Margo S Rowan

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PURPOSE Conceptual frameworks for primary care have evolved over the last 40 years, yet little attention has been paid to the environmental, structural and organizational factors that facilitate or moderate service delivery. Since primary care is now of more interest to policy makers, it is important that they have a comprehensive and balanced conceptual(More)
BACKGROUND The "Just-in-time Information" (JIT) librarian consultation service was designed to provide rapid information to answer primary care clinical questions during patient hours. This study evaluated whether information provided by librarians to answer clinical questions positively impacted time, decision-making, cost savings and satisfaction. (More)
BACKGROUND Limited access to specialist care remains a major barrier to health care in Canada, affecting patients and primary care providers alike, in terms of both long wait times and inequitable availability. We developed an electronic consultation system, based on a secure web-based tool, as an alternative to face-to-face consultations, and ran a pilot(More)
OBJECTIVE To explore and describe family physicians' personal and professional responses to performance assessment feedback. DESIGN Qualitative study using one-on-one semistructured interviews after feedback on performance. SETTING Fee-for-service family practices in eastern Ontario. PARTICIPANTS Eight physicians out of 25 physicians in the control(More)
The CMA's decision-making framework on core (i.e., publicly funded) and comprehensive health care services emphasizes flexibility and recognizes three levels at which decisions can be made: between patients and physicians (micro), in the community or by society (meso) and by governments (macro). Three major content dimensions are considered quality of care(More)
A surprisingly large and ever-growing number of alternative models of primary care service delivery have been developed in Ontario. The models are relatively poorly understood, and it is unclear why there are so many of them. What needs of providers and of government as payer are they attempting to address? Through a literature review and interviews with(More)
BACKGROUND Given the potential value of self-management support programs for people with chronic diseases, it is vital to understand how they influence participants' health attitudes and behaviours. The Stanford Chronic Disease Self-Management Program (CDSMP), the most well-known and widely studied such program, is funded in many provinces and jurisdictions(More)
BACKGROUND The growing prevalence of diabetes and heightened awareness of the benefits of early and intensive disease management have increased service demands and expectations not only of primary care physicians but also of diabetes specialists. While research has addressed issues related to referral into specialist care, much less has been published about(More)
BACKGROUND AND OBJECTIVES Family medicine preceptorships are crucial to educating future physicians, but there is a lack of research on how well preceptors are following the principles of primary care. This study used the Primary Care Assessment Tool (PCAT)-Provider Edition to determine how well medical preceptors provide quality medical care. METHODS A(More)
A study was conducted to determine whether there is a need for office-based resources to assist physicians in the prevention, assessment and/or management of patients, self and peers with substance use (excluding alcohol and tobacco) or pathological gambling disorders. The needs assessment was undertaken in three parts. Survey information was collected from(More)