Journal of general internal medicine
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Counseling on access to lethal means is highly recommended for patients with suicide risk, but there are no formal evaluations of its impact in real-world settings. ⋯ Clinicians should expand the use of counseling on access to lethal means, along with co-occurring suicide prevention practices, to all patients who report suicide ideation.
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Insurance-based denials are common barriers for transgender and non-binary individuals in accessing medically necessary gender-affirming care. Little is known about how experiences of transgender-related insurance denials may vary by insurance type. ⋯ Researchers and practitioners must consider the link between type of insurance coverage and experiences with different forms of transgender-related insurance denial. These results provide continuing support for broad non-discrimination policy efforts, but also direct our attention to targeted insurance policy interventions by form of denial, which can promote equitable access for transgender and non-binary people across all healthcare needs.
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Health systems are increasingly engaging in mission development around the quadruple aim of patient experience of care, population health, cost of care, and work-life balance of clinicians. This integrated approach is closely aligned with the education principles and competencies of health systems science (HSS), which includes population health, high-value care, leadership, teamwork, collaboration, and systems thinking. ⋯ Although GIM faculty are positioned to be early adopters and leaders in evolving systems of care and education, professional development and changes with academic health systems are required. This Perspective article explores the conceptualization and opportunities to effectively link GIM with healthcare and medical education transformation.