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A comparative study on the utility of telehealth in the provision of rheumatology services to rural and northern communities.

https://arctichealth.org/en/permalink/ahliterature176198
Source
Int J Circumpolar Health. 2004 Dec;63(4):415-21
Publication Type
Article
Date
Dec-2004
Author
Michael Jong
Majed Kraishi
Author Affiliation
Memorial University of Newfoundland, Labrador Health Center, Canada. mjong@hvgb.net
Source
Int J Circumpolar Health. 2004 Dec;63(4):415-21
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Arthritis, Rheumatoid - diagnosis - therapy
Attitude of Health Personnel
Health Care Surveys
Humans
Medically underserved area
Needs Assessment
Newfoundland and Labrador
Patient satisfaction
Physician's Practice Patterns
Professional Practice Location
Questionnaires
Remote Consultation - standards - trends
Rheumatology - standards - trends
Rural Population
Telemedicine - utilization
Videoconferencing
Abstract
There is a critical shortage of specialty rheumatology services in Canada. The impact is felt more in rural and northern regions than on urban areas of the country. In response to the need, this study was conducted to compare the satisfaction of referring physicians with rheumatology services through conventional visiting specialty clinics; email consults and regularly scheduled videoconference.
Three rural communities of similar size and availability of physician services were assigned to one of the following means of providing outreach rheumatology services: visiting rheumatologist clinics, email access to rheumatologist and scheduled videoconference consults. A case based pre/post test, and post satisfaction questionnaire were administered to the primary care physicians in these communities. Patient outcomes, and physician ability and confidence in managing specific arthritis problems, were measured.
Physicians responded positively to all methods of rheumatology service provision. The videoconference group were the most positive. The reasons were: immediate feedback to referring physician and patient, effective case based learning and transfer of knowledge, and improved accessibility.
Videoconference is preferred to visiting clinics and email as a method for rheumatology services to rural/northern communities. It is cost effective and there is knowledge transfer between the rheumatologist and the referring physicians.
PubMed ID
15709316 View in PubMed
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Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes.

https://arctichealth.org/en/permalink/ahliterature296635
Source
Rural Remote Health. 2018 Mar; 18(1):4426
Publication Type
Journal Article
Date
Mar-2018
Author
James Rourke
Shabnam Asghari
Oliver Hurley
Mohamed Ravalia
Michael Jong
Wendy Graham
Wanda Parsons
Norah Duggan
Danielle O'Keefe
Scott Moffatt
Katherine Stringer
Carolyn Sturge Sparkes
Janelle Hippe
Kristin Harris Walsh
Donald McKay
Asoka Samarasena
Author Affiliation
Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, Prince Philip Drive, St. John's, NL A1B 3V6, Canada jrourke@mun.ca.
Source
Rural Remote Health. 2018 Mar; 18(1):4426
Date
Mar-2018
Language
English
Publication Type
Journal Article
Keywords
Cohort Studies
Family Practice - education
Humans
Newfoundland and Labrador
Physicians, Family - supply & distribution
Professional Practice Location
Retrospective Studies
Rural health services - organization & administration
Rural Population
Schools, Medical - organization & administration
Abstract
Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools.
This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing where they received their MD and/or PG training with other medical schools who are the only medical school in their province (n=4). (2) National-level analysis compared Memorial PG graduates practicing in rural Canada with all other Canadian medical schools (n=16). Descriptive and bivariate analyses were performed.
Overall, 18 766 physicians practicing in Canada completed Canadian PG training (2004-2013), and of those, 8091 (43%) completed Family Medicine (FM) training. Of all physicians completing Canadian PG training, 1254 (7%) physicians were practicing rurally and of those, 1076 were family physicians. There were 379 Memorial PG graduates and of those, 208 (55%) completed FM training and 72 (19%) were practicing rurally, and of those practicing rurally, 56 were family physicians. At the national level, the percentage of all Memorial PG graduates (19.0%) and FM PG graduates (26.9%) practicing rurally was significantly better than the national average for PG (6.4%, p
PubMed ID
29548259 View in PubMed
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From pipelines to pathways: the Memorial experience in educating doctors for rural generalist practice.

