Journal of General Internal Medicine最新文献

{"title":"Outcomes of Asynchronous e-Visits vs. Telephone or Video Visits for Common Primary Care Concerns.","authors":"Mary Reed, Jie Huang, Evangeline Sievers, Reena Bhargava","doi":"10.1007/s11606-025-09533-3","DOIUrl":"https://doi.org/10.1007/s11606-025-09533-3","url":null,"abstract":"<p><strong>Background: </strong>Asynchronous structured electronic visits (e-Visits) can offer efficient day-or-night care-seeking for some uncomplicated conditions when linked to their electronic health record.</p><p><strong>Objective: </strong>Compare asynchronous e-Visit outcomes with scheduled telemedicine visits.</p><p><strong>Design: </strong>Observational cohort study in an integrated delivery system during a COVID-19 pandemic restrictions on in-person visits.</p><p><strong>Participants: </strong>All 24,584 patients newly seeking primary care for urinary tract infection (UTI) or pink eye via e-Visit or telephone/video visit April 2020-March 2021.</p><p><strong>Interventions: </strong>Asynchronous e-Visits.</p><p><strong>Main measures: </strong>Antibiotic prescribing and follow-up care-seeking within 72 h or 7 days (office or ED visits, hospitalization) were examined using multivariable analyses.</p><p><strong>Key results: </strong>Among 14,909 e-Visits, 6290 telephone visits, and 3385 video visits: 69.1% of UTI visits were e-Visits and 31.5% for pink eye were e-Visits. After adjustment, for UTI, 90.7% (95% CI: 90.2%-91.2%) of e-Visit patients received an antibiotic prescription and 13.9% (95% CI: 8.5%-9.5%) had a clinically related 7-day outpatient visit (vs. 60.7% [95% CI: 59.2%-62.1%] antibiotic prescribing for telephone and 57.3% [95% CI: 54.4%-60.2%] for video; 8.8% [95% CI: 8.0%-9.6%] return visits after telephone visit, and 9.0% [95% CI: 7.4%-10.6%] after video). For pink eye, 36.8% (95% CI: 33.7%-38.3%) of e-Visits received an antibiotic prescription and 13.9% (95% CI: 12.3%-15.6%) had an outpatient visit (vs. 42.6% [95% CI: 40.2%-45.1%] antibiotic prescribing for telephone and 39.9% [95% CI: 37.8%-41.9%] for video; 11.0% [95% CI: 9.4%-12.6%] return visits after telephone visit and 10.6% [95% CI: 9.4%-11.9%] after video). Clinically related emergency room visits were rare and not significantly different between visit types.</p><p><strong>Conclusions: </strong>Antibiotic prescribing varied, but return follow-up visits were comparable between telemedicine channels for UTI. Return rates for pink eye were 3% marginally higher after e-Visit than for scheduled telemedicine, without ED visit or hospitalization differences. Asynchronous care options for common primary care concerns may expand care access with comparable outcomes. Additional outreach may be needed to ensure access and awareness of e-Visits.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Equity at Premature Discharge: Reframing Discharge Against Medical Advice Using the Structural Competency Framework.","authors":"Sydney Katz, Amanda K Ramsdell","doi":"10.1007/s11606-025-09656-7","DOIUrl":"https://doi.org/10.1007/s11606-025-09656-7","url":null,"abstract":"<p><p>Discharge against medical advice (AMA) is a common clinical scenario in which power differentials, blame, and discordant priorities between the patient and provider may coalesce to produce a stigma-laden high-risk clinical encounter associated with poor health outcomes. Stigma against patients who leave AMA can manifest in many ways, including negative interactions with hospital staff, inadequate management of pain and withdrawal, stigmatizing documentation in the medical record, perceptions of being judged or discriminated against, and substandard care at discharge. Though AMA discharge is typically conceptualized by individual patient decision-making, larger societal forces cause patients to have prior experiences and competing priorities which drive them to leave the hospital prematurely. Risk factors related to the inequitable distribution of social resources, such as socioeconomic status, insurance status, and housing status, are associated with AMA discharge, and have potential to both drive poor health outcomes and perpetuate stigma. Structural competency (SC) is an educational framework that looks at symptoms, health, and illness as the downstream effects of larger structural societal forces. We believe that SC is a powerful tool to reframe AMA discharge to move blame away from the patient and re-imagine best practices for a more equitable and patient-centered premature discharge.