Journal of general internal medicine
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Editorial
Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape.
As the United States faces a looming shortage of primary care physicians and escalating rates of clinician burnout, there is a pressing need to explore alternative models of primary care delivery. Direct Primary Care (DPC) is an emerging primary care model in which patients enroll in a membership plan and make direct monthly or yearly payments to a DPC practice for specific primary care services. ⋯ We demonstrate that the DPC practice can yield upwards of $25,000 in annual cost savings over the FFS practice while also providing more personalized patient care. Thus, we argue that the cost-effectiveness and value-based approach of DPC positions the model as a transformative force in reshaping the American healthcare landscape towards a more patient-centric, accessible, and resilient future.
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Biomarkers are becoming crucial in ever more medical tasks and are proposed to change medicine in profound ways. By biomarking ever more attributes of human life, they tend to blur the distinction between health and disease and come to characterize life as such. Not only do biomarkers strongly influence the professional conception of disease by pervading ever more diagnoses, but they also impact patients' experience of illness. To manage how biomarkers influence patients, professionals, and societies, we urgently need to move from identifying potentially relevant biomarkers to determine their meaning and value to individuals, professionals, and public health.
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Self-sampling for primary HPV detection for cervical cancer screening is now FDA-approved. Many persons interested in cervical cancer screening are eager to opt out of the invasive speculum exam and opt into the self-sampling. There is no limitation on which persons can choose self-sampling. ⋯ However, no clinical guidelines describe the best practices to increase screening among this underserved population. Much community work needs to occur to make the language of screening gender-affirming for all participants. Solutions to currently invasive follow-up exams after abnormal screens need to be communicated in language directed by the TGD AFAB community.
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In 2022, the Accreditation Council for Graduate Medical Education updated its competencies for residents in all specialties to include health policy advocacy. A recent systematic review shows that while a growing number of residency curricula include policy advocacy, few programs join in policy advocacy efforts with community partners. ⋯ Our community-engaged advocacy curriculum successfully met its aims and has contributed to policy change. Future directions include building a statewide coalition of residents and CBOs.
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Creating clinical vignettes requires considerable effort. Recent developments in generative artificial intelligence (AI) for natural language processing have been remarkable and may allow for the easy and immediate creation of diverse clinical vignettes. ⋯ Overall, 97% of the clinical vignettes proved practically useful, based on confirmation and revision by Japanese medical physicians. Given the significant effort required by physicians to create vignettes without AI, using GPT is expected to greatly optimize this process.