Annals of family medicine
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Annals of family medicine · Jan 2025
Not Like They Used To: The Decline of Procedural Competency in Medical Training.
As a primary care pediatrician trained before work hour restrictions were enacted, I spent hours mastering procedures that trainees today rarely perform. The changing landscape of health care clinician roles, technology, and work hour restrictions have all contributed to a remarkable decline in trainees' procedural competence which has significant negative effects for patients, health care systems, and physicians themselves. I suggest simulation, live training, mentoring, and scheduled opportunities as ways to reemphasize the importance of learning these technical skills.
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Annals of family medicine · Jan 2025
A Qualitative Study of Primary Care Physicians' Approaches to Caring for Adult Adopted Patients.
Adoption has lifelong health implications for 7.8 million adopted people and their families in the United States. The majority of adoptees have limited family medical history (LFMH). Primary care physicians (PCPs) rarely receive training about adoptees including their mental health needs and increased suicide risk. The growing availability and popularity of direct-to-consumer genetic testing kits amplifies the need for PCPs to be prepared to address genetic testing for adoptees with LFMH. This study explores PCP training and approaches to adult adopted patients with LFMH. ⋯ Future research should expand education and training for PCPs on adult adoptees with LFMH.
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Annals of family medicine · Jan 2025
Breaking ICD Codes: Identifying Ambiguous Respiratory Infection Codes via Regional Diagnosis Heterogeneity.
We aimed to analyze regional variations in the assignment of International Classification of Diseases, 10th Revision (ICD-10) codes to acute respiratory infections, seeking to identify notable anomalies that suggest diverse diagnoses of the same condition. ⋯ To the best of our knowledge, this is the first study using observable anomalies to analyze regional coding variability for the same respiratory infection. Although some of these discrepancies may raise concerns about misdiagnosis, the majority of cases involving interchangeably used codes did not seem to substantially impact treatment or prognosis. This suggests that ICD codes may have clinical ambiguities and could face challenges not only in fulfilling their intended purpose of generating internationally comparable health data but also in their use for comprehensive government health planning.
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The impact of the Supreme Court of the United States ruling against race-conscious admissions extends beyond college admissions to professional schools. Based partially on the idea that enough time had elapsed for achievement of the stated goals of affirmative action, the court ruled race-conscious admissions are unconstitutional under the 14th Amendment's Equal Protection Clause. The ruling left a crack in the door to higher education, however, allowing students to write an essay showing how race or ethnicity affected their lives. ⋯ Admissions committees should complete implicit bias and cultural humility training. Support and allocation of funds must be provided to maintain training. Safeguards must ensure applicant and institutional legal compliance.