Primary Care

25 Sep

Posted at 23:28h in General Medicine, Primary Care

Notice: This post is provided for background information only. Consult your healthcare provider for specific medical advice, screening recommendations, or any health concerns.

When researchers at the federal Agency for Healthcare Research and Quality examined whether American adults were getting the preventive care recommended for them, they found that as of 2015, only 8% of US adults aged 35 and older had received every high-priority preventive service appropriate for them. Nearly 5% had received none at all. These are not obscure or experimental tests — the list included blood pressure checks, cancer screenings, vaccinations, and depression screening, services that major expert panels agree save lives. For most people with private insurance, many of them cost nothing out of pocket. Keeping patients current on that list is one of the less visible skills of the best family medicine specialists, and it is something patients can actively ask for. According to the AHRQ (Agency for Healthcare Research and Quality), the lack of a usual source of primary care is among the most consistent predictors of missed preventive services — alongside lack of insurance and difficulty getting appointments.

Adults and Preventive Care .png

27 Jul

Posted at 19:07h in Primary Care

A first primary care visit does more than address one symptom. It establishes a health baseline, records past issues, and initiates an ongoing relationship with a single clinician. Many patients expect a brief, impersonal appointment, yet the first meeting usually follows a careful sequence. With a clear idea of that process, patients can arrive calmer, answer questions more fully, and leave with a practical plan for follow-up care. For more on why regular checkups matter and what they can detect early, see this overview of the benefits of regular health checkups and early detection.

[caption id="attachment_75250" align="aligncenter" width="500"]primary care practice Photo by Ivan S[/caption]

03 Mar

Posted at 19:05h in Primary Care
[caption id="attachment_66958" align="aligncenter" width="500"]primary-care-pexels-image Photo by Gustavo Fring[/caption] Preventative medicine is the foundation of a healthier population, reducing the burden of chronic diseases and improving overall well-being. Primary care is at the heart of this approach, where medical professionals play a critical role in identifying risk factors, promoting healthy lifestyles, and detecting potential health issues before they escalate. For both medical professionals and the general public, understanding the value of primary care in prevention is key to enhancing patient outcomes and reducing long-term healthcare costs. Primary care as the first line of defense Primary care physicians are usually the first point of contact for patients, offering routine check-ups, screenings, and early interventions. Their important ability to build long-term relationships with patients allows them to monitor health trends over time and address potential concerns before they develop into serious conditions. For example, regular blood pressure monitoring in a primary care setting can lead to early detection of hypertension, significantly reducing the risk of heart disease and stroke. Similarly, routine screenings for diabetes, cholesterol levels, and cancer enable early treatment, improving survival rates and quality of life. Preventative screenings and early diagnosis One of the most effective ways primary care physicians contribute to preventative medicine is through evidence-based screenings and diagnostic tests. These include:
  • Cancer screenings (e.g., mammograms, Pap smears, colonoscopies) to detect early-stage cancers.
  • Cardiovascular risk assessments to identify hypertension, high cholesterol, and heart disease.
  • Diabetes screening for early detection and management of blood sugar abnormalities.
  • Vaccinations to prevent infectious diseases such as influenza, pneumonia, and HPV.
By implementing these screenings as part of routine care, primary care physicians reduce the risk of severe illness and promote early intervention, ultimately improving patient outcomes.

20 Nov

Posted at 23:50h in General Medicine, Primary Care
Frustrated with the rising costs and recurring treatments, patients are increasingly seeking solutions that prioritize their long-term well-being. In response, the healthcare sector is shifting its focus towards preventive care in primary care settings. The Growing Importance of Preventive Care in Primary Care Practices This proactive approach not only addresses immediate health issues but also emphasizes the prevention of future ailments, reshaping the healthcare landscape. By integrating preventive measures into routine care, providers are transforming patient outcomes and establishing new healthcare efficiency and effectiveness standards.