https://arctichealth.org/en/permalink/ahliterature296636
Source
Rural Remote Health. 2018 03; 18(1):4427
Publication Type
Journal Article
Date
03-2018
Author
James Rourke
Shabnam Asghari
Oliver Hurley
Mohamed Ravalia
Michael Jong
Wanda Parsons
Norah Duggan
Katherine Stringer
Danielle O'Keefe
Scott Moffatt
Wendy Graham
Carolyn Sturge Sparkes
Janelle Hippe
Kristin Harris Walsh
Donald McKay
Asoka Samarasena
Author Affiliation
Faculty of Medicine, Memorial University of Newfoundland, Health Sciences Centre, Prince Philip Drive, St. John's, NL A1B 3V6, Canada jrourke@mun.ca.
Source
Rural Remote Health. 2018 03; 18(1):4427
Date
03-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Attitude of Health Personnel
Career Choice
Family Practice - education
Female
Humans
Internship and Residency - organization & administration
Male
Medically underserved area
Newfoundland and Labrador
Professional Practice Location - statistics & numerical data
Rural health services - organization & administration
Rural Population
Students, Medical - statistics & numerical data
Abstract
This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners. Programs/interventions/initiatives: The 'pathways to rural practice' include initiatives in four stages: (1) before admission to medical school; (2) during undergraduate medical training (medical degree (MD) program); (3) during postgraduate vocational residency training; and (4) after postgraduate vocational residency training. Memorial's Learners & Locations (L&L) database tracks students through these stages. The Aboriginal initiative - the MedQuest program and the admissions process that considers geographic or minority representation in terms of those selecting candidates and the candidates themselves - occurs before the student is admitted. Once a student starts Memorial's MD program, the student has ample opportunities to have rural-based experiences through pre-clerkship and clerkship, of which some take place exclusively outside of St. John's tertiary hospitals. Memorial's postgraduate (PG) Family Medicine (FM) residency (vocational) training program allows for deeper community integration and longer periods of training within the same community, which increases the likelihood of a physician choosing rural family medicine. After postgraduate training, rural physicians were given many opportunities for professional development as well as faculty development opportunities. Each of the programs and initiatives were assessed through geospatial rurality analysis of administrative data collected upon entry into and during the MD program and PG training (L&L). Among Memorial MD-graduating classes of 2011-2020, 56% spent the majority of their lives before their 18th birthday in a rural location and 44% in an urban location. As of September 2016, 23 Memorial MD students self-identified as Aboriginal, of which 2 (9%) were from an urban location and 20 (91%) were from rural locations. For Year 3 Family Medicine, graduating classes 2011 to 2019, 89% of placement weeks took place in rural communities and 8% took place in rural towns. For Memorial MD graduating classes 2011-2013 who completed Memorial Family Medicine vocational training residencies, (N=49), 100% completed some rural training. For these 49 residents (vocational trainees), the average amount of time spent in rural areas was 52 weeks out of a total average FM training time of 95 weeks. For Family Medicine residencies from July 2011 to October 2016, 29% of all placement weeks took place in rural communities and 21% of all placement weeks took place in rural towns. For 2016-2017 first-year residents, 53% of the first year training is completed in rural locations, reflecting an even greater rural experiential learning focus.
Memorial's pathways approach has allowed for the comprehensive training of rural generalists for Newfoundland and Labrador and the rest of Canada and may be applicable to other settings. More challenges remain, requiring ongoing collaboration with governments, medical associations, health authorities, communities, and their physicians to help achieve reliable and feasible healthcare delivery for those living in rural and remote areas.
PubMed ID
29548258 View in PubMed
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Gender and snow crab occupational asthma in Newfoundland and Labrador, Canada.

