Journal of general internal medicine
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To fill the gap in knowledge on systematic differences between primary care practices (PCP) that do or do not provide intensive behavioral therapy (IBT) for obese Medicare patients. ⋯ Although the Centers for Medicare and Medicaid Services established payment codes for PCPs to deliver IBT for obesity in 2011, very few providers submitted fee-for-service claims for these services after almost 10 years. A survey completed by both a random and convenience sample of practices using and not using IBT for obesity payment codes revealed that billing for these services was problematic, and many providers that began using the codes discontinued using them over the past 7 years.
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Most medical schools offer medical Spanish education to teach patient-physician communication skills with the growing Spanish-speaking population. Medical Spanish courses that lack basic standards of curricular structure, faculty educators, learner assessment, and institutional credit may increase student confidence without sufficiently improving skills, inadvertently exacerbating communication problems with linguistic minority patients. ⋯ Recommended next steps for medical schools include formalizing medical Spanish courses as electives or required curricula; hiring and/or training faculty educators; incorporating learner assessment; and granting credit for student course completion. Future studies should evaluate implementation strategies to establish best practice recommendations beyond basic standards.
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Obesity is of epidemic proportion in the USA but most people with obesity do not receive treatment. ⋯ Treating obesity in primary care settings poses several challenges but can also be very satisfying and rewarding. To improve the ability of clinicians and practice members to treat obesity, important changes in payment, education, and work processes are necessary.