The Evolution of Preventive Care in Primary Care Settings

The traditional healthcare model, which often centered on treating illnesses as they emerged, is being transformed by a proactive approach to preventive care. This shift towards prevention is not only a medical necessity but a financial imperative, particularly as healthcare costs continue to escalate. As more patients seek primary care physicians near me who prioritize preventive care, healthcare providers are adapting their practices to meet this growing demand. By focusing first on the prevention of diseases before they have the chance to take hold, care providers can manage individual and public health in a far more sustainable manner. The evidence supporting this shift is strong, demonstrating that preventive care not only reduces healthcare costs but also dramatically and positively affects patient-centered health outcomes, including a reduction in hospital admissions due to chronic diseases.

23 Jul

Posted at 20:02h in Medicare, Primary Care
Navigating the complexities of Medicare can be challenging, especially when it comes to finding and choosing the right primary care doctor. This guide will help you understand the different parts of Medicare, how it covers primary care services, and provide actionable steps to find and evaluate primary care doctors that accept Medicare.

Understanding Medicare and Its Different Parts

Medicare is a federal health insurance program primarily for individuals aged 65 and older, though it also covers certain younger people with disabilities. Medicare consists of four parts:
  1. Medicare Part A: Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  2. Medicare Part B: Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
  3. Medicare Part C (Medicare Advantage): An alternative to Original Medicare that offers all Part A and Part B services through private insurance companies. These plans often include additional benefits like vision, dental, and prescription drug coverage.
  4. Medicare Part D: Covers prescription drugs.

06 Sep

Posted at 14:38h in Author Interviews, Heart Disease, JAMA, Primary Care, Stroke, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_59503" align="alignleft" width="150"]Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. Dr. Donahue[/caption] Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older.

13 Sep

Posted at 17:28h in Author Interviews, JAMA, Primary Care, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_58111" align="alignleft" width="200"]Karina W. Davidson, Ph.D., M.A.Sc. Professor of Behavioral Medicine Zucker School of Medicine at Hofstra University/Northwell Health Chairperson, USPSTF Dr. Davidson[/caption] Karina W. Davidson, Ph.D., M.A.Sc. Professor of Behavioral Medicine Zucker School of Medicine at Hofstra University/Northwell Health Chairperson, USPSTF MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The social and economic conditions in someone’s life, such as whether or not they have secure food, housing, or transportation, can affect their health in multiple ways. As part of our commitment to improving health equity, the U.S. Preventive Services Task Force took two key steps. We both thoroughly reviewed the existing research around screening and interventions for social risk factors, and audited our own portfolio of recommendation statements to determine how and how often social risks have been considered in the past. This information serves as a benchmark and foundation for our ongoing work to further advance health equity through our methods and recommendations.

09 Jul

Posted at 17:35h in Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA, Pediatrics, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_57766" align="alignleft" width="200"]Lisa Rotenstein, MD, MBA Assistant Medical Director Population Health and Faculty Wellbeing Department of Medicine Brigham and Women's Hospital Dr. Rotenstein[/caption] Lisa Rotenstein, MD, MBA Assistant Medical Director Population Health and Faculty Wellbeing Department of Medicine Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Our previous work in JAMA Internal Medicine demonstrated significant differences in time spent on the electronic health record (EHR) by specialty, and specifically showed that primary care clinicians spent significantly more total and after-hours time on the EHR than surgical and medical specialty counterparts. Primary care clinicians spent twice as long as surgical colleagues on notes, and received more than twice as many messages from team-mates, five times as many patient messages, and fifteen times as many prescription messages each day. Given these findings, the heavy administrative burden placed on primary care clinicians, and previous data about burnout among primary care clinicians, we wanted to better understand differences in time spent on the EHR among the different types of primary care clinicians.

