri M. Motupalli, Ravi Ketipally, Ramarao Nadendla
    INDIAN DRUGS.2024; 61(12): 43.     CrossRef
  • Global prevalence of constipation in older adults: a systematic review and meta-analysis
    Nader Salari, Mohammadrasool Ghasemianrad, Mojtaba Ammari-Allahyari, Shabnam Rasoulpoor, Shamarina Shohaimi, Masoud Mohammadi
    Wiener klinische Wochenschrift.2023; 135(15-16): 389.     CrossRef
  • Yaşlılarda Geriatrik Sendromlardan Biri Olan Kırılganlık ve Hemşirelik Bakımı
    Servet KALYONCUO
    Black Sea Journal of Health Science.2023; 6(3): 520.     CrossRef
  • Prevalence, Symptoms, and Associated Factors of Chronic Constipation Among Older Adults in North-East of Peninsular Malaysia
    Patimah Abdul Wahab, Dariah Mohd Yusoff, Azidah Abdul Kadir, Siti Hawa Ali, Lee Yeong Yeh
    Clinical Nursing Research.2022; 31(2): 348.     CrossRef
  • The Intestinal Barrier Dysfunction as Driving Factor of Inflammaging
    Eva Untersmayr, Annette Brandt, Larissa Koidl, Ina Bergheim
    Nutrients.2022; 14(5): 949.     CrossRef
  • Prevalence of constipation and use of laxatives, and association with risk factors among older patients during hospitalization: a cross sectional study
    Hanne Konradsen, Veronica Lundberg, Jan Florin, Anne-Marie Boström
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Effect of Fresh Dendrobe Juice Consumption on Senile Habitual Constipation for Older People: A Four-Week Randomized Controlled Trial
    Yuchao Le, Shihua Cao, Mengxin Wang, Danni He, Yanfei Chen, Beiying Qian
    Sustainability.2022; 14(6): 3656.     CrossRef
  • Effects of Lactobacillus plantarum P9 Probiotics on Defecation and Quality of Life of Individuals with Chronic Constipation: Protocol for a Randomized, Double-Blind, Placebo-Controlled Clinical Trial
    Wenjun Liu, Nong-Hua Lu, Xu Zhou, Yingmeng Li, Yong Xie, Longjin Zheng, Weifeng Zhu, Qiuping Xiao, Ni Yang, Kexuan Zuo, Qingni Wu, Tielong Xu, Heping Zhang, Mohammad Hashem Hashempur
    Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1.     CrossRef
  • The effect of Cassia fistula L. syrup in geriatrics constipation in comparison with the lactulose: A randomized clinical trial
    Farangiz Sepehr, Hoda Shirafkan, Catherine Behzad, Zahra Memariani, Seyyed Ali Mozaffarpur
    Journal of Ethnopharmacology.2022; 297: 115466.     CrossRef
  • Perioperative management of elderly and senile patients. Recommendations
    Igor B. Zabolotskikh, E. S. Gorobets, E. V. Grigoryev, Yu. V. Kotovskaya, K. M. Lebedinskii, T. S. Musaeva, E. A. Mkhitaryan, A. M. Ovechkin, V. S. Ostapenko, A. V. Rozanov, N. K. Runikhina, O. N. Tkacheva, N. V. Trembach, V. E. Khoronenko, M. A. Cherdak
    Annals of Critical Care.2022; (3): 7.     CrossRef
  • Diagnostics of Gastrointestinal Motility and Function: Update for Clinicians
    Amir Mari
    Diagnostics.2022; 12(11): 2698.     CrossRef
  • The mechanism of intestinal flora dysregulation mediated by intestinal bacterial biofilm to induce constipation
    Ruibiao Fu, Zhongpeng Li, Rui Zhou, Chaoyang Li, Shuai Shao, Jin Li
    Bioengineered.2021; 12(1): 6484.     CrossRef
  • Diagnosis and Treatment of Elderly and Senile Chronic Constipation: an Expert Consensus
    V. T. Ivashkin, M. G. Mnatsakanyan, V. S. Ostapenko, А. P. Pogromov, V. M. Nekoval, E. A. Poluectova, Yu. V. Kotovskaya, N. K. Runikhina, N. V. Sharashkina, P. V. Tsarkov, N. O. Tkacheva, Yu. N. Belenkov
    Russian Journal of Gastroenterology, Hepatology, Coloproctology.2021; 31(4): 7.     CrossRef
  • Management of Opioid-Induced and Non–Opioid-Related Constipation in Patients With Cancer: Systematic Review and Meta-Analysis
    Pamela Ginex, Brian Hanson, Kristine LeFebvre, Yufen Lin, Kerri Moriarty, Christine Maloney, Mark Vrabel, Rebecca Morgan
    Oncology Nursing Forum.2020; 47(6): E211.     CrossRef
  • 22,743 View
  • 481 Download
  • 25 Web of Science
  • 34 Crossref
Eosinophilic Esophagitis in Adults: A Concise Overview of an Evolving Disease
Amir Mari, Emmanouela Tsoukali, Afif Yaccob
Korean J Fam Med 2020;41(2):75-83.   Published online February 17, 2020
DOI: https://doi.org/10.4082/kjfm.18.0162
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease that encompasses esophageal symptoms along with eosinophilic infiltration of the esophageal epithelium. EoE is an evolving disease that has been a subject of interest to many researchers since the first studies recognized this condition as a new and distinct clinicopathological entity 25 years ago. Clinical presentation in adult patients may include dysphagia, food impaction, vomiting, and reflux symptoms. The diagnosis of EoE is based on the combination of clinical history suggestive of esophageal dysfunction, endoscopic features indicative of the disease, and histology revealing eosinophilic infiltration of the esophageal epithelium that persists after a trial of proton pump inhibitor therapy along with the exclusion of other disorders that may be associated with esophageal tissue eosinophilia. The interplay between EoE and gastroesophageal reflux disease (GERD) is complex, and differentiating these two conditions continues to be difficult and challenging in clinical practice. The mainstay treatment includes dietary modification, topical steroids, and/or endoscopic dilation. The primary care physician (PCP) plays an important role in improving patient care and quality of life by ensuring early referral and participating in management and follow-up. This article provides an overview of the current knowledge base regarding the disease including epidemiology, genetics, pathogenesis, common clinical presentations, the interplay between EoE and GERD, diagnostic approaches, and therapeutic options available to the PCP.

