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In recent years, Romania's stomatology private practice sector has seen substantial growth, with many dentists fully committing to building and expanding their own practices, often funded by their personal income. This study aimed to explore how various postures affect the muscle groups of dentists (380), particularly focusing on identifying positions that may jeopardize their musculoskeletal health. A group of dentists effectively participated in this study (10), adhering to their regular work routines while wearing wearable sensors on their backs to monitor posture and activity. The data gathered from these sensors were analyzed using the RULA (rapid upper-limb assessment) and REBA (rapid entire-body assessment) tools. The findings indicated that the head and shoulder movements during dental procedures involved considerable and repetitive angular shifts, which could strain the neck and back muscles and heighten the risk of musculoskeletal problems. Additionally, the standing postures adopted by the dentists were associated with an increased risk of postural issues and greater overall fatigue. Extended periods of trunk and head tilting were also identified as contributing factors to posture-related challenges. [ABSTRACT FROM AUTHOR]

Objective Design Setting Participants Results Conclusion To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs.A qualitative case study.This study was completed with staff working in private disability practices in a regional context in the Northern Territory.Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds.More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part‐time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation.This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas. [ABSTRACT FROM AUTHOR]

The category of registered counsellor was created to service the mental health care needs of the South African population at primary health care level. However, a lack of employment opportunities for registered counsellors within primary health care settings resulted in many opting to work within private practice. In this study, we explored barriers and facilitators to the delivery of mental health care by registered counsellors. We employed purposive and snowball sampling to recruit 15 participants, who were registered counsellors in private practice throughout South Africa, and registered with the Health Professions Council of South Africa. Semi-structured interviews were conducted online via Skype. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. We used the Capability, Opportunity, Motivation model of behaviour and the Theoretical Domains Framework as conceptual frameworks in the study. We identified facilitators and barriers that registered counsellors experienced in their attempts to provide mental health care at a primary care level. We identified three themes and named them as follows: (1) registered counsellors feeling competent, capable, and motivated to engage in community work, (2) the registered counsellor as an unacknowledged mental health professional, and (3) limited alternatives to private practice. We regarded the first theme as a facilitator, and the other two as barriers to the provision of mental health care by registered counsellors in private practice. These findings suggest that registered counsellors felt motivated and capable of providing mental health care, but that structural barriers prevent them from doing so. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the relationship between therapeutic techniques and session impact, by examining the replicability of findings observed in a university-based training clinic (Boswell et al., 2010) in another practice-oriented setting: private practice. Method:N = 8 therapists completed session-level assessments of their technique use for N = 38 clients. The same client sample completed session-level assessments of session outcome. Technique-outcome associations were examined with multilevel models. Results: As in Boswell et al., common factors were associated with positive session impact. For clients who received higher average common factor techniques (relative to their own therapist's caseload), session impact was the poorest in sessions with higher behavioral change techniques use (relative to the client's own average). Moreover, clients with the lowest average common factor techniques (relative to their therapist's caseload) reported better session impact in sessions that involved a higher degree of session-level behavioral change techniques (relative to their own average). Conclusion: In line with Boswell et al., therapists should be mindful of the consistency of their routine technique use between- and within-clients, and this can be aided through collection of their own practice-oriented data. [ABSTRACT FROM AUTHOR]

Following the collapse of the Delahoyde and Lucett joint enterprise, James Lucett resumed practice on his own account. He continued to implement his 'process', promoting it as a unique cure for intractable cases of insanity. For two decades he pursued his activities, with varying success, at different locations in the London area. He maintained his public profile by extensive advertising, letters to newspapers and published pamphlets, extolling his unique 'discovery' and recounting claims of successful cures achieved. Accusations of quackery persisted along with other hostile criticism, particularly from medical men, which Lucett strongly challenged. Periodically he faced more serious difficulties due to legal infractions or financial hardships, but somehow Lucett survived most of these and persevered with his endeavours. [ABSTRACT FROM AUTHOR]

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Introduction: According to the World Health Organisation (WHO) global Tuberculosis (TB) report in 2019, 10 million new cases of Tuberculosis were detected worldwide, with India being one of the significant contributors. After achieving some milestones in TB control, the Government of India launched the National Tuberculosis Elimination Program (NTEP) to end TB by 2025. The role of private practitioners in the success of national health programs in India cannot be overemphasised, considering they cater to three times more population than the public sector. Aim: To understand the knowledge and perceived bottlenecks of private practitioners in achieving the goals of NTEP. Materials and Methods: A web-based cross-sectional survey was conducted by Community Medicine Department of Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India, using a semi-structured questionnaire among randomly selected 110 doctors affiliated with the Indian Medical Association (IMA) from October 2020 to December 2020. The survey questionnaire was prepared by an experienced TB Chest expert and consensually validated. It covered all aspects of the Revised National TB Control Program (RNTCP) training modules. Descriptive statistics (Mean, SD, Frequency (%), etc.,) along with independent t-test and Analysis of Variance (ANOVA) were used to present the profile of the participants as well as associated factors with the knowledge score. A p-value of less than 0.05 was considered statistically significant. Results: Out of 110 invitations, 97 (88%) doctors responded. Most of the respondents were males 71 (73%), specialists (81, 83.5%), and had been practicing for more than 20 years (66, 68%). The mean (SD) score was 3.31±1.27 out of six for Multiple Choice Questions and 8.05±3.77 out of 15 for True/False questions. Only 37 (38%) participants scored above the passing benchmark of 60%, indicating a substantial knowledge gap. A higher Outpatient Department (OPD) strength (>50 patients per day) and attending a TB training program by the Government were associated with a higher total score (p=0.018). Conclusion: The knowledge of private practitioners about the diagnosis and management of Tuberculosis was found to be suboptimal. Participants also expressed a few systemic challenges like poor communication and the complexity of the system in the notification of Tuberculosis cases. Innovative training programs, proper communication, and supportive supervision will help in engaging the private practitioners to achieve TB elimination goals.

