Family medicine
-
Missed appointments can create financial, capacity, and continuity issues in primary care. An urban family medicine residency teaching clinic with a large culturally diverse population of low-income patients struggled for decades with a persistent no-show rate of 15%--17% despite multiple attempts to remind patients or otherwise address the problem. This study sought to measure the effects of a multi-method approach to decreasing the overall clinic no-show rate over time. ⋯ Indentifying a large at-risk population for no-shows and using a multi-method approach to addressing the issue can show persistent improvement and could be used in other residency training and community clinic settings.
-
Randomized Controlled Trial
Effect of a web-based curriculum on primary care practice: basic skin cancer triage trial.
Primary care physicians (PCPs) are uniquely positioned to detect melanoma. Effective educational interventions targeted at PCPs may improve early melanoma detection. A previous in-person Basic Skin Cancer Triage (BSCT) 2-hour course demonstrated significant short-term improvement in provider practices, attitudes, ability, confidence, and knowledge. We conducted a randomized trial to test the efficacy of the BSCT course implemented as a web-based learning program, compared to a similar (control) web-based course on weight assessment. ⋯ Given previous success with our in-person course, the features required to make WBL a more effective tool for medical education must be further explored.
-
Stress in medical education has been well documented, often with the primary focus on negative factors such as depression and burnout. Few studies have attempted to assess well-being mediating behaviors. This study describes the relationship between wellness behaviors and measures of well-being at the start of family medicine residency. ⋯ At the start of residency, well-being measures are consistent with findings in medical school. Restful sleep and exercise were associated with more positive well-being. Future longitudinal data analysis will help clarify the effect of residency training in well-being and lifestyle behaviors. Identification of protective factors and coping mechanisms could guide residencies in incorporating support services for residents.
-
Information about primary care physicians' (PCPs) and oncologists' involvement in cancer-related follow-up care, and care coordination practices, is lacking but essential to improving cancer survivors' care. This study assesses PCPs' and oncologists' self-reported roles in providing cancer-related follow-up care for survivors who are within 5 years of completing cancer treatment. ⋯ PCPs and oncologists differ in their involvement in cancer-related follow-up care of survivors, with co-management more often reported by PCPs than by oncologists. Given anticipated national shortages of PCPs and oncologists, study results suggest that improved communication and coordination between these providers is needed to ensure optimal delivery of follow-up care to cancer survivors.