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Social Needs and Total Healthcare Cost: A Cross-Sectional Study in a Large Integrated Health System.","authors":"Ariel R C Silverman, Paul J Chung, Michael K Gould, Quyen Ngo-Metzger, Maile M Tauali'i, David M Mosen, Mark C Duggan, Robert S Nocon","doi":"10.1007/s11606-025-09647-8","DOIUrl":"https://doi.org/10.1007/s11606-025-09647-8","url":null,"abstract":"<p><strong>Background: </strong>While research on health-related social needs (HRSNs) has expanded, important gaps remain in understanding associations between HRSN and healthcare cost, especially across general populations of patients with broad-ranging medical and social needs.</p><p><strong>Objective: </strong>To examine the association between HRSN and healthcare cost in a large, diverse, insured population.</p><p><strong>Design: </strong>In this cross-sectional study, we evaluated cost differences between patients with different HRSN levels using survey-weighted multivariable generalized linear models. We examined three alternate model specifications: one that included controls for basic demographics; another adding insurance type, race/ethnicity, and social isolation; and a third adding a diagnosis-based medical risk index called DxCG. Variables added in the latter models were assessed separately due to concern for over-correlations with HRSN.</p><p><strong>Participants: </strong>10,226 adult survey respondents (23% response rate) from eight states and Washington, D.C.</p><p><strong>Main measures: </strong>The primary exposure was patient-reported HRSN, based on survey questions asking about financial strain, food insecurity, housing instability, and transportation difficulties. HRSN was constructed as a three-level variable. The primary outcome was total direct healthcare cost.</p><p><strong>Key results: </strong>\"Moderate HRSN\" was not significantly associated with cost in any model. In the model controlling for patient demographics, costs for patients with \"Severe HRSN\" were 1.27 (95%CI: 1.00-1.60) times those of patients with \"No HRSN.\" In a model that adjusted for medical risk (DxCG), the relationship between HRSN and cost was not statistically significant.</p><p><strong>Conclusions: </strong>Relationships between HRSN and healthcare cost may vary by HRSN level. Our mixed findings highlight the complex relationship between medical and social risks, which often have bi-directional causal relationships. If measures of medical risk incidentally capture variation in social risk, then models controlling for medical risk may mask relationships between HRSN and cost. Further studies should investigate the extent to which HRSN may be related to cost, even when controlling for specific patient diagnoses.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioids in Critically Ill Acute Myocardial Infarction Patients: A Retrospective Analysis of the MIMIC-IV Database.","authors":"Siyuan Xie, Bryan Richard Sasmita","doi":"10.1007/s11606-025-09643-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09643-y","url":null,"abstract":"<p><strong>Background: </strong>Opioids are the most commonly prescribed analgesic for patients with critically ill acute myocardial infarction (AMI). Unfortunately, inconsistent findings and limited evidence leave healthcare providers uncertain about whether these drugs offer more benefit or harm. Hence, the present study aimed to evaluate the impact of opioid use in AMI patients admitted to the intensive care unit.</p><p><strong>Methods and results: </strong>A total of 5669 critically ill AMI patients' data were extracted from the MIMIC-IV databases. Of which, 4044 patients received opioid analgesics, while 1625 did not. The primary outcome was an association between different types of opioids and all-cause mortality at 30, 90, and 365 days. During follow-up, patients who received opioids had significantly higher mortality rates compared to those who did not (30-day: 20.3% vs. 10.1%; 90-day: 28.0% vs. 15.8%; 365-day: 35.2% vs. 26.4%; all p < 0.001). After propensity score matching, multivariable Cox regression analysis identified morphine as the only opioid significantly associated with increased all-cause mortality at 30 days (HR 2.693 [95%CI 2.144-3.383], p < 0.001), 90 days (HR 2.151 [95%CI 1.757-2.632], p < 0.001), and 365 days (HR 1.709 [95%CI 1.435-2.036], p < 0.001). Furthermore, feature selection using the Boruta algorithm and SHAP summary plot highlighted opioid use, particularly morphine, as a key determinant of cumulative mortality.