Southern Medical Journal最新文献

{"title":"Suicide and Global Warming.","authors":"Rif S El-Mallakh, Omar H Elsayed, Shaishav Shah","doi":"10.14423/SMJ.0000000000001829","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001829","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 6","pages":"355"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating Health Disparities: Bridging the Digital Divide in Modern Health Care.","authors":"Daniel Elikman, Robert Anderson, Margarita Balish, Mihail Zilbermint","doi":"10.14423/SMJ.0000000000001830","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001830","url":null,"abstract":"<p><p>In the rapidly evolving landscape of US health care, technological advances promise significant improvements. The ongoing digital divide, however, is a critical factor affecting equitable access to health care. This perspective examines the multifaceted nature of the digital divide and its impact on health literacy, the use of electronic health tools, and disparities rooted in race, ethnicity, and socioeconomic status. The partnership between healthcare providers and health communication researchers, along with seamless data sharing, emerges as a crucial catalyst for elevating health literacy. To effectively address the digital divide, healthcare providers may find it beneficial to conduct assessments of the evolving health literacy and digital health landscape. An essential paradigm shift involves the customization of digital health solutions by medical providers, aligning them with the diverse needs and preferences of patients. This transformative approach necessitates a departure from static, one-way communication channels, emphasizing the dynamic adaptation of digital health interventions to enhance accessibility and relevance in patient care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 6","pages":"330-332"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Interpreter Utilization among Telephone Schedulers Assisting Patients with Non-English-Language Preference.","authors":"Alice J Lin, Eliana Bonifacino, Joyce Rowan, Sami Ahmad, Alessandra Leong, Keily Ortega, Shiva Yagobian, Tanya Nikiforova","doi":"10.14423/SMJ.0000000000001839","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001839","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with non-English-language preference (NELP) face language barriers that impede effective communication and delivery of high-quality care. Recognizing call centers as pivotal points of contact for patients with NELP, we proposed a quality improvement initiative to evaluate and enhance interpreter utilization among telephone schedulers within a tertiary healthcare system.</p><p><strong>Methods: </strong>Staff interpreters and medical students posing as patients with NELP placed test calls to schedulers to request five non-English languages. Schedulers were surveyed to assess their attitudes toward and confidence levels in accessing and utilizing interpreters. We subsequently informed scheduling leadership of preintervention test call and survey results and recommended areas of improvement. Postintervention test calls and surveys were conducted 3 months later to assess for improvement.</p><p><strong>Results: </strong>Schedulers' confidence in their ability to identify a caller in need of interpreter services improved by 9.2% (<i>P</i> = 0.046). The percentage of schedulers who accessed interpreter services in the last year increased by 14.3% (<i>P</i> < 0.001). Schedulers reported long wait times for an interpreter as the most frequently encountered difficulty when attempting to access a telephone interpreter. Test callers identified the telephone tree as the most significant barrier to scheduling.</p><p><strong>Conclusions: </strong>Our initiative improved schedulers' confidence in their ability to identify a caller in need of interpreter services, and it increased the percentage of schedulers who accessed interpreter services. Overall interpreter usage among telephone schedulers in this healthcare system remains suboptimal, however, and continuous internal testing and feedback with in-person scheduler education and larger test call sample sizes may facilitate sustained and meaningful improvements. We hope that our study can lay the groundwork for future studies to enhance the scheduling process for linguistically diverse patient populations.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 6","pages":"319-323"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Burnout and Fulfillment Rates between Physicians in Direct Primary Care and Other Practice Models.","authors":"Melissa E Boylan, Deborah M Hurley","doi":"10.14423/SMJ.0000000000001821","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001821","url":null,"abstract":"<p><strong>Objectives: </strong>Primary care internal medicine and family medicine physicians experience the second and sixth highest rates of burnout among all medical specialties. Direct primary care (DPC) is an understudied model of practice in which physicians are believed to have lower rates of burnout. In this study, we surveyed primary care physicians to assess burnout and fulfillment rates as well as quantify several burnout risk factors in DPC and non-DPC practicing physicians.