1,603 results match your criteria Journal of the American Board of Family Medicine[Journal]


Re: The Complex Interpretation and Management of Zika Virus Test Results.

J Am Board Fam Med 2019 Mar-Apr;32(2):280-281

Department of Biological Science, Joseph Ayobabalola University, Pune, India.

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http://dx.doi.org/10.3122/jabfm.2019.02.180340DOI Listing
March 2019
1 Read

Re: Family Medicine and Obstetrics: Let's Stop Pretending.

J Am Board Fam Med 2019 Mar-Apr;32(2):279

College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL.

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http://dx.doi.org/10.3122/jabfm.2019.02.180329DOI Listing

Screening for Psychotherapeutic Medication Misuse in Primary Care Patients: Comparing Two Instruments.

J Am Board Fam Med 2019 Mar-Apr;32(2):272-278

From Virginia Commonwealth University, Richmond, VA (STT, KMP, GCV, WRS, DSS); University of Texas Health Science Center at Houston, TX (MFW).

Introduction: Prescription psychotherapeutic medication misuse is a growing problem in the United States, but no method exists to routinely screen for this in primary care. Our study sought to (1) describe the prevalence of prescription psychotherapeutic medication misuse in primary care and the characteristics of patients who misuse and (2) compare 2 screening instruments modified to identify prescription medication misuse in primary care.

Methods: Primary care patients from underserved, urban clinics within a health system completed anonymous computer-directed health screens that included standard questions about prescription medication misuse. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180172DOI Listing
June 2018
1 Read

Reports of Two Broken Nexplanon® Rods.

J Am Board Fam Med 2019 Mar-Apr;32(2):269-271

From University of Arizona College of Medicine Phoenix, Phoenix, AZ.

Damage to progestin containing contraceptive implants has been reported for Implanon® rods but there appear to be few reports of damage to Nexplanon® rods. This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180222DOI Listing
August 2018
2 Reads

Emergency Department High Utilizers among Family Medicine Patients.

J Am Board Fam Med 2019 Mar-Apr;32(2):264-268

From University of Florida College of Medicine, Gainesville, FL (SK); Department of Community Health and Family Medicine ((DFGA, KL, PC), Department of Epidemiology (DFGA), University of Florida, Gainesville.

Background: Increases in emergency department (ED) use are contributing to inefficient health care spending and becoming a public health concern. Previous studies have identified characteristics of ED high utilizers aimed at designing interventions to improve efficiency. We aim to expand on these findings in a family medicine outpatient population. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.02.180184
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http://dx.doi.org/10.3122/jabfm.2019.02.180184DOI Listing
June 2018
5 Reads

Relationship of Training in Acupuncture to Physician Burnout.

J Am Board Fam Med 2019 Mar-Apr;32(2):259-263

From the Department of Family Medicine, Uniformed Services University of the Health Services, Bethesda, MD (PFC, CJWL); Nellis Family Medicine Residency, Nellis Air Force Base, NV (PFC, JR); Military Primary Care Research Network, Bethesda (JTJ); Department of Osteopathic Manipulative Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH (SW).

Background: Physician burnout is an ongoing problem that affects both physician wellbeing and patient care. Burnout is characterized by emotional exhaustion and depersonalization. Studies have explored ways to prevent and alleviate burnout. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180204DOI Listing

A Randomized Trial to Train Vulnerable Primary Care Patients to Use a Patient Portal.

J Am Board Fam Med 2019 Mar-Apr;32(2):248-258

From the Center for Vulnerable Populations (CRL, LT, US, MH, NR, DS), Division of General Internal Medicine (CRL, LT, US, MH, NR, DS), UCSF Division of Hospital Medicine (SS), Zuckerberg San Francisco General Hospital Library (SK), University of California-San Francisco, San Francisco, CA; Jonathan and Karin Fielding School of Public Health, University of California-Los Angeles, Los Angeles (LT); Office of Health Informatics, San Francisco Health Network, San Francisco (SS).

Background: Patient portals are becoming ubiquitous. Previous research has documented substantial barriers, especially among vulnerable patient subgroups such as those with lower socioeconomic status or limited health literacy (LHL). We tested the effectiveness of delivering online, video-based portal training to patients in a safety net setting. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180263DOI Listing
September 2018

Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis.