Introduction: While the provision of unapproved regenerative medicine has been problematic worldwide, few studies have examined the implementation status of regenerative medicine (RM) in the specific field. This study aimed to determine the current status of therapy and clinical research in the obstetrics and gynecology (OBGYN) in Japan under the Act on the Safety of Regenerative Medicine (RM Act). Methods: Detailed data were extracted from publicly available websites provided by the Ministry of Health, Labour, and Welfare. We extracted descriptive details, including risk classification of the RM Act, modality, target disease, locality, institution, and administration route. For therapy, the price for each modality was evaluated. Results: The total number of therapeutic provision plans in OBGYN (1.9% of RM in Japan) are classified as Class II (moderate) risk. Most were administered in clinics in urban areas for treating endometrial or ovarian infertility by locally administering platelet-rich plasma (PRP) or autologous mesenchymal stem cells (MSCs). The price using MSCs is approximately eight times more expensive that of those involving PRP (1832.1 ± 1139.8 vs 240.8 ± 106.5 thousand yen, p

Background Methods Results Conclusion Key points Plain language summary Periodontitis is one of the most prevalent oral diseases with significant implications for systemic health. This study aims to explore themes influencing successful long‐term outcomes in periodontal treatment through a historical lens, focusing on various factors influencing the longevity of periodontal health and dentition stability.Utilizing an inductive qualitative thematic analysis approach, this study utilized a retrospective chart review of 19 patient records spanning, on average, 40 years.Four major themes contributing to periodontal stability were identified: (1) adequate patient plaque control; (2) regular periodontal maintenance; (3) collaboration between hygienists and periodontists; and (4) the application of various periodontist/dentist‐performed procedures.Current findings underscore the importance of these factors in preserving patients’ periodontal health by emphasizing conservative treatment approaches in the maintenance and retention of the natural dentition. Adequate patient plaque control is essential for maintaining a patient's periodontal health and dentition long‐term. A regular periodontal maintenance schedule should be assigned and modified as necessary for each individual patient's care. Collaborative care with hygienist colleagues and ensuring there are flexible treatment options for patients can lead to successful treatment outcomes when hygiene alone is not sufficient. Adequate patient plaque control is essential for maintaining a patient's periodontal health and dentition long‐term.A regular periodontal maintenance schedule should be assigned and modified as necessary for each individual patient's care.Collaborative care with hygienist colleagues and ensuring there are flexible treatment options for patients can lead to successful treatment outcomes when hygiene alone is not sufficient.Periodontitis is a widespread oral disease with significant systemic health implications. This study examined patient records to identify factors contributing to long‐term periodontal stability and maintenance of teeth. By analyzing 19 patient charts over an average of 40 years using a qualitative approach, four key themes were identified in successful patient treatments: effective patient plaque control, regular periodontal maintenance, collaboration between dental hygienists and periodontists, and the addition of other approaches by periodontists and dentists when necessary. The study underscores the importance of these factors in preserving periodontal health and retaining natural teeth with conservative treatment approaches. This research highlights the critical role of sustained, multifaceted dental care and professional collaboration in achieving successful long‐term oral and systemic health outcomes. [ABSTRACT FROM AUTHOR]

Measurement-based care, an evidence-based practice endorsed by the American Psychological Association, is underpinned by routine assessment supporting a data-driven approach to clinical decision making. Nonetheless, there is a need for brief, nonproprietary measures assessing non-symptom-based outcomes. The present study examined the psychometric properties of the Therapy Progress Scale (TPS), a four-item measure assessing clients' perceived treatment progress in multiple life functioning domains. The sample included 36,420 clients (66% female, 55.5% White, 31.5% Racial/Ethnic Minority) receiving outpatient psychotherapy from a practice-research group of private practitioners. The TPS demonstrated a one-factor solution (χ2 (2) = 362.08, RMSEA =.076, CFI =.999, TLI =.996) with high reliability estimate (coefficient α =.87). Additionally, the factor structure was consistent across client gender and race/ethnicity. There were moderate negative correlations with symptom-based measures (i.e. PHQ-9 and GAD-7). Test-retest correlation was also strong. Implications for research and practice are provided. [ABSTRACT FROM AUTHOR]

Introduction: According to the World Health Organisation (WHO) global Tuberculosis (TB) report in 2019, 10 million new cases of Tuberculosis were detected worldwide, with India being one of the significant contributors. After achieving some milestones in TB control, the Government of India launched the National Tuberculosis Elimination Program (NTEP) to end TB by 2025. The role of private practitioners in the success of national health programs in India cannot be overemphasised, considering they cater to three times more population than the public sector. Aim: To understand the knowledge and perceived bottlenecks of private practitioners in achieving the goals of NTEP. Materials and Methods: A web-based cross-sectional survey was conducted by Community Medicine Department of Pramukhswami Medical College, Bhaikaka University, Karamsad, Anand, Gujarat, India, using a semi-structured questionnaire among randomly selected 110 doctors affiliated with the Indian Medical Association (IMA) from October 2020 to December 2020. The survey questionnaire was prepared by an experienced TB Chest expert and consensually validated. It covered all aspects of the Revised National TB Control Program (RNTCP) training modules. Descriptive statistics (Mean, SD, Frequency (%), etc.,) along with independent t-test and Analysis of Variance (ANOVA) were used to present the profile of the participants as well as associated factors with the knowledge score. A p-value of less than 0.05 was considered statistically significant. Results: Out of 110 invitations, 97 (88%) doctors responded. Most of the respondents were males 71 (73%), specialists (81, 83.5%), and had been practicing for more than 20 years (66, 68%). The mean (SD) score was 3.31±1.27 out of six for Multiple Choice Questions and 8.05±3.77 out of 15 for True/False questions. Only 37 (38%) participants scored above the passing benchmark of 60%, indicating a substantial knowledge gap. A higher Outpatient Department (OPD) strength (>50 patients per day) and attending a TB training program by the Government were associated with a higher total score (p=0.018). Conclusion: The knowledge of private practitioners about the diagnosis and management of Tuberculosis was found to be suboptimal. Participants also expressed a few systemic challenges like poor communication and the complexity of the system in the notification of Tuberculosis cases. Innovative training programs, proper communication, and supportive supervision will help in engaging the private practitioners to achieve TB elimination goals. [ABSTRACT FROM AUTHOR]

OBJECTIVE To compare results from 2 previously published surveys aimed at determining how pyometra is treated in high-quality, high-volume spay-neuter clinics (HQHVSNCs) and private practices (PPs), with a specific focus on identifying opportunities for partnership between the clinic types to improve access to care in pyometra treatment. SAMPLE Responses from 123 PPs and 87 HQHVSNCs. METHODS A previously published survey of PPs conducted from June to July 2021 and a similar previously published survey of HQHVSNCs conducted from June to July 2020 were compared regarding demographics, pyometra treatment availability, estimated outcome, alternative outcome, disruption, cost, and protocol between HQHVSNCs and PPs. A comparison was also run of the surveys' responses regarding referral of a pyometra to an HQHVSNC by a PP. RESULTS Although PPs estimated that economic euthanasia is the most likely alternative outcome for 13% of patients unable to access care at their practice, 80% would be reluctant to refer to an HQHVSNC. The 3 primary reasons indicated by PPs with a reluctance to refer were a perceived lack of prompt appointment availability (20%), lack of aftercare (18%), and lack of adequate equipment (14%). In contrast, most HQHVSNCs estimated that they generally accept referrals the same day (50%) or the next day (30%) and 95% of HQHVSNCs reported having the resources needed to treat most pyometras. CLINICAL RELEVANCE There are several opportunities for partnership between PPs and HQHVSNCs in the treatment of pyometra. The most frequent concerns expressed by PPs regarding referral to HQHVSNCs were not shared by HQHVSNCs or could be ameliorated by referral to an HQHVSNC for surgery and transfer back to the PP for aftercare. [ABSTRACT FROM AUTHOR]