</p><p><strong>Methods: </strong>The Stanford Professional Fulfillment Index was used to measure physician fulfillment and burnout in a select population of currently practicing primary care physicians in the southeastern United States. Physicians were classified by current practice model as DPC or non-DPC (self-identified). Data were analyzed to assess whether any differences existed in physician fulfillment, burnout, and other practice characteristics by medical practice/payment model.</p><p><strong>Results: </strong>DPC physicians had significantly lower burnout (<i>P</i> = 0.002) and higher fulfillment scores (<i>P</i> = 0.013) compared with non-DPC physicians despite working a similar number of hours per week (<i>P</i> = 0.923). DPC physicians had a higher rate of practice ownership (<i>P</i> < 0.001) and saw a lower number of patients per day (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Results show that compared with non-DPC physicians, physicians practicing the DPC model of care experience greater professional fulfillment and lower burnout. Given these significant results and the small sample size of this study, more research is warranted. A larger sample size and additional data collection would increase statistical power to better evaluate clinic and physician characteristics, allow for further exploration of the findings from this study, and increase the generalizability of results.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"275-280"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On \"Predictors of Blood Transfusion in Patients Undergoing Cytoreductive Surgeries for Ovarian Malignancy\".","authors":"Jana K Elsawwah, Patricia B Stopper, Zoltan H Nemeth","doi":"10.14423/SMJ.0000000000001819","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001819","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"251"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching to Teach: A Scoping Review of Teaching Skill-Development Programs across Medical Education.","authors":"Alicia Darwin, Ashley Mason, Alyssa Faye Clare, Sarah Nestler, Antoinette Spoto-Cannons","doi":"10.14423/SMJ.0000000000001828","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001828","url":null,"abstract":"<p><strong>Objectives: </strong>Teaching is an integral part of the day-to-day responsibilities of physicians and physicians-in-training. We provide an overview across the medical education continuum of who is being trained how to teach, the methods of delivery used, and the effectiveness of the program in improving teacher confidence and teaching skills to improve the execution of teaching training programs.</p><p><strong>Methods: </strong>In October 2020, the authors conducted a scoping review, systematically searching six databases (PubMed, Embase, MEDLINE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and Web of Science) for literature dating back to 2010 describing interventions aimed at teaching physicians or physicians-in-training how to teach effectively. Four authors screened the articles for inclusion based on title and key words. Four authors reviewed all of the articles selected to identify key features, including manuscript citation, study design, study institution, demographic information, course description, and efficacy, and entered the data into a Qualtrics survey. Two authors then analyzed the data extracted.</p><p><strong>Results: </strong>Of 23,409 potentially eligible studies, 163 were included. The populations studied included medical students (17%), residents (55%), fellows (13%), faculty/attendings (23%), and other (4%). The length of the training interventions ranged from half a day or less to longer than 1 year. Multiple instructional methods were used including lecture (71), observed teaching in action (71), case-based learning (34), learner feedback (24), modules (25), objective structured teaching exercises (19), essays/writing assignments (11), portfolio and/or personal teaching philosophy development (5), and tests/examinations (4). Evaluation methods varied, and efficacy was measured by an improvement in confidence in teaching abilities (61), in self-reported teaching abilities (59), objective structured teaching exercises scores (3), and an increased interest in academic medicine (33).</p><p><strong>Conclusions: </strong>Current programs designed to teach medical students, residents, and physicians how to teach vary widely. We propose that future research is needed to advance the instruction of physicians and physicians-in-training on how to be effective clinical educators.