> Society granted physicians status, respect, autonomy in practice, the privilege of self-regulation, and financial rewards on the expectation that physicians would be competent, altruistic, moral, and would address the health care needs of individual patients and society. This “arrangement”
{"title":"THE SOCIAL CONTRACT, PROFESSIONALISM, AND ITS ASSESSMENT: THE STRATEGY OF THE ABFM GOING FORWARD","authors":"W. Newton, Coleen Conry, Beth A. Bortz, E. Baxley","doi":"10.1370/afm.2506","DOIUrl":"https://doi.org/10.1370/afm.2506","url":null,"abstract":"> Society granted physicians status, respect, autonomy in practice, the privilege of self-regulation, and financial rewards on the expectation that physicians would be competent, altruistic, moral, and would address the health care needs of individual patients and society. This “arrangement”","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"14 1","pages":"85 - 86"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78315056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patterns of organizational development appear more clearly in retrospect, as do their lessons learned. The Association of Departments of Family Medicine (ADFM) has evolved over more than 40 years in distinct phases as previously described by Borkan et al.[1][1] This commentary aims to articulate
{"title":"ADFM: FROM PAPER CLIPS TO PERFORMANCE—THE LAST 15 YEARS","authors":"A. Davis, J. Borkan","doi":"10.1370/afm.2509","DOIUrl":"https://doi.org/10.1370/afm.2509","url":null,"abstract":"Patterns of organizational development appear more clearly in retrospect, as do their lessons learned. The Association of Departments of Family Medicine (ADFM) has evolved over more than 40 years in distinct phases as previously described by Borkan et al.[1][1] This commentary aims to articulate","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"26 1","pages":"88 - 89"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81923908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"FEE SCHEDULE SUMMARY: AAFP ADVICE VISIBLE IN CMS FINAL RULE","authors":"","doi":"10.1370/afm.2508","DOIUrl":"https://doi.org/10.1370/afm.2508","url":null,"abstract":"","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"707 ","pages":"84 - 85"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91458626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PB The Annals of Family Medicine encourages readers to develop a learning community to improve health care and health through enhanced primary care. Participate by conducting a RADICAL journal club. RADICAL stands for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. We encourage diverse participants to think critically about important issues affecting primary care and act on those discussions.1
{"title":"Peer-Delivered Cognitive Behavioral Training and Reduced Pain","authors":"M. Johansen, Alexandra Blood, J. Boateng","doi":"10.1370/afm.2514","DOIUrl":"https://doi.org/10.1370/afm.2514","url":null,"abstract":"PB The Annals of Family Medicine encourages readers to develop a learning community to improve health care and health through enhanced primary care. Participate by conducting a RADICAL journal club. RADICAL stands for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. We encourage diverse participants to think critically about important issues affecting primary care and act on those discussions.1","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"22 1","pages":"iii - iii"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76202111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
When I first became the Program Director of the Sutter Santa Rosa Family Medicine Residency in June of 2017, I thought I had my hands full. Learning the ropes of running a community-based residency program, continuing to be a teacher, and trying to maintain my small outpatient panel seemed like an
{"title":"ON COMING HOME AFTER THE FIRES","authors":"T. Scott, Sara Martin","doi":"10.1370/afm.2510","DOIUrl":"https://doi.org/10.1370/afm.2510","url":null,"abstract":"When I first became the Program Director of the Sutter Santa Rosa Family Medicine Residency in June of 2017, I thought I had my hands full. Learning the ropes of running a community-based residency program, continuing to be a teacher, and trying to maintain my small outpatient panel seemed like an","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"97 1","pages":"91 - 92"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73632610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As the US population becomes increasingly racially and ethnically diverse, it becomes more important than ever to increase the diversity of the family medicine workforce. Racial and ethnic minority groups experience significant health care disparities that result in unacceptable negative health
