Annals of family medicine
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Annals of family medicine · Jul 2023
Telemedicine in Primary Care: Lessons Learned About Implementing Health Care Innovations During the COVID-19 Pandemic.
During the COVID-19 pandemic, telemedicine emerged as an important tool in primary care. Technology and policy-related challenges, however, revealed barriers to adoption and implementation. This report describes the findings from weekly and monthly surveys of primary care clinicians regarding telemedicine during the first 2 years of the pandemic. ⋯ The implementation of telemedicine during COVID-19 identified barriers and opportunities for technology adoption and highlighted steps that could support primary care clinics' ability to learn, adapt, and implement technology.
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Annals of family medicine · Jul 2023
ReviewImpact of Service-Based Student Loan Repayment Program on the Primary Care Workforce.
As the average level of medical education indebtedness rises, physicians look to programs such as Public Service Loan Forgiveness (PSLF) and National Health Service Corps (NHSC) to manage debt burden. Both represent service-dependent loan repayment programs, but the requirements and program outcomes diverge, and assessing the relative uptake of each program may help to inform health workforce policy decisions. We sought to describe variation in the composition of repayment program participant groups and measure relative impact on patient access to care. ⋯ Although PSLF supports family physicians intending to work in public service, their peers who choose NHSC are much more likely to work in underserved settings. Our findings may prompt a review of the goals of service loan forgiveness programs with potential to better serve health workforce needs.
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Annals of family medicine · Jul 2023
Reimbursement for HPV Vaccine Cost in the Private Sector: A Comparison Across Specialties.
The human papillomavirus (HPV) vaccine is the most expensive of all routinely recommended pediatric vaccines. Adequate cost reimbursement by 3rd-party payers is a critical enabling factor for clinicians to continue offering vaccines. ⋯ Furthermore, a $1 increment in return was associated with an increase in HPV vaccine doses administered (highest for family physicians; 0.08% per dollar). Reimbursement for HPV vaccine costs by private payers is adequate; however, return margins are small for non-pediatric specialties.
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Annals of family medicine · Jul 2023
Presence of Primary Care Physicians and Patients' Ability to Register: A Simulated-Patient Survey in the Paris Region.
Using the health care system fully in some countries requires patients to register with a primary care physician (PCP). Public health policies measure PCP density to maintain satisfactory local PCP supplies and limit geographic inequalities. ⋯ Of 5,188 census blocks, 55.4% had at least 1 PCP; however, only 38.6% had at least 1 PCP accepting registration for office visits, and only 19.4% had at least 1 PCP accepting registration for home visits (P <.001 across the 3 indicators). Cross-block inequalities in accepting registration were steeper than those related to PCP density, indicating that this density metric offers false reassurance and is inadequate to support policy decisions.
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Family medicine physicians take care of patients and their families "from womb to tomb." This phrase is particularly apt in Oregon, where the Death with Dignity Act allows for terminally ill patients to end their lives with self-administered medications prescribed by a physician. This story chronicles my first experience caring for a patient under the Death with Dignity Act; that night of her death at home, surrounded by the warmth of her life and loved ones, opened my mind to the possibilities of what the patient-physician relationship entails, from the routine of meeting her family to the intimacy of assisting in her decision to die.