10 Jun

Posted at 17:42h in Author Interviews, Brigham & Women's - Harvard, Primary Care, Surgical Research, Weight Research
MedicalResearch.com Interview with: [caption id="attachment_57605" align="alignleft" width="142"] Dr. Turchin[/caption] Alexander Turchin, MD, MS Director of Informatics Research Division of Endocrinology, Diabetes and Hypertension Associate Professor of Medicine, Harvard Medical School Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: There is an epidemic of obesity in the U.S.: over 40% of adults are obese. Obesity causes numerous complications, ranging from heart attacks to cancer. Bariatric surgery is one of the most effective ways to treat obesity, but very few patients utilize it; it is unclear why. 

28 Jan

Posted at 19:39h in Author Interviews, JAMA, Primary Care, Smoking, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_47324" align="alignleft" width="133"]Michael Silverstein, M.D., M.P.H. Professor of pediatrics Director of the Division of General Academic Pediatrics Vice chair of research for the Department of Pediatrics Boston University School of Medicine Dr. Silverstein[/caption] Dr. Michael Silverstein M.D., M.P.H Professor of Pediatrics Director of the Division of General Academic Pediatrics Vice Chair of Research, Department of Pediatrics Boston University School of Medicine  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tobacco use is the leading preventable cause of disease, disability, and death in the United States and quitting is one of the best things people can do for their health. Additionally, smoking during pregnancy can cause serious harms to both the pregnant person and the baby. The Task Force continues to recommend that clinicians ask all adults and pregnant people about their tobacco use, advise those who use tobacco to quit, and connect them to proven, safe methods to help them quit. 

19 May

Posted at 15:29h in Author Interviews, Cost of Health Care, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_54263" align="alignleft" width="168"]Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California Dr. Martin[/caption] Sara Martin, MD, MSc Santa Rosa Family Medicine Residency Program Santa Rosa, California MedicalResearch.com: What is the background for this study? Response: To improve access to comprehensive primary care, we need to understand how much is being spent on primary care. Until recently, the United States lacked any data-based estimate of primary care expenditure.  This study utilizes Medical Expenditure Panel Survey (MEPS)data from 2002 – 2016 to estimate the percentage of healthcare expenditures that was spent on primary care. Most discussions around health care expenditure in the U.S. focus on the fact that we spend more than any other country and do not have the corresponding outcomes to match that investment.  This paper focuses the conversation around the distribution of the expenditure.

27 Jan

Posted at 22:20h in Author Interviews, Dartmouth, JAMA, Pharmaceutical Companies, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_52969" align="alignleft" width="147"]Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice Prof. Woloshin[/caption] Steven Woloshin, MD, MS Professor of Medicine and Community and Family Medicine Professor, The Dartmouth Institute for Health Policy and Clinical Practice MedicalResearch.com: What is the background for this study? Response: Industry spends more on detailing visits and free samples than any other form of prescription drug marketing.  There is good evidence that these activities can lead to more use of expensive new drugs over equally effective cheaper options.  Given these concerns there have been efforts by some hospitalls and practices to restrict these forms of marketing. We asked physicians in group practices delivering primary care about how often pharmaceutical reps visit their practice and whether they have a free sample closet. 

22 Jan

Posted at 21:40h in Author Interviews, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_52904" align="alignleft" width="106"]Leah Marcotte, MD Clinical Assistant Professor, Medicine Associate Medical Director, Population Health Dr. Marcotte[/caption] Leah Marcotte, MD Clinical Assistant Professor, Medicine University of Washington
[caption id="attachment_52905" align="alignleft" width="107"]Joshua Liao, MD, MSc, FACP Assistant Professor, Department of Medicine Director, UW Medicine Value and Systems Science Lab Associate Medical Director, Contracting and Value-Based Care Dr. Liao[/caption] Joshua M. Liao, MD, MSc, FACP Assistant Professor, Department of Medicine Director, UW Medicine Value and Systems Science Lab Medical Director of Payment Strategy, UW Medicine University of Washington
  MedicalResearch.com: What is the background for this study? Response: In the last 7 years, Medicare has implemented payment reforms to encourage primary care and other ambulatory providers for dedicated care coordination activities. One such reform, Transitional Care Management (TCM) billing codes, was introduced in 2013 and emphasized coordination during care transitions from hospital to home – a particularly vulnerable period in which patients may be at risk for adverse outcomes. TCM services include patient contact (e.g., phone call) within two business days of discharge, a visit (e.g., office or home-based) within 14 days of discharge with at least moderate complexity medical decision making, and medication reconciliation. TCM services may be delivered after inpatient hospitalization, observation stay, skilled nursing facility admission or acute rehab admission. There have been few studies that have looked at early data in Transitional Care Management, and none that have described national use of and payment for these codes over an extended period of time. We analyzed a national Medicare dataset looking at 100% of submitted and paid TCM claims from 2013-2018. 

