Family medicine
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Comparative Study
Communicating with terminal patients: lessons from "wit" and students.
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Medication adherence is a complex phenomenon, influenced by a variety of factors. Most adherence research focuses on one medicine and does not represent the realities of clinical family medicine. This analysis examined factors associated with medication knowledge and adherence in family medicine patients with chronic conditions. ⋯ We recommend that family physicians enhance medication adherence by providing good information about treatment and counseling strategies to build patients' confidence. Our findings suggest that poor health status can be a barrier to, rather than a motivator for, treatment adherence.
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American health care consumers want the option of seeing specialists whenever they wish, but given this option, do they in fact use it without consideration of their health status? This paper reports on a cross-sectional analysis that compares the demographics and health status of fee-for-service Medicare enrollees who exhibited four different patterns of physician access. ⋯ As expected, the healthiest subjects were least likely to visit any health care provider. Subjects with the worst health status were likely to access both generalists and specialists for their care. Subjects who visited a specialist only had higher incomes, more education, and urban residence but no difference in health status when compared to subjects who visited a generalist only.
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Comparative Study
Does provision of health counseling differ by patient race?
Empirical data on health counseling provided to patients of different racial groups in primary care settings are limited, and existing studies have yielded inconsistent findings. This study's purpose was to use a national medical care survey to examine whether the visit-based rates of health counseling/education differed between black and white patients in primary care practice settings. ⋯ Black patients received similar or higher rates of certain types of health counseling than whites during the clinical encounters with their primary care providers. However, there was a significantly lower rate of mental health counseling provided to black patients. Reasons for this disparity require further investigation.