Annals of family medicine
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Annals of family medicine · Mar 2009
Comparative StudyDeclining trends in the provision of prenatal care visits by family physicians.
We wanted to measure trends in the proportion of prenatal visits provided by family physicians nationally for a 10-year period and determine characteristics of prenatal visits made to family physicians compared with visits made to obstetricians. ⋯ Family physicians reduced their provision of prenatal visits by nearly 50% during a 10-year period and at an even greater rate in rural, non-metropolitan statistical areas. These findings should be considered as family medicine considers the role of maternity care and strives to provide accessible prenatal services for all.
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Annals of family medicine · Mar 2009
Comparative StudyPay for performance in primary care in England and California: comparison of unintended consequences.
We undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. ⋯ Our study findings suggest that unintended consequences of incentive programs relate to the way in which these programs are designed and implemented. Although unintended, these consequences are not necessarily unpredictable. When designing incentive schemes, more attention needs to be paid to factors likely to produce unintended consequences.
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Annals of family medicine · Mar 2009
Meta AnalysisThe effects of barley-derived soluble fiber on serum lipids.
We wanted to determine the association between consumption of barley and changes in plasma lipids in healthy and hypercholesterolemic men and women. ⋯ Barley-derived beta-glucan appears to beneficially affect total cholesterol, LDL-cholesterol, and triglycerides, but not HDL-cholesterol.
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Annals of family medicine · Mar 2009
'They don't ask me so I don't tell them': patient-clinician communication about traditional, complementary, and alternative medicine.
Although high rates of traditional medicine and complementary and alternative medicine (TM/CAM) use have been well documented, there has been less attention to the factors influencing communication between patients and their primary care clinicians about TM/CAM. Such communication can be important in anticipating possible drug-herb interactions and in assuring agreement about therapeutic plans. ⋯ Specific communication barriers limit patient-clinician communication about TM/CAM. Clinicians who wish to communicate more effectively with their patients about these topics and better integrate the types of care their patients use can change the communication dynamic with simple strategies designed to overcome these barriers.