Annals of family medicine
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Annals of family medicine · Jul 2014
Effect of payment incentives on cancer screening in Ontario primary care.
There is limited evidence for the effectiveness of pay for performance despite its widespread use. We assessed whether the introduction of a pay-for-performance scheme for primary care physicians in Ontario, Canada, was associated with increased cancer screening rates and determined the amounts paid to physicians as part of the program. ⋯ The pay-for-performance scheme was associated with little or no improvement in screening rates despite substantial expenditure. Policy makers should consider other strategies for improving rates of cancer screening.
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Annals of family medicine · Jul 2014
A technology-based quality innovation to identify undiagnosed hypertension among active primary care patients.
The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system. ⋯ Our technology-based innovation identified a large number of patients at risk for undiagnosed hypertension and successfully classified the majority, including many with hypertension. This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients.
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When I began my medical student clinical rotations, I quickly became overwhelmed by feelings of inadequacy. While the doctors around me conjured appropriate diagnoses and treatment approaches, I fumbled with the only tools I possessed: my time and a smile. ⋯ She gave me the confidence to construct this ability of comforting patients into a small platform of confidence from which I could safely venture to educate patients or suggest treatments to residents. It could be something that I could reliably fall back on in times of doubt and something I could pass along to other people I met.