Annals of family medicine
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Annals of family medicine · Jan 2021
Randomized Controlled TrialAn Electronic Tool to Support Patient-Centered Broad Consent: A Multi-Arm Randomized Clinical Trial in Family Medicine.
Patients are frequently asked to share their personal health information. The objective of this study was to compare the effects on patient experiences of 3 electronic consent (e-consent) versions asking patients to share their health records for research. ⋯ Patients who used e-consents with interactive research details and trust-enhancing messages reported higher satisfaction and understanding at 6-month follow-up. Research institutions should consider developing and further validating e-consents that interactively deliver information beyond that required by federal regulations, including facts that may enhance patient trust in research.
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Annals of family medicine · Jan 2021
Medical Practice Variation Among Primary Care Physicians: 1 Decade, 14 Health Services, and 3,238,498 Patient-Years.
Variation in medical practice is associated with poorer health outcomes, increased costs, disparities in care, and increased burden on the public health system. In the present study, we sought to describe and assess inter- and intra-primary care physician variation, adjusted for patient and clinic characteristics, over a decade of practice and across a broad range of health services. ⋯ Our results show greater variation in practice patterns between physicians than for individual physicians over the years. It appears that the variation remains high even after adjustment for patient and clinic characteristics and that the individual physician utilization patterns are stable across health services. We propose that personal behavioral characteristics of medical practitioners might explain this variation.
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Annals of family medicine · Jan 2021
Family Medicine, Community, and Race: A Minneapolis Practice Reflects.
The uprisings for racial justice that followed the brutal murder of George Floyd on May 28, 2020 in Minneapolis, Minnesota damaged the physical building where a family medicine residency is situated. We discuss the emotions that follow that event and reflect on ways that family medicine should address racism and discrimination. We also call on those in family medicine to work more in the communities that we serve, and to make advocacy a core part of the identity of family medicine.
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Annals of family medicine · Jan 2021
Access, Equity, and Neutral Space: Telehealth Beyond the Pandemic.
As I begin my 4th year of medical school amidst the coronavirus disease 2019 (COVID-19) pandemic, telehealth has allowed me to connect with many patients who previously struggled to access consistent primary care. In this essay, I describe 2 of my most formative experiences with telehealth: participating in my medical school's new "tele-hotspotting" elective, and providing virtual gender-affirming care through our student-run free clinic. These experiences demonstrate not only telehealth's utility during a viral pandemic, but also its potential as a powerful tool for expanding access to care and promoting health equity over the coming years. ⋯ Patients and clinicians alike have expressed concerns regarding the challenge of performing a physical exam and maintaining emotional connection across physical distance. A sustained expansion of telehealth is further challenged by inconsistent availability of broadband Internet, as well as a lack of standardized reimbursement procedures for telehealth visits. Strategies are available to help meet these challenges while maximizing health equity.