J Am Board Fam Med
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There is little qualitative research on the type of weight loss counseling patients prefer from their physicians and whether preferences differ by race. ⋯ While both African American and white women desired specific strategies from physicians in weight management, some white women may first need assistance in overcoming their stigma, depression, and low self-esteem before attempting weight loss.
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It is important to advise parents when to consult a doctor when their child has fever. To provide evidence-based, safety-net advice for young febrile children, we studied the risk of complications, the occurrence of alarm symptoms, the duration of fever. ⋯ In children with uncomplicated illnesses, the daily occurrence of alarming symptoms reported by parents was high. The median duration of fever was 4 days. The predictive value of alarming symptoms reported by parents for complicated illness should be reconsidered.
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After a contact with a primary care physician (PCP) cooperative for out-of-hours care, many patients have subsequent contact with health care. Little is known about the factors associated with these follow-up contacts. The objective of this study was to examine whether patient experiences with nurse telephone consultations and the cooperative's organizational characteristics were associated with the probability of follow-up contact. ⋯ Although follow-up contacts can be medically required, a substantial number of contacts seem to be not required and thus are potentially avoidable (eg, by changes in work routine and communication).
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To conduct a survey of primary care physicians and advanced registered nurse practitioners (ARNPs) in Washington State (WA) focused on changes in practice patterns and use of support tools in the prescription of opioids for the treatment of chronic noncancer pain (CNCP). ⋯ Overall, prescribing providers in WA reported ongoing concerns regarding opioid use for CNCP, but those affiliated with a health care organization with opioid prescribing guidelines and access to pain consultation were less likely to report being concerned about opioid-related problems or to have discontinued prescribing opioids.
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Physician and practice characteristics associated with family physician adoption of electronic health records (EHRs) remain largely unexplored but may be important for tailoring policies and interventions. ⋯ Variation in EHR adoption is associated with physician and practice characteristics that may help guide intervention. These findings may be important to other specialties and could instruct interventions to improve adoption. Certification boards could play an important role in tracking EHR adoption and help target resources and facilitation.