J Am Board Fam Med 2019 Mar-Apr;32(2):234-247

From the Department of Epidemiology and Biostatistics, College of Public Health, (CSM, MHE, APD, YS, CCW), Department of Infectious Diseases, College of Veterinary Medicine (EH), University of Georgia, Athens, GA.

Background: A systematic review of clinical decision rules to identify patients at low risk for community-acquired pneumonia (CAP) has not been previously presented in the literature.

Methods: A systematic review of MEDLINE for prospective studies that used at least 2 signs, symptoms, or point-of-care tests to determine the likelihood of CAP. We included studies that enrolled adults and adolescents in the outpatient setting where all or a random sample of patients received a chest radiograph as the reference standard. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180219DOI Listing
July 2018
1 Read

Impact of a Rapid Point of Care Test for Influenza on Guideline Consistent Care and Antibiotic Use.

J Am Board Fam Med 2019 Mar-Apr;32(2):226-233

From Department of Epidemiology and Biostatistics, University of Georgia, Athens (APD, ME, BM, AH, KD); Center for Ecology of Infectious Diseases, University of Georgia, Athens (AH); University Health Center, University of Georgia, Athens (RF).

Background: Rapid influenza diagnostic tests that detect the presence of viral antigens are currently used throughout the United States but have poor sensitivity. The objective of this study was to identify if the use of a new highly accurate rapid point of care test would significantly increase the likelihood of guideline consistent care.

Methods: We prospectively recruited 300 students at a university health clinic who presented with cough and 1 influenza-like illness symptom between December 2016 and February 2017 to receive care guided by a rapid polymerase chain reaction (PCR) test. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180183DOI Listing

Primary Care Physician Characteristics Associated with Low Value Care Spending.

J Am Board Fam Med 2019 Mar-Apr;32(2):218-225

From Robert Graham Center, Washington, DC (TWB, YC, SP, AB, WL); Department of Family and Community Medicine, UT Health San Antonio, San Antonio, TX (TWB); University of Pittsburgh School of Medicine, Pittsburgh, PA (PW) John Peter Smith Hospital Family Medicine Residency Program, Fort Worth (RAY); Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston (WL).

Background: Previous work has shown that $210 billion may be spent annually on unnecessary medical services and has identified patient and hospital characteristics associated with low value care (LVC). However, little is known about the association between primary care physician (PCP) characteristics and LVC spending. The objective of this study was to assess this association. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180111DOI Listing

Patterns of Diabetes Screening and Prediabetes Treatment during Office Visits in the US.

J Am Board Fam Med 2019 Mar-Apr;32(2):209-217

From Presbyterian College School of Pharmacy, Clinton, SC (KMS, JW, JW, NAT, GBS).

Introduction: The American Diabetes Association recommends annual screenings for prediabetes if the patient meets the suggested requirements. The overall prevalence of prediabetes has decreased from an estimated 86 million adults in 2012 to 84.1 million adults in 2015 in the United States. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.02.180259
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http://dx.doi.org/10.3122/jabfm.2019.02.180259DOI Listing
September 2018
5 Reads

Patient Characteristics Associated with Making Requests during Primary Care Visits.

J Am Board Fam Med 2019 Mar-Apr;32(2):201-208

From the Department of Family and Community Medicine (JJF, EMM, AJ, PF), the Center for Healthcare Policy and Research (JJF, EMM, AJ, RLK, PF), the Division of General Medicine, Department of Internal Medicine (RLK), University of California, Davis Medical Center, Sacramento, CA.

Background: Patient requests for tests, treatments, or referrals occur frequently during primary care visits and pose challenges for clinicians to address, but little is known about patient characteristics that may predict requests.

Objective: To identify patient characteristics associated with a higher rate of patient requests during primary care visits.

Design, Setting, And Sample: Cross-sectional analyses of data from 1141 adult patients attending 1319 visits with 56 primary care physicians (including 45 resident and 11 faculty physicians) in an academic family medicine practice. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180218DOI Listing
July 2018
1 Read

The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium.

J Am Board Fam Med 2019 Mar-Apr;32(2):191-200

From Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).

