Journal of general internal medicine
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Physician self-disclosure has been viewed either positively or negatively, but little is known about how patients respond to physician self-disclosure. ⋯ Physician self-disclosure is significantly associated with higher patient satisfaction ratings for surgical visits and lower patient satisfaction ratings for primary care visits. Further study is needed to explore these intriguing findings and to define the circumstances under which physician self-disclosure is either well or poorly received.
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Multicenter Study Comparative Study
Race and patient refusal of invasive cardiac procedures.
To determine whether patients' decisions are an important determinant of nonuse of invasive cardiac procedures and whether decisions vary by race. ⋯ Patient decisions to decline recommended invasive cardiac procedures were infrequent and may explain only a small fraction of racial disparities in the use of invasive cardiac procedures.
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Comparative Study
Variation in participation in health care settings associated with race and ethnicity.
To use the ecology model of health care to contrast participation of black, non-Hispanics (blacks); white, non-Hispanics (whites); and Hispanics of any race (Hispanics) in 5 health care settings and determine whether disparities between those individuals exist among places where they receive care. ⋯ Fewer blacks and Hispanics than whites received health care in physicians' offices, outpatient clinics, and emergency departments in contrast to hospitals and home care. Research and programs aimed at reducing disparities in receipt of care specifically in the outpatient setting may have an important role in the quest to reduce racial and ethnic disparities in health.
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To use spatial and epidemiologic analyses to understand disparities in mammography use and to formulate interventions to increase its uptake in low-income, high-recent immigration areas in Toronto, Canada. ⋯ We found marked variation in mammography rates by area, with the lowest rates associated with low income and high immigration. Spatial patterns identified areas with low mammography and low physician visit rates appropriate for outreach and public education interventions. We also identified areas with low mammography and high physician visit rates appropriate for interventions targeted at physicians.
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To evaluate the prevalence of nutrition and exercise counseling for patients with hypertension. ⋯ While there were significant differences in counseling rates with respect to age, race, comorbidity, and survey cohort, counseling for therapeutic lifestyle changes for patients with hypertension was uniformly suboptimal. Physicians need to recognize the importance of nonpharmacologic treatment in hypertension.