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
ReviewShaping the future of academic health centers: the potential contributions of departments of family medicine.
Academic health centers (AHCs) must change dramatically to meet the changing needs of patients and society, but how to do this remains unclear. The purpose of this supplement is to describe ways in which departments of family medicine can play leadership roles in helping AHCs evolve. This overview provides background for case studies and commentaries about the contribution of departments of family medicine in 5 areas: (1) ambulatory and primary care, (2) indigent care, (3) education in community and international settings, (4) workforce policy and practice, and (5) translational research. ⋯ Finally, family medicine departments and their faculty have a central role in helping AHCs respond to workforce needs and in developing translational research that emphasizes the health of the population and effectiveness of care. AHCs are a public good that must now evolve substantially to meet the needs of patients and society. By pushing for substantial change, by helping to reinvigorate the relationship between AHCs and the communities they serve, and by emphasizing fundamental innovation in clinical care, teaching, and research, family medicine can help lead the renewal of the AHC.
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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.