Background: Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children.

Objective: To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population.

Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.02.180225
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http://dx.doi.org/10.3122/jabfm.2019.02.180225DOI Listing
August 2018
7 Reads

Barriers and Facilitators of Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC).

J Am Board Fam Med 2019 Mar-Apr;32(2):180-190

From the Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX (KRY, BGC, MRUM, GB); Medical Humanities Program, College of Arts and Sciences, Baylor University, Waco (LAB); Family Health Center, Waco (BH, RL, JOG).

Introduction: Colorectal cancer is a leading cause of cancer-related mortality in the United States. Current screening recommendations for individuals aged 50 to 75 years include colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or annual stool-based testing. Stool-based testing, including fecal immunochemical tests (FITs), are cost effective, easy to perform at home, and noninvasive, yet many patients fail to return testing kits and go unscreened. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180205DOI Listing

Improving the Adoption of Advance Directives in Primary Care Practices.

J Am Board Fam Med 2019 Mar-Apr;32(2):168-179

From the Department of Family and Preventive Medicine, Research Division (EW, MG, ZN), Primary Care Health Policy Division (MG), Department of Biostatistics and Epidemiology, College of Public Health (MHD), University of Oklahoma College of Medicine, Oklahoma City, OK.

Background: Oklahoma's Advance Directive completion rate is less than 10%. We compared the implementation performance of 2 advance directive forms to determine which form could be more successfully disseminated.

Methods: The implementation of the Oklahoma Advance Directive (OKAD) and the Five Wishes form were compared in an 8-month pair-matched cluster randomized study in 6 primary care practices. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180236DOI Listing

Canadian HIV Care Settings as Patient-Centered Medical Homes (PCMHs).

J Am Board Fam Med 2019 Mar-Apr;32(2):158-167

From the CT Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CEK, ESS, JEP, LMB, LC, RR, CB, PL, CL); Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada (CEK, ESS, CL); School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada (CEK, LMB); Department of Family and Community Medicine, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada (CEK, ESS); Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (CEK); Departments of Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (MLB); Department of Family Medicine, Centre for Rural Health Studies, Memorial University of Newfoundland, St. John's, Newfoundland, Canada (SA); Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada (SBR); Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada (SBR).

Purpose: For people living with HIV (PLWH) using continuous antiretroviral therapy, HIV is now a complex chronic condition often managed in primary care settings. The patient-centered medical home (PCMH) is a model to deliver comprehensive, coordinated, and integrated primary care that promotes collaboration between primary and specialist care and allied services. The study assessed how both Canadian primary and specialist HIV care settings align with the PCMH. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.02.180231
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http://dx.doi.org/10.3122/jabfm.2019.02.180231DOI Listing
August 2018
5 Reads

Assessment of the Generalizability of an eConsult Service through Implementation in a New Health Region.

J Am Board Fam Med 2019 Mar-Apr;32(2):146-157

From C.T. Lamont Primary Healthcare Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, IM, AM); Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (CL); Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada (EK); Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).

Introduction: Excessive wait times for specialist care are a significant issue in many countries. Electronic consultation (eConsult) services have demonstrated the ability to improve access to specialist care. In this article, we evaluated the implementation of a successful eConsult service in a new jurisdiction to test its generalizability. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180169DOI Listing

Implementation and Evaluation of a Laboratory Safety Process Improvement Toolkit.

J Am Board Fam Med 2019 Mar-Apr;32(2):136-145

From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (BMK, DF, PF, JSH, EWS, JMW); American Academy of Family Physicians National Research Network, Leawood, KS (NL).

Purpose: The purpose of this project was to evaluate the real-world usability and usefulness of a revised version of the published Agency for Healthcare Research and Quality "Improving Your Office Testing Process" toolkit, designed to help primary care practices standardize and systematize laboratory testing processes.

Method: We used a multiple case study approach to evaluate toolkit implementation in 2 primary care practices with existing quality improvement (QI) infrastructure. We collected qualitative data at baseline, midpoint (3 to 4 weeks), and follow-up (7 to 8 weeks postimplementation). Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.02.180109
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http://dx.doi.org/10.3122/jabfm.2019.02.180109DOI Listing
April 2018
5 Reads

Practice Intentions of Family Physicians Trained in Teaching Health Centers: The Value of Community-Based Training.