</p><p><strong>Conclusions: </strong>Opioid use was a significant predictor of mortality in critically ill AMI patients. Notably, only morphine was independently associated with an increased risk of both short- and long-term mortality.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Population Attributable Fractions for Cardiovascular Disease and All-Cause Mortality Associated with Living Arrangement in Community-Dwelling Older People.","authors":"Achamyeleh Birhanu Teshale, Htet Lin Htun, Alice J Owen, J R Baker, Irja Isaksen, Rosanne Freak-Poli","doi":"10.1007/s11606-025-09648-7","DOIUrl":"https://doi.org/10.1007/s11606-025-09648-7","url":null,"abstract":"<p><strong>Background: </strong>Living alone poses significant cardiovascular disease (CVD) and mortality risks. The population attributable fraction (PAF) quantifies the proportion of disease burden attributable to a specific risk factor. This study aims to estimate the PAF for CVD and all-cause mortality related to living completely alone. Additionally, the study examined the PAFs associated with not living with a partner/spouse.</p><p><strong>Methods: </strong>This study used longitudinal data from the Aspirin in Reducing Events in the Elderly (ASPREE) study and its sub-study, the ASPREE Longitudinal Study of Older Persons (ALSOP), which included 5853 men and 6998 women. The participants were community-dwelling healthy adults aged 70 + years without CVD, dementia, or significant physical disabilities. Adjusting for social determinants and traditional risk factors, the gender-specific PAFs of CVD and all-cause mortality attributable to living completely alone and not living with a partner/spouse were determined.</p><p><strong>Results: </strong>Among women, 13.5% (95% CI: 6.3%, 22.4%) of CVD events could be attributed to living completely alone, and 14.1% (95% CI: 4.6%, 25.2%) to not living with a partner/spouse. For all-cause mortality in women, the corresponding PAFs were 9.8% (95% CI: 3.7%, 16.6%) and 12.3% (95% CI: 5.8%, 20.8%), respectively. In contrast, among men, only the PAF between not living with a partner/spouse and all-cause mortality reached statistical significance (PAF = 6.0%; 95% CI: 1.7%, 10.2%). The remaining PAF estimates for CVD events and all-cause mortality were not statistically significant.</p><p><strong>Conclusion: </strong>The observed gender differences in CVD and all-cause mortality related to living alone highlight the need for tailored public health interventions to meet gender-specific needs for social connectedness.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outreach Assessment for Social Health Needs in Patients with Multiple Chronic Conditions: Qualitative Study of Patient Experience.","authors":"James D Ralston, Kathy S Gleason, Elizabeth A Bayliss, Karen Estacio, Luesa Healy, Erika Holden, Jodi McCloskey, Ilana Peterson, Lisa Shulman, Tobie Taylor-McPhail, Connie S Uratsu, Richard W Grant","doi":"10.1007/s11606-025-09650-z","DOIUrl":"https://doi.org/10.1007/s11606-025-09650-z","url":null,"abstract":"<p><strong>Background: </strong>Unmet social needs are common among individuals with multiple chronic health conditions (MCC).</p><p><strong>Objective: </strong>To evaluate the acceptability of proactive outreach to assess and follow up on social health needs among patients with MCC.</p><p><strong>Design: </strong>Qualitative study using semi-structured interviews.</p><p><strong>Participants: </strong>We interviewed 25 patients with 2 or more chronic health conditions in three integrated care settings in Washington, Colorado, and California that experienced proactive outreach offering assessment and follow-up for social health risks. All patients had a higher likelihood of social health risks based on a predictive model using health plan and electronic health record data. Patients received initial outreach from clinical pharmacists at the Northern California site, licensed practical nurses in primary care at the Washington site, and Community Specialists at the Colorado site.</p><p><strong>Approach: </strong>Transcripts were analyzed using a mixed deductive and inductive thematic approach informed by the Theoretical Framework of Acceptability.