https://arctichealth.org/en/permalink/ahliterature173275
Source
Environ Res. 2006 Jun;101(2):163-74
Publication Type
Article
Date
Jun-2006
Author
Dana Howse
Denyse Gautrin
Barbara Neis
André Cartier
Lise Horth-Susin
Michael Jong
Mark C Swanson
Author Affiliation
SafetyNet, Newfoundland and Labrador Centre for Applied Health Research, Faculty of Medicine, Memorial University, St. John's, Nfld., Canada A1B 3V6.
Source
Environ Res. 2006 Jun;101(2):163-74
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Animals
Asthma - epidemiology
Crustacea
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Newfoundland and Labrador - epidemiology
Occupational Diseases - epidemiology
Quality of Life
Questionnaires
Sex Factors
Socioeconomic Factors
Abstract
Fish and shellfish processing employs many thousands of people globally, with shellfish processing becoming more important in recent years. Shellfish processing is associated with multiple occupational health and safety (OHS) risks. Snow crab occupational asthma (OA) is work-related asthma associated with processing snow crab. We present a gender analysis of findings from a 3-year multifaceted study of snow crab OA in Newfoundland and Labrador, Canada. The study was carried out in four snow crab processing communities between 2001 and 2004. An anonymous survey questionnaire on knowledge, beliefs, and concerns related to processing snow crab administered to 158 workers attending community meetings at the start of the research found that women were significantly more likely than men to associate certain health problems, especially chest tightness, difficulty breathing, and cough, with crab processing (P
PubMed ID
16109398 View in PubMed
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Introduction [Primary Care, Service Delivery, Health Promotion and E-Health]

https://arctichealth.org/en/permalink/ahliterature286451
Source
Pages 491-493 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Publication Type
Conference/Meeting Material
Date
2010
PRIMARY CARE, SERVICE DELIVERY, HEALTH PROMOTION AND E-HEALTH @@M#Q INTRODUCTION Dr. Michael Jong Associate Professor (Internal Medicine) Memorial University, St. John's, Newfoundland and Labrador Labrador Health Centre, Goose Bay, Newfoundland and Labrador, Canada The delivery of health
  1 document  
Author
Michael Jong
Author Affiliation
Associate Professor (Internal Medicine), Memorial University, St. John's, Newfoundland and Labrador, Labrador Health Centre, Goose Bay, Newfoundland and Labrador, Canada
Source
Pages 491-493 in S. Chatwood, P. Orr and Tiina Ikaheimo, eds. Proceedings of the 14th International Congress on Circumpolar Health, Yellowknife, Canada, July 11-16, 2009. Securing the IPY Legacy: from Research to Action. International Journal of Circumpolar Health 2010; 69 (Suppl 7).
Date
2010
Language
English
Geographic Location
Multi-National
Publication Type
Conference/Meeting Material
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Documents
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Managing suicides via videoconferencing in a remote northern community in Canada.

https://arctichealth.org/en/permalink/ahliterature176197
Source
Int J Circumpolar Health. 2004 Dec;63(4):422-8
Publication Type
Article
Date
Dec-2004
Author
Michael Jong
Author Affiliation
Memorial University of Newfoundland, Labrador Health Center, Canada. mjong@hvgb.net
Source
Int J Circumpolar Health. 2004 Dec;63(4):422-8
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Health Care Costs
Humans
Medically underserved area
Mental health services
Newfoundland and Labrador
Remote Consultation - methods
Risk factors
Rural Health Services
Rural Population
Suicide - prevention & control
Treatment Outcome
Videoconferencing
Abstract
Telehealth in remote communities has been reported to be cost-effective for emergency medicine and possibly for psychiatry.
The cost of sending a patient out of a remote community for suicide assessment was compared with the cost of maintenance and on-line charges of videoconference. The cost comparison was used to determine the potential savings to the provincial government. User satisfaction was assessed through qualitative questionnaires.
The use of videoconferencing for mental health assessment for 71 patients in a remote northern community saved the Government of Newfoundland and Labrador dollar 140,088 in 2003. Patients and health professionals were satisfied with mental health assessment via videoconference.
The provision of mental health assessments for patients in a remote community in Labrador, Canada by videoconference was effective and saved money.
PubMed ID
15709317 View in PubMed
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Needs of specialists in rural and remote Canada.