J Am Board Fam Med 2019 Mar-Apr;32(2):134-135

From The Robert Graham Center, Washington, DC (ZL, AB); West Side Community Health Services, Saint Paul, MN (PM); The American Board of Family Medicine, Lexington, KY (LP); Department of Family and Community Medicine, University of Kentucky, Lexington, KY (LP); Dartmouth College, Hanover, NH (AH).

Family medicine residents who graduate from Federally Qualified Health Center-aligned Teaching Health Center (THC) training residencies are nearly twice as likely to pursue employment in safety-net settings compared with non-THC graduates. This trend has been consistent over the past few years, suggesting that the program is fulfilling its mission to strengthen primary care in underserved settings. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.180292DOI Listing
October 2018

Multiple Research Methodologies Can Advance the Science of Family Medicine.

J Am Board Fam Med 2019 Mar-Apr;32(2):123-125

This issue of the evidences the wide variety of research methods that can effectively answer questions important to the practice of family medicine. For example, this issue includes 4 highly informative reports from qualitative or mix-methods research, plus surveys, a meta-analysis, a case report, and more. Mixed-methods were used to look at practice changes and to compare advance directive tools. Read More

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http://dx.doi.org/10.3122/jabfm.2019.02.190005DOI Listing

Re: Impact of Medical Scribes in Primary Care on Productivity, Face-to-Face Time, and Patient Comfort.

Authors:
David H Thom

J Am Board Fam Med 2019 Jan-Feb;32(1):120

Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA.

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http://dx.doi.org/10.3122/jabfm.2019.01.180283DOI Listing
January 2019

Re: If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers.

J Am Board Fam Med 2019 Jan-Feb;32(1):119

DY Patil University, Pune, India and Ayobabalola University, Nigeria.

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http://dx.doi.org/10.3122/jabfm.2019.01.180267DOI Listing
January 2019
4 Reads

Re: How Evolving United States Payment Models Influence Primary Care and its Impact on the Quadruple Aim: The Need for Health Equity.

J Am Board Fam Med 2019 Jan-Feb;32(1):118

Department of Family Medicine, University of Colorado, Aurora, CO.

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http://dx.doi.org/10.3122/jabfm.2019.01.180261DOI Listing
January 2019

Los Seres Humanos Matter: A Hispanic Health Story from Texas.

Authors:
John W Davis

J Am Board Fam Med 2019 Jan-Feb;32(1):115-117

From University of Texas, Medical Branch at Galveston, Galveston, TX.

Latino health deserves intense focus in promoting a just health care system. Despite the surprisingly positive health outcomes associated with the "Hispanic Paradox" phenomenon, the trend of Latino immigrants tending to have better health outcomes than other minorities, linguistic issues persist. The following essay is a combination of actual patient encounters through my experiences serving Spanish-speaking patients, as a medical student and Spanish speaker, and a reflection on the clash between impersonal interpretation services and Hispanic cultural values. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180207DOI Listing
July 2018
1 Read

A Reflective Case Study in Family Medicine Advance Care Planning Conversations.

J Am Board Fam Med 2019 Jan-Feb;32(1):108-114

From the Family Medicine Residency Program, Natividad Medical Center, Salinas, CA (MT); Department of Family and Preventive Medicine University of Arkansas for Medical Sciences, Salinas, CA (WV).

Advance care planning conversations traditionally have been promoted using the Standard of Substituted Judgment and the Standard of Best Interests. In practice, both are often inadequate. Patients frequently avoid these conversations completely, making substituted judgment decisions nearly impossible. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180198DOI Listing

Exercise Is Medicine: Primary Care Counseling on Aerobic Fitness and Muscle Strengthening.

J Am Board Fam Med 2019 Jan-Feb;32(1):103-107

From Departments of Family Medicine and Community Health and of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (CC, KS, JS); Center for Primary Health Care Research, Lund University, Malmö, Sweden (KS, JS); Stanford Prevention Research Center, Stanford University, Stanford, CA (MAW).

Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450080PMC

Teaching Benign Skin Lesions as a Strategy to Improve the Triage Amalgamated Dermoscopic Algorithm (TADA).

J Am Board Fam Med 2019 Jan-Feb;32(1):96-102

From Maine Medical Center, Division of Dermatology, Portland, ME (EVS); Department of Family & Community Medicine (HTA) and Department of Dermatology (AG, MB), Penn State Milton S. Hershey Medical Center, Hershey, PA; Dermatology Department, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain (OY); Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY (OY, SWD, AAM).

Introduction: Dermoscopy aids family physicians (FPs) in skin cancer detection. The triage amalgamated dermoscopic algorithm (TADA) was created to simplify the dermoscopic evaluation of a skin growth. The purpose of this image-based study was to evaluate the effect of teaching the clinical and dermoscopic features of benign skin lesions on the diagnostic accuracy of skin cancer identification using TADA. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.01.180049
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http://dx.doi.org/10.3122/jabfm.2019.01.180049DOI Listing
February 2018
18 Reads

The American Board of Family Medicine's Data Collection Method for Tracking Their Specialty.

J Am Board Fam Med 2019 Jan-Feb;32(1):89-95

From the American Board of Family Medicine, Lexington, KY.

Background: Medical certifying boards' core mission is assuring the public that Diplomates have the requisite knowledge, skills, and professional character to provide high-quality medical care. By understanding their Diplomates' workforce and practice environments, Boards ensure that certification is relevant to the profession and accountable to the public. Current and reliable data are key to meeting this function. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180138DOI Listing
May 2018
1 Read

Physician Opinions about American Board of Family Medicine Self-Assessment Modules (2006-2016).

J Am Board Fam Med 2019 Jan-Feb;32(1):79-88

From the American Board of Family Medicine, Lexington, KY (MD, MH, ARE, LEP); Department of Family Community Medicine, University of Kentucky, Lexington (MH, LEP).

Introduction: Maintenance of Certification (MOC) was implemented to help physicians remain current with evolving medical standards, but has been criticized for being irrelevant to practice. We assessed family physicians' (FPs') opinions about the content of American Board of Family Medicine (ABFM) self-assessment modules (SAMs).

Methods: We used ABFM administrative data from feedback surveys completed after each of the 16 SAMs from 2006 to 2016. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.170472DOI Listing
December 2017
1 Read

Physician Burnout and Higher Clinic Capacity to Address Patients' Social Needs.

J Am Board Fam Med 2019 Jan-Feb;32(1):69-78

From Department of Family & Community Medicine, University of California San Francisco, San Francisco (ED, DH, JNO, LMG), Center for Excellence in Primary Care, Department of Family & Community Medicine, University of California San Francisco, San Francisco (MK, RW-G, KG), American Board of Family Medicine, Lexington, KY (LEP).

Background: A recent regional study found lower burnout among primary care clinicians who perceived that their clinic had greater capacity to meet patients' social needs. We aimed to more comprehensively investigate the association between clinic capacity to address social needs and burnout by using national data that included a more representative sample of family physicians and a more comprehensive set of practice-level variables that are potential confounders of an association between clinic social needs capacity and burnout.

Methods: We conducted a cross-sectional analysis of 1298 family physicians in ambulatory primary care settings who applied to continue certification with the American Board of Family Medicine in 2016. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180104DOI Listing
April 2018
5 Reads

Assessing the Quality of the After-Visit Summary (AVS) in a Primary-Care Clinic.

J Am Board Fam Med 2019 Jan-Feb;32(1):65-68

From the Department of Family and Community Medicine, University of Texas Southwestern Medical School, Dallas, TX (THM); Family Medicine Residency Program, Gwinnett Medical Center, Lawrenceville, GA (AO); Department of Family and Community Medicine, University of Texas Health Sciences Center-San Antonio, San Antonio, TX (KK); Department of Family and Community Medicine, University of Texas-Southwestern Medical School, Dallas (KB, PD).