Citations

Citations to this article as recorded by  
  • A clinical perspective towards oropharyngeal dysphagia management in neurological conditions: a brief literature review
    Samet Tosun, Fenise Selin Karalı, Nilgün Çınar
    The European Research Journal.2025; 11(3): 654.     CrossRef
  • Imaging Findings of Eosinophilic Gastrointestinal Diseases in Adults
    Camila Lopes Vendrami, Linda Kelahan, David J. Escobar, Lori Goodhartz, Nancy Hammond, Paul Nikolaidis, Guang-Yu Yang, Ikuo Hirano, Frank H. Miller
    Current Problems in Diagnostic Radiology.2023; 52(2): 139.     CrossRef
  • Novel Questionnaires for Assessing Signs and Symptoms of Eosinophilic Esophagitis in Children
    Siddhesh Kamat, Andrew Yaworsky, Isabelle Guillemin, Meaghan Krohe, Leighann Litcher-Kelly, Megan McLafferty, Roger E. Lamoureux, Caitlyn Lowe, Mirna Chehade, Jonathan M. Spergel, Kevin Weinfurt, Diane M. Turner-Bowker
    The Journal of Allergy and Clinical Immunology: In Practice.2022; 10(7): 1856.     CrossRef
  • Prevalence of esophageal eosinophilia in patients referred for diagnostic upper gastrointestinal endoscopy
    Nancy Abdel Fattah Ahmed, Hebat-Allah Moheb Amer, Dina Abdallah Ibrahim, Islam Abd El-Hamid El-Zayyadi
    Egyptian Liver Journal.2021;[Epub]     CrossRef
  • The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers’ Experiences
    Amir Mari, Fadi Abu Baker, Helal Said Ahmad, Ali Omari, Yazed Jawabreh, Rand Abboud, Amir Shahin, Fahmi Shibli, Wisam Sbeit, Tawfik Khoury
    Medicina.2021; 57(12): 1336.     CrossRef
  • 7,478 View
  • 171 Download
  • 8 Web of Science
  • 5 Crossref

Brief Communication

Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name
Ka Young Kim, Kangjin Lim, Eal Whan Park, Eun Young Choi, Yoo Seock Cheong
Korean J Fam Med 2016;37(5):303-307.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.303
Background

Patients' perspectives of family medicine according to the physician's identity and role as a primary-care specialist need to be investigated. This study was conducted to investigate the perceived quality of the primary care of family medicine clinics as assessed by patients in a community setting.

Methods

Patients (or their guardians) visiting nine community family medicine clinics were surveyed using the Korean Primary Care Assessment Tool from April 2014 to June 2014. The scores of the Korean Primary Care Assessment Tool domains were compared according to the clinics' designation (or not) as 'family medicine' and the patients' recognition (or not) of the physicians as board-certified family medicine specialists.

Results

A total of 196 subjects responded to the questionnaire. They assessed the community clinics' quality of primary care as moderate to high. Of the clinics, those that were not designated as family medicine scored higher than those that were designated as family medicine (P<0.05). The group of patients that recognized a clinic as that of a board-certified family medicine specialist awarded higher scores than the non-recognition group in the domains of coordination function and personalized care (P<0.05).

Conclusion

The moderate to high scores for the community family medicine clinics' quality of primary care are encouraging. It seems that patients' recognition of the family physician's role and of the physician-patient relationship has a significant influence on their assessment of the quality of primary care.

Citations

Citations to this article as recorded by  
  • Factors influencing contracting of residents with family doctors in China: a national cross-sectional survey
    Ning Zhao, Mei Gu, Jin Li, Haiyan Zhang, Jia Yang
    BMC Health Services Research.2024;[Epub]     CrossRef
  • Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia
    Bashair M Alshammrani, Renad O Aljuhani, Khadijah M Basaqr, Eman A Bin Mahfouz, Ebtisam M Alhawsawi, Reem Alqahtani
    Cureus.2022;[Epub]     CrossRef
  • Aile Hekimliği Uygulamasını Daha Az Tercih Eden Kişilerin Uygulama Hakkındaki Bilgilerinin Değerlendirilmesi: Kesitsel Bir Çalışma
    Fatma Nur ÖZDEMİR, Can ÖNER, Huseyin CETİN, Engin Ersin ŞİMŞEK
    Turkish Journal of Family Medicine and Primary Care.2022; 16(4): 823.     CrossRef
  • In the Name of Family Medicine: A Nationwide Survey of Registered Names of Family Medicine Clinics in Taiwan
    Ya-An Liu, Sally Cheng, Ya-Chuan Hsu, Po-Chin Yang, Hsiao-Ting Chang, Ming-Hwai Lin, Tzeng-Ji Chen, Li-Fang Chou, Shinn-Jang Hwang
    International Journal of Environmental Research and Public Health.2020; 17(11): 4062.     CrossRef
  • Public's perception and satisfaction on the role and services provided by family physicians in Saudi Arabia: A cross-sectional study
    AmnahAli Abdulqader Elagi, BasemAmer Jaber, AlmontherHussain Ahmed Wassly, RubaMohammed Sallam Ahmed, FatimahAli Ahmed Bosily
    Journal of Family Medicine and Primary Care.2019; 8(10): 3282.     CrossRef
  • 4,700 View
  • 41 Download
  • 5 Web of Science
  • 5 Crossref

