J Am Board Fam Med
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To understand changes in reasons for visit to primary care in the face of an aging population, growing evidence for proactive preventive and chronic disease services, and the rise of the chronic care model. ⋯ Growing emphasis on chronic disease management is not reflected in the percent of primary care visits for chronic illness. This study highlights the potential utility of longitudinal data within a historical interpretive frame, while raising questions about the utility of using a main reason for visit to classify complex primary care visits.
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Although solo and small practices are a vital part of primary care, the proportion of family physicians reporting working in practices with 5 or fewer providers declined from 15% to 11% for solo and 37% to 34% for small (2 to 5 providers) practices from 2014 to 2018. These decreasing trends are concerning, mainly when a low proportion of family physicians have solo practices in rural locations given the access to care challenges in these underserved populations.
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In addition to the collection of veterans' health articles, this edition of the journal contains a wide range of family medicine research reports, commentaries, clinical reviews, and scholarly observations. These articles clearly exemplify a key strength of family medicine scholarship: the focus is on our patients. ⋯ Two other articles explore the role of pharmacists in an interdisciplinary team. A clever use of big databases provides a thought-provoking answer about the long-term health of patients with methicillin-resistant Staphylococcus aureus Three articles give us possible glimpses into the future of family medicine, exploring a potential payment reform model, suggesting an alternative approach to cancer screening guideline development, and considering how family physicians remain relevant in the technology-laden medical world of tomorrow.
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Since 2009, pharmacists in all 50 states have been authorized to provide vaccinations to adults. The objective of this study was to assess primary care physicians' (PCPs) experiences with and attitudes about pharmacists administering vaccinations. ⋯ PCPs have mixed feelings about pharmacists delivering vaccines. Universal use of IISs by pharmacists could partially address physicians' concerns by providing a systematic way for pharmacists and physicians to share patient vaccination histories.
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The objective of this study was to assess the 11-year mortality risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization in community-dwelling adults aged 40 to 85 years. ⋯ MRSA colonization in middle-aged and older adults in the community is associated with a significantly increased mortality risk. Considering that this effect was in the community and not in hospitalized patients, this finding of increased mortality risk is especially troubling.