</p><p><strong>Key results: </strong>Mean age across the groups was 66 years. We identified five themes common across all three healthcare sites. Participants appreciated the outreach, stating they felt understood and cared for by their providers; recognized how their social needs were intertwined with their physical and mental health; and found that uncomfortable social health conversations were easier with known healthcare providers. Assessment of social health needs and referral to community resources provided some participants with hope that their needs would be met, while others felt discouraged by prior experience. Following referral to community resources, participants had uneven experiences receiving resources to address their needs.</p><p><strong>Conclusions: </strong>Our results suggest proactive outreach by healthcare team members to assess and address social health needs is valued by patients with MCC despite challenges with accessing some social health resources. Future work is needed to support access to community resources and evaluate the outcomes of outreach to those with MCC who have social needs.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescriber-Level Changes in Buprenorphine Dispensing in the USA Before and After Federal Policy Changes Aimed at Increasing Prescribing.","authors":"Gery P Guy, Christopher M Jones, S Michaela Rikard, Kun Zhang, Yngvild Olsen","doi":"10.1007/s11606-025-09655-8","DOIUrl":"https://doi.org/10.1007/s11606-025-09655-8","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Unmet Pain Treatment Preference, Pain Treatment Satisfaction and Subsequent Opioid Misuse: A Secondary Analysis of a National Multisite RCT.","authors":"Max Jordan Nguemeni Tiako, Eden Engel-Rebitzer, Ari Friedman, Frances Shofer, Abby Dolan, Erik P Hess, Jeanmarie Perrone, Marilyn M Schapira, Zachary F Meisel","doi":"10.1007/s11606-025-09637-w","DOIUrl":"https://doi.org/10.1007/s11606-025-09637-w","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities in opioid prescriptions for pain are well documented. Evidence shows undertreated acute pain increases the risk of developing chronic pain, which puts patients at risk of long-term opioid use and misuse. We sought to determine the association between satisfaction with analgesia, unmet opioid preference, and opioid misuse risk by race in a diverse, longitudinal cohort.</p><p><strong>Methods: </strong>We conducted a secondary analysis of participants with complete data in an RCT of 1301 patients who presented to the emergency department (E.D.) for acute kidney or back pain. Our primary outcome was opioid misuse risk quantified by the current opioid misuse measure (COMM), a self-report 17-item measure of risk of aberrant medication-related behavior among persons prescribed opioids for chronic pain, measured 90 days after the index E.D. visit. We used descriptive statistics and linear regressions to determine associations between satisfaction with analgesia (1-10, measured 1-day post-visit), unmet opioid preference, and opioid misuse risk by race, adjusting for age and sex.</p><p><strong>Results: </strong>We analyzed 735 participants. The mean (SD) age was 39.6 (13.6), 58.9% (n = 432) were female, 46.4%(n = 341) were White, and 36.9%(n = 271) were Black. Unmet preference was more common among Black (21.8%, n = 59) vs. White (15%, n = 51) participants. Black (vs White) participants had a higher median (IQR) COMM (4 (1 - 12) vs 3 (1 - 6), P < 0.001, and lower median satisfaction (7 (4-10) vs 8 (5 - 10), P = 0.002). Adjusting for unmet preference and satisfaction, Black (vs. White) participants had higher COMM (β = 3.4, 95% CI 1.6-5.3, P = 0.01). Unmet preference was associated with higher COMM (β = 2.3, 95% CI 1.3-3.2, P < 0.001). Satisfaction was associated with lower COMM (β = - 0.5 pp, 95% CI - 0.7, - 0.2, P < 0.01). In a model with a triple interaction between satisfaction, unmet preference, and race, satisfaction was associated with lower COMM (- 0.3 pp, 95% CI - 0.5, - 0.1, P = 0.03) and mitigated the effect of unmet preference on Black participants' COMM (marginal effect β = - 1.3 pp, 95% CI - 1.9, - 0.7, P = 0.01).</p><p><strong>Conclusion: </strong>Satisfaction with analgesia was protective against opioid misuse risk, especially among Black participants whose opioid preference was unmet. Addressing unmet preferences and understanding factors that shape patient satisfaction with analgesia could help reduce racial disparities in opioid misuse.