Background And Objective: As part of Affordable Care Act, the Centers for Medicaid Services (CMS) recommend physicians provide patients with an After-Visit Summary (AVS) following a clinic visit. Information should be relevant and actionable with specific instructions regarding their visit and health. Until recently, this recommendation was included as part of meeting the standard for Stage 1 Meaningful Use for all physicians using electronic-health-record (EHR) technology. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.01.180055
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http://dx.doi.org/10.3122/jabfm.2019.01.180055DOI Listing
February 2018
22 Reads

Are Patients Frequently Readmitted to the Hospital Different from the Other Admitted Patients?

J Am Board Fam Med 2019 Jan-Feb;32(1):58-64

From the Department of Community Health and Family Medicine (MP, DQ, DFA, LC, KL, LB, and PJC) and Department of Biostatistic (XF and YY), University of Florida, Gainesville, FL.

Introduction: Although the characteristics of readmitted patients associated with a family medicine inpatient service have been reported, differing characteristics between groups of patients based on readmission rates have not been studied. The aim of this project was to examine patients with differing rates of readmission.

Methods: Patients admitted to a family medicine inpatient service were classified into 1 of 3 groups based on the number of admission and readmissions in a given year. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180052DOI Listing
February 2018
1.848 Impact Factor

Veterans' Likelihood of Reporting Cardiovascular Disease.

Authors:
Ramon Hinojosa

J Am Board Fam Med 2019 Jan-Feb;32(1):50-57

From Department of Sociology, University of Central Florida, Orlando (RH).

Objective: Cardiovascular disease (CVD) is the most common chronic health condition affecting Americans. One important group of Americans that health researchers have noted as key to understanding general population health and wellbeing are veterans of the US military. The healthy soldier effect has been used to explain the health benefits of military service during and for a period of time after service. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180148DOI Listing

Colorado Asthma Toolkit Implementation Improves Some Process Measures of Asthma Care.

J Am Board Fam Med 2019 Jan-Feb;32(1):37-49

From the Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado (KLC); Adult & Child Consortium for Health Outcomes Research & Delivery Science, Aurora, CO (LH); Department of Pediatrics, National Jewish Health, Denver (BGB); Department of Medicine, University of Colorado School of Medicine, Aurora (BMK, LMS); Pediatrics, University of Colorado School of Medicine, Aurora (MRS).

Background: The Colorado Asthma Toolkit Program (CATP) has been shown to improve processes of care with less evidence demonstrating improved outcomes.

Objective: To model the association between pre-and-post-CATP status and asthma-related process and outcome measures among patients ages 5 to 64 years receiving care in safety-net primary care practices.

Methods: This is an implementation study involving secondary prepost analysis of existing structured clinical, administrative, and claims data. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2019.01.180155
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http://dx.doi.org/10.3122/jabfm.2019.01.180155DOI Listing
May 2018
9 Reads

#Diversity: Conversations on Twitter about Women and Black Men in Medicine.

J Am Board Fam Med 2019 Jan-Feb;32(1):28-36

From the Department of Family Medicine (RM, KWL), Department of Computer Science (LS, YW), Georgetown University School of Medicine, Washington, DC.

Background: Discussions about racism, ethnicity, sexism, discrimination, and diversity have increased within medicine, and their impact on the physician workforce, advancement, hiring, wage inequities, mistreatment, and scholarly output, to name a few. Most medical organizations have created policies and initiatives on diversity and inclusion, focusing on supporting underrepresented minorities. Similar discussions are taking place online, including on Twitter, via specific hashtags, such as #BlackMenInMedicine, #ILookLikeASurgeon. Read More

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Awareness of Prediabetes Status and Subsequent Health Behavior, Body Weight, and Blood Glucose Levels.

J Am Board Fam Med 2019 Jan-Feb;32(1):20-27

From Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, TN.

Background: Lifestyle intervention decreases diabetes risk in prediabetic subjects, but the impact of passive notification of prediabetes status on glycemia or health behavior is unclear.

Methods: The Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) study followed normoglycemic African American (AA) and European American (EA) offspring of parents with type 2 diabetes mellitus for incident prediabetes. During 5. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472472PMC
August 2018
11 Reads

Better Doctor-Patient Relationships Are Associated with Men Choosing More Active Depression Treatment.

J Am Board Fam Med 2019 Jan-Feb;32(1):13-19

From the Department of Psychiatry, University of British Columbia, Vancouver, Canada (DK, JSO); The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia (SMR); School of Nursing, University of British Columbia, Vancouver (OF, JLO).

