J Am Board Fam Med
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Increased attention towards infection control measures during the COVID-19 pandemic have brought to light the dermatological consequences of intensified hand hygiene measures. Healthcare workers are inherently at an increased risk of developing both allergic and irritant contact dermatitis. ⋯ Similarly, handwashing practices with soap and alcohol-based hand rubs (ABHRs) undermine the natural skin barriers with increasing frequency of use. We highlight clinical pearls for the frontline healthcare worker experiencing COVID-19 surges and offer practical measures to minimize the development of hand-based dermatitis.
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Black men are disproportionately impacted by prostate cancer (PrCa). Current guidelines recommend that all men make informed decisions about whether to be screened for PrCa. Little is known about the barriers and facilitators of informed decision-making (IDM) about PrCa screening in Black men. ⋯ Our results indicate that Black men may lack the prerequisite information to make informed decisions about PrCa screening, which is notable in light of known PrCa racial disparities. Clinicians can play an important role in facilitating IDM through fostering discussions about the benefits and risks of PrCa screening and educating Black men about racial disparities.
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The Department of Family Medicine and Community Health at the University of Minnesota engaged in a 5-year transformation to expand research and scholarship opportunities to all faculty. A harmonization framework was used to integrate the 3 missions of clinical care, education, and research to ensure that research and scholarship were an ongoing focus of the department. ⋯ Important lessons learned during the harmonized transformation included the following: (1) key elements of the transformation need to be balanced as an ensemble, (2) cultural and organizational shifts take concerted effort and time, (3) embrace iteration: allow "bumps in the road" to propel the work forward, (4) transformation is financially feasible, (5) career research faculty can mutually benefit from clinical faculty engaging in scholarship, and (6) honor skepticism or disinterest and let people cultivate enthusiasm for research and scholarship rather than being forced.
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To increase the utilization of Community Health Service (CHS) centers for primary care, the Central Government of China has promoted the use of contracts-known as "service agreements" (SAs)-between patients and primary care physicians. This study sought to identify factors that predict who signed SAs and the association between SAs and frequency of primary care visits in a CHS center in Beijing. ⋯ The evidence provides an important consideration for reducing gaps in the use of primary care services during the nationwide transition from the fee-for-service specialty care system to the patient-centered primary care-driven medical home model.
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The rise of health system and hospital ownership of primary care practices raises policy questions about the survival of independent physician-owned practices. Our data indicate that a substantial proportion of FPs in 2017-2019 remained in independently owned practice: 81% of solo practitioners and 35% of FPs in practices with 2-5 clinicians. These findings suggest that independent practice is surviving, and that it's incumbent on researchers, payers, and policymakers to better understand their unique contributions and challenges in the effort to improve primary care access, quality, and cost.