J Am Board Fam Med
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Disruptions in primary care practices, like ownership change, clinician turnover, and electronic health record system implementation, can stall quality improvement (QI) efforts. However, little is known about the relationship between these disruptions and practice participation in facilitated QI. ⋯ Disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator. Facilitators may benefit from additional training in approaches for helping practices attenuate the effects of disruptions and adapting strategies to help interventions work to continue building QI capacity.
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Health behaviors, mental health, and social needs impact health, but addressing these needs is difficult. Clinicians can partner with community programs to provide patients support. The relationship between program location and community need is uncertain. ⋯ Community programs are generally not colocated with need. This poses a barrier for people who need help addressing these domains.
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Medical schools have an important directive: to train the next generation of physicians. Faced with a primary care physician shortage, increasing numbers of under-represented faculty leaving academic medicine, low representation of women in leadership positions, and an ongoing pandemic, medical schools have a duty to implement solutions to alleviate these issues. Efforts have been made to create more diverse medical school classes, but those efforts are not mirrored in senior faculty demographics. ⋯ Based on the analysis, in 2019 only 11% of deans were under-represented minorities, 16% of deans were primary care physicians, and 18% of deans were women. When compared with the makeup of physicians in the United States and the population as a whole, these numbers are unrepresentative of national demographics. By hiring deans with a variety of race/ethnicities, specialties, and genders, schools set an important precedent that could lead to more pipeline programs, increased under-represented faculty retention, and more primary care physicians.
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Medication-assisted treatment (MAT) for opioid use disorder (MAT) is encouraged for primary care use, but evidence for effectiveness when fully integrated with primary care versus provided separately is limited. METHOD: We conducted a retrospective cohort study of 257 MAT patients in our family medicine clinic to assess retention in treatment for patients receiving MAT integrated with primary care compared with our MAT patients who received their primary care elsewhere. ⋯ In this rural family medicine clinic, MAT integrated with primary care was associated with higher retention in treatment. Providing MAT as a component of comprehensive primary care may be superior to referring patients to an outside source.
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Molecular tests (ie, real-time polymerase chain reaction [RT-PCR]) and antigen tests are used to detect SARS-CoV-2. RT-PCR tests are generally considered to be the standard for clinical diagnosis of SARS-CoV-2 due to accuracy and reliability but can take longer to return results than antigen tests. Our aim was to examine if point-of-care (POC) testing for SARS-CoV-2 infection would provide a flexible resource to help achieve workplace safety. We compared test results and time-to-test results between a POC RT-PCR test and a send-out PCR test in a program implemented in summer 2020. ⋯ POC testing for SARS-CoV-2 with RT-PCR technology is possible at reduced time compared with send-out PCR testing.