Journal of General Internal Medicine最新文献

{"title":"The Cave.","authors":"Atsuko Yamahiro","doi":"10.1007/s11606-026-10905-6","DOIUrl":"https://doi.org/10.1007/s11606-026-10905-6","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136991","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":"Visible and Invisible Wounds.","authors":"Ben Sommers","doi":"10.1007/s11606-026-10912-7","DOIUrl":"https://doi.org/10.1007/s11606-026-10912-7","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137019","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":"Follow Up for What? A Multisite Content Analysis of Emergency Department Discharge Instructions for Older Adults.","authors":"Thomas K Hagerman, Arqam Husain, Fabrice I Mowbray, Satheesh Gunaga, David Willens, Joseph Miller","doi":"10.1007/s11606-026-10903-8","DOIUrl":"https://doi.org/10.1007/s11606-026-10903-8","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137022","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 Screening: From Assessment to Action.","authors":"John C Lin, Corinne M Rhodes, Jaya Aysola","doi":"10.1007/s11606-026-10891-9","DOIUrl":"https://doi.org/10.1007/s11606-026-10891-9","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136988","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":"Expanding the HIV Workforce Through Residency HIV Pathways.","authors":"Jehan Z Budak, Christopher Bositis, Philip G Day, Vanessa Carson-Sasso, Scott Hebert, E Hatheway Simpson, Cody Chastain, David Spach, Lydia Barakat, Philip Bolduc","doi":"10.1007/s11606-026-10809-5","DOIUrl":"https://doi.org/10.1007/s11606-026-10809-5","url":null,"abstract":"<p><strong>Background: </strong>As persons with HIV live longer and require more comprehensive care, the number of clinicians proficient in HIV management is declining. HIV training pathways in family medicine (FM) and internal medicine (IM) residencies have contributed to the HIV clinician workforce but are not concentrated in areas of greatest need.</p><p><strong>Aim: </strong>To expand the HIV clinician workforce in high HIV prevalence regions.</p><p><strong>Setting: </strong>HIV training pathways within FM and IM residencies.</p><p><strong>Participants: </strong>Twenty-four FM and IM residents from 2023 to 2024.</p><p><strong>Program description: </strong>We secured pilot funding and identified six programs in high prevalence areas to receive seed funding, resources, and mentorship to start or grow HIV residency pathways. We also created a national community of practice among these new and existing HIV pathway residency program directors.</p><p><strong>Program evaluation: </strong>The funded HIV residency pathways matriculated 24 residents (6 FM, 18 IM). Exit survey responses showed the pilot project was well received by both faculty and residents. This 1-year pilot project demonstrates the feasibility of expanding HIV residency pathways in areas of need.</p><p><strong>Discussion: </strong>Our project offers a replicable model for strengthening the HIV clinician workforce.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136970","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":"Attuning and Sharing Sacred Moments: Awe and Wonder in the Clinical Encounter.","authors":"Lenny López, Horace Delisser","doi":"10.1007/s11606-026-10883-9","DOIUrl":"https://doi.org/10.1007/s11606-026-10883-9","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127672","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":"Am I Keeping You from Something Important?","authors":"Dana Arenz, Karen Stenehjem, Stephen Fuest","doi":"10.1007/s11606-026-10865-x","DOIUrl":"https://doi.org/10.1007/s11606-026-10865-x","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127668","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":"Where Women Veterans Seek Emergency Care: Patterns and Predictors of VA and Community Emergency Department Use.","authors":"Jessica Faiz, Christopher J Carvalho, Tracy Urech, Siqi Wu, Jessica Y Breland, Susan M Frayne, Donna L Washington, Kristina M Cordasco, Anita A Vashi","doi":"10.1007/s11606-026-10847-z","DOIUrl":"https://doi.org/10.1007/s11606-026-10847-z","url":null,"abstract":"<p><strong>Background: </strong>Women using Veterans Health Administration (VA) facilities have nearly doubled over the past decade. Women Veterans have distinct emergency care needs across their lifespan; examining care setting (VA versus non-VA, hereafter Community Care) can inform service planning. Despite ongoing improvement efforts, there has not been a recent comprehensive, national assessment of emergency care utilization patterns among women Veterans.