This study assesses the utility of Maslach's concept of burnout for family practice physicians. Maslach Burnout Inventory (MBI) subscale correlations for the 67 residents in this sample are compared with Maslach's normative sample. The residents scored in the moderate to high range on the MBI subscales. MBI interscale correlations were similar to the pattern reported by Maslach. Significant correlations between job satisfaction and five of the six MBI subscales suggest that the construct of burnout has considerable psychological import for these physicians. The validity of the emotional exhaustion subscale is demonstrated by significant correlations with self‐assessed burnout, job satisfaction, and faculty assessments of resident burnout. Independent observers were most sensitive to residents' emotional exhaustion and less likely to assess accurately the less visible aspects of burnout related to depersonalization and lack of achievement, which suggests the usefulness of multiple measures for assessing the burnout phenomenon.

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An understanding of perceived barriers to health-care is critical to improving healthcare access for all Americans. To determine perceived barriers to health-care in an urban poor population in Dayton, Ohio, a face-to-face door-to-door survey of individuals identified through targeted, stratified, area probability sampling was done. A sample of 413 non-elderly poor adults, including 19% without telephones, reported personal relevance of various barriers to healthcare access. Most frequently endorsed barriers were lack of information about free or reduced-cost health-care, anticipated cost, and difficulty accessing child-care. Seventy-four per cent of respondents reported more than one barrier. Individuals without telephones and those without health insurance reported more barriers to health-care. Reported barriers were similar for working and non-working poor, except for transportation problems, more frequently reported by non-working respondents. This study provides important data on what poor people in a medically underserved community perceive to be barriers to accessing health-care and underscores the importance of including people without telephones in the study design. Respondents who did not have telephones were more likely to report multiple barriers, particularly problems with lack of information about free or discounted medical care, child-care, and transportation. These findings suggest the importance of door-to-door surveys rather than telephone surveys for getting accurate data on the poor.

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Survey responses were obtained from 113 family physicians in an exploratory investigation of bereavement care by family physicians. Respondents generally indicated that they believed that bereavement presented significant health risks to their patients and that the identification and treatment of bereaved patients was an important part of their role. However, physicians were highly variable in how they reported identifying and responding to bereaved patients in terms of counseling, addressing spiritual concerns, and medically treating symptoms. The "grief-responsive" physician is described based on these data. We document the interest and need for training in bereavement care.