BACKGROUND: While barriers to care for pregnant patients with opioid use disorder (OUD) have been described, the experiences and challenges of the physicians providing care to these patients are poorly understood. OBJECTIVES: To describe the experiences of family physicians providing comprehensive care to pregnant people with OUD and the challenges they face in providing such care.
BACKGROUND: Disease prevention is a central aspect of primary care practice and is comprised of primary (eg, vaccinations), secondary (eg, screenings), tertiary (eg, chronic condition monitoring), and quaternary (eg, prevention of overmedicalization) levels. Despite rapid digital transformation of primary care practices, digital health interventions (DHIs) in preventive care have yet to be systematically evaluated. OBJECTIVE: This review aimed to identify and describe the scope and use of current DHIs for preventive care in primary care settings.
Female physicians earn less than their male counterparts, and many explanatory factors have been offered to account for these differences. An analysis of the 2019 American Board of Family Medicine New Graduate Survey Data demonstrates that women make 16% less than men, regardless of experience or hours worked.
The proportion of family physicians reporting provision of patient care in Spanish changed little between 2013 to 2020 but rose substantially for care delivered in other non-English languages. Physician-patient language concordance is associated with better clinical outcomes and higher patient satisfaction, serves as a proxy indicator for workforce diversity, and should be monitored and encouraged as the US population continues to diversify.
BACKGROUND: The Centers for Medicare and Medicaid Services proposed that the Transforming Clinical Practice Initiative (TCPI) would improve health outcomes for patients, reduce utilization of institutional services, and generate significant savings for payers by the end of September 2019.
As health systems grow in number and complexity, so do their associated leadership roles. And this growing array of opportunities to direct increasingly intricate clinical practice groups, public health systems, academic departments, research enterprises and policy begs for generalists trained to first diagnose problems faced before seeking and applying solutions. Breadth of training and the variety of experience begets competency in facing the unknown and undifferentiated and is the wellspring of innovation.
Earlier this year, the National Academies of Sciences, Engineering, and Medicine (NASEM) published the first formal consensus study of primary care in 25 years. The consensus committee’s report, “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care,” built on the 1996 Institute of Medicine primary care report. Since the report’s launch on May 4, 2021, there have been several efforts to elevate its recommendations as well as some recent breakthroughs in supporting them.
Clinical knowledge is fundamental to the social contract between medicine and society. As 1 of the 6 core competencies, appropriate clinical knowledge is effortfully acquired, constantly updated through practice and learning, and regularly assessed independently through board certification—and patients care a lot about it. It is thus important for ABFM to regularly review the validity of ABFM high-stakes knowledge assessments.
BACKGROUND: Patient-centered care is the best practice in the care of pregnant and postpartum patients. The COVID-19 pandemic prompted changes in perinatal care policies, which were often reactive, resulting in unintended consequences, many of which made the delivery of patient-centered care more difficult. This study aimed to understand the impact of the COVID-19 pandemic on perinatal health care delivery from the perspective of family physicians in the United States. METHODS: From October 5 to November 4, 2020, we surveyed mid- to late-career family physicians who provide perinatal care.
In May 2021, the National Academies of Sciences, Engineering, and Medicine (NASEM) released Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. Linking coordination of primary care to national health priorities was key to the launch of the Initiative to Strengthen Primary Health Care, which is designing a plan for a federal office or council for primary care. In this issue of Annals, 2 articles link the NASEM report to the national priority of health equity. A third article addresses the critical neglect of funding for primary care research.
Recent events remind us that deeply embedded inequities in health care access and health outcomes are rooted in historically white, and male, systems of power. A new series of JABFM policy briefs and accompanying commentaries will apply a critical perspective to topics of equity and diversity in the primary care workforce, and support a more inclusive and diverse array of collaborators and authors.
The graduate medical education (GME) system is heavily subsidized by the public in return for producing physicians who meet society's needs. Under the terms of this implicit social contract, decisions about how this funding is allocated are deferred to the individual training sites. Institutions receiving public funding face potential conflicts of interest, which have at times prioritized institutional purposes and needs over societal needs, highlighting that there is little public accountability for how such funding is used.
Objective: To learn from primary health care experts' experiences from the COVID-19 pandemic across countries. Methods: We applied qualitative thematic analysis to open-text responses from a multinational rapid response survey of primary health care experts assessing response to the initial wave of the COVID-19 pandemic.
OBJECTIVE: To compare physician versus practice-level primary care continuity and their association with expenditure and acute care utilization among Medicare beneficiaries and evaluate if continuity of outpatient primary care at either/both physician or/and practice level could be useful quality measures. DATA SOURCE: Medicare Fee-For-Service claims data for community dwelling beneficiaries without End-Stage Renal Disease who were attributed to a national random sample of primary care practices billing Medicare (2011-2017).
PURPOSE: Physicians' use of self-assessment to guide quality improvement or board certification activities often does not correlate with more objective measures, and they may spend valuable time on activities that support their strengths instead of addressing gaps. Our objective was to study whether viewing quality measures, with peer comparisons, would affect the selection of certification activities.
INTRODUCTION: COVID-19 pandemic-related health care disruptions necessitated rapid adaptation among family physicians to safely meet patient needs while protecting themselves and their staff. On April 1, 2020, the American Board of Family Medicine (ABFM) introduced a COVID Performance Improvement (PI) activity for physicians to report on and receive Family Medicine certification credit for practice adjustments they made during the early stages of the pandemic. We aimed to understand the types of interventions implemented, and lessons physicians learned from the efforts.
With conversational agents triaging symptoms, cameras aiding diagnoses, and remote sensors monitoring vital signs, the use of artificial intelligence (AI) outside of hospitals has the potential to improve health, according to a recently released report from the National Academy of Medicine. Despite this promise, the success of AI is not guaranteed, and stakeholders need to be involved with its development to ensure that the resulting tools can be easily used by clinicians, protect patient privacy, and enhance the value of the care delivered.
BACKGROUND AND OBJECTIVES: Racial/ethnic score disparities on standardized tests are well documented. Such differences on the American Board of Family Medicine (ABFM) certification examination have not been previously reported. If such differences exist, it could be due to differences in knowledge at the beginning of residency or due to variations in the rate of knowledge acquisition during residency. Our objective was to examine the residents' mean initial scores and score trajectories using the In-Training Examination (ITE) and certification examination.
BACKGROUND: Because improved patient outcomes and experiences have been associated with health care workforce diversity, efforts to create a diverse family physician workforce have increased. However, a metric that could properly measure family physician representation in various contexts has seldom been studied. OBJECTIVE: The goal of this study is to propose a new metric logRQ and use it to examine the diversification progress of American Board of Family Medicine (ABFM) certification candidates relative to national, state, and historic populations, as well as medical school matriculants.
Despite reports of a physician burnout epidemic, there is little research on the relationship between burnout and objective measures of care outcomes and no research on the relationship between burnout and costs of care. Linking survey data from 1,064 family physicians to Medicare claims, we found no consistent statistically significant relationship between seven categories of self-reported burnout and measures of ambulatory care-sensitive admissions, ambulatory care-sensitive emergency department visits, readmissions, or costs.