Original Articles

Cancer Prevalence among Physicians in Korea: A Single Center Study
Hye Lin Kim, Hae Jin Park, Yun Hye Sim, Eun Young Choi, Kyung Won Shim, Sang Wha Lee, Hong Soo Lee, Hyejin Chun
Korean J Fam Med 2016;37(2):91-96.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.91
Background

There is little research regarding whether working as a physician affects cancer risk. Moreover, there is no research on cancer prevalence among physicians in Korea. This study utilized the Korea National Cancer Incidence Database to determine whether the prevalence of cancer among physicians differs from the prevalence of cancer within the general population.

Methods

We analyzed the medical records of a representative sample of 382 doctors who underwent a health examination between 2010 and 2013 at a health examination center in a Ewha Womans University Medical Center.Cancer incidence was measured as cases that were eventually diagnosed as cancer according to a biopsy.

Results

We collected medical records from 382 physicians (mean age, 51.9±8.1 years) and calculated the standardized prevalence ratios compared to the general population. Thirty physicians (9 male and 21 female) were identified as having cancer. Physicians had a significantly higher prevalence of cancer compared to the general population.Cancer prevalence in male physicians was found to be 2.47 times higher than the prevalence expected within the general population (P=0.006). Among female physicians, cancer prevalence was 3.94 times higher than that in the general population (P<0.001).

Conclusion

This study revealed that physicians had a higher prevalence of cancer compared to the general population in Korea, which suggests that there may be a problem present in the health care of physicians. Changes to the working environment of physicians will be needed to reduce the high prevalence of cancer among physicians.

Citations

Citations to this article as recorded by  
  • Analysis of Cancers in A University Hospital Employees between 2006 and 2022
    Serkan ÇELİKGÜN, Tülay KOÇ, Reyhan UÇKU
    Journal of Basic and Clinical Health Sciences.2023; 7(3): 174.     CrossRef
  • Health and Mortality in Korean Healthcare Workers
    Yoonhee Shin, Ui Jeong Kim, Hye Ah Lee, Eun Jeong Choi, Hyun Jin Park, Hyeong Sik Ahn, Hyesook Park
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Importance of lifestyle, stress, and chronic diseases in self-rated health of Korean doctors
    Su Hyun Oh, Jin Suk Kim
    Journal of the Korean Medical Association.2020; 63(9): 566.     CrossRef
  • Cancer Incidence among Healthcare Workers in Cancer Centers: A 14-Year Retrospective Cohort Study in Thailand
    Chatchai Ekpanyaskul, Suleeporn Sangrajrang
    Annals of Global Health.2018; 84(3): 429.     CrossRef
  • Comparison of Cancer Prevalence in Physicians with That of the General Population, and Important Considerations
    Yousef Veisani, Ali Delpisheh
    Korean Journal of Family Medicine.2016; 37(5): 308.     CrossRef
  • 4,502 View
  • 52 Download
  • 5 Web of Science
  • 5 Crossref
Health-Promotion and Disease-Prevention Behaviors of Primary-Care Practitioners
Hwa-Yeon Seong, Eal-Whan Park, Yoo-Seock Cheong, Eun-Young Choi, Ki-Sung Kim, Sang-Wook Seo
Korean J Fam Med 2014;35(1):19-27.   Published online January 23, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.1.19
Background

In the 1990s the primary focus of medicine was shifted to disease prevention. Accordingly, it became the responsibility of primary-care physicians to educate and counsel the general population not only on disease prevention specifically but health promotion generally as well. Moreover, it was, and is still today, considered important that physicians provide positive examples of health-promotion behaviors to patients. The purpose of this study was to investigate physicians' health-promotion behaviors and to identify the factors that influence them.

Methods

We conducted a postal and e-mail survey of the 371 members of the Physician Association of Cheonan City between May 16th and June 25th, 2011. The questionnaire consisted of 18 items, including questions relating to sociodemographic factors, screening tests for adult diseases and cancer, and health habits.

Results

There were 127 respondents. The gender breakdown was 112 men (88.2%) and 15 women (11.8%), and the mean age was 47.8 years. Fifty-nine (46.4%) were family physicians or interns, and 68 (53.6%) were surgeons. Twenty-six percent (26%) were smokers, and 74.8% were drinkers; 53.5% did exercise; 37% had chronic diseases; 44.9% took periodic cancer screening tests, and 72.4% took periodic screening tests for adult diseases.

Conclusion

It was found that general characteristics and other health-promotion behaviors of physicians do not affect physicians' practice of undergoing periodic health examination.