Physicians have gravitated toward larger group practice arrangements in recent years. However, consolidation trends in colorectal surgery have yet to be well described. Our objective was to assess current trends in practice consolidation within colorectal surgery and evaluate underlying demographic trends including age, gender, and geography. We performed a retrospective cross-sectional study using the Center for Medicare Services National Downloadable File from 2015 to 2022. Colorectal surgeons were categorized by practice size and by region, gender, and age. From 2015 to 2022, the number of colorectal surgeons in the United States increased from 1369 to 1621 (+18.4%), while the practices with which they were affiliated remained relatively stable (693-721, +4.0%). The proportion of colorectal surgeons in groups of 1-2 members fell from 18.9% to 10.7%. Conversely, those in groups of 500+ members grew from 26.5% to 45.2% (linear trend P < 0.001). The midwest region demonstrated the highest degree of consolidation. Affiliations with group practices of 500+ members saw large increases from both female and male surgeons (+148.9% and +86.9%, respectively). New surgeons joining the field since 2015 overwhelmingly practice in larger groups (5.3% in groups of 1-2, 50.1% in groups of 500+). Colorectal surgeons are shifting toward larger practice affiliations. Although this change is happening across all demographic groups, it appears unevenly distributed across geography, gender, and age. New surgeons are preferentially joining large group practices. [ABSTRACT FROM AUTHOR]

Introduction. Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim. We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods. Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-toface semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results. All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion. This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour. [ABSTRACT FROM AUTHOR]

Objective: Characterizing access to sudden sensorineural hearing loss (SSNHL) care at private practice otolaryngology clinics of varying ownership models. Study Design: Cross‐sectional prospective review. Setting: Private practice otolaryngology clinics. Methods: We employed a Secret Shopper study design with private equity (PE) owned and non‐PE‐owned clinics within 15 miles of one another. Using a standardized script, researchers randomly called 50% of each clinic type between October 2021 and January 2022 requesting an appointment on behalf of a family member enrolled in either Medicaid or private insurance (PI) experiencing SSNHL. Access to timely care was assessed between clinic ownership and insurance type. Results: Seventy‐eight total PE‐owned otolaryngology clinics were identified across the United States. Only 40 non‐PE clinics could be matched to the PE clinics; 39 PE and 28 non‐PE clinics were called as Medicaid patients; 39 PE and 25 non‐PE clinics were called as PI patients; 48.7% of PE and 28.6% of non‐PE clinics accepted Medicaid. The mean wait time to new appointment ranged between 9.55 and 13.21 days for all insurance and ownership types but did not vary significantly (P >.480). Telehealth was significantly more likely to be offered for new Medicaid patients at non‐PE clinics compared to PE clinics (31.8% vs 0.0%, P =.001). The mean cost for an appointment was significantly greater at PE clinics than at non‐PE clinics ($291.18 vs $203.75, P =.004). Conclusions: Patients seeking SSNHL care at PE‐owned otolaryngology clinics are likely to face long wait times prior to obtaining an initial appointment and reduced telehealth options. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions Private practice is one of the most rapidly growing, but under‐researched employment sectors for graduate dietitians in Australia, limiting evidence‐based workforce development. This scoping review examines existing international literature to gain an understanding of the current private practice workforce size, distribution, demography and workforce development considerations, including competencies, supply and demand, remuneration and professional development activities.The databases MEDLINE, EMBASE, CINAHL, EMCARE, PsycInfo (Ovid) and grey literature were systematically searched in August 2023 using key search terms to identify studies for inclusion. Articles were included if they related to private practice dietetics and described an aspect of workforce. Original research, government and organisational reports, statements of practice and websites providing governmental or organisational statistics were included. A directed content analysis and qualitative constant comparison technique were used to deductively map intelligence sources against a workforce development framework. A gap analysis was also conducted to provide a focus for future workforce development research.A total of 72 peer‐reviewed and grey literature sources were included, with 65% of the studies being Australian‐based publications. Private practice dietetics research interest has increased in the last decade. Despite a breadth of published sources, this review found little published data on workforce size, distribution, demography, supply, demand, continued professional development and remuneration, indicating a significant gap in the evidence base. Existing literature focuses on workforce challenges and barriers, the work of private practice dietitians, with limited exploration of competency requirements for graduate private practitioners.The literature on the private practice dietetics workforce is lacking worldwide, which constrains evidenced‐based workforce development initiatives. Workforce development research across all workforce aspects is warranted to address current evidence gaps. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Extensive literature has shown that poor sleep quality, anxiety symptoms and catastrophizing contribute to worsening of temporomandibular disorder (TMD) conditions. However, most studies are conducted in public institutions. Therefore, the aim of this study was to evaluate the influence of sleep quality on pain characteristics and psychological factors in patients with symptomatic TMD treated in a private orofacial pain clinic. METHODS: This is a cross-sectional study. Forty-four adult patients were selected according to the Axis I of the diagnostic criteria for TMD (DC/TMD) and completed the questionnaires Pittsburgh Sleep Quality Index(PSQI); Pain Catastrophizing Scale (PSC) and Generalized Anxiety Disorder Scale (GAD-7). The sample was divided into poor sleep quality and good sleep quality based on PSQI scores. The Visual Analogue Scale (VAS) quantified pain intensity and the pain duration was recorded in months. RESULTS: 63.64% of the patients had muscle TMD (myofascial pain), 18.18% had joint TMD (arthralgia) and 18% had both disorders. 72.73% of all patients had pain for more than 6 months. Patients reporting poor sleep quality had more anxiety symptoms (p=0.009) and catastrophic thoughts related to pain (p=0.006); of these, 93.7% had pain for more than 6 months. Negative correlations were observed between age and pain intensity, and between age and anxiety symptoms. CONCLUSION: Poor sleep quality was significantly associated with anxiety, catastrophizing and pain duration in TMD patients treated in orofacial pain private practice.

