Journal of general internal medicine
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Hospital medicine (HM) is an important career option for internal medicine (IM) residency graduates. Limited data exist regarding preferences and educational gaps in HM competencies among IM residents. ⋯ Our data can inform targeted inpatient competencies and educational curricula for IM residents in the USA.
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Since 2020, there has been a significant cultural and political backlash in the USA to growing acceptance of gender diversity and gender-affirming care. Legislative attacks, particularly targeting gender-affirming care access for transgender and gender diverse youth, have occurred in a media environment rife with misinformation and disinformation. Even in states where a ban is not enacted, we have seen significant harm caused by such misinformation and disinformation, to transgender and gender diverse patients, their families, and clinicians who provide this important and much needed care, in the form of clinic closures and disruption of services. In this hostile sociopolitical environment, we present strategies for health care organizations and workers to continue to provide this lifesaving care thoughtfully, to safeguard the protections currently in place, and to continue to advocate for patients, families, and health care staff.
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Exploring the experiences of Long COVID patients who face challenges with employment may inform improvements in how healthcare systems can provide holistic care for this patient population. ⋯ Patients with Long COVID may face significant challenges due to changes in their ability to work. Healthcare providers can support these patients by connecting them to financial assistance resources, facilitating appropriate mental health treatment, and expediting workplace accommodation requests.
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Behavioral health care access is inadequate and new primary care-based strategies are needed to meet the rising demand. Behavioral health integration (BHI) models, such as collaborative care (CoCM) or the primary care behavioral health (PCBH) model, are often touted as actionable and sustainable solutions. The intent of such models is to bring behavioral health expertise into medical settings with the aims of improving outcomes, increasing treatment capacity, and reducing stigma. ⋯ Recent encouraging developments include technical assistance opportunities for MBC implementation and emerging payment models that emphasize MBC. However, concerns remain surrounding the limitations of existing MBC billing codes. Ultimately, with continued advocacy and thoughtful policy decision-making, MBC has the potential to be a solution to the current behavioral health crisis.
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Many social need screening to advance population health and reduce health disparities, but barriers to screening remain. Improved knowledge of patient populations at risk for social needs based on administrative data could facilitate more targeted practices, and by extension, feasible social need screening and referral efforts. ⋯ The identification of characteristics associated with increased unmet social needs may provide opportunities for targeted screenings. As this cluster was also younger and had fewer comorbidities, they may be less likely to be identified as experiencing need through interactions with healthcare providers.