To examine the career prevalence of abusive encounters for family physicians in Canada. A 7-page cross-sectional mailed survey in English and French. Canada. A total of 3802 randomly selected practising family physicians who were members... more
To examine the career prevalence of abusive encounters for family physicians in Canada. A 7-page cross-sectional mailed survey in English and French. Canada. A total of 3802 randomly selected practising family physicians who were members of the College of Family Physicians of Canada. Demographic characteristics of survey participants, career prevalence of abusive encounters, and perpetrators of abuse. Twenty percent (20.4%) of the surveys (n = 774) were returned. Of the respondents, 44% were men and 56% were women. Most were in private practice in urban settings. The average number of years in practice was 15. The career prevalence of abusive encounters was divided into "minor," "major," and "severe" incidents. Of all the respondents, 98% had experienced at least 1 incident of minor abuse, 75% had experienced at least 1 incident of major abuse, and 39% had experienced at least 1 incident of severe abuse. Using chi(2) analysis, a number of demographic va...
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Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. Methods. A 7-page cross-sectional survey. Results. Of the entire study sample (N=720), 29% of the... more
Objective. The goal of this study was to examine the monthly incidence rates of abusive encounters for family physicians in Canada. Methods. A 7-page cross-sectional survey. Results. Of the entire study sample (N=720), 29% of the physicians reported having experienced an abusive event in the last month by a patient or patient family member. Abusive incidents were classified as minor, major, or severe. Of the physician participants who reported having been abused, all reported having experienced a minor event, 26% a major, and 8% a severe event. Of the physicians who experienced an abusive event, 55% were not aware of any policies to protect them, 76% did not seek help, and 64% did not report the abusive event. Conclusion. Family physicians are subjected to significant amounts of abuse in their day-to-day practices. Few physicians are aware of workplace policies that could protect them, and fewer report abusive encounters. Physicians would benefit from increased awareness of institut...
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Research Interests: Violence, Organizational Culture, Family Medicine, Qualitative Research, Medicine, and 13 moreSexual Harassment, Social behavior, Canada, Workplace, Humans, Philosophy and Religious Studies, Female, Male, Harassment, Questionnaires, Social Behavior, Cross Sectional Studies, and Medical and Health Sciences
To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members... more
To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members of the College of Family Physicians of Canada in 2009. Surveys were mailed to a random sample of family physicians (N = 3802), and 37 family physicians who had been abused in the past year participated in telephone interviews. A total of 770 surveys (20%) were completed. A small number of respondents reported having been subjected to abuse by physician colleagues (9%) or coworkers (6%) in the previous month. Many of the respondents reported that the same physician colleagues or coworkers were repeat abusers. More than three-quarters (77%) of the physician-colleague abusers were men, whereas more than three-quarters (77%) of the other coworker abusers were women. Interviewed family physicians described feeling humiliated and unappreciated, and devel...
Research Interests: Violence, Family Medicine, Bullying, Research, Medicine, and 15 moreAnxiety, Self Efficacy, Social behavior, Canada, Humans, Female, Male, Feeling, Self Concept, Questionnaires, Public health systems and services research, ANXIETY, Social Behavior, Interviews as topic, and interprofessional relations
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To determine the views of family physicians regarding selected asthma recommendations from a Canadian practice guideline and the supporting evidence, and to identify issues needing further development if family physicians are to find... more
To determine the views of family physicians regarding selected asthma recommendations from a Canadian practice guideline and the supporting evidence, and to identify issues needing further development if family physicians are to find guideline recommendations to be truly useful clinical tools. Four urban communities in Nova Scotia, Prince Edward Island and New Brunswick. Twenty community family physicians representing different practice settings, and varying according to age and sex, were recruited to participate. Four focus groups were held, each lasting 2 h, at which recommendations from a published asthma guideline were presented for discussion on the applicability to their practices. The data were analyzed using a grounded theory method. Physicians rely on clinical judgment in lieu of objective measures in diagnosing asthma and resist treating every exacerbation with steroids. They thought that the recommendations on smoking and patient education should have been stronger or mor...