Recovery-oriented practice is the dominant framework for mental health services in Australia. However, evidence demonstrating recovery processes outside public services is scant. This study explores how key processes from the Connectedness, Hope, Identity, Meaning, and Empowerment (CHIME) personal recovery conceptual framework related to service-user experiences of a rural mental health service during the COVID-19 pandemic. Qualitative telephone or video-conference interviews were conducted with 19 service users. Deductive and inductive data analysis was employed, applying the CHIME framework as a predetermined organisational structure. Themes were constructed according to the CHIME framework categories. The data reflected all five categories; connectedness and empowerment were salient. Participants' service-delivery experiences could either enhance or hinder connectedness, the cultivation of hope, a positive identity, meaning in life, and empowerment. Nonclinical aspects of their experience were viewed as an extension of treatment. Opportunities exist for mental health practitioners to intentionally prioritise and strengthen recovery-oriented practice. Trauma-informed approaches are consistent with and complement personal recovery principles. Accountability structures are needed to monitor recovery-oriented practice in mental health settings. Family-focused interventions also need strengthening to build connectedness, meaning, and hope. IMPLICATIONS Recovery can be promoted and enhanced within primary care mental health services through intentional focus on the key processes. Trauma-informed principles and care are congruent with a recovery-oriented approach and support connectedness and empowerment. Social workers are well placed to lead and drive recovery-oriented practices in private settings that move beyond an individualistic focus to include holistic care and family-focused practice. [ABSTRACT FROM AUTHOR]

Reducing morbidity, length of hospital stay, and readmission rate are of paramount importance to improve patients' care. In the present paper, we aim to describe our experience in managing major oncologic thoracic surgery in clinical practice. This is a retrospective experience over the last 7 years. Data from 215 consecutive patients (performed by a single-team of two surgeon) undergoing thoracic surgery were reviewed and evaluated. The total hospital mean stay was 3,3 days. Complications were represented by 4 hemothorax, 1 pleural empyema without fistula, 3 arrhythmias (atrial fibrillation), 2 pnuemonias and 1 chylotorax. No 30-day severe surgery-related complication occurred, no mortality. In 169 Vats procedures, no convertion was necessary. We conclude that a united team work represented by two close-knit surgeons, with similar clinical background, propensity to share problems, no competitive behavior, allow to do faster surgery, to standardize the procedure improving the post-operative outcomes of cancer patients. [ABSTRACT FROM AUTHOR]

Background The variable relationship between the orbicularis supercilii and frontalis muscles may cause side effects with botulin toxin; steadily frowning is the usual recommendation. Eliminating the need to frown until all injections are over might enhance efficacy and lessen the neurotoxicity risks related to muscle exhaustion. Objectives The goal of this study was to investigate whether the digital caliper–assessed distances between the medial and lateral corrugator injection sites and the midline differed significantly in patients persistently frowning from patients resting. Methods Seventy-six individuals with glabellar wrinkles treated with botulinum toxin in the authors' private practices for glabellar lines voluntarily contributed their retrospective data about the positions of injection sites. The investigators had freely chosen to inject the medial and lateral sections of the corrugator supercilii during persistent maximum frown or at rest. Results The mean differences in distances between the medial and lateral injection points and the estimated midline were clinically trivial (1.0 ± 1.28 and 1.5 ± 2.53 mm, respectively), although the distances between the relaxed and contracted medial and lateral injection sites exceeded 1.8 and 2.5 mm in 33.9% and 46.4% of patients, respectively. Distance differences, not significant before 40 years old, were statistically significant only for the lateral injections in older patients (on average, 1.9 ± 3.01 mm). Conclusions The average distances from the medial and lateral injection points and the midline appear minimally different in patients who frown until all injections are over and, conversely, patients who rest. Persistently frowning might be advisable only in patients older than 40. Facial asymmetries may be a confounding factor. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

The purpose of this qualitative phenomenological study was to gain insight into the lived experiences of psychotherapists transitioning to private practice during the COVID‐19 pandemic. With an ever‐expanding need for targeted and accessible mental health care, it is vital to understand this phenomenon and how it impacted patient access and care, and the providers themselves. Eighteen licensed psychotherapists were interviewed and their responses highlighted meaningful professional and clinical implications. As a result of the participant interviews, three major themes were identified: (1) the unknown related to COVID‐19, (2) ease of transition and (3) work–life balance. Eleven additional subthemes emerged. Results suggested that psychotherapists had various personal and professional stressors exacerbated by the pandemic, along with a desire to balance work and life, manage the changes brought on by the pandemic, and gain or retain autonomy in their professional careers. Ultimately, the results of the study point to some shared experiences among psychotherapists, potential issues of access to psychotherapy, issues related to career satisfaction among psychotherapists, as well as some important areas for future research. [ABSTRACT FROM AUTHOR]

In recent years, there has a been a rapid and significant drop in the number of private practices in US radiology. Many factors have driven this change. One of the most important has been the corporatization of practices. In many cases, this involves third-party financing, one type of which is venture capital. This article will provide an introduction to the venture capital investment model for medical professionals. [ABSTRACT FROM AUTHOR]

Academic radiology is essential for advancing medical knowledge, improving patient care, and leading professional organizations. Any shortage of academic faculty affects the ability to provide quality education in radiology, conduct research, and advance the field. In this study, we aimed to identify contributors to the challenges faced by academic radiology in Korea and compare the work burden, career satisfaction, and burnout between academic radiology and private practice. A Google survey of members of the Korean Society of Radiology, conducted between August 19, 2022 and August 31, 2022, attracted responses from 642 radiologists, including 511 board-certified radiologists and 131 radiologist trainees. The survey assessed career satisfaction, burnout, and reasons for working in academia and frustrations with an academic career. Of the responding academic radiologists, 53% were located in Seoul, and of the responding private practice radiologists, 71% were located in regions outside Seoul. The reported volume of image readings per month (CT and/or MRI) was higher for academic radiologists than for private practice radiologists, but no significant difference in the time taken to complete the readings was evident between the two groups. Compared with private practice radiologists, academic radiologists required more time for education, clinical conferences, and additional nonclinical tasks. Lower scores for career satisfaction and higher scores for burnout were reported by academic radiologists, compared with private practice radiologists. The field of academic radiology in Korea faces challenges because of a faculty shortage. To prevent the collapse of education in radiology, interventions must address the identified contributors to this shortage, while increasing career satisfaction and reducing burnout among academic radiologists. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Physiotherapy private practitioners represent a growing proportion of Australia's primary care workforce; however, they face significant barriers in integrating seamlessly within interprofessional teams. Historically, the landscape of primary care in Australia has been one where many physiotherapists work in monoprofessional private practice facilities at dispersed locations, potentially limiting collaborative and coordinated care. The aim of this study was to investigate strategies recommended by physiotherapists to promote effective interprofessional collaborative practice (IPCP) within the Australian private practice setting. Methods: Using interpretive description as the guiding methodological framework, semi-structured interviews were conducted with 28 physiotherapists in 10 private practice sites in Queensland, Australia. Results: Data analysis produced three themes that characterised physiotherapy private practitioners' recommendations to improve IPCP: (a) the need for improved funding and compensation, particularly addressing the limitations of the Medicare Chronic Disease Management program; (b) the development of integrated and secure digital communication systems to facilitate better information exchange; and (c) prioritising professional development and training to enhance collaboration. Conclusions: This research lays the groundwork for informed policy making to advance person-centred care and support the integration of services in the Australian healthcare system. The findings from this study indicate that promoting effective IPCP in physiotherapy private practice requires a comprehensive strategy that addresses systemic funding and compensation issues, enhances digital communication systems and optimises interprofessional education and training. Physiotherapists working in primary care are becoming increasingly important members of interprofessional healthcare teams. This research outlines key strategies from the perspective of Queensland physiotherapy private practitioners, including reforming funding structures, leveraging digital communication and improving education and training initiatives, to promote effective interprofessional collaborative practice. The insights from this study underscore the broader complexities within Australia's healthcare system and emphasise the need for strategic changes to achieve collaboration in ensuring optimal patient care. [ABSTRACT FROM AUTHOR]