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    Naila A Shaheen, Ahmed Alaskar, Abdulrahman Almuflih, Naif Muhanna, Sufyan Barrak Alzomia, Mohammed A Hussein
    International Journal of General Medicine.2021; Volume 14: 6975.     CrossRef
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Occupational Stress and Physical Symptoms among Family Medicine Residents
So-Myung Choi, Yong Soon Park, Jun-Hyun Yoo, Go-Young Kim
Korean J Fam Med 2013;34(1):49-57.   Published online January 28, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.1.49
Background

The purpose of this study was to examine the levels of occupational stress and physical symptoms among family medicine residents and investigate the effect of subscales of occupational stress on physical symptoms.

Methods

A self-administered questionnaire survey of 1,152 family medicine residents was carried out via e-mail from April 2010 to July 2010. The response rate was 13.1% and the R (ver. 2.9.1) was used for the analysis of completed data obtained from 150 subjects. The questionnaire included demographic factors, resident training related factors, 24-items of the Korean Occupational Stress Scales and Korean Versions of the Wahler Physical Symptom Inventory.

Results

The total score of occupational stress of family medicine residents was relatively low compared to that of average workers. The scores of 'high job demand', 'inadequate social support', 'organizational injustice', and 'discomfort in occupational climate' were within the top 50%. Parameters associated with higher occupational stress included level of training, on-duty time, daily patient load, critical patient assigned, total working days, night duty day, sleep duration, and sleep quality. The six subscales of occupational stress, except for 'Job insecurity', had a significant positive correlation with physical symptom scores after adjustment had been made for potential confounders (total score, r = 0.325 and P < 0.001; high job demand, r = 0.439 and P < 0.001).

Conclusion

After the adjustment had been made for potential confounders, the total score of occupational stress and six subscales in family medicine residents showed a significant positive correlation with physical symptom scores.

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    Heba K. Khalifa, Amira A. Wahdan, Moataz Y. Soliman, Fatma G. Sobeeh
    Egyptian Journal of Forensic Sciences.2024;[Epub]     CrossRef
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    Bo Young Kim, Inah Yoon, Seong John Han, Suk-Kyung Hong, Sehoon Choi, Hyo-Jin Kwon, Eun Key Kim
    Annals of Surgical Treatment and Research.2023; 105(4): 188.     CrossRef
  • ETIOLOGICAL FACTORS DETERMINING OCCUPATIONAL STRESShttps://journals.4science.ge/index.php/jecm/article/view/885
    MARINA TSIMAKURIDZE, NINO KHACHAPURIDZE, MAIA TSIMAKURIDZE, NATO KHUNASHVILI, DALI ZURASHVILI, ETERI MAISURADZE
    EXPERIMENTAL & CLINICAL MEDICINE GEORGIA.2022;[Epub]     CrossRef
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  • Job stress among resident physicians in Tanta University Hospitals, Egypt
    Nadira Mansour Hassan, Mira M. Abu-Elenin, Rania M. Elsallamy, Ibrahim A. Kabbash
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    Haytham I. AlSaif
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    BMJ Open.2017; 7(8): e016479.     CrossRef
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Effects of Brief Advice from Family Physicians on the Readiness to Change of Korean Male At-risk Drinkers
Bora Kwon, Jong Sung Kim, Sung Soo Kim, Jin Gyu Jung, Min Yeong Kim, In Gyu Song, Kwang Mi Youn
Korean J Fam Med 2012;33(3):157-165.   Published online May 24, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.3.157
Background

This study examined the effects of the method of delivery of brief advice on the readiness to change in at-risk drinkers.

Methods

The participants were 103 at-risk male drinkers who visited Chungnam National University Hospital for general health examinations. Baseline data on drinking behavior, readiness to change drinking behavior, and sociodemographic characteristics were obtained from a questionnaire. Family physicians gave two minutes of advice by telephone or in-person. The brief advice comprised a simple statement that the patient's drinking exceeded the recommended limits and could lead to alcohol-related problems. It also included advice to moderate one's drinking. One month later, the readiness to change was assessed again by telephone. The improvement in the readiness to change according to each method of delivery was investigated.

Results

Initially, among the 58-patient in-person advice group, 12 patients were in the precontemplation stage, 38 in the contemplation stage, and 8 in the action stage. One month after the advice was given to the patients, the distribution had changed significantly (P < 0.001) to 1, 21, and 36 patients, respectively. Among the 45-patient telephone advice group, 7 patients were in the precontemplation stage, 32 patients were in the contemplation stage, and 6 patients were in the action stage before the advice. The distribution had changed significantly (P < 0.001) to 1, 17, and 27 patients, respectively, 1 month after the advice.

Conclusion

These results suggest that brief advice by family physicians is effective in improving the readiness to change of at-risk drinkers, regardless of the delivery method.