https://arctichealth.org/en/permalink/ahliterature124534
Source
Can J Rural Med. 2012;17(2):56-62
Publication Type
Article
Date
2012
Author
Clare Toguri
Michael Jong
Judith Roger
Author Affiliation
Faculty of Medicine, University of Toronto, Toronto, Ont. clare.toguri @mail.utoronto.ca
Source
Can J Rural Med. 2012;17(2):56-62
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Canada
Choice Behavior
Databases, Factual
Education, Medical, Continuing
Female
Humans
Male
Middle Aged
Needs Assessment
Professional Practice Location
Rural Health Services - manpower
Social Support
Societies, Medical
Specialization
Workload
Abstract
Very little literature exists on rural specialists as a unique group and how best to meet their needs. We sought to provide some baseline information on specialists practising in rural and remote Canada to better understand their reasons for working rurally, their workload and how supported they felt, as well as their sources of advice and satisfaction with continuing medical education (CME).
The Society of Rural Physicians of Canada mailed a survey to specialists working in rural and remote Canada. Specialists were identified based on databases of the Canadian Medical Association (CMA) and the provincial colleges. The survey focused on reason(s) for working in a rural or remote setting, level of support and CME.
The survey was sent to 1500 physicians and yielded a 19% response rate. Although 85% of respondents felt supported overall, less than 20% felt supported by the CMA or by the Royal College of Physicians and Surgeons of Canada (RCPSC). Conversely, most felt supported by immediate colleagues (85%) and their community (78%). Most wished they had access to more training, with close to 90% agreeing that additional training should be available if they had worked for several years in a rural or remote area and a need was demonstrated.
The CMA and the RCPSC may wish to work with rural specialists to foster a more supportive relationship and better meet their needs. Additionally, efforts should be made to provide rural specialists with better access to relevant CME.
PubMed ID
22572064 View in PubMed
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Pathways to rural family practice at Memorial University of Newfoundland.

https://arctichealth.org/en/permalink/ahliterature303221
Source
Can Fam Physician. 2018 03; 64(3):e115-e125
Publication Type
Journal Article
Date
03-2018
Author
James Rourke
Danielle O'Keefe
Mohamed Ravalia
Scott Moffatt
Wanda Parsons
Norah Duggan
Katherine Stringer
Michael Jong
Kristin Harris Walsh
Janelle Hippe
Author Affiliation
Professor of Family Medicine and was past Dean of Medicine, in the Faculty of Medicine at Memorial University of Newfoundland (MUN). Jrourke@mun.ca.
Source
Can Fam Physician. 2018 03; 64(3):e115-e125
Date
03-2018
Language
English
Publication Type
Journal Article
Keywords
Family Practice - education
Humans
Internship and Residency
Newfoundland and Labrador
Physicians, Family - supply & distribution
Professional Practice Location - statistics & numerical data
Rural Health Services
Students, Medical
Abstract
To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach.
Analysis of anonymized secondary data.
Canada.
Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091).
National effect was measured by the proportion of MUN's family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN's MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN's 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN.
Memorial's comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN's MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial's 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns.
A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada.
Notes
ErratumIn: Can Fam Physician. 2018 May;64(5):331 PMID 29760250
PubMed ID
29540400 View in PubMed
Less detail
Source
Can J Rural Med. 2007;12(2):71-2
Publication Type
Article
Date
2007

President's message. Growing like a weed.

https://arctichealth.org/en/permalink/ahliterature167887
Source
Can J Rural Med. 2006;11(3):181-2
Publication Type
Article
Date
2006

23 records – page 1 of 3.