Systematic implementation of evidence-based, clinical practice guidelines for management of knee osteoarthritis (OA) in primary care physiotherapy in Australia is embryonic. Clinical practice guidelines have been implemented in the public healthcare sector at a State-level for physiotherapists in the form of multidisciplinary programs, but the reach of physiotherapy-led OA management programs is grossly inadequate in the private sector. To provide a snapshot of the management of people with knee OA in private physiotherapy practice in an Australian setting. Primarily the aim was to determine the alignment between the treatment provided and guideline-based management. Secondary aims included the capture of both patient-reported improvement after 3-months and patient satisfaction with treatment. Whether patient-reported outcome measures (PROMS) were routinely used was also ascertained. A prospective, observational study enrolling adults >=45 years with knee OA across nine primary care physiotherapy practices. Knee injury OA Outcome Score (KOOS) and Routine Assessment Patient Index 3 (RAPID3) were collected (baseline; 3 months) by researchers along with satisfaction with treatment. Treatment details and use of PROMS were obtained from physiotherapy record audit and patient interview. The treatment provided was compared to the minimum core elements of management stipulated in OA management guidelines. Twenty-six adults (58% female, mean age 60 (9) years, 54% overweight or obese) participated. 100% were prescribed ≥1 appropriate exercise(s); 42% received OA education; 12% received weight management advice. Mean improvement (95%CI) in KOOS Pain was 9.8 (3.4 to 16.1) and RAPID3 was −3.4 (−5.5 to −1.3). Satisfaction with treatment was high (8.3/10). No PROMs were used for assessment or monitoring. Primary care physiotherapy treatment of knee OA did not meet minimum criteria per clinical practice guidelines. However, participant improvement at three months reached minimally important change thresholds for patient-reported measures and satisfaction was high. The data provide useful insights about areas that are deficient, thus, should inform future implementation strategies designed to improve care delivery and the uptake of routine measurement of patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Abstract Objectives To explore the perceptions that Colombians have about voluntary private health insurance plans (VPHI) in the health system to identify the tensions that exist between the public and private systems. Methods A qualitative case study approach with 46 semi structured interviews of patients, healthcare workers, healthcare administrators, decision-makers, and citizens. Interviews were recorded, transcribed, anonymized, digitally stored, and analyzed following grounded theory guidelines. Results We developed a paradigmatic matrix that explores how, in a context mediated by both the commodification of health and social stratification, perceptions about the failures in the public health system related to lack of timely care, extensive administrative procedures, and the search for privileged care led to positioning VPHI as a solution to these failures. The interviewees identified three consequences of using VPHI: first, the worsening of problems of timely access to care in the public system; second, higher costs for citizens translated into double payment for technologies and services to which they are entitled; third, the widening of inequity gaps in access to health services between people with similar needs but different payment capacities. Conclusions These findings can help decision makers to understand citizens´ perceptions about the implications that VPHI may have in worsening equity gaps in the Colombian health system. It also shows, how VPHI is perceived as a double payment for services covered within social security plans and suggests that the perceived lack of timely access to care in the public systems and the fear that citizens have for themselves or their family members when using suboptimal healthcare are important drivers to purchase these private insurances.

In recent years, Romania’s stomatology private practice sector has seen substantial growth, with many dentists fully committing to building and expanding their own practices, often funded by their personal income. This study aimed to explore how various postures affect the muscle groups of dentists (380), particularly focusing on identifying positions that may jeopardize their musculoskeletal health. A group of dentists effectively participated in this study (10), adhering to their regular work routines while wearing wearable sensors on their backs to monitor posture and activity. The data gathered from these sensors were analyzed using the RULA (rapid upper-limb assessment) and REBA (rapid entire-body assessment) tools. The findings indicated that the head and shoulder movements during dental procedures involved considerable and repetitive angular shifts, which could strain the neck and back muscles and heighten the risk of musculoskeletal problems. Additionally, the standing postures adopted by the dentists were associated with an increased risk of postural issues and greater overall fatigue. Extended periods of trunk and head tilting were also identified as contributing factors to posture-related challenges.

Purpose: The main objective of this study was to assess the influence of bone remodeling on late marginal bone loss in immediately loaded, implant-supported, complete-arch restorations and, secondarily, to determine its relationship to peri-implant disease occurrence using a multilevel analysis. Materials and Methods: A retrospective cohort study of patients treated consecutively in a private clinic with immediately loaded full-arch restorations with at least 12 months of follow-up was conducted. Bone remodeling and marginal bone loss were determined through measurements made on panoramic radiographs by two calibrated examiners. Peri-implant health status was diagnosed in a visit for peri-implant maintenance. Descriptive, bivariate, and multilevel analyses were performed with Stata/IC 15.1 software (StataCorp). Results: A total of 30 patients (11 men and 19 women, mean age: 63.3 ± 10.4 years), with a mean follow-up of 37.7 ± 19.6 months were included. Forty arches (20 maxillary and 20 mandibular) received 207 implants. Bone remodeling had an inversely proportional effect on marginal bone loss (P =.005) but was not related to peri-implantitis (P =.103; hazard rate [HR] = 2.1). Conclusion: Taking into account the limitations of this study, bone remodeling around immediately loaded dental implants supporting complete-arch restorations does not appear to increase marginal bone loss or peri-implantitis. [ABSTRACT FROM AUTHOR]

Objectives: To explore the perceptions that Colombians have about voluntary private health insurance plans (VPHI) in the health system to identify the tensions that exist between the public and private systems. Methods: A qualitative case study approach with 46 semi structured interviews of patients, healthcare workers, healthcare administrators, decision-makers, and citizens. Interviews were recorded, transcribed, anonymized, digitally stored, and analyzed following grounded theory guidelines. Results: We developed a paradigmatic matrix that explores how, in a context mediated by both the commodification of health and social stratification, perceptions about the failures in the public health system related to lack of timely care, extensive administrative procedures, and the search for privileged care led to positioning VPHI as a solution to these failures. The interviewees identified three consequences of using VPHI: first, the worsening of problems of timely access to care in the public system; second, higher costs for citizens translated into double payment for technologies and services to which they are entitled; third, the widening of inequity gaps in access to health services between people with similar needs but different payment capacities. Conclusions: These findings can help decision makers to understand citizens´ perceptions about the implications that VPHI may have in worsening equity gaps in the Colombian health system. It also shows, how VPHI is perceived as a double payment for services covered within social security plans and suggests that the perceived lack of timely access to care in the public systems and the fear that citizens have for themselves or their family members when using suboptimal healthcare are important drivers to purchase these private insurances. [ABSTRACT FROM AUTHOR]