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Qualitative Research on Experience of Primary Physicians Operating Their Primary Health Care Centers.
Daegeun Lee, Myung Sun Yi, Eun Young Park, Sung Hee Jo, Sang Min Park
Korean J Fam Med 2010;31(4):275-283.   Published online April 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.4.275
Background
The purpose of the study was to understand how family physicians managed their primary health care centers and to identify the factors for successful management of their privative clinics. Methods: The data was collected through individual interviews from five family physicians who operated their private clinics. All interviews were tape-recorded and transcribed into verbatim data. The data was analyzed using qualitative content analysis. Results: Three major categories were identified: 1) types of physician based on major value as a doctor; 2) difficulties in operation and management; 3) desirable operating strategies for success. The first category described what kinds of value the physicians pursued as they operated their private clinics. Two different types were identified. One was intrinsic value oriented and the other was extrinsic value oriented. The second category illustrated many difficulties that family physicians faced in operating and managing their private clinics. Lack of private time, social isolation, and gap between mission and reality of practice were identified as major difficulties. Desirable strategies for the successful management were four subcategories: location; self-oriented developmental plan; specialization of the services; and activating network with larger hospitals. Conclusion: The results of the study would be helpful in setting up and operating private clinics through understanding the difficulties and strategies of primary physicians and recognizing mission and major value of them.
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Attitudes toward Smoking Cessation Intervention and Services among Korean Physicians: A Questionnaire Survey.
Cheol Hwan Kim, Hye Ryoung Song, Won Sik Lee, Ji Yoon Kim
Korean J Fam Med 2009;30(11):857-863.   Published online November 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.11.857
Background
There are limited data regarding smoking cessation treatment by physicians in Korea. Thus, we investigated the attitude to smoking cessation intervention and services among Korean physicians. Methods: This survey was conducted in 987 participating physicians who had experiences in smoking cessation services. The subjective diffi culties of smoking cessation services and its causes and the presumptive reasons for failure of smoking cessation among their patients were investigated using questionnaires. Results: Overall smoking rate among Korean physicians who participated in this survey was 12.6%. Most participating physicians had a diffi culty in smoking cessation services and its causes were high cost of medication for smoking cessation due to non-imbursement (50.7%) and the absence of a medical fee on smoking cessation services (34.8%). The high cost of medication for smoking cessation due to non-imbursement (29.5%) also ranked high in the presumptive reasons for failure of smoking cessation among their patients. Conclusion: The smoking rate of Korean physicians in this survey was lower than those of the general population. Most participating physicians had a difficulty in offering smoking cessation services. And the most common cause for the diffi cult was non-imbursement of their services and medication.

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    Rebekah Gunter, Edwin Szeto, Se-Hoon Jeong, Sooyeon Suh, Andrew J. Waters
    Korean Journal of Family Medicine.2020; 41(1): 3.     CrossRef
  • Association and affecting factor between smoking and suicide idea: Focusing on comparison between district
    Seonhwa Yu, So Young Kim, Bo Ram Park, Mi-na Jo, Siekeyong Kim, Jong Hyock Park
    Korean Journal of Health Education and Promotion.2018; 35(3): 1.     CrossRef
  • Effect of Standardized Smoking Cessation Training Program for Healthcare Professionals on Their Knowledge
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  • The Prevalence of and Factors Associated with the Use of Smoking Cessation Medication in Korea: Trend between 2005–2011
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    PLoS ONE.2013; 8(10): e74904.     CrossRef
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Use of Dietary Supplements in Cancer Patients.
Bong Cheol Kim, Yun Mi Song, Seung Jin Park, Sun Young Kim, Jung Im Gwak
Korean J Fam Med 2009;30(8):632-640.   Published online August 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.8.632
Background
Dietary supplements (DS) have been increasingly utilized as a way of the promoting health and com-plementary therapy. This study aimed to evaluate the patterns of dietary supplement use in Korean cancer patients and to examine the related factors. Methods: Between April and May of 2008, 366 patients who were hospitalized for diagnosis and treatment of cancer in a university affiliated tertiary hospital were surveyed using a self-administered structured questionnaire after receiving written informed consent. Among them, 322 patients with adequate answers were fi nally included. Results: Two hundred forty patients (72.3%) reported to have ever taken DS with the mean number of 3.6 ± 2.98. Vitamins were the most frequently used, followed by ginseng steamed red, ginseng, and glucosamine. The most infl uential factor regarding DS use was the recommendation by family members or relatives. The main reason for DS use was for resolution of fatigue, followed by supplementation of therapy, and immune enhancement. Information concerning DS most eager to know about was the effect of DS (44.6%), followed by interaction of DS with therapeutics (33.2%). Doctor (74.4%) was the most preferred health care provider to be consulted concerning DS, but only 34% of DS users have actually consulted with a doctor. Multiple logistic regression analysis showed that increasing age, Catholicism, and higher educational level were associated with higher use of DS. Conclusion: DS use was very prevalent in cancer patients. In spite of the great need, only small proportion of cancer patients using DS has consulted with a doctor.