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To determine the views of family physicians regarding selected asthma recommendations from a Canadian practice guideline and the supporting evidence, and to identify issues needing further development if family physicians are to find... more
To determine the views of family physicians regarding selected asthma recommendations from a Canadian practice guideline and the supporting evidence, and to identify issues needing further development if family physicians are to find guideline recommendations to be truly useful clinical tools. Four urban communities in Nova Scotia, Prince Edward Island and New Brunswick. Twenty community family physicians representing different practice settings, and varying according to age and sex, were recruited to participate. Four focus groups were held, each lasting 2 h, at which recommendations from a published asthma guideline were presented for discussion on the applicability to their practices. The data were analyzed using a grounded theory method. Physicians rely on clinical judgment in lieu of objective measures in diagnosing asthma and resist treating every exacerbation with steroids. They thought that the recommendations on smoking and patient education should have been stronger or mor...
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To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members... more
To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members of the College of Family Physicians of Canada in 2009. Surveys were mailed to a random sample of family physicians (N = 3802), and 37 family physicians who had been abused in the past year participated in telephone interviews. A total of 770 surveys (20%) were completed. A small number of respondents reported having been subjected to abuse by physician colleagues (9%) or coworkers (6%) in the previous month. Many of the respondents reported that the same physician colleagues or coworkers were repeat abusers. More than three-quarters (77%) of the physician-colleague abusers were men, whereas more than three-quarters (77%) of the other coworker abusers were women. Interviewed family physicians described feeling humiliated and unappreciated, and devel...
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This study examined the work environment of rural family physicians in New Brunswick, a province in eastern Canada. The purpose of the research was to explore the job satisfaction of rural family physicians based on gender, age, years in... more
This study examined the work environment of rural family physicians in New Brunswick, a province in eastern Canada. The purpose of the research was to explore the job satisfaction of rural family physicians based on gender, age, years in practice, and language and location of practice. We used a qualitative, collective case study approach (24 cases of two individuals each: 48 interviews). Cases were selected based on gender, location (urban/rural), language (French/English) and number of years since medical school graduation (<10 years, 10-20 years, >20 years). The data reported is based on 21 interviews with rural physicians. Participants were recruited using the College of Physicians and Surgeons of New Brunswick website information. The research team traveled to physicians' offices throughout the province of New Brunswick to conduct interviews in the language of preference of the physician (French or English). Male researchers interviewed male participants and female re...
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To determine use of breast cancer screening and barriers to screening among women in First Nations communities (FNCs). Structured, administered survey. Five FNCs in New Brunswick. One hundred thirty-three (96%) of 138 eligible women... more
To determine use of breast cancer screening and barriers to screening among women in First Nations communities (FNCs). Structured, administered survey. Five FNCs in New Brunswick. One hundred thirty-three (96%) of 138 eligible women between the ages of 50 and 69 years. After project objectives, methods, and expected outcomes were discussed with community health representatives, we administered a 32-item questionnaire on many aspects of breast cancer screening. Rate of use of mammography and other breast cancer screening methods, and barriers to screening. Some 65% of participants had had mammography screening within the previous 2 years. Having mammography at recommended intervals and clinical breast examinations (CBEs) yearly were significantly associated with having had a physician recommend the procedures (P < .001). A family history of breast cancer increased the odds of having a mammogram 2.6-fold (P < .05, 95% confidence interval [CI] 1.03 to 6.54). Rates of screening di...
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To explore the tensions between professional and personal boundaries and how they affect the work and private lives of family physicians. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight... more
To explore the tensions between professional and personal boundaries and how they affect the work and private lives of family physicians. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the t...
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To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians... more
To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis...
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To create a list of core and enhanced procedures suitable for family medicine training. Mailed or e-mailed survey using a Delphi technique. Randomly selected family physician practices across Canada. Family physicians from urban,... more
To create a list of core and enhanced procedures suitable for family medicine training. Mailed or e-mailed survey using a Delphi technique. Randomly selected family physician practices across Canada. Family physicians from urban, small-town, and rural practice locations and academic family physicians. All were experienced family physicians with from 3 to 36 years in practice. Participant physicians were asked to rate each of 158 procedures as to whether they would expect a graduate from a Canadian family practice training program to have learned and be capable of performing that procedure in their own community. In a second survey, participants were asked to verify the core and enhanced procedures lists produced from the first survey. Physicians' opinions about a comprehensive list of skills. Twenty-two physicians responded to the first survey (92% response rate) and 14 to the second (58% response rate). Sixty-five core procedures and 15 enhanced procedures were identified in th...