The private practice setting is understudied. Private practice includes settings in which mental health providers are unaffiliated with healthcare and hospital systems. Private practices may accept insurance (private and sometimes public) or no insurance (private pay). Increasing attention to this setting is critical to facilitating equitable access to mental health services, especially given enduring mental health workforce shortages and service waitlists. Further, there have been recent federal government calls to increase mental health and physical healthcare parity and to reduce out-of-pocket patient costs. Implementation science theories, models, frameworks, and methods can help illuminate determinants of private practice service availability and quality (e.g., evidence-based intervention delivery with fidelity), guide evaluation of implementation outcomes such as cost and acceptability of interventions to patients, and identify strategies to mitigate barriers to high-quality, affordable private practice services. This article suggests research questions to begin filling the private practice research gap using an implementation determinants framework — the Consolidated Framework for Implementation Research (CFIR) 2.0. Research questions are proposed across CFIR domains: outer context (e.g., policies impacting whether private practices accept insurance); individuals involved (e.g., provider professional experiences; direct-to-consumer marketing impacts on evidence-based intervention demand); innovation characteristics (e.g., appropriateness for private practice); inner context (e.g., organizational characteristics); and implementation processes (e.g., innovation sustainability). The illustrative research questions aim to begin a conversation amongst researchers and funders. Bringing an implementation science lens to the private practice context has the potential to improve the quality and affordability of mental health care for many. [ABSTRACT FROM AUTHOR]

The career trajectory of medical professionals, particularly in specialized fields like gastroenterology, can significantly impact healthcare and research. This study aimed to analyze career choices among gastroenterology fellows in the US and investigate the factors influencing these choices. We utilized data from the American Medical Association on internal medicine subspecialty fellows. The study examined career plans of gastroenterology fellows and compared them with those of other subspecialties. A chi-square test was performed to assess differences in career choices and practice settings. Among gastroenterology fellows, 46% opted for private practice, 28% pursued further training, and 26% chose academia. Notably, gastroenterology fellows were more inclined toward private practice than their counterparts in other subspecialties (46.3% vs 38.4%) and were less likely to pursue academic careers (25.6% vs 30.7%). This study highlights a concerning trend among recent gastroenterology fellowship graduates favoring private practice over academic careers or additional training. To sustain and strengthen academic medicine in gastroenterology, interventions such as scholarships, mentorship programs, and loan repayment initiatives tailored to academic pursuits could play a crucial role. [ABSTRACT FROM AUTHOR]

Purpose: Physician and medical practices have undergone significant consolidation over the last decade. This has been in response to federal and financial changes to health care delivery within the United States. As per the 2021 AUA annual census, the percentage of employed practicing urologists (not in solo or partnership practice) increased from 51.3% to 64.4% between 2015 and 2020 (AUA Census 2021). Our objective was to further examine the changing trends among provider groups within Urology between 2014 and 2021. Methods: Publicly available information from within Medicare Physician Compare, published by the US Centres for Medicare and Medicaid Services (CMS) was used. Practice size data were pulled from 1 month each year between 2014 and 2021 and filtered by physicians listing 'Urology' as their primary specialty. Practices were divided into categories based on size. Statistical calculations were conducted using R (version 4.0.2). Results: Solo or partnership practice declined by 15.9% compared to larger practice groups which increased by an average of 5.1%. Providers within the Northeast US illustrated the largest migration to larger practices with 101%, 162% and 232% growth among practices with 25–99, 100–499 and over 500 providers, respectively. Conclusion: Urologists have been moving increasingly towards larger group practice since 2014. An emphasis on value-based healthcare, integration of electronic records and an increase in administrative workload are only some of the influencing factors likely responsible for this trend. Further studies are needed to examine the effect practice consolidation has on patient outcomes and cost of care. [ABSTRACT FROM AUTHOR]

Introduction and aims: Czech music therapists lacked the skills and knowledge to adapt their practice to virtual music therapy (VMT) at the beginning of the COVID-19 pandemic, when physical contact was restricted. The aims of this project were to implement the best evidence-based recommendations concerning VMT in the practice of Czech music therapists and increase the number of therapists using VMT. Methods: The project used the JBI Evidence Implementation Framework to promote change in the practice of participants. A baseline audit of 26 practitioners was conducted using questionnaires and interviews. The audit criteria consisted of 8 best practice recommendations, followed by the implementation of targeted strategies and a follow-up audit. Results: Of the 26 music therapists, 18 began practicing VMT following the rollout of the implementation strategies. Strategies included educational workshops, instructional materials, technological support, individual counseling, and interactive training sessions. There was an increase in compliance with all audit criteria. The most critical barriers were lack of knowledge about VMT and lack of technical skills; lack of resources; technological challenges; low confidence of music therapists to provide VMT; and reduced need for VMT after the lockdown restrictions were relaxed. Conclusions: The implementation project helped to overcome temporary pandemic restrictions, increase the quality of VMT practice, develop strategies for VMT training, and identify reasons for using VMT during the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Comparative data on Advanced Practice Providers (APPs) in interventional radiology (IR) is helpful to understand APP utilization in different practice settings. A 60-question survey was distributed to 3159 IRs on the Society of Interventional Radiologists Doctor Finder, with 357 responses (11.3% response rate). Respondents represented 258 practices, 100 (39%) academic interventional radiology (AIR), and 158 (61%) private practice interventional radiology (PPIR), in 40 states. APPs generated on average 2442 ± 1824 work Relative Value Units/APP group/year (n = 42), with no significant differences between practice models (p =.31). Most APPs did not work weekends (74%, n = 189) or take overnight call (90%, n = 190). The most reported procedures by APPs included paracentesis/thoracentesis (93%), venous access peripherally inserted central catheter placement (63%), and fluoroscopy-guided lumbar puncture (57%). AIR APPs were more likely to perform venous tunneled catheter placement (p =.003) and venous access port placement (p =.003), whereas PPIR APPs were more likely to perform joint injections (p <.001) Self-reported data from PPIR and AIR groups shows that APPs perform a myriad procedure with variation between practice models. • Academic interventional radiology practices reported using significantly greater Full-Time equivalents of Advanced Practice Providers (APPs) (4) when compared with their private counterparts (2), a trend that held when normalizing for practice size. • APPs generated similar work Relative Value Units between the two practice models, with the practice receiving similar amounts of revenue generated by APPs. • The top 3 procedures performed by APPs in private practice interventional radiology and academic interventional radiology practices were paracentesis/thoracentesis, venous access PICC placement, and fluoroscopy-guided lumbar punctures. • APPs in academic practice were more likely to perform venous tunneled catheter and access port placement than APPs in private practices, who were in turn more likely to perform joint injections. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to identify the factors associated with the life satisfaction and peace of mind (PoM) of dentists not in full-time clinical training. Materials and methods: Cross-sectional questionnaires were distributed to dentists in Taiwan to collect their life satisfaction, PoM, sociodemographic data, and dental career-related characteristics. Life satisfaction was measured using a 5-item Satisfaction with Life Scale. PoM was measured using a 7-item Peace of Mind Scale. Descriptive statistics and multiple linear regression models were estimated to explore potential associations between the two scales and the examined factors. Results: A total of 1196 dentists (45.6% female; mean age = 44.12) completed the questionnaires. The response rate of completed questionnaires from email invitations was 32.9%. On multivariable analysis, life satisfaction and PoM were associated with age (b = 0.008 in both), better perceived health (b = 0.262 and 0.308, respectively), family interaction (b = 0.264 and 0.207, respectively), and friend relationships (b = 0.076 and 0.091, respectively). Being married (b = 0.191), being specialized (b = 0.127), working in private practice, and spending 10 to 39 h per week with patients (b = 0.101 to 0.162) were associated with a higher level of life satisfaction but not PoM. Conclusions: Specialists working in private practice without working overtime were associated with better life satisfaction. However, the dentists' health and relationships with family were more related to their subjective well-being than their professional achievements. Clinical relevance: Our findings can help policymakers increase awareness of the well-being of general dentists and those in academia or hospitals to promote their mental health. [ABSTRACT FROM AUTHOR]

