Journal of general internal medicine
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Primary prevention of intimate partner violence (IPV) at the level of the primary care provider is unexplored. ⋯ Men appear to underreport current IPV perpetration in face-to-face primary care encounters when compared to other methods of reporting. Men may more readily report past IPV perpetration in face-to-face encounters.
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In the United States, Hispanics are less likely to undergo colorectal cancer (CRC) screening than non-Hispanic whites (whites). ⋯ Factors associated with CRC screening disparities between Hispanics and non-Hispanic whites appear similar among Hispanic sub-groups. However, the relative contribution of these factors to disparities varies by Hispanic national origin group, suggesting a need for differing approaches to increasing screening for each group.
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Historical Article
Learning from the legal history of billing for medical fees.
When patients pay for care out-of-pocket, physicians must balance their professional obligations to serve with the commercial demands of medical practice. Consumer-directed health care makes this problem newly pressing, but law and ethics have thought for millennia about how doctors should bill patients. ⋯ Ethical and professional principles might require providers to return to discounting fees for patients in straitened circumstances, but imposing such a duty formally (by law or by ethical code) on doctors would be harder both in principle and in practice than to impose such a duty on hospitals. Still, professional ethics should encourage physicians to give patients in economic trouble at least the benefit of the lowest rate they accept from an established payer.
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One of the most significant changes in US hospitals over the past decade has been the emergence of hospitalists as key providers of inpatient care. The number of hospitalists in both community and teaching hospitals is growing rapidly, and as the field burgeons, many are questioning where hospitalists should reside within the academic medical center (AMC). ⋯ We believe that in many large AMCs, separate divisions of hospital medicine are less likely to form soon, and in our opinion should not form until they are able to fulfill the tripartite mission traditionally carried out by independent specialist divisions. At community hospitals and less research-oriented AMCs, hospital medicine programs may soon be ready to become separate divisions.
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Monitoring and modifying physicians' prescribing behavior through prescription tracking is integral to pharmaceutical marketing. Health information organizations (HIOs) combine prescription information purchased from pharmacies with anonymized patient medical records purchased from health insurance companies to determine which drugs individual physicians prefer for specific diagnoses and patient populations. This information is used to tailor marketing strategies to individual physicians and to assess the effect of promotions on prescribing behavior. ⋯ Although it has been argued that prescription tracking benefits public health, data gathered by HIOs is designed for marketing drugs. These data are sequestered by industry and are not generally available for genuine public health purposes.