{"title":"BUILDING A DIVERSE ACADEMIC FAMILY MEDICINE WORKFORCE: URM INITIATIVE FOCUSES ON FOUR STRATEGIC AREAS","authors":"E. Walters","doi":"10.1370/afm.2511","DOIUrl":"https://doi.org/10.1370/afm.2511","url":null,"abstract":"As the US population becomes increasingly racially and ethnically diverse, it becomes more important than ever to increase the diversity of the family medicine workforce. Racial and ethnic minority groups experience significant health care disparities that result in unacceptable negative health","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"1 1","pages":"87 - 88"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76976790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On our 2018 ADFM Annual Survey, we asked the membership, “What does population health mean to you in your institution?” Responses addressed definitions, policies, strategies, processes, and tools related to the clinical, educational, and research implications of population health. Main findings
{"title":"WHAT DOES POPULATION HEALTH MEAN TO YOU IN YOUR INSTITUTION?","authors":"Amanda Weidner, A. Perkins, V. Gilchrist","doi":"10.1370/afm.2481","DOIUrl":"https://doi.org/10.1370/afm.2481","url":null,"abstract":"On our 2018 ADFM Annual Survey, we asked the membership, “What does population health mean to you in your institution?” Responses addressed definitions, policies, strategies, processes, and tools related to the clinical, educational, and research implications of population health. Main findings","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"25 1","pages":"566 - 567"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80157879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Scott, Paulina Stehlik, J. Clark, Dexing Zhang, Zuyao Yang, T. Hoffmann, C. Mar, P. Glasziou
PURPOSE Antibiotic use in acne treatment raises concerns about increased resistance, necessitating alternatives. We assessed the effectiveness of blue-light therapy for acne. METHODS We analyzed randomized controlled trials comparing blue light with nonlight interventions. Studies included people of any age, sex, and acne severity, in any setting, and reported on investigator-assessed change in acne severity, patients’ assessment of improvement, change in inflammatory or noninflammatory lesions, and adverse events. Where data were sufficient, mean differences were calculated. RESULTS Eighteen references (14 trials) including 698 participants were included. Most of the trials were small and short (<12 weeks) and had high risk of bias. Investigator-assessed improvement was quantitatively reported in 5 trials, of which 3 reported significantly greater improvement in blue light than comparator, and 2 reported improvement. Patients’ assessments of improvement were quantitatively reported by 2 trials, favoring blue light. Mean difference in the mean number of noninflammatory lesions was nonsignificant between groups at weeks 4, 8, and 10-12 and overall (mean difference [MD] = 3.47; 95% CI, -0.76 to 7.71; P = 0.11). Mean difference in the mean number of inflammatory lesions was likewise nonsignificant between groups at any of the time points and overall (MD = 0.16; 95% CI, -0.99 to 1.31; P = 0.78). Adverse events were generally mild and favored blue light or did not significantly differ between groups. CONCLUSION Methodological and reporting limitations of existing evidence limit conclusions about the effectiveness of blue light for acne. Clinicians and patients should therefore consider the balance between its benefits and adverse events, as well as costs.
{"title":"Blue-Light Therapy for Acne Vulgaris: A Systematic Review and Meta-Analysis","authors":"A. Scott, Paulina Stehlik, J. Clark, Dexing Zhang, Zuyao Yang, T. Hoffmann, C. Mar, P. Glasziou","doi":"10.1370/afm.2445","DOIUrl":"https://doi.org/10.1370/afm.2445","url":null,"abstract":"PURPOSE Antibiotic use in acne treatment raises concerns about increased resistance, necessitating alternatives. We assessed the effectiveness of blue-light therapy for acne. METHODS We analyzed randomized controlled trials comparing blue light with nonlight interventions. Studies included people of any age, sex, and acne severity, in any setting, and reported on investigator-assessed change in acne severity, patients’ assessment of improvement, change in inflammatory or noninflammatory lesions, and adverse events. Where data were sufficient, mean differences were calculated. RESULTS Eighteen references (14 trials) including 698 participants were included. Most of the trials were small and short (<12 weeks) and had high risk of bias. Investigator-assessed improvement was quantitatively reported in 5 trials, of which 3 reported significantly greater improvement in blue light than comparator, and 2 reported improvement. Patients’ assessments of improvement were quantitatively reported by 2 trials, favoring blue light. Mean difference in the mean number of noninflammatory lesions was nonsignificant between groups at weeks 4, 8, and 10-12 and overall (mean difference [MD] = 3.47; 95% CI, -0.76 to 7.71; P = 0.11). Mean difference in the mean number of inflammatory lesions was likewise nonsignificant between groups at any of the time points and overall (MD = 0.16; 95% CI, -0.99 to 1.31; P = 0.78). Adverse events were generally mild and favored blue light or did not significantly differ between groups. CONCLUSION Methodological and reporting limitations of existing evidence limit conclusions about the effectiveness of blue light for acne. Clinicians and patients should therefore consider the balance between its benefits and adverse events, as well as costs.","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"14 