Issue link: http://viewer.e-digitaledition.com/i/748278
BY STEVE BARRETT PATIENTS RECEIVED URGENT CARE OF WIDEšR ANGING QUALIT Y VIA VIDEOCONFERENCE, TELEPHONE OR WEBCHAT WITH PROVIDERS AT COMMERCIAL VIRTUAL VISIT WEBSITES, ACCORDING TO RESE ARCH IN JAMA INTERNAL MEDICINE. BY STEVE BARRETT TR AUMATIC CHILDBIRTH IS A DOUBLEšEDGED SWORD FOR OBSTE TRICIANS AND MIDWIVES, RECENT RESE ARCH FINDS. Traumatic Childbirth's Complex IMPACT ON CLINICIANS Quality of VIRTUAL URGENT CARE Varies Widely AT TEMPTING TO DE AL with feelings of g ui lt when complications lead to traumatic childbirth, the providers may su– er secondary traumatic stress, notes a study in Acta Obstetricia et Gynecologica Scandinavica. However, such occurrences also tend to improve their capabilities as physicians and midwives and lead them to ponder the meaning of life. Researchers surveyed more than 1,000 clinicians who had been involved in a childbirth in which either the mother or infant had labor-and-delivery-related injuries that were severe or fata l. The study found half of respondents felt guilty and a similar proportion thought more deeply about the meaning of life as a result of the traumatic childbirth. Roughly two- thirds believed the experience made them better physicians or midwives. " S e l f- b l a m e a n d g u i lt a p p e a r t o dominate when midw ives a nd obste- t r ic i a n s s t r u g g le t o c op e w it h t he a f termat h of a traumatic chi ldbir t h, w h i c h w a s a c o n s i s t e n t f i n d i n g rega rd less of t i me si nce t he event ," Katja Schrøder, R M, MSc Hea lt h, of the Universit y of Southern Denma rk, stated in a news relea se. " This cou ld i nd ic at e t h at a lt hou g h t he c u r rent patient safety programs have promoted a more just a nd lea rning culture with less blaming and shaming after adverse event s, t he persona l feel i n g of g u i lt rema i ns a burden for t he i ndiv idua l hea lthca re professiona l." Resea rchers say the f indings could enha nce effor ts to provide suppor t to hea lt hca re prov iders i n t he wa ke of traumatic childbir th. ■ APPROXIMATELY 70 STANDARDIZED a nd t r a i ne d pa t ient s pr e s ent e d t o eight such companies with conditions including acute rhinosinusitis, ankle pain, low-back pain, recurrent fema le urinary tract infection, streptococca l pharyngitis and viral pharyngitis. They completed 599 virtual visits — most by videoconference — with 157 physicians in emergency medicine, family practice or internal medicine. Researchers assessed the thorough- ness of the resulting patient histories and physical exams, as well as the correctness of diagnoses and physicians' adherence to guidelines in management decisions. The study found that physicians: + Covered a l l recommended patient history questions and performed all recommended exa m ma neuvers in nearly 70 percent of visits + Correctly diagnosed the condition in roughly 77 percent of visits, incorrectly diagnosed the condition in about 15 per- cent of visits and provided no diagnosis in the remaining visits + Followed guidelines for key management decisions in about 54 percent of visits + Referred patients to brick-and-mortar healthcare facilities in about 14 percent of visits Variation on care measures was signifi - cantly higher for viral pharyngitis and acute rhinosinusitis than for the other conditions, the authors note, but "No statistically sig- nifi cant variation in guideline adherence by mode of communication (videoconference vs telephone vs webchat) was found." Video consultations between primary care physicians and patients are expected to grow to 5.4 million annually by 2020, according to analytics fi rm IHS. ■ 2 2 2 2❱❱❱❱❱ P R A C T I C E M A N A G E M E N T