Protocol management of male genitourinary infections.
As part of a demonstration study, 567 male patients presenting to a "walk-in" clinic with common genitourinary complaints were interviewed by health assistants guided by a protocol. Independent examination of 19 patients by a health assistant and a physician formally demonstrated that the health assistants could collect the clinical data accurately. Forty-four patients were then randomly chosen to be examined, diagnosed and treated either by a health assistant guided by the protocol and supported by an available physician, or only by a physician. Using medical records and a follow-up interview, we assessed the thoroughness of the medical record, adequacy of diagnosis and treatment, symptom relief, patient satisfaction and patient education: the health assistant-protocol system proved as safe and effective as the MD-only system, and the health assistants were able to manage 68% of patients without involving the physician. The study suggests that briefly-trained health assistants may help save physician and nurse time, and that the development of protocols can help set standards for the medical management of defined problems while providing a mechanism for rapidly creating a complete medical record which can be easily audited for conformance with standards.
D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel / Q000706:statistics & numerical data*; D005832:Genital Diseases, Male / Q000628:therapy*; D006801:Humans; D008297:Male; D008499:Medical Records; D008501:Medical Records, Problem-Oriented; D008875:Middle Aged; D010823:Physician Assistants / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy; D014570:Urologic Diseases / Q000628:therapy*