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Journal of the American Board of Family Medicine: JABFM

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https://www.readbyqxmd.com/read/29535249/already-19-further-reflections-on-parenting-aniridia-and-being-a-doctor
#1
Nancy Elder
The author, a family physician, reflects on raising a daughter with a rare eye disease, aniridia, and learning and memory disabilities as the daughter heads off to college.
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535248/revisiting-primary-care-s-critical-role-in-achieving-health-equity-pisacano-scholars-reflections-from-starfield-summit-ii
#2
Brian Park, Anastasia J Coutinho, Noemi Doohan, Jonathan Jimenez, Sara Martin, Max Romano, Diana Wohler, Jennifer DeVoe
The second Starfield Summit was held in Portland, Oregon, in April 2017. The Summit addressed the role of primary care in advancing health equity by focusing on 4 key domains: social determinants of health in primary care, vulnerable populations, economics and policy, and social accountability. Invited participants represented an interdisciplinary group of primary care clinicians, researchers, educators, policymakers, community leaders, and trainees. The Pisacano Leadership Foundation was one of the Summit sponsors and held its annual leadership symposium in conjunction with the Summit, enabling several Pisacano Scholars to attend the Summit...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535247/moral-distress-with-obstacles-to-hepatitis-c-treatment-a-council-of-academic-family-medicine-educational-research-alliance-cera-study-of-family-medicine-program-directors
#3
Aditya Simha, Camille Maria Webb, Ramakrishna Prasad, N Randall Kolb, Peter J Veldkamp
BACKGROUND AND OBJECTIVE: To determine whether family medicine program directors (PDs) experienced moral distress due to obstacles to Hepatitis C virus (HCV) treatment, and to explore whether they found those obstacles to be unethical. DESIGN: An omnibus survey by the Council of Academic Family Medicine's Educational Research Alliance was administered to 452 and completed by 273 US-based PDs. The survey gauged attitudes and opinions regarding ethical dilemmas in patient access to HCV treatment...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535246/plantar-fascia-rupture-ultrasound-to-facilitate-recognition
#4
Jessica T Servey, Christopher Jonas
Plantar fascia rupture in the absence of previous diagnosis of plantar fasciitis, corticosteroid injection, or injury is a rare occurrence with only 7 case reports in the literature since 1978. This is a case of spontaneous plantar fascia rupture in a 38-year-old active-duty US military member with current considerations in musculoskeletal ultrasound, other radiologic imaging, treatment, and followup of this diagnosis.
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535245/evaluation-of-an-ongoing-diabetes-group-medical-visit-in-a-family-medicine-practice
#5
Amy T Cunningham, David J Delgado, Joseph D Jackson, Albert G Crawford, Serge Jabbour, Robert D Lieberthal, Victor Diaz, Marianna LaNoue
PURPOSE: Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. METHODS: This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535244/humor-during-clinical-practice-analysis-of-recorded-clinical-encounters
#6
Kari A Phillips, Naykky Singh Ospina, Rene Rodriguez-Gutierrez, Ana Castaneda-Guarderas, Michael R Gionfriddo, Megan Branda, Victor Montori
OBJECTIVE: Little is known about humor's use in clinical encounters, despite its many potential benefits. We aimed to describe humor during clinical encounters. DESIGN: We analyzed 112 recorded clinical encounters. Two reviewers working independently identified instances of humor, as well as information surrounding the logistics of its use. RESULTS: Of the 112 encounters, 66 (59%) contained 131 instances of humor. Humor was similarly frequent in primary care (36/61, 59%) and in specialty care (30/51, 59%), was more common in gender-concordant interactions (43/63, 68%), and was most common during counseling (81/112, 62%)...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535243/physician-multisite-practicing-impact-on-access-to-care
#7
Imam M Xierali
BACKGROUND: Physician multisite practicing may affect access to care. However, study measuring the degree of multisite practicing is generally lacking. This study aimed to describe physician multisite practicing patterns in Georgia and to assess its impact on access to care. METHODS: Using data from the Georgia Medicaid Management Information System, the American Medical Association Physician Masterfile, and the US Census, mean number of practice sites per physician was calculated...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535242/a-model-for-measuring-ambulatory-access-to-care-recovery-after-disasters