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  • Korean Red Ginseng extract reduces hypoxia-induced epithelial-mesenchymal transition by repressing NF-κB and ERK1/2 pathways in colon cancer
    Eui Joo Kim, Kwang An Kwon, Young Eun Lee, Ju Hyun Kim, Se-Hee Kim, Jung Ho Kim
    Journal of Ginseng Research.2018; 42(3): 288.     CrossRef
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  • 1 Crossref
Perspectives of Primary Care Physicians toward Sexual History Taking in Routine Clinical Practice.
Su Hyun Kim, Young Mee Lee
J Korean Acad Fam Med 2008;29(4):269-275.   Published online April 10, 2008
Background
Physicians rarely take patients' sexual history during routine medical visit, although it would give very helpful information to reach accurate diagnosis and proper management. This survey was conducted to assess the primary physicians' perspectives towards sexual history taking and their actual behaviors on it. Methods: The survey questionnaire was made through the literature review, in-depth interview and pilot survey. We mailed this questionnaire to 400 primary care physicians who were randomly selected from the lists of internists and family physicians in Seoul and Gyunggi province and 73 of them responded. Results: The mean age of the respondents was 44.3 years. Most of them responded that sexual history is necessary only when the patients' chief complaints are directly related to sexual issues. Among the total, 94% of them answered that he or she took sexual history in less than 25% of the patients who visited his/her own clinic during last one month. The most prevalent barriers to initiate sexual history taking were fear of patients' misunderstanding about sexual harassment or intrusion into patients' personal life (60.3%) and uncertainty to conducting sexual history taking (53.4%). They thought that they were not well educated enough to take sexual history with confidence and more structured education is needed in medical schools and postgraduate residency training. Conclusion: Sexual history seemed not to be taken by primary care physicians as a routine medical practice and physicians showed rather passive attitude. Beneficial effects of sexual history taking on patients' management and related communication skills should be emphasized and systematically educated. (J Korean Acad Fam Med 2008;29:269-275)
  • 1,243 View
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Smoking Prevalence and Habits of Physicians in Korea: a Mail Questionnaire Survey Conducted in 2000.
Hong Gwan Seo, Seon Ha Ji, Hyung Joon Jhun
J Korean Acad Fam Med 2007;28(8):599-603.   Published online August 10, 2007
Background
Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. Methods: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. Results: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15∼20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). Conclusion: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed. (J Korean Acad Fam Med 2007;28:599-603)
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PAP Smear-screening in Primary Care Women Physicians and Its Influence on Patients.
Soon Ok Kim, Dae Gyeun Kim, Jun Su Kim, Jung Kwon Lee, Jun Hyun Yoo
J Korean Acad Fam Med 2007;28(8):589-598.   Published online August 10, 2007
Background
PAP smear has been highly appraised for screening cervical cancer. Generally regarded is that women physicians regularly screen for PAP would promote patients' early detection and treatment rate by their strong recommendation. Hereby we investigated PAP-screening in primary care women physicians, recommending proportion and associated factors. Methods: Questionnaires were sent to 981 members of the Korean Academy of Family Medicine, Korean Association of Family Practitioners, Korean Medical Women's Association, and Songpa-gu and Kangdong-gu family practitioners. a total of 193 respondents was analyzed. Results: Among the total 55.4% of the respondents screened for PAP smear regularly, either annually (23.9%), or from their treating gynecologists (61.6%) or through routine check-up (81.1%). Common reasons for not screening were lack of time (40.7%) and forgetfulness (38.4%). Recommending proportion for PAP to patients was 49.2%. Reasons for not recommending were lack of equipment, forgetfulness (18.8% each). Confidence of PAP as a screening test was very high (71.5%); significantly related to PAP-screening and to recommending proportion (P=0.033, P=0.005, respectively). Many of the respondents thought physician's own PAP-screening affected its recommendation (45.3%), whereas significant relation to their actual PAP-screening was not found (P=0.845). PAP-screening in physicians showed no significant relationship with recommending proportion (P=0.053). Internal disease history had meaningful relation only with recommending proportion (P=0.001). Conclusion: Though physicians show strong confidence in PAP and undergo more than the general public, most do not screen for it regularly and the recommending proportion was low. To improve physician's PAP-screening and recommending proportion, re-education of physicians and provision of proper clinical equipment are required. (J Korean Acad Fam Med 2007;28:589-598)
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Family Physician's Knowledge, Attitude, Experience and Training on Breastfeeding.
Hai Lim Kim, Hong Soo Lee, Young A Oh, Su Yun Kim
J Korean Acad Fam Med 2006;27(2):120-127.   Published online February 10, 2006
Background
: Breastfeeding is not common in Korea despite its known benefits. The role of family physicians is important in promoting breast-feeding since they can provide prenatal and postnatal care on lifelong basis. This paper analyzed a survey of family physicians on their knowledge, attitude, experience, and training concerning breastfeeding.

Methods : The survey was carried out by e-mail enquiry to the residents and board-certified physicians registered in the Korean Academy of Family Medicine. The enquiry was developed by Gary L. Freed composed of 18 questions about knowledge, attitudes, experience, and training. The answers to the questions were analyzed to give frequency and the associations between the variables.

Results : Among the total, 64% of the residents and 76% of the physicians answered yes to whether breastfeeding was the best means of feeding an infant under 6 months of age. Also, 83% of the residents and 85% of physicians answered it was right to quit breastfeeding completely when breast abscess developed. The breastfeeding promotion was done more frequently by those who had personal experience. They had higher rate of educating patients than those who did not (28% vs. 9%, P<0.0001). Despite its importance, 86.5% of the residents and 77.6% of the physicians answered that they did not have enough opportunity to learn about breastfeeding during their training years.

Conclusion : Although family physicians are required to play a role in promoting breastfeeding, they are insufficiently trained under the current system. Therefore, it is necessary to develop a training program to educate the residents on breastfeeding.
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Understanding the Culture of Antibiotics Prescribing of Primary Physicians for Acute Upper Respiratory Infection.
Soong Nang Jang, Nam Soon Kim
J Korean Acad Fam Med 2004;25(12):901-907.   Published online December 10, 2004
Background
: To understand why primary physicians prescribe antibiotics for some cases of acute upper respiratory infections and to explore the factors that influence their prescribing.

Methods : Qualitative analysis of semi-structured interviews. Participants were 12 primary physicians in the maximum variety sample.

Results : Interviewees were identified the problems of antibiotics abuse and misuse in Korea. Primary physicians were certain that patients will benefit from antibiotics and prescribe for the patients' expectation of fast relief. Doctors are mostly comfortable with their prescribing decisions by their clinical experiences. They are also more likely to prescribe antibiotics in pressures of time and in competitive clinical environment.