11 Dec

Posted at 17:35h in Author Interviews, Cost of Health Care, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_52362" align="alignleft" width="200"]Julie Reiff Researcher Health Care Cost Institute Julie Reiff[/caption] Julie Reiff BA Researcher Health Care Cost Institute  MedicalResearch.com: What is the background for this study? Response: Prior studies have attempted to define primary care spending and quantify such spending. Using definitions from the Milbank Memorial Fund, we used Health Care Cost Institute data to calculate primary care utilization and spending among those age 0-64 with employer-sponsored insurance.

07 Oct

Posted at 16:44h in Author Interviews, Critical Care - Intensive Care - ICUs, End of Life Care, Primary Care, Pulmonary Disease, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_51756" align="alignleft" width="180"]Gary Weissman, MD, MSHP Assistant Professor of Medicine Pulmonary, Allergy, and Critical Care Division Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  Dr. Weissman[/caption] Gary Weissman, MD, MSHP Assistant Professor of Medicine Pulmonary, Allergy, and Critical Care Division Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  MedicalResearch.com: What is the background for this study? Response: There are millions of hospitalizations every year in the United States (US) that include a stay in an intensive care unit (ICU). Such ICU stays put strain on health system resources, may be unwanted by patients, and are costly to society. As the population of the US gets older and more medically complex, some have argued that we need more ICU beds and a larger ICU workforce to keep pace. We hypothesized that some proportion of these ICU admissions could be prevented with early and appropriate outpatient care. Such a strategy would alleviate some of the strains and costs associated with ICU stays. If an appreciable proportion of ICU stays were preventable in this way, it would strengthen support for an alternative population-health based framework instead of further investments in the ICU delivery infrastructure. 

18 Sep

Posted at 11:14h in Author Interviews, Health Care Systems, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_51306" align="alignleft" width="200"]Deborah Korenstein, MD FACP General internist and Chief, General Internal Medicine Memorial Sloan Kettering Cancer Center Dr. Korenstein[/caption] Deborah Korenstein, MD FACP General internist and Chief, General Internal Medicine Memorial Sloan Kettering Cancer Center  MedicalResearch.com: What is the background for this study? Response: Executive physicals are 1 to 2-day comprehensive health assessments offering disease screening and preventive testing. Large companies can arrange for these evaluations for senior executives. They are often offered by prestigious academic medical centers, but can also be located in less formal settings like spas. They generally include a set of tests that sometimes vary based on patient characteristics. Any tests that are done in response to from findings from executive physicals are billed to health insurance companies. A single 2008 paper described executive physicals and criticized them for being non-evidence based. Since then, executive physicals have grown in popularity, but their nature and impact have not been described. We set out to describe included services and cost of executive physicals at top academic medical centers.

30 Aug

Posted at 18:19h in Author Interviews, JAMA, Opiods, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_51102" align="alignleft" width="150"]Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota Dr. Neprash[/caption] Dr. Hannah T. Neprash, PhD Assistant Professor, Division of Health Policy and Management School of Public Health University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Physicians play a pivotal role in the opioid epidemic and it's important to understand what factors that drive opioid prescribing. Variation in opioid prescribing across physicians has been well-documented, but there’s very little research on variation within physicians…which is surprising, given the widespread concern about time pressure and cognitive fatigue having a potentially detrimental effect on the quality of care provided by physicians.