</p><p><strong>Objective: </strong>We sought to describe women Veterans' emergency department (ED) utilization across VA-provided and VA Community Care settings, identify predictors of setting, and compare patterns to that of men Veterans. DESIGN, PARTICIPANTS, MAIN MEASURES: We conducted a retrospective cohort study of VA enrollees with at least one ED visit (VA-provided or Community Care) from 10/2022 to-9/2023. Patient- and visit-level characteristics were derived from VA administrative data. Descriptive statistics compared characteristics by sex. Among women Veterans, logistic regression with generalized estimating equations identified predictors of receiving VA-provided versus Community Care ED care.</p><p><strong>Key results: </strong>Among 1.6 million Veterans with ED visits, most ED visits by women occurred at VA sites (60%). In adjusted models, women had higher odds of using VA EDs for low acuity (OR 1.62, 95% CI 1.59-1.64) and behavioral health conditions (OR 1.10, 95% CI 1.06-1.14). Racially and ethnically minoritized women had greater odds of using VA EDs than White women. VA ED use was less likely among women experiencing homelessness (OR 0.90, 95% CI 0.86-0.93), with emergency care-sensitive conditions (OR 0.61, 95% CI 0.60-0.63), or living farther from VA EDs.</p><p><strong>Conclusions: </strong>While a majority of women Veterans-particularly those with complex medical, mental health, and social needs-continue to rely on VA EDs for care, two-fifths utilize Community Care EDs with geographic distance and visit acuity being drivers. Findings underscore the need to improve care coordination and ensure that both VA and community ED providers are equipped to meet the diverse needs of women Veterans.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127773","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":"Teal Drain Output.","authors":"Gabriel Haw, Benjamin Vipler","doi":"10.1007/s11606-026-10869-7","DOIUrl":"https://doi.org/10.1007/s11606-026-10869-7","url":null,"abstract":"","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127798","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":"Hospital-Based Clinicians' Knowledge and Practices Regarding Stigmatizing Language in Clinical Documentation: A Multicenter Survey.","authors":"Julia Caton, Bo Sun, Natasha Steele, Christine Santiago, Farzana Antara, Jason Hom, Rebecca Dougherty","doi":"10.1007/s11606-026-10803-x","DOIUrl":"https://doi.org/10.1007/s11606-026-10803-x","url":null,"abstract":"<p><strong>Background: </strong>Stigmatizing language is common in the medical record and can perpetuate bias, which has downstream effects on clinical decision-making and patient care. Internal medicine faculty, residents, and advanced practice providers (APPs) are front-line clinicians for composing documentation, and faculty and APPs are also tasked with providing trainees with feedback and training on best documentation practices. However, resident, APP, and faculty preparedness to address stigmatizing language in documentation is unknown. Furthermore, little is known about clinicians' knowledge, attitudes, and behaviors regarding such language.</p><p><strong>Objective: </strong>We sought to understand resident, APP, and faculty experiences, values, and beliefs around stigmatizing language in clinical documentation.</p><p><strong>Design: </strong>We conducted a cross-sectional online survey and knowledge test.</p><p><strong>Participants: </strong>Internal medicine residents, faculty, and APPs within two large academic internal medicine departments.</p><p><strong>Main measures: </strong>The knowledge test measured participants' ability to identify stigmatizing language in snippets of documentation and the survey measured attitudes and perceived skills via a series of Likert-style questions.</p><p><strong>Key results: </strong>In total, 82 faculty/APPs (72 faculty and 10 APPs; 52% response rate) and 63 residents (21% response rate) responded. Nearly all respondents reported considering how their word choices impact patients (91% of faculty/APPs [n = 74] and 92% of residents [n = 58]) and other clinicians (90% of faculty/APPs [n = 73] and 84% of residents [n = 53]). However, only 10% (n = 8) of faculty/APPs and 24% (n = 15) of residents were confident that their clinical documentation avoided stigmatizing language. Only 4% (n = 3) of faculty/APPs and 3% (n = 2) of residents correctly identified all 11 stigmatizing terms assessed on the knowledge test.</p><p><strong>Conclusions: </strong>Faculty/APPs and residents at our institutions value the importance of patient-centered language, yet they lack knowledge and skills around this topic, highlighting key opportunities for future targeted educational and systems-level interventions.</p>","PeriodicalId":15860,"journal":{"name":"Journal of General Internal Medicine","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127640","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}