Background: Men tend to have low rates of treatment uptake for depression. The quality of the relationship with their family physician may be a factor influencing attitudes toward treatment. The present study was developed to explore this issue in a nationally representative sample of Canadian men. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.170430DOI Listing
November 2017
4 Reads

Long-acting Reversible Contraception (LARC) Provision by Family Physicians: Low But on the Rise.

J Am Board Fam Med 2019 Jan-Feb;32(1):10-12

From the VA Health Services Research and Development Fellow, Department of Veterans Affairs Medical Center, VA HSR&D Center for Innovation to Implementation, Palo Alto, CA (MC); Division of Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA (JGS); Robert Graham Center, Washington, DC (YJ, MC, AJ).

Although the fraction of family physicians (FPs) providing Long Acting Reversible Contraceptive (LARC) services increased between 2014 and 2017, the most recent estimates show that less than a quarter of family physicians include provision of LARC in their practice. Increasing the number of FPs providing LARC will help increase patients' access to the most effective forms of birth control currently available. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180215DOI Listing

No Magic Pill: A Prescription for Enhanced Shared Decision-Making for Depression Treatment.

J Am Board Fam Med 2019 Jan-Feb;32(1):6-9

From Department of Counseling and School Psychology, University of Massachusetts, Boston, MA (LC); Department of Family Medicine, Tufts University School of Medicine, Boston (DE); Tufts University School of Medicine, Tufts University Family Medicine Residency at Cambridge Health Alliance, Boston, MA (AFS).

For over 2 decades, there have been debates, sometimes contentious, about the efficacy and safety of antidepressants. Growing awareness of the difficulty some patients have when discontinuing these medications has intensified these debates. Recently, Cipriani and colleagues published the largest meta-analysis to date that assessed the efficacy and tolerability of antidepressants. Read More

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http://dx.doi.org/10.3122/jabfm.2019.01.180182DOI Listing
June 2018
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Commentary Response for "LARC Provision by Family Physicians: Low But on the Rise".

Authors:
Marji Gold

J Am Board Fam Med 2019 Jan-Feb;32(1):4-5

From the Department of Family and Social Medicine, Montefiore Medical Center/Albert Einstein School of Medicine, Bronx, NY.

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January 2019

Conversations, Communication and Counseling Are Key Family Medicine Tactics to Improve Patient Health.

J Am Board Fam Med 2019 Jan-Feb;32(1):1-3

This issue includes research on conversations, communication and counseling regarding depression treatment, the diagnosis of prediabetes, the topics of diversity and inclusion in medicine on Twitter, asthma treatment outcomes, muscle strengthening as an important form of exercise, multiple hospital readmissions, as well as after-visit summaries and advance care planning. Read More

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January 2019
1 Read

Author Index to Volume 31, 2018.

Authors:

J Am Board Fam Med 2018 Nov-Dec;31(6):964-969

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November 2018

Re: Doctor-Patient Trust Among Chronic Pain Patients on Chronic Opioid Therapy after Opioid Risk Reduction Initiatives: A Survey.

J Am Board Fam Med 2018 Nov-Dec;31(6):957

Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL.

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November 2018
10 Reads

Practice Rurality of Family Physicians Enrolled in a Practice Transformation Network.

J Am Board Fam Med 2018 Nov-Dec;31(6):952-956

From the American Board of Family Medicine, Lexington, KY.

The Transforming Clinical Practice Initiative prioritized the delivery of free practice transformation assistance by Practice Transformation Networks (PTNs) to small and rural practices that may otherwise lack the resources needed to succeed in Medicare's value-based payment (VBP) programs. We assessed the enrollment of rural practices in PTNs using 2016 TCPI enrollment data and American Board of Family Medicine recertification examination registration data from 2013 to 2016. PTNs enrolled a higher proportion of rural family medicine practices than are represented across the general workforce ( < . Read More

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http://dx.doi.org/10.3122/jabfm.2018.06.170332DOI Listing
August 2017
8 Reads

Recruiting Primary Care Practices for Research: Reflections and Reminders.

