Journal of general internal medicine
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Regular mammogram screening for eligible average risk women has been associated with early detection and reduction of cancer morbidity and mortality. Delayed follow-up and resolution of abnormal mammograms limit early detection efforts and can cause psychological distress and anxiety. ⋯ Health organizations varied in their processes for abnormal results communication and availability of support staff and interpretation services. Women who received care from institutions with more robust support staff, such as bilingual navigators, more often than not reported understanding their results and timely abnormal mammogram follow-up. These reports were consistent across women from diverse ethnic groups and suggest the value of organizational support services between an abnormal mammogram and resolution for improving follow-up times and minimizing patient distress.
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Despite increasing numbers of older adults undergoing surgery and the known risks of opioids, little is known about the potential association between opioid prescribing and serious falls and fall-related injuries after surgery. ⋯ Serious falls after elective, outpatient surgery are uncommon, but correlated with age, sex, Medicaid eligibility, and the amount of opioids filled in the perioperative period. Judicious prescribing of opioids after surgery is paramount and is an opportunity to improve the safety of surgical care among older individuals.
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Improving patient-centered (PC) communication is a priority in many healthcare organizations. Most PC communication metrics are distal to the care encounter and lack clear attribution, thereby reducing relevance for leaders and clinicians. ⋯ Assessing provider communication at the point-of-care is acceptable and useful to clinicians. Challenges remain to properly incentivize and support the use of this data for improving PC communication.
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Evidence is growing that interprofessional team-based models benefit providers, trainees, and patients, but less is understood about the experiences of staff who work beside trainees learning these models. ⋯ Increased recognition of and expanded support for PCMH staff members to participate in educational endeavors is essential as interprofessional training clinics grow.
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Given the long history and pervasive nature of racism in medical culture, this essay argues that diversifying efforts alone cannot address systemic racism in medical education. Positive affirmation of anti-racist values and racial consciousness in the admissions process is necessary to create a truly inclusive culture in medical education and begin to undo centuries of racial prejudice in medicine. Drawing from historic examples, scholarship on the sociology of racialized space, recent research on race and medical education, and personal experience, we propose that medical educational institutions make a more concerted effort to consider racial attitudes and awareness as part of the admissions process as well as curricular reform efforts. We also provide examples of potential ways to practically implement this proposal in the admissions process.