26 Jul

Posted at 13:28h in Author Interviews, Global Health, Opiods, Pain Research, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_50430" align="alignleft" width="133"]Marisha Burden, MD, FACP, SFHM Associate Professor of Medicine Division Head of Hospital Medicine University of Colorado School of Medicine Dr. Burden[/caption] Marisha Burden, MD, FACP, SFHM Associate Professor of Medicine Division Head of Hospital Medicine University of Colorado School of Medicine MedicalResearch.com: What is the background for this study? Response: The United States has seen a marked increase in opioid prescribing since 2000 and while there has been a slight decline in prescribing since 2012, prescription rates for opioids still remain much higher than in the late 1990’s and are considerably higher when compared to other countries. The US continues to see opioid-related complications such as overdoses, hospitalizations, and deaths. Hospitalized patients frequently experience pain and opioid medications are often the mainstay for treatment of pain. Studies have suggested that receipt of opioid prescriptions at the time of hospital discharge may increase risk for long-term use.

23 Jul

Posted at 11:41h in Annals Thoracic Surgery, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_50354" align="alignleft" width="140"]Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine Dr. Wee[/caption] Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age.  The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017,  a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation.

11 Jul

Posted at 22:39h in Author Interviews, Health Care Systems, Primary Care, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_50224" align="alignleft" width="200"]Molly Candon PhD Research Assistant Professor of Psychiatry Lecturer, Department of Health Care Management The Wharton School, University of Pennsylvania Co-Instructor, Health Services and Policy Research Methods II, MS in Health Policy Research Program, Perelman School of Medicine, University of Pennsylvania  Dr. Candon[/caption] Molly Candon PhD Research Assistant Professor of Psychiatry Lecturer, Department of Health Care Management The Wharton School, University of Pennsylvania Co-Instructor, Health Services and Policy Research Methods II, MS in Health Policy Research Program, Perelman School of Medicine, University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: A team of researchers (led by Karin Rhodes, MD and Dan Polsky, PhD) conducted a secret shopper study of thousands of primary care practices across 10 states, with trained callers simulating patients with Medicaid and requesting appointments. One of the outcome measures was whether an appointment was scheduled with a physician or Advanced Practitioner. Between 2012 and 2016, the share of appointments scheduled with Advanced Practitioners increased by five percentage points. 

28 May

Posted at 22:56h in Author Interviews, Outcomes & Safety, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_49386" align="alignleft" width="133"]Janice D. Walker, RN, MBABeth Israel Deaconess Medical Center Janice Walker[/caption] Janice D. Walker, RN, MBA Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: In 2010-2011, we launched a pilot intervention in which a limited number of primary care doctors shared the notes they wrote about an office visit with their patients via secure online portals they accessed through their health systems; this practice became known as open notes (our program is called “OpenNotes”). We then surveyed patients and their primary care providers to get feedback on their experiences and published the results in the Annals of Internal Medicine in 2012. After the study, the three large health systems that participated—Beth Israel Deaconess Medical Center in Boston, University of Washington Medicine in Seattle, and Geisinger in rural Pennsylvania—made open notes available across ambulatory specialties. In this paper, “OpenNotes After 7 Years: Patient Experiences with Ongoing Access to their Clinicians’ Outpatient Visit Notes," we wanted to examine the ongoing experiences and perceptions of patients who read ambulatory notes written by a broad range of doctors, nurses and other clinicians. We did this by surveying patients who had been seen in a hospital or community based practice, were registered on their patient portal, and had at least one note available to read in a recent 12-month period. The main measures include patient-reported behaviors and their perceptions concerning the benefits and risks of reading their visit notes.