Conclusion : Multiple factors are involved in primary physicians' decision of their prescribing for acute upper respiratory infections. Further interventions to reduces prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations. Repeating evidence for lack of effectiveness and lack of efficiency in general might be helpful.
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Review

A Brief Discussion on Family Medicine in Edmonton, Alberta, Canada.
Lina Bohee Kim, Chang Won Won, Yun Jin Kim
J Korean Acad Fam Med 2003;24(7):605-611.   Published online July 10, 2003
In early May 2003, a small group of four, including three family physicians and a media person, visited various family medicine education and training facilities in Edmonton, Alberta, Canada. This paper is a brief discussion of what knowledge and insight was gained during this trip.
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Original Articles
Verification of Job Description for Korean Family Physicians.
Hoon Ki Park, Jong Lull Yoon, Jae Ho Lee
J Korean Acad Fam Med 2002;23(6):740-752.   Published online June 30, 2002
  • 1,267 View
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Recognition and behavior of family physicians working in private clinic on continuing medical education.
Sang Peel Bae, Su Jin Kim, Hong Jun Cho, Ji Hyun Ahn
J Korean Acad Fam Med 2001;22(12):1806-1813.   Published online December 1, 2001
Background
: Obligatory continuing medical education was applied by medical law for lifelong education to physicians in Korea. A new method of continuing medical education was needed because of wide-spread and easy access to internet which resulted in improved public knowledge of medicine, and appearance of a new internet site for doctors's continuing medical education.

Methods : A questionnaire was sent twice by mil and fax to randomly selected 256 office based family physicians in Seoul and Kyonggi Province in May 2001 and 124 available responses were received.

Results : The response rate to the questionnaire was 50.7%. Median studying time per week for the past one year of the responders was 3 hours and there was no significant correlation in studying time per week with duration in practice, age, sex, or internet accessibility at clinic. The group with more than or equal to 6 years in duration of practice was significantly more than the group of participating academic conferences(P=0.027), number of participating lectures for office based physicians(P=0.001) and points of formal continuing medical education(P=0.002). The practice pattern change after attendance was 51.3% in 5years or less in duration of practice, 42.7% in 6years on more. Main causes of being reluctant to attend continuing medical education activities were 'no practical content' and 'long distance'.

Conclusion : For the improvement of quality of care by continuing medical education, practical program applicable to the clinical practices should be developed and continuing medical education activities be carried out in various areas.
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Job analysis of family physicians in Korea.
Hoon Ki Park, Jong Lull Yoon, Jae Ho Lee, Jee Hyuck Yim, Byung Wook Doh
J Korean Acad Fam Med 2001;22(6):811-827.   Published online June 1, 2001
Background
: The role and future of family physician are not yet clearly determined even when 20 years lapsed since its introduction to korea. This study was conducted to establish identity of family physician, to develop pragmatic. curriculum of training, and to sort out frame of certification exam by analysing the job of family physicians who were practicing in community.

Methods : We analysed the job of practicing family physician by using DACUM(Development of Curriculum) method from March 11, 2000 through March 12. Job analysis team was composed of five practitioners, four professors, one facilitator, and one scriber. Six sessions of 2 hours were mainly devoted to brain storming of the idea related to family physician.

Results : Job analysis results are as follows. Family physician was defined as "primary care physician who provides primary medical service continuously and comprehensively by offering individual patient and/or family health promotion, disease prevention, and treatment of common illness". Family physician had seven duties and 129 tasks. The duty of physical exam had 18 tasks, duty of test, 21 tasks, duty of treatment, 40 tasks, duty of health promotion and disease prevention, 15 tasks, duty of patient/client, management, 12 tasks, duty of clinic management, 15 tasks, and self-development, 8 tasks respectively. Number of tasks whose impotance was classified as 'A'(very important) were 43 as total, 3 in physical exam, 7 in test, 9 in treatment, 11 in health promotion and disease prevention, 2 in patient/client management, 9 in clinic management, and 2 in self-development respectively. Number of tasks whose difficulty was classified as 'A'(very dif-ficult) were 19 as total. 2 in physical exam, 7 in test, 7 in treatment, 1 in clinic management, and 2 in self-development respectively. Number of tasks whose frequency was classified as 'A'(very frequent) were 22 as total, 6 in physical exam, 1 in test 8 in treatment, 3 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively. Number of tasks which were required for entry level were 74 as total, 18 in physical exam, 14 in test, 29 in treatment, 9 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively.

Conclusion : Family physicians in Korea perform 7 duties and 129 tasks. Seventy four tasks are required to enter into the job.
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The effect of diet education provided by physicians and dieticians on serum lipid profiles during more than 1 year.
Ka Young Lee, Tae Jin Park, Eun Ryung Kwon, Ki Jung Kim
J Korean Acad Fam Med 2000;21(12):1523-1533.   Published online December 1, 2000
Background
: The purpose of this study was to compare the long-term effect of the cholestreol-lowering diet education provided by physicians with the education provided by dieticians on serum lipid profiles of hypercholestreolemic patients.

Methods : Among 248 ambulatory patients who had mean baseline serum total cholesterol (TC) level >200mg/dL and received cholesterol-lowering diet education from physicians or dieticians, 41 patients who checked serum lipid profiles three times during the mean of 403 days after education were included as subjects. The differences in means of all serum lipid profiles associated with education methods after controlling for follow-up duration, differences in means of all serum lipid profiles associated with follow-up duration after controlling for education methods, any interaction between education methods and follow-up duration on serum lipid profiles were analyzed by using repeated measures of analysis of variance. The difference between the baseline lipid levels and the third lipid levels after education were analyzed by using Wilcoxon signed ranks tests in each group. Correlations between baseline serum lipid profiles and the last changes in serum lipid profiles were analyzed.

