Annals of family medicine
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We wanted to analyze National Institutes of Health (NIH) awards to departments of family medicine. ⋯ Most NIH awards to family medicine departments went to PIs in noncore organizational components, where most physician PIs were not family physicians. Family medicine departments interested in increasing NIH funding may want to consider 4 models that appear to exist: individual faculty in core departmental components, K awards, core faculty also working in university-wide organizational components that provide research infrastructure, and integrating noncore administrative components into the department.
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Annals of family medicine · Sep 2006
A workforce analysis informing medical school expansion, admissions, support for primary care, curriculum, and research.
This case study describes the findings of a physician workforce analysis and how an institution is using these findings to address the decreasing proportion of medical students choosing primary care careers. ⋯ The analysis has wide potential applicability, but it has special relevance for primary care and has been particularly useful in making the case for supporting primary care education in the WWAMI region.
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Annals of family medicine · Sep 2006
Family medicine's identity: being generalists in a specialist culture?
Family medicine has been in conflict about whether it is a specialty or a generalist discipline. Although for a time the family was offered as a solution to family medicine being marginalized in biomedicine, a more biomedical focus prevailed. As a result, the practice of family medicine came more to resemble the world of biomedicine despite an insistence on the discipline's distinctiveness. Ways to avoid identity pitfalls in the future might be to seek solutions that do not promise to solve our identity problem once and for all, to refrain from adopting generalized slogans that do not encourage critical thinking, to practice what we preach, to accept that specialization is part of the American cultural ethos, and to embrace reflective practice.
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Annals of family medicine · Sep 2006
US men discussing prostate-specific antigen tests with a physician.
Informed decision making is recommended for prostate cancer screening. I wanted to examine demographic and screening-related factors associated with men's discussion of the advantages and disadvantages of prostate-specific antigen (PSA) tests with their physicians. ⋯ Characteristics of the patient-physician relationship were more central to the discussion of risks and benefits than were patient attributes. Future research should examine what role practice setting and the physician-patient relationship play in a discussion of PSA testing and how to facilitate active involvement of patients in decision making.
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Annals of family medicine · Sep 2006
Short-term impacts of coverage loss in a Medicaid population: early results from a prospective cohort study of the Oregon Health Plan.
Medicaid programs in all 50 states recently implemented cost-saving strategies, including benefit reductions, cost sharing, and tightened administrative rules. These changes resulted in loss of insurance coverage for thousands of low-income adults nationwide. In this study we assessed the immediate impacts of disrupted and lost Medicaid coverage on adults enrolled in the Oregon Health Plan (OHP) when program changes were implemented. ⋯ Medicaid program changes that increase cost sharing and limit enrollment have significant negative impacts on health care access and utilization among Medicaid beneficiaries; these impacts occur rapidly, within the first 10 months after changes.