Journal of general internal medicine
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The justice-involved population faces significant health disparities yet is often overlooked in medical education, resulting in medical providers having limited preparation to serve this community. The objective of this study is to understand the scope and context of medical education in correctional healthcare. ⋯ Registration number CRD42023427470.
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As part of a continuing medical education activity, primary care physicians in Arizona were asked to draw how they feel about treating patients with chronic pain and addiction. Their drawings, complete with cliffs, walls, torn-out hair, and connected hearts, make for a harrowing look at burnout, angst, and empathy among physicians who treat this subset of patients. Public health and exercise facilitators were troubled, leading them to publish this essay along with a selection of the drawings that depict the feelings of the physicians who feel ill-prepared to treat this patient population, which is only growing in number and needs.
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Hospital admission is a significant event in the healthcare trajectory of older adults (age 60 +). Numerous harms such as delirium, falls, and adverse medication events can arise that outweigh the benefits of admission. Little is known about how older adults feel about being hospitalized or what they think admission will achieve for them. These issues are particularly important to understand in socioeconomically disadvantaged patients, who have poor access to outpatient care and higher hospitalization rates. ⋯ Older adults' expectations of hospitalization exceed stabilization of acute illness. Hospital admission of older adults presents an opportunity for shared decision-making and communication about likely outcomes of hospitalization. Incorporating patient-centered outcomes into admission decisions may help align care with older adults' priorities in the ED.