Journal of the American Board of Family Medicine : JABFM

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INTRODUCTION: Understanding how physicians' practice patterns change over a career is important for workforce and medical education planning. This study examined trends in self-reported practice activity among early- and later-career stage family physicians (FPs). METHODS: Data on early career FPs came from the American Board of Family Medicine's National Graduate Survey (NGS) and on later career FPs from its Continuous Certification Questionnaire (CCQ). Both cohorts could complete the Practice Demographic Survey (PDS) 3 years later...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Medical cannabis is commonly used for chronic pain, but little is known about differences in characteristics, cannabis use patterns, and perceived helpfulness among primary care patients who use cannabis for pain versus nonpain reasons. METHODS: Among 1688 patients who completed a 2019 cannabis survey administered in a health system in Washington state, where recreational use is legal, participants who used cannabis for pain (n = 375) were compared with those who used cannabis for other reasons (n = 558) using survey and electronic health record data...

Social isolation is a risk factor for many diseases and overall increased mortality. Alternatively human connection has been noted to lead to healthier lives and longevity. Medical clinicians need to be more aware of this condition and consider how to prescribe friendship. This is not just an issue for the elderly; many Americans are being ravaged by being alone. There are many organizations that we can refer our patients to in order to make connections. This lesson is one we as physicians need to embrace ourselves as loneliness during our busy days is affecting us too...

BACKGROUND: Advance care planning (ACP), a process of sharing one's values and preferences for future medical treatments, can improve quality of life, reduce loved ones' anxiety, and decrease unwanted medical utilization and costs. Despite benefits to patients and health care systems, ACP uptake often remains low, due partially to lack of knowledge and difficulty initiating discussions. Digital tools may help reduce these barriers to entry. METHODS: We retrospectively examined data from pilot deployment of Koda Health patient-facing ACP among Houston Methodist Coordinated Care patients, for quality improvement (QI) purposes...

BACKGROUND: When we consider weather impacts, we mainly consider how the event affects the person, not the clinicians treating them. There is a paucity of studies discussing the effect of weather on the clinicians and the care of their patients. METHODS: A survey covering weather effects was distributed to American Academy of Family Physicians National Research Network (AAFP NRN) members in August 2020. Descriptive statistics and Fisher's exact tests were completed on the survey responses...

INTRODUCTION: Health centers provide primary and behavioral health care to the nation's safety net population. Many health centers served on the frontlines of the COVID-19 pandemic, which brought major changes to health center care delivery. OBJECTIVE: To elucidate primary care and behavioral health service delivery patterns in health centers before and during the COVID-19 public health emergency (PHE). METHODS: We compared annual and monthly patients from 2019 to 2022 for new and established patients by visit type (primary care, behavioral health) and encounter visits by modality (in-person, telehealth) across 218 health centers in 13 states...

PURPOSE: To determine the incidence of the documentation of athlete failure of preparticipation sports physicals. METHODS: This was a retrospective observational study that involved review of preparticipation examination physical form documentation from multiple clinicians for all student athletes who participated in athletics during the 2018 to 2019 academic year at Galveston Independent School District (GISD). We collected the reasons for failure to pass the preparticipation physical examination...

BACKGROUND: Postacute sequelae of coronavirus (PASC) disease of 2019 (COVID-19) include morbidity and mortality, but little is known of the impact on medical expenditures. This study measures patients' health care costs after COVID hospitalization before vaccinations. METHODS: The Merative MarketScan database is used to track trends in medical expenditures for commercially insured patients hospitalized for COVID-19 (case subjects) compared with COVID-19 patients not hospitalized (control subjects) using a propensity score matching model...

The Medicare Advantage Program, home to nearly half of the eligible Medicare population, has recently come under increased scrutiny. The Government Accountability Office called on the Centers for Medicare & Medicaid Services to monitor "disenrollment of MA beneficiaries in the last year of life, validate MA-provided encounter data, and strengthen audits used to identify and recover improper payments to MA plans." The House Subcommittee on Oversight and Investigations of the Committee on Energy & Commerce, dedicated a hearing to "Protecting America's Seniors: Oversight of Private Sector Medicare Advantage Plans...

BACKGROUND: Physician departure causes considerable disruption for patients, colleagues, and staff. The cost of finding a new physician to replace the loss coupled with lost productivity as they build their practice can cost as much as $1 million per departure. Therefore, we sought to characterize drivers of departure from practice with the goal of informing retention efforts (with a special emphasis on the connection between electronic health record (EHR)-related stress and physician departure)...

INTRODUCTION: Integrating behavioral health services into primary care has a strong evidence base, but how primary care training programs incorporate integrated behavioral health (IBH) into care delivery and training has not been well described. The goal of this study was to evaluate factors related to successful IBH implementation in family medicine (FM) residency programs and assess perspectives and attitudes on IBH among program leaders. METHODS: FM residency programs, all which are required to provide IBH training, were recruited from the American Academy of Family Physicians National Research Network...

BACKGROUND: Primary care clinicians screen for breast cancer risk factors and assess the risk level of their patients. Women at high risk for breast cancer (eg, 5-year risk of at least 3% or lifetime risk of ≥20%) are eligible for enhanced screening and/or chemoprophylaxis. However, many clinicians do not identify women at high risk and offer appropriate referrals, screening, or chemoprophylaxis. METHODS: We reviewed a sample of 200 charts of women ages 35 to 50 years old with a family history of breast cancer...

BACKGROUND: Caregivers of children with special health care needs (SHCN) report worse self-rated health when compared with caregivers of children without SHCN and have experienced significant stress during the COVID-19 pandemic. We sought to determine whether COVID-19 pandemic-era declines in well-being among caregivers of children with SHCN were steeper than among caregivers of children without SHCN. METHODS: We used 2020 to 2021 (pandemic-era, n = 89,560) and 2018 to 2019 (pre-pandemic, n = 57,927) data from the National Survey of Children's Health...

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