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"260-266"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness in the Use of Clinical Artificial Intelligence.","authors":"Neil Nusbaum","doi":"10.14423/SMJ.0000000000001817","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001817","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"258-259"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral Distress in Training: A Disquieting Suggestion.","authors":"Benjamin Frush","doi":"10.14423/SMJ.0000000000001818","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001818","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"267-268"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Language Gaps in Health Care: Clinician Experiences and Challenges in Utilizing Medical Interpreters.","authors":"Tharani Ravi, Jasmine Rodriguez, Robert Wood, Anthony Pascullo, Etny Candelario, Daniela Estrada Gomez, Mario Hernandez, Carolina Sanchez, Fozia Ali","doi":"10.14423/SMJ.0000000000001826","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001826","url":null,"abstract":"<p><strong>Objectives: </strong>Providing high-quality care to patients from diverse ethnic and linguistic backgrounds demands effective communication using interpreters and the ability to build patient-physician relationships. This study aimed to explore clinician perceptions of healthcare quality when using interpreter services and identify barriers to effective interpreter use in a family medicine clinic.</p><p><strong>Methods: </strong>This was a multimethod study involving clinician and staff surveys and resident/faculty focus groups about experiences using interpreters. The study was conducted in a residency clinic in Bexar County, Texas, where 48% of the population speaks a foreign language.</p><p><strong>Results: </strong>Of the 70 clinicians and staff participants in the surveys, 87% were at least \"somewhat comfortable\" using qualified interpreters, and 76% believed that they could effectively overcome language barriers; however, only 39% were satisfied with the medical care they provided. More than 70% of clinicians felt capable of diagnosing and treating diseases (74% and 78%, respectively) using interpreters, but fewer than 50% were satisfied with their ability to empower patients (44%) or establish a personal connection (33%). Fifty-one percent of clinicians reported that they did not use interpreters at least once in the preceding 3 months, even when necessary, citing long wait times to connect to interpreter services, poor interpreter telephone connection, and patient request to use family/friend as interpreter. Focus groups identified other logistical challenges when using interpreters, as well as the impact of interpreter use on clinician-patient relationships.</p><p><strong>Conclusions: </strong>Clinicians and staff were comfortable using interpreter services and could fulfill their essential duties, yet they expressed dissatisfaction with both the medical care delivered and the relationships created with patients.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"252-257"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White Blood Counts of Hospitalized Patients Without Infection, Malignancy, or Immune Dysfunction.","authors":"Yazan Abu Omar, Erin Sullivan, Rebecca Schulte, Rayli Pichardo, Michael B Rothberg","doi":"10.14423/SMJ.0000000000001820","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001820","url":null,"abstract":"<p><strong>Objectives: </strong>An elevated white blood cell (WBC) count may indicate malignancy, infection, and immune dysfunction. In diagnosing these conditions, physicians generally evaluate laboratory results compared with reference ranges based on healthy populations. Reference ranges for hospitalized patients are lacking. This study aims to define a normal reference range for WBC count in hospitalized patients without malignancy, infection, or immune dysfunction.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study of nonsurgical patients hospitalized from 2017 to 2018 in the Cleveland Clinic Health System without malignancy, infection, or immunological dysfunction. WBC count, absolute neutrophil count, and absolute lymphocyte count were collected. We calculated means, standard deviations, and the reference range for each variable.</p><p><strong>Results: </strong>A total of 46,419 patients had WBC counts. Mean WBC count was 8.0 (standard deviation 3.31, reference range 1.6-14.5). In a multivariable linear regression, mean WBC count decreased with age, Black race relative to White race, and congestive heart failure. Body mass index, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, and steroid use were associated with higher WBC count. In total, 13.5% of patients in this cohort had WBC counts above the \"normal\" threshold of 11.</p><p><strong>Conclusions: </strong>Among hospitalized patients without infection, malignancy, or immune dysfunction, the normal range for WBC count was 1.6 to 14.5 × 10⁹ WBCs/L. Age, race, body mass index, steroid use, and several comorbidities were associated with WBC count variation from the reference levels established based on healthy populations. Physicians should be cautious when interpreting WBC counts between 11 and 14.5 × 10⁹ WBCs/L, which appear to represent normal values in the hospital.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"287-292"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}