Findings suggest that the provision of CAM is widespread in the German outpatient setting. However, it has to be taken into account that a selection bias may apply which may lead to an overestimation of CAM provision. Doctors' reasons to offer CAM are manifold; therapeutic reasons seem to outweigh economic motives.
Introduction: The majority of physicians consider administrative tasks to be a burden. The present questionnaire is intended to clarify the expense of time for documentation tasks in the treatment of inpatients in a gynaecological department of a Swiss hospital and to what extent differences occur between senior physicians and junior physicians. Materials and Methods: For three weeks physicians in the gynaecological department of a central Swiss hospital documented minute for minute predefined tasks during their duty periods. A questionnaire in tabular form served as survey instrument for this working time analysis. The minute for minute details for the individual participants were summed for each clinical task listed in the questionnaire in order to subsequently calculate the amounts of time spent for the respective task categories and to subject them to a subgroup analysis. Results: The participation rate of the physicians amounted to 87 %. 287 questionnaires were included in the evaluation. According to the responses, 25% of the clinical working time for inpatients was used for documentation of clinical tasks. The subgroup analysis revealed a higher proportion for assistant physicians (30 %) than for senior physicians (18 %). Discussion: The present working time analysis reveals an unfavourable ratio between surgical and administrative tasks between junior and senior physicians. In addition there is a danger that the true burden for junior physicians is underestimated by their superiors due to hierarchal differences.
Advanced therapy medicinal products (ATMP) are associated with high expectations because they offer new opportunities for the treatment of diseases, e.g., the possibility of regenerating damaged or lost tissue. What the products (gene therapy, somatic cell therapy, and tissue engineered products) have in common is an innovative and complex development process that combines science and engineering. At the same time, this field of research is becoming increasingly interdisciplinary and requires international cooperation. A comprehensive assessment of ATMP has to take these issues into account. The application of Beauchamp and Childress' Four Principles (Principle-Based Ethics) as well as Discourse Ethics as a framework may lead to a broader consideration of medical ethics issues.
Hintergrund: Deutschland weist gegenüber zahlreichen anderen Staaten die Besonderheit auf, dass neben Ärzten auch Heilpraktiker eine staatliche Zulassung zur Ausübung der Heilkunde erlangen können. Das Verhältnis der beiden Berufsgruppen zueinander gilt als schwierig - unabhängig von berufsrechtlichen Hindernissen. Ziel der Untersuchung war es zu klären, inwieweit bei niedergelassenen Ärzten eine Bereitschaft zur Zusammenarbeit mit Heilpraktikern besteht. Gleichzeitig sollten Bedingungen, Chancen sowie Hindernisse einer Kooperation aufgezeigt werden. Methoden: Um die ärztliche Bereitschaft zur Zusammen arbeit mit Heilpraktikern zu evaluieren, wurden mit 15 niedergelassenen Ärzten und Zahnärzten semi-strukturierte Interviews geführt. Die Fragen thematisierten Bedingungen, Chancen sowie Barrieren einer Kooperation. Im Anschluss wurden die Interviews wörtlich transkribiert und mithilfe der thematischen Inhaltsanalyse ausgewertet. Ergebnisse: Einer Zusammenarbeit gegenüber aufgeschlossene Ärzte sehen Heilpraktiker als ergänzende Therapeuten bei leichteren oder psychisch beeinflussten Erkrankungen. Dafür bestehen allerdings klare Bedingungen: Heilpraktiker müssten die Grenzen ihrer Behandlungsfähigkeit erkennen. Voraussetzungen seien auch transparente Regelungen der Kostenerstattung durch Krankenkassen, insbesondere dürften ärztliche Leistungen im Bereich der Komplementär- und Alternativmedizin nicht diskriminiert werden. Neben dem mangelnden Vertrauen der befragten Ärzte in die Heilpraktikerausbildung erweist es sich als hinderlich, wenn Heilpraktiker störend auf die bestehende Arzt-Patienten-Beziehung einwirken bzw. den Abbruch einer schulmedizinischen Therapie veranlassen. Gleichzeitig wird die bestehende Patientenversorgung bereits als zu komplex für eine Kooperation eingeschätzt. Schlussfolgerungen: Um zu reproduzierbaren Ergebnissen zu gelangen, sind Untersuchungen mit quantitativem Forschungsdesign nötig. Auch sollte geklärt werden, inwieweit aus Sicht der Heilpraktiker eine Zusammenarbeit mit Ärzten wünschenswert ist. Der Abbau von Kommunikationsbarrieren ist nötig, damit Patienten offen mit ihrem Arzt über Heilpraktiker besuche sprechen kön-nen. Das Wissen über Unterschiede in Ausbildung und Zulassung zum Arzt oder Heilpraktiker ist Grundvoraussetzung für eine informierte Entscheidung der Patienten.
Seasonal influenza vaccination rates among European countries remain low despite the World Health Organization’s recommendations to vaccinate high-risk groups. Healthcare worker recommendations are strong predictors of increased vaccination uptake in the population. Therefore, this study aimed to analyze seasonal influenza vaccination recommendation behavior among pharmacists towards high-risk groups including patients, coworkers, and pharmacists’ family members during the COVID-19 pandemic. This cross-sectional, questionnaire-based research was conducted in Switzerland during the flu season and sent to all members of the Swiss Pharmacist Association. In December 2020, 569 community pharmacists completed the online survey. The influenza vaccination recommendation rates for high-risk patients were 93.6% for the elderly, 70.7% for pregnant women, 65.2% for immunocompromised people, and 60.3% for patients with chronic diseases. Pharmacists tend to recommend influenza immunization to patients more than to family members and colleagues. Holding a certification to administer immunization and personal influenza vaccine history were the main predictors for recommending influenza vaccination to patients, family members, and colleagues. Our results indicated that influenza vaccination recommendation rates in our whole sample of pharmacists, were higher for vaccinated and immunizing pharmacists. Ensuring high vaccinations rates and high ratio of immunizing pharmacists may be important in promoting seasonal influenza vaccination in the general population.
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