11 May

Posted at 21:22h in Author Interviews, JAMA, Opiods, Primary Care, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_49122" align="alignleft" width="140"]Kao-Ping Chua, M.D., Ph.D.Department of PediatricsSusan B. Meister Child Health Evaluation and Research CenterUniversity of Michigan, Ann Arbor Dr. Kao-Ping Chua[/caption] Kao-Ping Chua, M.D., Ph.D. Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan, Ann Arbor MedicalResearch.com: What is the background for this study?   Response: Doctor and pharmacy shopping is a high-risk behavior in which patients obtain opioid prescriptions from multiple prescribers and fill them at multiple pharmacies. Because this behavior is associated with a high risk of overdose death, there have been many efforts to help clinicians detect doctor and pharmacy shopping among patients prescribed opioids. For example, 49 states have a prescription drug monitoring program that provides information on patients’ prior controlled substance prescriptions. In contrast, there has been little attention to the possibility that patients prescribed opioids may have family members who are engaged in opioid doctor and pharmacy shopping. Such family members may divert opioids prescribed to patients because of their access to these opioids.

07 May

Posted at 22:56h in Author Interviews, Electronic Records, JAMA, Pediatrics, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_49055" align="alignleft" width="173"]Cari McCarty, PhDResearch Professor, UWInvestigator, Seattle Children’s Research Institute Dr. McCarty[/caption] Cari McCarty, PhD Research Professor, UW Investigator, Seattle Children’s Research Institute  MedicalResearch.com: What is the background for this study? Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care.

23 Apr

Posted at 21:29h in Author Interviews, Environmental Risks, JAMA, Pediatrics, Primary Care, Toxin Research, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_48777" align="alignleft" width="160"]Alex H. Krist, MD, MPHVice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University Dr. Krist[/caption] Alex H. Krist, MD, MPH Vice-Chairperson, U.S. Preventive Services Task Force Professor of family medicine and population healt Virginia Commonwealth University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Exposure to lead can have serious lifelong effects on the health and wellbeing of children. There is no safe level of lead exposure, so finding and removing any source of lead exposure is essential. In its review of the evidence, the Task Force found that more research is needed to determine what primary care clinicians can do to help prevent and treat the health problems that can result from lead exposure in childhood and pregnancy.

01 Feb

Posted at 00:24h in Author Interviews, Diabetes, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_47260" align="alignleft" width="106"]Diane M. Gibson, Ph.D. Executive Director – New York Federal Statistical Research Data Center, Baruch RDC Associate Professor – Marxe School of Public and International Affairs, Baruch College - CUNY Dr. Gibson[/caption] Diane M. Gibson, Ph.D. Executive Director – New York Federal Statistical Research Data Center, Baruch RDC Associate Professor – Marxe School of Public and International Affairs, Baruch College - CUNY MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior studies have found that screening for diabetic retinopathy in primary care settings using telemedicine increased screening rates among individuals with diabetes and among subgroups of individuals with diabetes who are at high risk of missing recommended eye exams.  In a previous paper I looked at how often U.S. adults with diabetes visited primary care and eye care providers for recommended diabetes preventive care services using a sample from the 2007-2013 Medical Expenditure Panel Survey.  I found that while visits to eye care providers were often skipped, most adults with diabetes did visit primary care physicians.  I argued that these findings suggest that screening for diabetic retinopathy in primary care settings using telemedicine has the potential to fulfill unmet needs and reach most U.S. adults with diabetes. My brief report in JAMA Ophthalmology examines patterns of eye examination receipt and visits to primary care physicians among U.S. adults with diabetes using a sample from the 2016 National Health Interview Survey.  The report pays particular attention to individuals who are at high-risk of missing recommended eye exams. The study found that 87.7% of the sample of adults with diabetes visited a primary care physician in the past year and that, except for the uninsured subgroup, more than 78% of each high-risk subgroup visited a primary care provider in the past year. 

