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Record W1589942091

Nurse practitioners and physician attrition.

2005· article· en· W1589942091 on OpenAlexaboutno aff
Barry Munn, Catherine Lee

Bibliographic record

VenuePubMed · 2005
Typearticle
Languageen
FieldHealth Professions
TopicGlobal Health Workforce Issues
Canadian institutionsnot available
Fundersnot available
KeywordsLegislationAttritionWorkloadEconomic shortageWorkforcePhysician assistantsNurse practitionersFamily medicineMedicineNursingManagementPolitical scienceHealth careLaw
DOInot available

Abstract

fetched live from OpenAlex

This brief note describes one possible solution to the problem of doctor shortages in urban Canada. It involves a family physician (B.M.) nearing the end of his career and wishing to reduce his overall workload in his fi nal years of practice. Th is family physician had hoped to pass on the care of his substantial practice in a medium-sized city of southern Ontario to a younger colleague. Unfortunately, dwindling numbers of family physicians in the 1990s were willing to take on an active practice, and B.M. was able to continue working beyond the age of 60 only with the help of a physician associate, who carried the practice for 2 days weekly on a locum tenens basis. In time, even the supply of part-time physician associates dried up. By 2002, B.M. was faced with three alternatives: return to full-time activity and simply keep working, close the practice and leave almost 3000 patients with no ongoing care, or look for creative alternatives. Having worked with nurse practitioners in the past, B.M. began to explore having one as a colleague (designated RN[EC] under current Ontario legislation) join the practice as an independent associate to take on many of the responsibilities of locum physicians employed previously. The key was to have the associate practise independently but in conformity with collaborative guidelines outlined in provincial legislation. Such arrangements have worked well in isolated areas where physician supply has been minimal, but B.M. was unaware of similar collaborations in southern Ontario.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.008
metaresearch head score (Gemma)0.035
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.183
Threshold uncertainty score0.364

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0080.035
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.002
Science and technology studies0.0080.001
Scholarly communication0.0040.002
Open science0.0010.005
Research integrity0.0020.004
Insufficient payload (model declined to judge)0.0220.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.051
GPT teacher head0.390
Teacher spread0.339 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2005
Admission routes1
Has abstractyes

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