Patients who receive prescription opioids have higher satisfaction rates than those without, but paradoxically experience more pain. Non-patient medical requests from family and friends require a nuanced response. Diabetes care emphasizes communication, coordination, and biopsychosocial approaches to engage patients.
A resident physician's experience with a deceased patient teaches her to approach relationships with empathy, rather than avoidance. This insight is gained through a difficult patient-case that highlights the complexities of human life and death.
The Anticholinergic Cognitive Burden Scale (ACB) is associated with increased risk of emergency department visits, hospitalizations, and incident dementia in older adults. High ACB scores are linked to a dose-response relationship between anticholinergic burden and adverse clinical outcomes.
Postpartum depression affects women differently than anticipated, with factors including societal expectations and stigma surrounding mental illness. Dr. Frankhouser's autoethnographic study aims to raise awareness and promote understanding, encouraging physicians to provide compassionate care and support.
Researchers developed a new framework to report and design models of care for multimorbidity, highlighting changing elements such as reduced home care and increased extended appointments. The framework provides a tool for standardized reporting and research on multimorbidity interventions.
Shared decision making among adult Americans increased from 4.4 to 5 between 2002 and 2014. Disparities exist by race/ethnicity and insurance status, but same-race clinician responses improve perceptions.
A new study found a positive association between allopurol initiation and recurring doctor visits for gout, highlighting the need for regular chronic disease reviews to evaluate patients' preferences and eligibility for treatment. The study suggests that more frequent monitoring could reduce barriers to successfully treating gout.
A family physician advocates for prioritizing human connection in medical practices, shifting focus from productivity to relationships. He suggests viewing the practice as a unit of care, encouraging ingenuity and problem-solving skills among employees to strengthen cultures.
A recent study found that older adults with four or more chronic conditions are less likely to participate actively in medical decisions. In contrast, those without multiple conditions tend to prefer more active involvement.
General practitioners trained in compression ultrasonography achieve excellent accuracy in diagnosing deep vein thrombosis, with a diagnostic accuracy of 96%. The technique's sensitivity and specificity rates are comparable to those of expert physicians.
A randomized controlled trial found that text message reminders increased vaccine uptake among eligible patients, with the greatest effect seen in children under five years old. The study suggests cost-efficient strategies to improve vaccine uptake, particularly for vulnerable populations.
A new study has identified six attributes associated with high-value primary care practices, including decision support for evidence-based medicine and careful selection of specialists. These attributes are linked to three themes: care traffic control, cognitive burden reduction, and value-based reimbursement.
A UK study found that older patients experiencing more discontinuity of care in general practice are at a higher risk of emergency hospital admissions. Patients with the least continuity had a risk of admission twice as high as those with complete continuity.
A new diagnostic test found that disappearing of heart murmur while standing reliably rules out pathologic heart murmurs in children. The test showed a high predictive positive value and specificity, but poor sensitivity, making it a valuable tool for primary care docs to exclude costly cardiologist referrals.
A new study found that disappearance of heart murmur while standing reliably rules out pathologic heart murmurs. The test, using an acoustic-based stethoscope, has a high predictive positive value and specificity, but poor sensitivity.
The study found that scribes significantly improved physician satisfaction in terms of overall satisfaction, time spent charting, and chart quality. Physicians were more satisfied with scribed charts than their own, suggesting a potential solution to the clerical burden associated with documentation.
The Affordable Care Act has expanded Medicaid coverage, leading to significant decreases in medical visits among uninsured patients across all racial and ethnic groups. However, disparities persist, with Hispanic patients experiencing smaller declines in uninsured visit rates compared to non-Hispanic whites and blacks.
Primary care physicians spend an average of 355 minutes (5.9 hours) per day in the EHR, including 269 minutes during clinic hours and 86 minutes after hours. This excessive time spent on clerical tasks can lead to burnout and decreased productivity. The study suggests that solutions like proactive planned care, team-based care, and sha...
A regional health center established an office-based opioid treatment program after a patient's overdose death, treating patients on-site. A massive open online course is also available for free, educating participants about falls and fall prevention strategies.
A new scoring tool, G-TRUST, evaluates guideline trustworthiness and identifies useful practice guidelines. The tool's reliability needs to be researched, especially when used with technology like smartphone applications.
Primary care physicians dedicate half of their workday to EHR activities, with significant time spent on clerical tasks and inbox management. The authors suggest that solutions, such as proactive planned care and sharing of clerical tasks, can improve EHR system applications.
Four primary methods are used by primary care practices to risk stratify patient populations: practice-developed algorithm, AAFP clinical algorithm, payer claims/electronic health record, and clinical intuition. Practices that developed their own algorithm identify more high-risk patients than those using other methods.
Primary care staff often attribute blame to individuals rather than system failures in patient safety incident reports. This may reflect a healthcare culture that prioritizes individual accountability over system improvement.
A study of British general practitioners found that physicians are more likely to support smoking cessation in primary care patients with coronary heart disease. Cancer patients are less likely to stop smoking due to lack of recording and advice from their doctors.
Adults with intellectual disabilities have a nearly threefold higher rate of emergency hospitalizations and five times more preventable admissions than their matched controls. The most common ACSCs resulting in admission are convulsions/epilepsy, lower respiratory tract infection, and urinary tract infection.