#8
Tiffany A Radcliff, Karen Chu, Claudia Der-Martirosian, Aram Dobalian
INTRODUCTION: Although little research has examined impacts of disasters on scheduled ambulatory care services, routine care delivery is important for emergency planning and response because missed or delayed care can lead to more urgent care needs. This article presents potential measures of ambulatory care recovery and resilience and applies the measures to data around a recent disaster. METHODS: We conceptualize "ambulatory care recovery" as the change in median business days to complete appointments that were canceled, and "ambulatory care resiliency" as the change in percentage of completed appointments in time frames before, during, and after disasters...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535241/moving-away-from-the-tip-of-the-pyramid-screening-and-brief-intervention-for-risky-alcohol-and-opioid-use-in-underserved-patients
#9
Kamilla L Venner, Victoria Sánchez, Jacqueline Garcia, Robert L Williams, Andrew L Sussman
PURPOSE: Rates of risky substance use and substance use disorders are high in primary-care practices, yet the adoption of universal screening and brief intervention (SBI) has been slow and uneven. This study aimed to describe SBI-related attitudes, practices, and perspectives regarding practice change among medical providers in a minority-majority state. METHODS: We conducted a cross-sectional, on-line survey of a practice-based research network of medical providers serving predominantly Hispanic/Latinx and Native American patients in rural and urban settings...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535240/critical-factors-to-practicing-medical-acupuncture-in-family-medicine-patient-and-physician-perspectives
#10
Christy J W Ledford, Carla L Fisher, David A Moss, Paul F Crawford
INTRODUCTION: Although an increasing number of physicians are completing medical acupuncture training, only half of those physicians are able to successfully incorporate acupuncture into practice. We conducted a qualitative study to identify the factors and barriers that can enhance and impede physicians' delivery of and patients' engagement in medical acupuncture within the family medicine clinic. METHODS: We conducted interviews with 15 family physicians and 17 patients in a US family medicine clinic that has integrated medical acupuncture into its practice...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535239/barriers-and-facilitators-to-expanding-roles-of-medical-assistants-in-patient-centered-medical-homes-pcmhs
#11
Jeanne M Ferrante, Eric K Shaw, Jennifer E Bayly, Jenna Howard, M Nell Quest, Elizabeth C Clark, Connie Pascal
BACKGROUND: Many primary care practices participating in patient-centered medical home (PCMH) transformation initiatives are expanding the work roles of their medical assistants (MAs). Little is known about attitudes of MAs or barriers and facilitators to these role changes. METHODS: Secondary data analysis of qualitative cross-case comparison study of 15 New Jersey primary care practices participating in a PCMH project during 2012 to 2013. Observation field notes and in-depth and key informant interviews (with physicians, office managers, staff and care coordinators) were iteratively analyzed using grounded theory...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535238/retrospective-comparison-of-cardiac-testing-and-results-on-inpatients-with-low-pretest-probability-compared-with-moderate-high-pretest-probability-for-coronary-artery-disease
#12
Aaron Lear, Merritt Huber, Amy Canada, Jessica Robertson, Evan Bosman, Stephen Zyzanski
OBJECTIVE: To determine whether admission, and provocative stress testing of patients who have ruled out for acute coronary syndrome put patients with low-risk category for coronary artery disease (CAD) at risk for false-positive provocative stress testing and unnecessary coronary angiogram/imaging. METHODS: A retrospective chart review was performed on patients between 30 and 70 years old, with no pre-existing diagnosis of CAD, admitted to observation or inpatient status chest pain or related complaints...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535237/greater-occipital-nerve-block-for-acute-treatment-of-migraine-headache-a-large-retrospective-cohort-study
#13
Sorcha M Allen, Farouk Mookadam, Stephen S Cha, John A Freeman, Amaal J Starling, Martina Mookadam
INTRODUCTION: Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief. METHODS: This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535236/delivering-interconception-care-during-well-child-visits-an-implicit-network-study
#14