1","pages":"545 - 553"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74722296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The initial ecology of medical care study was published in 1961, offering a framework by which to investigate individuals’ contact with the medical system. We studied changes in the framework around the implementation of the Patient Protection and Affordable Care Act (ACA) within longer-term trends. METHODS The 2002-2016 Medical Expenditure Panel Survey was used to determine rates of visit/contact per 1,000 individuals per month for physicians, primary care physicians, specialty physicians, emergency departments, inpatient hospitalizations, dental visits, and home health visits for the overall population and by age group, poverty category, health status, and race/ethnicity. Adjusted Wald tests were used to investigate differences between the pre-ACA (2012-2013) and post-ACA (2014-2015) periods. Multivariable linear regression was used to determine trends over the study period (2002-2016). RESULTS The survey included 525,804 person-years. The uninsured rate decreased from 12.8% (95% CI, 12.0%-13.7%) in 2013 to 7.6% (95% CI, 7.0%-8.3%) in 2016. From 2002 to 2016, the numbers of individuals in a month who had contact with primary care physicians, dental care, and inpatient hospitalizations decreased. Primary care physician contact decreased most among the elderly and those reporting fair/poor health. After ACA implementation, few significant changes were identified in the overall population or by age, poverty category, race/ethnicity, or health status. CONCLUSIONS The medical ecology framework was not notably altered 2 years after implementation of the ACA. The long-term decrease in primary care contact does not appear to have been interrupted after implementation of the ACA, was observed across income and age categories, and was most evident among the elderly and individuals reporting fair/poor health.
{"title":"The Ecology of Medical Care Before and After the Affordable Care Act: Trends From 2002 to 2016","authors":"M. Johansen, C. Richardson","doi":"10.1370/afm.2462","DOIUrl":"https://doi.org/10.1370/afm.2462","url":null,"abstract":"BACKGROUND The initial ecology of medical care study was published in 1961, offering a framework by which to investigate individuals’ contact with the medical system. We studied changes in the framework around the implementation of the Patient Protection and Affordable Care Act (ACA) within longer-term trends. METHODS The 2002-2016 Medical Expenditure Panel Survey was used to determine rates of visit/contact per 1,000 individuals per month for physicians, primary care physicians, specialty physicians, emergency departments, inpatient hospitalizations, dental visits, and home health visits for the overall population and by age group, poverty category, health status, and race/ethnicity. Adjusted Wald tests were used to investigate differences between the pre-ACA (2012-2013) and post-ACA (2014-2015) periods. Multivariable linear regression was used to determine trends over the study period (2002-2016). RESULTS The survey included 525,804 person-years. The uninsured rate decreased from 12.8% (95% CI, 12.0%-13.7%) in 2013 to 7.6% (95% CI, 7.0%-8.3%) in 2016. From 2002 to 2016, the numbers of individuals in a month who had contact with primary care physicians, dental care, and inpatient hospitalizations decreased. Primary care physician contact decreased most among the elderly and those reporting fair/poor health. After ACA implementation, few significant changes were identified in the overall population or by age, poverty category, race/ethnicity, or health status. CONCLUSIONS The medical ecology framework was not notably altered 2 years after implementation of the ACA. The long-term decrease in primary care contact does not appear to have been interrupted after implementation of the ACA, was observed across income and age categories, and was most evident among the elderly and individuals reporting fair/poor health.","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"216 2 1","pages":"526 - 537"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73658997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Every high-stakes examination should have a set of test specifications that describes the content of the examination. This includes the number of questions presented to candidates, the content categories included in the exam, and the percentage of questions devoted to each category. These test
{"title":"CREATING A NEW BLUEPRINT FOR ABFM EXAMINATIONS","authors":"R. Fain, W. Newton, T. O'neill","doi":"10.1370/afm.2480","DOIUrl":"https://doi.org/10.1370/afm.2480","url":null,"abstract":"Every high-stakes examination should have a set of test specifications that describes the content of the examination. This includes the number of questions presented to candidates, the content categories included in the exam, and the percentage of questions devoted to each category. These test","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":"10 1","pages":"562 - 564"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79245040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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