28 Jan

Posted at 19:24h in Author Interviews, Hospital Readmissions, JAMA, Primary Care
MedicalResearch.com Interview with: Dr. Dawn Wiest, 7-day pledge after hospital admissionDawn Wiest, PhD Director, Action Research & Evaluation Camden Coalition of Healthcare Providers MedicalResearch.com: What is the background for this study? Response: Understanding the role of care transitions after hospitalization in reducing avoidable readmissions, the Camden Coalition launched the 7-Day Pledge in 2014 in partnership with primary care practices in Camden, NJ to address patient and provider barriers to timely post-discharge primary care follow-up. To evaluate whether our program was associated with lower hospital readmissions, we used all-payer hospital claims data from five regional health systems. We compared readmissions for patients who had a primary care follow-up within seven days with similar patients who had a later or no follow-up using propensity score matching.

10 Jan

Posted at 16:47h in Author Interviews, JAMA, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_46878" align="alignleft" width="142"]Ying Xue, DNSc, RN Associate Professor University of Rochester School of Nursing Rochester NY 14642 Dr. Ying Xue[/caption] Ying Xue, DNSc, RN Associate Professor University of Rochester School of Nursing Rochester NY 14642 MedicalResearch.com: What is the background for this study? Response: Shortages of primary care physicians have been a national concern, and forecasts project worsening trends in the future.1 The shortfall of primary care physicians is particularly severe in rural and other underserved communities, and some evidence indicates that the shortage of primary care physicians is due to maldistribution rather than insufficient supply.2 Nurse practitioners (NPs) constitute the largest and fastest growing group of non-physician primary care providers. The Health Resources and Services Administration (HRSA) estimated that the number of primary care NPs will grow 93% from 2013 to 2025, and a projected shortage of 23,640 full-time equivalent primary care physicians in 2025 could be effectively mitigated with better utilization of NPs and physician assistants.1 As the primary care physician shortage persists, examination of trends in the distribution of primary care NP supply, particularly in relation to populations most in need, will inform strategies to strengthen primary care capacity. However, such evidence is limited, particularly in combination with physician workforce trends. We thus characterized the temporal trends in the distribution of primary care NPs in low-income and rural areas compared with the distribution of primary care physicians.

03 Jan

Posted at 17:03h in Addiction, Author Interviews, Cocaine, Opiods, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_46771" align="alignleft" width="184"]Sarah M. Bagley MD, MSc Assistant Professor of Medicine and Pediatrics Director, CATALYST Clinic Boston University School of Medicine/Boston Medical Center Boston, MA Dr. Bagley[/caption] Sarah M. Bagley MD, MSc Assistant Professor of Medicine and Pediatrics Director, CATALYST Clinic Boston University School of Medicine/Boston Medical Center Boston, MA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Urine drug testing is a routine part of the management of primary care patients with opioid use disorder treated with medications such as buprenorphine. In addition, most providers also ask patients about recent drug use. The point of this study was to see the agreement between the urine drug testing and what patients told a nurse and whether that changed the longer a patient was in treatment. We found that truthful disclosure of opioid and cocaine use increased with time in treatment and that urine drug tests are a useful tool to monitor patients. 

20 Nov

Posted at 00:58h in Alcohol, Author Interviews, CDC, JAMA, Primary Care, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_46135" align="alignleft" width="200"]Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P Ronald Reagan UCLA Medical Center Division Chief of General Internal Medicine and Health Services Research Professor of Medicine. Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California Dr. Mangione[/caption] Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P Ronald Reagan UCLA Medical Center Division Chief of General Internal Medicine and Health Services Research Professor of Medicine. Barbara A. Levey, MD, and Gerald S. Levey, MD Endowed chair in medicine David Geffen School of Medicine University of California MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unhealthy alcohol use is relatively common and is increasing among U.S. adults. Alcohol use is the third leading cause of preventable death in the U.S. and contributes to more than 88,000 deaths per year. In pregnancy, it also leads to birth defects and developmental problems in children. The Task Force found that screening tests and brief counseling interventions can help detect and reduce unhealthy alcohol use among adults, and in turn help prevent negative consequences related to alcohol use. For adolescents ages 12 to 17, clinicians should use their best judgment when deciding whether or not to screen and refer their patients to counseling, until we have better studies available.