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To explore and describe primary care physicians' experiences in providing care to depressed patients and to increase understanding of the possibilities and constraints around diagnosing and treating depression in primary care.... more
To explore and describe primary care physicians' experiences in providing care to depressed patients and to increase understanding of the possibilities and constraints around diagnosing and treating depression in primary care. Qualitative study using personal interviews. A hospital region in eastern Canada. A purposely diverse sample of 20 physicians chosen from among all 100 practising family physicians in the region. Invitations were mailed to all physicians practising in the region. Twenty physicians were chosen from among the 39 physicians responding positively to the invitation. Location of practice, sex, and year of graduation from medical school were used as sampling criteria. The 20 physicians were then interviewed, and the interviews were audiotaped and transcribed verbatim. Data were analyzed using a constant comparative approach involving handwritten notes on transcripts and themes created using qualitative data analysis software. Three themes related to diagnosis eme...
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One distressing health problem facing breast cancer patients is breast cancer-related lymphedema (BCRL). This incurable condition can occur many years after treatment is completed and often causes pain and disability and interferes with... more
One distressing health problem facing breast cancer patients is breast cancer-related lymphedema (BCRL). This incurable condition can occur many years after treatment is completed and often causes pain and disability and interferes with work and activities of daily living. Patients at risk of BCRL are those who have received radiation therapy or axillary node dissection; higher incidence is reported among patients who have had both radiation and dissection. Our objective was to explore New Brunswick women's experiences of BCRL and its treatment. A focus group and 15 individual in-depth interviews. Province of New Brunswick. A diverse sample of 22 women with BCRL was obtained using age, location, time after breast cancer diagnosis, and onset of BCRL symptoms as selection criteria. The focus group discussion guided development of a semistructured interview guide that was used for 15 individual interviews exploring women's experiences with BCRL. Four themes emerged from the int...
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The purpose of this study was to find out, from the patient's perspective and using qualitative methodology, how cancer follow-up care is managed in a New Brunswick health region. From focus group discussions with 23 participants... more
The purpose of this study was to find out, from the patient's perspective and using qualitative methodology, how cancer follow-up care is managed in a New Brunswick health region. From focus group discussions with 23 participants 1-year post-cancer diagnosis, 3 prominent themes emerged: fear of recurrence, cancer surveillance/testing and support issues. The fear of recurrence permeates day-to-day life for many patients. To allay these fears, some patients feel a need to be subjected to extensive cancer surveillance. Emotional support, which is important for survivors, is complex. The majority of the participants in this study received cancer follow-up care from specialists. More rural than urban participants received their follow-up care from their family physicians (FPs). Participants had high expectations for follow-up care, regardless of which type of physician--specialist or FP--provided it. If physicians did not provide the level and intensity of care expected by their pati...
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To assess family physicians' and specialists' involvement in cancer follow-up care and how this involvement is perceived by cancer patients. Self-administered survey. A health region in New Brunswick. A nonprobability cluster... more
To assess family physicians' and specialists' involvement in cancer follow-up care and how this involvement is perceived by cancer patients. Self-administered survey. A health region in New Brunswick. A nonprobability cluster sample of 183 participants. Patients' perceptions of cancer follow-up care. More than a third of participants (36%) were not sure which physician was in charge of their cancer follow-up care. As part of follow-up care, 80% of participants wanted counseling from their family physicians, but only 20% received it. About a third of participants (32%) were not satisfied with the follow-up care provided by their family physicians. In contrast, only 18% of participants were dissatisfied with the follow-up care provided by specialists. Older participants were more satisfied with cancer follow-up care than younger participants. Cancer follow-up care is increasingly becoming part of family physicians' practices. Family physicians need to develop an approa...
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To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members... more
To assess the effects of physician-colleague and coworker abuse on family physicians in Canada. A mixed-methods, bilingual study that included surveys and telephone interviews. Canada. Family physicians in active practice who were members of the College of Family Physicians of Canada in 2009. Surveys were mailed to a random sample of family physicians (N = 3802), and 37 family physicians who had been abused in the past year participated in telephone interviews. A total of 770 surveys (20%) were completed. A small number of respondents reported having been subjected to abuse by physician colleagues (9%) or coworkers (6%) in the previous month. Many of the respondents reported that the same physician colleagues or coworkers were repeat abusers. More than three-quarters (77%) of the physician-colleague abusers were men, whereas more than three-quarters (77%) of the other coworker abusers were women. Interviewed family physicians described feeling humiliated and unappreciated, and devel...