Children and older adults with developmental disabilities experience the greatest disparities in unmet healthcare needs. Medical schools are urged to incorporate specific training in developmental disabilities into their curricula to reduce these disparities.
In at least 18 states, academic health centers partner with cooperative extension systems to improve local community health. These collaborations focus on nutrition education, healthy cooking demonstrations, and health and nutrition education for seniors.
Medical expenditures in the US have increased by 47% between 1996-1997 and 2011-2012, mainly due to higher prescription drug use. However, primary care physician visits and home health care costs remained relatively stable.
A cluster randomized factorial trial found that training and support have a lasting impact on primary care clinicians' delivery of screening and advice to heavy drinkers. The study suggests that repeated training and support can lead to an increase in the volume of brief interventions delivered to heavy drinking patients.
A new clinical decision rule uses point scores and C-reactive protein to diagnose acute rhinosinusitis with good accuracy. The rule successfully identifies patients at low risk for bacterial infection, leading to more conservative use of antibiotics.
Residents reflect on patient struggles, joys, and future goals to cultivate inner lives and balance professional and personal selves. Writing reflections helps physicians integrate their emotions, spirituality, and clinical expertise.
A national survey of rural physicians found significant barriers to prescribing buprenorphine for opioid use disorder, including time constraints and lack of mental health support services. The study calls for tailored strategies to address these barriers and support physicians in providing Buprenorphine Maintenance Treatment.
Primary care physicians identify barriers to deprescribing, including patient expectations and organizational constraints. Less experienced physicians face additional challenges, highlighting the need for supportive interventions to promote safer prescribing practices.
A study of rural primary care physicians found that younger physicians experience higher turnover rates than older counterparts, with 17% biennial turnover among younger physicians. Rural practice is particularly challenging, with non-retention worse in counties without a hospital or smaller population.
Research reveals that insured patients struggle to secure appointments with psychiatrists, highlighting the challenges of accessing behavioral health care. The study estimates that a patient may need to call seven to ten psychiatrists to find an available appointment, underscoring the need for improved access to mental health services.
A family physician shares her experience with patient denial and anger towards opioid prescription limits, but finds healing through medication-assisted treatment training. She urges healthcare professionals to recognize opioid addiction and support one another in providing treatment.
A change in cervical cancer screening guidelines led to a decrease in Pap testing and chlamydia testing among young women. Chlamydia testing declined by 26% in females aged 15-19, resulting in lower reported incidence rates for this age group.
US medical expenditures increased by 47% between 1996-1997 and 2011-2012, driven largely by prescription drug use. Expenditures rose in most categories except primary care physicians and home health care, with the largest increases seen in specialty physicians, emergency department visits, and prescribed medications.
A widespread telehealth project in Brazil has reduced wait times for specialty consultations, while solo practices use patient-entered data to supercharge self-management. These innovations expand primary care access and enhance patient engagement.
Patients with opioid use disorder on buprenorphine are at significantly higher risk of death when in and out of treatment. The study found a 2.6 times increased risk of mortality compared to individuals without addiction issues during the same time period.
A proposed solution to disrupt healthcare disruptions is the creation of a chief primary care medical officer. This position would lead hospital efforts to create systems ensuring a complete primary care continuum, even for complex patients, resulting in improved value, reduced costs, and better health outcomes.
Ambiguous losses in physicians' roles can cause stress and grief, which contributes to burnout if not acknowledged. A proposed solution is supporting physicians in addressing their grief, rather than focusing on resilience training.
Family physicians are well-qualified to treat addiction due to their focus on relationships, communities, and team-based care. Primary care physicians must be responsible for the initial and longitudinal care of patients with substance use disorders, and specialized services must be widely available and accessible.
Researchers found that Canadian primary care practices scored an average of 5.36 out of 10 on the Patient Medical Home (PMH) model, with Ontario being the only province to score higher than the national average. Despite efforts to implement the PMH model, provinces showed little variation in achieving key objectives.
A study published in the Annals of Family Medicine found that in-office automated blood pressure monitoring over 30 minutes significantly reduced the number of patients who met criteria for antihypertensive medication regimes. The technique, known as OBP30, yielded lower blood pressure readings than routine office blood pressure readings.
Poor primary care coordination affects 1 in 3 patients globally, with the US having the highest rate. The study found that US patients reported similar levels of poor care regardless of insurance status or health conditions.
New research finds automated blood pressure monitoring over 30 minutes significantly reduces the number of patients meeting criteria for antihypertensive medication. This technique yields lower blood pressure readings than routine office measurements, helping to avoid overtreatment.
A recent study published in Annals of Family Medicine found that oral and topical antibiotics have no meaningful benefit for milder clinically infected eczema in children. Topical corticosteroids and emollient treatment led to rapid resolution of symptoms.
Researchers found no decline in primary care availability despite the millions of newly insured individuals. Appointment rates and wait times remained stable or increased slightly in some states, supporting the possibility that primary care capacity was sufficient to absorb the new patients.
The National Commission on Prevention Priorities has released updated rankings for clinical preventive services, highlighting the most effective and cost-effective options. The top three services include immunizing children, tobacco-use screening, and alcohol misuse screening, with scores of 10 out of a possible 10.