Results : There were no significant differences in means of all serum lipid profiles associated with education methods of follow-up duration except LDL-cholesterol (LDL-C). The first LDL-C level after education was significantly lower in the group educated by physicians compared with the baseline LDL-C, but there was no such change in the group educated by dieticians. There were no interactions between education methods and follow-up duration on all serum lipid profiles. The last change of total cholesterol in both groups and LDL-C only in the group educated by dieticians were significant. Correlation coefficients between baseline triglyceride (TG) and change in TG, baseline LDL-C and change in LDL-C, baceline total cholesterol (TC) and change in TC in patients with TC 240mg/dL were -0.500 (P=0.002), -0.597 (P<0.001), and -0.578 (P=0.001), respectively.

Conclusion : The changes of serum lipid profile during more than 1 year after education were not significantly different according to diet education methods, but total cholesterol level was significantly degreased in both groups.
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Computer use and factors affecting computer use by family physicians.
Sun Im Moon, Hye Ree Lee
J Korean Acad Fam Med 2000;21(4):479-488.   Published online April 1, 2000
Background
: Computer can in many ways improve the quality and efficacy of medical care. The purpose of this study was to perform a comprehensive survey of present computer use and investigate the factors affecting computer use by family physicians.

Methods : 1250 family physicians were surveyed by mail from May to August, 1999. The survey protocol included demographic characteristics, opinions on computer use in medicine, present computer usages and wanted applications in the future.

Results : Of the 306 responses received, 291 responses were analysed, 91.4% replied that they used computers in the medical field, and 58.1% said they used computers during medical interview. Factors preventing computer use in medicine were cost(33%), time(16%), insufficient information(14%), the doctor-patient relationship(12%) and no perceived need(6%). While 46% of the responders who used computers in the medical field cited fellow doctors for their interest in computer use in the medical field, only 6.2% answered that medical societies or associations had promoted their interest. Present usage of computers included word processing. online communication, internet, medical insurance billing, in descending order. Factors affecting the present degree of computer use that were statistically significant, were the computer system used, factors preventing computer use and the preset form of practice.

Conclusion : Although, most family physicians use computers in the medical field, its use is still limited to a few areas.
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Professional satisfaction of family physicians in south korea.
Jae Ho Lee
J Korean Acad Fam Med 1999;20(12):1697-1708.   Published online December 1, 1999
Background
: Physicians’ satisfaction with their professional life influences the quality of patient care they provide and helps to determine the number and type of students attracted to the various fields of medicine. In South Korea, two decades have passed already since the introduction of family medicine. But, S. Korean health policy has not developed a strong plan a strong plan to control a high medical cost and ineffective utilization of medical resources. Additionally, the number of students applying for family medicine is less than that for internal medicine or pediatrics. The purpose of this study was to de-lineate factors relation to professional satisfaction among family physicians in South Korea.

Methods : The subjects were 840 family physicians who had been trained formally and registered to the Korean Academy of Family Physicians. The self-administered questionnaires were collected by three mailings during March 18 to May 24 in 1998.

Results : Completed questionnaires were received from 292 South Korean family physicians. With respect to income, there showed ‘satisfaction in 31.4%, ‘middle’ 47%, and ‘dissatisfaction’ 20.5%(no response 1.0%). Three periods of certification acquisition(P=0.001), four practice types(P=0.005), and three degrees of training satisfactioni(P=0.003) had significantly different degrees of satisfaction. In the aspect of pride as a family physician, there showed ‘high’ in 42.1%, ‘middle’ 45.8%, and ‘low’ 10.9%(no response 1.2%). In the aspect of future view as a family physician, there showed ‘bright‘ in 40.6%, ‘middle’ 40.6%, and ‘dark’ 17.6%(no response 1.2%).
After confounding variables were controlled, practice types(faculty family physicians rather than private practitioners) (P=0.003), the degree of training satisfaction(P=0.001, positive relationship), and the number of patients encountered per an hour(P-0.0098, positive relationship) were significant variables of the degree of general professional satisfaction.

Conclusion : Though standard measure of professional satisfaction have not been developed, this survey result seems to help understand factors relating to professional satisfaction of S. Korean family physicians. This information may be useful in the development of policy to structure a primary care oriented health care system in S. Korea.( J Korean Acad Fam Med 1999;20:1697-1708)
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BACKGROUND
Importance of the participation of clinical practitioners in the development of guideline is increasingly emphasized. We studied the attitude of family physicians to the guideline for hypertension management and compared it with their reported practice patterns.
METHODS
We developed a guideline for hypertension management with reference to other guidelines previously published and used by WHO and health organizations in many countries. A questionnaires asking attitude to the contents of the guideline and real practice pattern was sent to 200 Korean family physicians. Response rate to the questionnaire was 27.5%.
RESULTS
The agreement rate to annual blood screening in persons aged 15 and older was 87%, while the reported practice rate in most of patients was only 42%. The agreement rates to medical history taking in hypertensives were high in all items, but reported practice rate was very low. The agreement rates to physical examination in hypertensives were relatively high in all items, while reported practice rate was high only in lung and heart examination. The reported practice rate of laboratory tests were less than 60% and that of electrolyte check was only 22%. Most of the study subjects agreed with all behavior modification methods. Although 80% of the subjects agreed that diuretics or beta blocker should be used as an initial regimen, the reported practice rate was only 36 %.
CONCLUSION
There observed a big difference between attitude to the guideline and reported practice pattern in this study. It showed the need to narrow the gap between them.
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