Annals of family medicine
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Recent controversies over the characteristics of "professionalism" and its enforcement by medical educators underscore the racialized and gendered norms implicit in this practice. In this essay, we describe the ways nebulous definitions of "professionalism" imbue White, cisgender, straight, and able-bodied standards to police the boundaries of belonging in medicine. ⋯ We seek to resculpt professionalism in a way that centers patients and trainees currently at the margins. This will strengthen the increasingly diverse workforce and ensure that they can effectively address the needs of patients often excluded from quality care.
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Annals of family medicine · Nov 2022
Primary Care Research Is Hard to Do During COVID-19: Challenges and Solutions.
Conducting research in primary care during the COVID-19 pandemic is hard, due to baseline stresses on primary care, which have been compounded by the pandemic. We acknowledge and validate primary care researchers' frustrations. ⋯ We present strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. In order to overcome and grow from these challenging times we encourage normalization and self-compassion, and encourage researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
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Annals of family medicine · Nov 2022
Leveraging Free-Form Comments to Assess and Improve Patient Satisfaction.
This study employed a text-analysis methodology to identify themes within patient comments and measure the relationship of those themes to patient satisfaction. Using these findings, a spreadsheet tool was created to allow a large sample of comments to be readily analyzed. ⋯ The tool gives clinicians the ability to easily analyze patient comments and identify actionable measures of patient satisfaction. Additionally, this tool will allow researchers to reduce vast sets of comment text into numerical data suited for quantitative analyses.
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Annals of family medicine · Nov 2022
Continuous Glucose Monitoring in Primary Care: Understanding and Supporting Clinicians' Use to Enhance Diabetes Care.
Diabetes affects approximately 34 million Americans and many do not achieve glycemic targets. Continuous glucose monitoring (CGM) is associated with improved health outcomes for patients with diabetes. Most adults with diabetes receive care for their diabetes in primary care practices, where uptake of CGM is unclear. ⋯ Primary care clinicians are interested in using CGM for patients with diabetes, but many lack the resources to implement use of this diabetes technology. Use of CGM can be supported with education in the form of workshops and consultation on insurance issues targeted toward residents, recent graduates, and practices without a nearby endocrinologist. Continued expansion of Medicare and Medicaid coverage for CGM can also support CGM use in primary care.
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Minutes after starting my family medicine rotation, my first patient crumpled before my eyes. She shared a story of anguish and worry, overwhelmed with the grief of her partner's unexpected death and consequential housing instability. ⋯ It is one thing to read about structural trauma and deeply embedded inequalities; it is another to look into the eyes of the patients whose families are, in part, shaped by them. In this essay, I grapple with a myriad of emotions on my first day of family medicine-and contemplate the courage required to show up, wholeheartedly, for our patients.