Sukanya Srinivasan, Lisa Schlar, Stephanie E Rosener, Daniel J Frayne, Scott G Hartman, Michael A Horst, Jessica L Brubach, Stephen Ratcliffe
BACKGROUND: Preterm birth, birth defects, and unintended pregnancy are major sources of infant and maternal morbidity, mortality, and associated resource use in American health care. Interconception Care (ICC) is recommended as a strategy to improve birth outcomes by modifying maternal risks between pregnancies, but no established model currently exists. The Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network developed and implemented a unique approach to ICC by assessing mothers during their baby's well-child visits (WCVs) up to 24 months...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535235/patient-centered-guidelines-for-geriatric-diabetes-care-potential-missed-opportunities-to-avoid-harm
#15
Ellen M McCreedy, Robert L Kane, Sarah E Gollust, Nathan D Shippee, Kirby D Clark
BACKGROUND: Clinicians strive to deliver individualized, patient-centered care. However, these intentions are understudied. This research explores how patient characteristics associated with an high risk-to-benefit ratio with hypoglycemia medications affect decision making by primary care clinicians. METHODS: Using a vignette-based survey, we queried primary care clinicians on their intended management of geriatric patients with diabetes. The patients' ages, disease durations, and comorbidities were systematically varied...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535234/menthol-cough-drops-cause-for-concern
#16
Danika Johnson, Robert Mead, Korey Kennelty, David Hahn
BACKGROUND: Over-the-counter (OTC) cough remedies are lightly regulated and their potential side effects may go unrecognized. During 2015, over 282 million cough drops were sold in the United States. A Wisconsin community clinician (RM) made clinical observations suggesting that excessive use of OTC cough drops may exacerbate rather than benefit coughs. The goal of this project was to assess whether menthol in cough drops is related to worse cough symptoms. METHODS: From April 2016 through May 2017, 5 Wisconsin primary care clinics invited adolescent and adult outpatients seeking medical care for an acute or subacute cough to take a voluntary, anonymous, 10-question cough drop use survey that included age, sex, smoking status, cough severity, cough duration, and cough drop use (including type and amount)...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535233/wide-gap-between-preparation-and-scope-of-practice-of-early-career-family-physicians
#17
Lars E Peterson, Bo Fang, James C Puffer, Andrew W Bazemore
We found substantial gaps between preparation for, and practice of, early career family physicians in nearly all clinical practice areas. With reported intentions of graduates for a broad scope of practice, gaps between practice and preparation suggest family physicians early in their careers may not be finding opportunities to provide comprehensive care.
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535232/potentially-alarming-trends-in-the-scope-of-practice-for-family-physicians
#18
Peter J Carek
No abstract text is available yet for this article.
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29535231/real-life-observational-studies-provide-actionable-data-for-family-medicine
#19
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue includes several excellent observational studies prompted by physicians' clinical questions. Many people use lots of menthol cough drops-does the menthol overall lengthen the cough duration? When should we intensify treatment of older individuals with diabetes? Do occipital nerve blocks work for acute migraine headaches? Did you know that the plantar fascia can rupture? What happens to those patients with chest pain but low pretest probability for serious cardiac disease who are admitted to the hospital? Acupuncture can work well-for the patients-but how can we incorporate it into the usual pace of the family medicine office? Is it a win-lose situation when medical assistant roles are expanded? How many practice sites do physicians have and does that make a difference in the number or type of health personnel shortage areas? What would you guess on the presence of humor in the medical office-more or less than half of the visits; introduced by doctors or patients; primary care or specialty doctors?...
March 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330253/re-the-numbers-quandary-in-family-medicine-obstetrics
#20
LETTER
Tyler Barreto, Aimee R Eden, Andrew Bazemore, Lars E Peterson
No abstract text is available yet for this article.
January 2018: Journal of the American Board of Family Medicine: JABFM
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