J Am Board Fam Med 2018 Nov-Dec;31(6):947-951

From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO (DHF, BTJ, RW, LMD, WPD); Department of Family and Community Medicine, University of California-San Francisco, San Francisco, CA (DMH, LF).

Background: Recruiting primary care practices for research projects has always required carefully tended relationships, a compelling message, and good timing. Recruiting practices to participate in practice transformation research trials may take more and different efforts. We reflect on practice recruitment for a recently-concluded trial of a diabetes self-management support system in 2 states and 36 practices. Read More

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http://dx.doi.org/10.3122/jabfm.2018.06.180025DOI Listing
January 2018
17 Reads

Academic Detailing for Postpartum Opioid Prescribing.

J Am Board Fam Med 2018 Nov-Dec;31(6):944-946

From Department of Medical Education (KAV), and Department of Obstetrics and Gynecology (CS), Gundersen Health System, La Crosse, WI.

Introduction: Overprescribing opioid pain medications has become a major concern in our society due to the increasing rates of substance use disorders and the rate of accidental overdoses. The widespread availability of opioid medications suggests that patients are being prescribed opioids in amounts larger than they require for pain control. Efforts are now being made on a variety of fronts to decrease overprescribing. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2018.06.180071
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http://dx.doi.org/10.3122/jabfm.2018.06.180071DOI Listing
March 2018
13 Reads

The Association of Patient Satisfaction-Based Incentives with Primary Care Physician Opioid Prescribing.

J Am Board Fam Med 2018 Nov-Dec;31(6):941-943

From The Department of Anesthesiology, University of Colorado, Aurora, CO (JAC, KM, KB); Department of Psychiatry, Division of Substance Dependence, University of Colorado, Aurora (KMR, JTS, SKMG, CJH); Department of Family Medicine, University of Colorado, Aurora (LM, PCS); School of Public Health, Department of Biostatistics & Informatics, University of Colorado, Aurora (SKMG).

Purpose: The opioid epidemic in the United States is an ongoing public health concern. Health care institutions use standardized patient satisfaction surveys to assess the patient experience and some offer incentives to their providers based on the results. We hypothesized that providers who report being incentivized based on patient satisfaction surveys are more likely to report an impact of such surveys on their opioid prescribing practices. Read More

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http://www.jabfm.org/lookup/doi/10.3122/jabfm.2018.06.180067
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http://dx.doi.org/10.3122/jabfm.2018.06.180067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396292PMC
March 2018
18 Reads

Core Principles to Improve Primary Care Quality Management.

J Am Board Fam Med 2018 Nov-Dec;31(6):931-940

From Department of Medicine, Center for Biomedical Ethics and Humanities, University of Virginia School of Medicine, Charlottesville, VA (JBM); Robert Graham Center, Washington DC (JBM, WL, AB); Department of Family and Community Medicine, University of Texas Health Science Center at Houston, Houston, TX (WL); Department of Family and Preventative Medicine, Emory University School of Medicine, Atlanta, GA (MAM); Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond (RSE); Department of Population Health and Primary Care, Norwich Medical School University of East Anglia, Norwich, UK (AH).

Quality management in American health care is in crisis. Performance measurement in its current form is costly, redundant, and labyrinthine. Increasingly, its contribution to achieving the Quadruple Aim is under close examination, especially in the domain of primary care services, where the burden of measurement is heaviest. Read More

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http://dx.doi.org/10.3122/jabfm.2018.06.170172DOI Listing

The Complex Interpretation and Management of Zika Virus Test Results.

J Am Board Fam Med 2018 Nov-Dec;31(6):924-930

From the Department of Family Medicine, Georgetown University Medical Center, Washington, DC (KWL); Department of Health Systems Administration, Georgetown University, Washington (JDK, MAS); New York University College of Global Public Health, New York, NY (RP-L).

Zika virus disease provides the latest example of a critical nexus between public health and clinical practice. Interpreting Zika virus test results is complicated by the absence of a single testing approach with superior validity across contexts and populations. Molecular tests are highly specific, variably sensitive, and have a short window period. Read More

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http://dx.doi.org/10.3122/jabfm.2018.06.180061DOI Listing
February 2018
14 Reads