Severe asthma is a subset of difficult‐to‐treat asthma which requires a systematic and multidimensional approach including the need to manage multiple comorbidities that mimic asthma. Multidisciplinary care is becoming the standard for the assessment of such patients. Multidisciplinary team (MDT) clinics are virtually nonexistent in the private space. We developed an MDT clinic to handle needs in the private space and found it was an invaluable tool for assessment, reflective practice and professional development. [ABSTRACT FROM AUTHOR]

Up to one third of adults who receive mental health services in Australia are parents. Psychologists in private practice are one of the largest groups within the Australian mental health workforce who support parents experiencing mental ill-health. Parents have specific support needs relating to their parenting role and "treatment as usual" may not address their integrated parenting and mental health concerns. The service experiences of parents in this setting have not been studied. This qualitative study addresses this knowledge gap through investigation of the experiences of Australian mothers who received support from a psychologist in private practice. Semi-structured interviews were conducted with 14 mothers and interviews were analysed using Interpretive Phenomenological Analysis. Three overarching themes were identified in relation to (i) participants' need to feel understood and heard as a parent, (ii) their need for a nonjudgmental therapeutic space and (iii) their desire for practical parental support from psychologists. These findings corroborate the value of family-focused practices when supporting parents with a mental health condition. The results include ways in which family-focused practices have been incorporated by clinicians in private practice settings which may have application in other mental health service contexts. What is already known about this topic: Psychologists in private practice make up a substantial group within the Australian mental health workforce who support parents with a mental health condition. Parents who receive mental health care in tertiary mental health settings report a lack of dedicated parenting support and resources. Family-focused practices are effective in supporting parenting and recovery for parents with a mental health condition who receive mental health care in tertiary mental health settings. What this paper adds: Psychologists who support parents in private practice should collaborate with their clients to identify which aspects of their parenting may be relevant to the therapeutic work and provide targeted support for parenting difficulties. Most participants expected that their psychologist would provide targeted support for parenting difficulties, and they felt disappointed when this did not occur. The lived experiences of parents with mental ill-health in private practice psychology services are highlighted, addressing a key knowledge gap in the literature. [ABSTRACT FROM AUTHOR]

Aim: A shortage in primary care physicians has been a well-known challenge in many Western countries for several years. In addition, we currently see a trend in primary care, where an increasing number of physicians work as employees instead of being self-employed, even among general practitioners. To address this shortage, knowledge of the future specialists' attitudes toward working self-employed is needed. This qualitative systematic review aims to explore the attitudes of future specialists towards self-employment in private practice, and what factors influence these attitudes. Subject and methods: We conducted a systematic search using PubMed, Embase, and Web of Science. We developed a search strategy that collected terms for future specialists, career choices, and self-employment and linked these with the Boolean operator "AND". We analysed the results using a qualitative content analysis, as both qualitative and quantitative studies were included in the research. Results: Self-employment is less attractive to future specialists. In particular, women prefer to be employed and receive a fixed salary. The main factors that influence the decision as to whether to become self-employed or not are financial conditions, bureaucracy and non-medical tasks, organisation, job satisfaction during residency, personal responsibility, career opportunities, specialty-dependent factors, personal environment, and education. Conclusion: Among future specialists, being self-employed is less attractive than being an employee. Students should be better informed about future career opportunities to make an informed decision. However, it should be examined whether other forms of organisation are more in line with the wishes of future specialists. [ABSTRACT FROM AUTHOR]

Aims: The aims of this register study were: 1. To study whether the type of ownership of the dental practice was correlated with the type of dental care provided, that is public versus private ownership and professional (dentist or dental hygienist) versus non-professional ownership. 2. To study the extent of follow-up of patients who have undergone two types of treatments. Material and method: Two types of dental care were defined in the two groups studied, periodontitis/peri-implantitis and comprehensive restorative/rehabilitation. All relevant treatment codes that fall under these definitions are noted when they are performed. Also, the follow-up of each treatment code is noted. Differences in dental and socioeconomic status over time and between regions were adjusted for. A drop-out analysis was performed. Results: Dental practices owned by dentists or dental hygienists schedule follow-up appointments for patients who have undergone comprehensive restorative or rehabilitation dentistry more often than practices with other types of ownership. Dental practices owned by dentists or dental hygienists follow up patients with periodontitis and peri-implantitis less frequently. Conclusion: Type of ownership of a dental business influences the extent to which periodontal, and comprehensive restorative or rehabilitation dentistry were followed up.

Refractory ischemic priapism is a difficult to treat clinical entity for which there are a host of shunt procedures identified, but no singular agreed upon technique for surgical therapy. Recent literature describes success using a penoscrotal decompression technique that uses a similar dissection of a penoscrotal penile prosthesis placement. We demonstrate that this technique is easily applicable in the private practice setting as it uses a familiar setup to most general urologists in our case report.

