Family medicine
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Conducted by a task force of the Association of Departments of Family Medicine, this study defines current issues in the clinical practice of academic departments of family medicine in US medical schools. ⋯ Departments of family medicine are increasing their practice activities, perhaps to the detriment of teaching and research. The clinical practice autonomy of departments of family medicine is being diluted by increased institutional control and by mergers with the practices of other primary care disciplines. These changes give rise to a reasonable concern that academic departments of family medicine and their faculty may give up control of their clinical practice and lose their identity through conversion to "generic" primary care departments and providers.
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This study demonstrates the use of a community household survey and how it can provide information beyond that obtained with secondary epidemiologic data alone. ⋯ Although household surveys are expensive to conduct, the information garnered from this survey could not be obtained from secondary data sources and was important in determining the direction of outreach and intervention programs being carried out in the community by the COPC clinic.
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Despite a relatively fixed demand for services, access to abortion services has become increasingly limited, in part due to fewer training opportunities for OB-GYN residents. The recommended core educational guidelines for family practice residents include voluntary interruption of pregnancy up to 10 weeks gestation, but the availability of and interest in such training have not been reported. ⋯ About one of eight family practice residency programs nationwide offer training in abortion. When offered, nearly half of family practice residents choose to participate in this training. Interested family practice residents could be trained to fill an increasing need for physicians willing and able to perform first-trimester abortions.
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This study evaluated the usefulness of temperature, leukocyte count, and laboratory screening tests for abdominal pain to distinguish dischargeable from admittable illness and to distinguish admittable, nonsurgical disease from surgical disease in elderly patients (> or = 65 years) who present to the emergency department with acute (< 1 week) nontraumatic abdominal pain. ⋯ Temperature and laboratory screening tests for evaluation of abdominal pain in the elderly do not differentiate admittable, nonsurgical disease from surgical disease. Physicians who evaluate elderly patients with acute abdominal pain must be aware that their clinical impression of surgical illness is of greater importance than laboratory tests in the decision to request special studies or surgical consultation.
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Although the medical literature emphasizes the role of the research environment in research productivity, no study has investigated the effect of different environmental features on research productivity in a family medicine department. This study evaluated the association between departmental features and scholarly productivity. ⋯ Certain departmental features were associated with quantity of research, faculty involvement in research, and quantity of presentations made.