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually Transmitted Infection Testing and Prevalence Among Veterans With and Without Military Sexual Trauma.","authors":"Traci A Takahashi, Desta Gebregiorgis, Marissa Maier, Joleen Borgerding, Lauren A Beste","doi":"10.1007/s11606-025-09649-6","DOIUrl":"https://doi.org/10.1007/s11606-025-09649-6","url":null,"abstract":"<p><strong>Background: </strong>Since the Veterans Health Administration (VHA) implemented universal screening for military sexual trauma (MST) in 2001, one-third of female Veterans and 1 in 50 male Veterans have reported MST. Despite evidence that MST negatively impacts physical and mental health and has been associated with sexual practices that increase the risk of acquiring sexually transmitted infections (STIs), little is known about the association between MST and STI risk in Veterans.</p><p><strong>Objective: </strong>To assess the percent tested for an STI, STI prevalence, and odds of acquiring an STI among Veterans in VHA care during 2022 with and without a history of MST.</p><p><strong>Design: </strong>Retrospective cohort study of Veterans in VHA care during 2022 who ever completed VHA's MST screening questions. Metrics of STI testing and infection were obtained for 2022.</p><p><strong>Participants: </strong>All Veterans in VHA care during 2022, defined as at least one inpatient or outpatient visit in 2022 or the previous year, who completed VHA's MST screening questions.</p><p><strong>Key results: </strong>Of nearly 6.4 million Veterans in VHA care during 2022 who ever answered the MST screening questions, 35% of female and 2% of male Veterans reported a history of MST. Male Veterans with MST had an increased STI prevalence compared to those without MST (0.7% vs. 0.2%); no difference was observed in STI prevalence among female Veterans with and without MST (0.3% vs. 0.2%). Among male Veterans tested for an STI, MST was associated with a 23% increased odds of acquiring an STI after adjusting for key demographic and health-related factors.</p><p><strong>Conclusions: </strong>In male Veterans tested for an STI, MST was associated with an increased risk of STI acquisition, a finding not seen in female Veterans. Differences in health care utilization, sexual behaviors, and mental health sequelae from sexual trauma between males and females may explain this finding.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirituality and Religiosity of Internal Medicine Physicians in the USA: Results from a National Survey.","authors":"Kristin M Collier, M Todd Greene, David Ratz, Rachel Ehrlinger, Sanjay Saint","doi":"10.1007/s11606-025-09651-y","DOIUrl":"https://doi.org/10.1007/s11606-025-09651-y","url":null,"abstract":"<p><strong>Background: </strong>Medicine as a profession is steeped in meaning. Spiritual and religious practices are one way in which providers make meaning in their lives and therefore in their work. Recent attention has focused on the religious and spiritual commitments of physicians as they relate to topics such as self-care, physician conscience, and how these beliefs impact clinical practice.</p><p><strong>Objective: </strong>To assess the religious and spiritual beliefs of internal medicine physicians and the degree to which these beliefs are associated with burnout.</p><p><strong>Design: </strong>A national, cross-sectional survey of internal medicine physicians.</p><p><strong>Participants: </strong>Between June 2023 and May 2024, surveys were sent to 1421 randomly selected internal medicine physicians practicing in the USA identified through the American Medical Association membership database.</p><p><strong>Main measures: </strong>The survey included 42 questions designed to assess factors hypothesized to influence physician well-being and professional burnout. We also collected physician demographic data and assessed burnout via the Maslach Burnout Inventory.</p><p><strong>Key results: </strong>A total of 629 (44.3%) completed a survey. Almost 70% of the general internists who responded endorsed belief in God or a higher power, and approximately half endorsed praying privately at least once a week at a place other than a place of worship and had a belief in life after death. Black respondents had four times greater odds of believing in God compared with non-Black respondents (OR = 4.14, 95% CI = 1.24 - 13.84, P = 0.02). A total of 61% of respondents were classified as having at least one manifestation of burnout. Having a religious affiliation was protective against one manifestation of burnout (OR = 0.43, 95% CI = 0.26 - 0.72, P = 0.001).</p><p><strong>Conclusions: </strong>Religion and spirituality are prominent and important aspects in the lives of many practicing internal medicine physicians in the USA and may impact physician well-being.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}