Objective: To compare the use of sealants in permanent molars between public and private dentists in Brazil. Material and Methods: This was a cross-sectional and analytical web survey study. The convenience sample consisted of dentists in Brazil who answered a pre-tested online form released via social media between July and October 2021. Descriptive analysis was performed using absolute and relative frequencies (%) and associations using the Chi-square test (p0.05). Conclusion: The percentage of use of sealants among dentists in Brazil is high, especially among professionals in the public service, and the most used materials were resinous sealants and glass ionomer cement.

Abstract Background No research has been conducted to assess whether antibiotic prophylaxis prescribing differs by dental setting. Therefore, the goal of this study was to compare the prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-Veterans Affairs settings. Methods This was a retrospective study of veteran and non-veteran dental patients with cardiac conditions or prosthetic joints between 2015–2017. Multivariable log binomial regression analysis was conducted to compare concordant prescribing by setting with a sub-analysis for errors of dosing based on antibiotic duration (i.e., days prescribed). Results A total of 61,124 dental visits that received a prophylactic antibiotic were included. Most were male (61.0%), and 55 years of age or older (76.2%). Nearly a third (32.7%) received guideline concordant prophylaxis. VA dental settings had a lower prevalence of guideline concordant prescribing compared to non-VA settings in unadjusted results (unadjusted prevalence ratio [uPR] = 0.92, 95% CI: 0.90–0.95). After adjustment, prevalence of guideline concordant prescribing was higher in those with prosthetic joints in the VA setting (adjusted prevalence ratio [aPR] = 1.73, 95% CI: 1.59–1.88), with no difference identified in those without a prosthetic joint (aPR = 0.99, 95% CI: 0.96–1.01). Concordance of dosing was higher in VA compared to non-VA settings (aPR = 1.11, 95% CI: 1.07–1.15). Conclusions VA has a higher prevalence of guideline concordant prescribing among those with prosthetic joints and when assessing dosing errors. Though the presence of an integrated electronic health record (EHR) may be contributing to these differences, other system or prescriber-related factors may be responsible. Future studies should focus on to what extent the integrated EHR may be responsible for increased guideline concordant prescribing in the VA setting.

In developing countries like Zimbabwe, the issue of private practice in social work is at a formative stage. This paper explored the opinion of social workers regarding the issue of private practice in social work in the country. Using quantitative research design, data was collected from randomly sampled social workers (n = 462) from various fields of practices. The study findings revealed that the majority (47%) of social workers (n = 218) strongly believed that they ought to venture into private practice. Based on the regression models, the following factors were statistically significant (ρ < .05) in predicting engagement in private practice: desire to expand resource base, quest to create employment, professional empowerment, professional autonomy, improved quality of services, influence from other professions, favorable regulatory environment, desire to reach new clients, existence of wider clientele base, improving professional identity, and knowledge base. The study recommends increased public debates, development of private practice legal framework, and inter-professional collaboration with other professions. The paper concluded that private practice in social work is a welcome initiative among Zimbabwean social workers and there is a need for increased publicity in this area. [ABSTRACT FROM AUTHOR]

The efficacy and effectiveness of psychotherapy for depression are well established in many clinical settings. Nonetheless, its effectiveness in private practice, perhaps the most common clinical setting, has yet to be examined. Likewise, the trajectories of change in depressive symptoms observed during psychotherapy for depression in private practice have yet to be studied. The present study harnessed a large practice-research group of private practitioners to address these important omissions in the literature. The sample of clients with depression (N = 2,268) included in the study displayed medium-to-large and large-sized reductions in depressive symptoms following treatment (depending on baseline severity). These effects were benchmarked against those synthesized from randomized controlled trials (RCTs), a comparable benchmark study, and the course of untreated depression. The outcomes exhibited by the private practice clients were found to be superior to no treatment, equivalent to those reported in other naturalistic clinical settings, and nonequivalent to those exhibited by experimental groups in RCTs. Furthermore, the analysis of trajectories of change indicated that higher session frequency early on in treatment led to better outcomes. Overall, these findings attest to the effectiveness of psychotherapy for depression delivered in private practice. Additionally, they provide clinically useful findings underscoring the importance of higher session frequency in the early phase of psychotherapy. Public Significance Statement: Findings from the present study support the effectiveness of psychotherapy for depression delivered in private practice. Moreover, they underscore the importance of higher session frequency in the early phase of treatment. [ABSTRACT FROM AUTHOR]

Private equity acquisitions are increasing among orthopedic practices. The concepts and vocabulary surrounding these deals may be foreign to physicians. There are both potential risks and potential benefits to physicians at the center of these complex deals, and a clear understanding of any proposed private equity acquisition is crucial. Short-term data on private equity acquisition in other procedure-based outpatient specialties have shown that private equity ownership consistently increased the number of patients seen per provider, allowed amount per claim, and utilization of advanced practice practitioners. These studies did not show consistent changes in the rates of invasive procedures or negative impacts on patient care. Each practice will need to carefully consider any potential private equity involvements. [ABSTRACT FROM AUTHOR]

Background: Social media is an important tool for networking, recruitment, and promoting clinical practice. No study has specifically assessed which FPRS practitioners have professional social media accounts, how they utilize them, and what barriers or resources exist to their use. Objectives: This study aims to examine differences in social media use based on provider demographics and practice setting, and identify resources and barriers to professional social media use. Methods: This cross-sectional analysis was an anonymous survey sent to AAFPRS members. Data collected included demographics, practice setting, resources, and barriers encountered to use of professional social media. Results: Most facial plastic surgeons (80%) use professional social media, notably Instagram and Facebook, and mostly post patient photos and stories (67.9%). Social media is more commonly utilized in private practice (56% vs 23%, P =.0016), where there are less institutional barriers (10% vs 40%, P =.02) and more resources available (82.5% vs 12.5%, P =.01). Conclusions: Social media is widely used in FPRS. Working in private practice is associated with increased availability of resources for support, and a reduction in institutional barriers to maintaining a social media presence. With this understanding, facial plastic surgeons can be better equipped for networking, marketing, and promoting the field of FPRS. [ABSTRACT FROM AUTHOR]

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This article discusses why surgeons get into trouble more than most other specialties. It explores some of the areas that are known to be associated with the highest risk of suspension and malpractice claims, including unacceptable professional behaviour, inadequate consent, documentation and peri-procedural precautions, the introduction of new procedures and devices without adequate training, lack of resources and support, whistleblowing, independent work in the private sector, and medicolegal work as an expert. In each of these areas, pitfalls to avoid are highlighted. The article concludes by emphasizing the importance of teamworking, an adequate workload and support, keeping up-to-date, regular peer review, thorough counselling of patients, meticulous record keeping and attention to detail. [ABSTRACT FROM AUTHOR]