Southern Medical Journal最新文献

{"title":"A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.","authors":"Mark Mitchell, Richard Huynh, Chenhao Zhao, Lorri Reaves, Alva Weir, Lindsey Lands","doi":"10.14423/SMJ.0000000000001756","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001756","url":null,"abstract":"<p><strong>Objectives: </strong>The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center. The goals were to evaluate the institutional resilience and analyze the problems associated with this major healthcare crisis.</p><p><strong>Methods: </strong>This closed cohort study included all positive FITs from our local Veterans Affairs (VA) medical center from October 2019 to January 2020 and July 2020 to May 2021. A total of 115 VA patients with a positive FIT prepandemic and 157 VA patients with a positive FIT during the pandemic were included. Completion rates within 180 days were measured, and charts were reviewed to identify the reasons for lack of completion. Both community and local VA procedures for veterans were included. Univariate and multivariable analyses were applied to calculate odds ratios (ORs). The Pearson χ² test was applied to calculate <i>P</i> values.</p><p><strong>Results: </strong>VA patients' percentage of timely completion was lower pre-COVID-19 than it was during the pandemic, and the percentage of delayed completion was higher pre-COVID-19 than it was during the pandemic. Comparing patients who completed a colonoscopy with those who did not, increasing age had an OR of 0.947 (95% CI 0.920-0.975), and White race had an OR of 0.504 (95% CI 0.291-0.873). Evaluating delays in colonoscopy completion, VA colonoscopies versus referral to the community had an OR of 4.472 (95% CI 1.602-12.483), and pre-COVID-19 completion versus during COVID-19 had an OR of 4.663 (95% CI 1.727-12.594) with multivariable logistic regression.</p><p><strong>Conclusions: </strong>There was a statistically significant increase in timely colonoscopy completion during the study period when compared with the pre-COVID-19 period. The completion rate was higher at the Lt. Col. Luke Weathers, Jr. VA Medical Center than a large population average in 2020, possibly related to community colonoscopies and an aggressive case management system. In addition, increasing age and White race were associated with decreased colonoscopy completion. Predictors of an increased delay in colonoscopy completion included a pre-COVID-19 positive FIT and colonoscopies performed within the VA rather than being referred to providers in the community. A common reason for delay in all of the groups was patients declining intervention and delay/lack of referral.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"657-661"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565107","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":"Lymphedema Awareness and Experience in the Turner Syndrome Community.","authors":"Carolina Gutierrez, Hannah Uhlig-Reche, Meaghan Mones, Michelle Rivera-Davila, Siddharth K Prakash, Melissa B Aldrich","doi":"10.14423/SMJ.0000000000001748","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001748","url":null,"abstract":"<p><strong>Objective: </strong>Lymphedema commonly affects females with Turner syndrome (TS), although it may be underrecognized and untreated. The objective of this study was to better understand self-reported lymphedema prevalence, knowledge, and experience in TS.</p><p><strong>Methods: </strong>A 24-question anonymous survey was distributed to females with TS or their caregivers at a TS community event, a TS adult comprehensive care center, and an associated pediatrics clinic. Survey questions assessed lymphedema awareness, diagnosis and history, treatments and compliance, and sequelae. Data were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Forty-one surveys were returned, with 51.2% (n = 21) completed by the patient (mean age 25.8 years), 26.8% by the caregiver (n = 11), 2.5% by both the patient and the caregiver (n = 1), and 19.5% (n = 8) with unmarked respondent type. Greater than 75% (n = 31) reported having heard of lymphedema, 26.8% (n = 11) reported discussing lymphedema with a healthcare provider, and 22% (n = 9) reported receiving a diagnosis of lymphedema. The median age at the time of lymphedema diagnosis was 2 years. The most commonly affected body sites were legs/feet, followed by arms/hands and neck/face; the majority of patients experienced lymphedema at multiple body sites. Lymphedema resolution was reported by half, with a median duration of 4.25 years. Only one-third of those with lymphedema reported receiving treatment for the condition, including use of specialized massage/manual lymphatic drainage and compression garments.</p><p><strong>Conclusions: </strong>Identification of knowledge gaps and experience with lymphedema in TS can help with the development of targeted educational interventions. Greater awareness and understanding of this treatable condition in TS may contribute to improved health outcomes.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"666-668"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565146","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":"Running Helps: Medical Students and Attending Physicians are on the Same Track.","authors":"T Parks Remcho","doi":"10.14423/SMJ.0000000000001746","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001746","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"678-679"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565191","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":"Healthcare Provider Burnout: Red Flag for a Rising Epidemic.","authors":"Ashley Adams, Ensaf Alhujaily, Vishwanth Anil, Omar Kandah, Austin Patrick-Eisenberg, Kelsey Decker, Sara R Khouzam, Shashi Nagabandi, Rami N Khouzam","doi":"10.14423/SMJ.0000000000001752","DOIUrl":"10.14423/SMJ.0000000000001752","url":null,"abstract":"<p><strong>Objectives: </strong>This article aims to broaden the understanding of burnout in healthcare providers, its causes, and its reduction strategies. The objectives are to raise awareness, facilitate early intervention, and, ultimately, improve the overall well-being of healthcare providers and the quality of patient care.</p><p><strong>Methods: </strong>The study investigated healthcare-provision-associated burnout, an often-unrecognized syndrome affecting professionals worldwide, and its prevalence. It also examined the impact of burnout on patient outcomes, safety, and provider health and well-being. Here, we delve into the triad of burnout attributes: emotional exhaustion, depersonalization, and decreased personal accomplishment. Specific causes, such as work-life balance, workplace environment, and communication/teamwork, are investigated. The existing literature and studies we report explore the pathophysiological effects of burnout, including its impact on health, sleep patterns, and the alarming correlation with suicide.</p><p><strong>Results: </strong>The prevalence of burnout among healthcare providers is between 30% and 50%. Burnout is a significant factor contributing to poor patient outcomes and threatening patient safety. Furthermore, burnout can induce physical symptoms, including psychological, cardiovascular, and gastrointestinal disorders. We emphasize the importance of identifying and preventing burnout to maintain the overall integrity of healthcare providers and eliminate vulnerabilities for harm to their patients.</p><p><strong>Conclusions: </strong>Burnout awareness should be a priority from the early stages of healthcare providers' careers because it is crucial for maintaining their well-being, preventing medical errors, and sustaining high-quality patient care. The identification and prevention of burnout are deemed vital not only for the well-being of healthcare providers but also to safeguard against potential harm to patients. This article calls for increased awareness of burnout, its underlying causes, and the implementation of effective reduction strategies in the healthcare profession.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"629-633"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565125","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":"Efficacy and Safety of Direct Oral Anticoagulants Compared to Warfarin in Patients with Cirrhosis and Splanchnic Vein Thrombosis.","authors":"Sean-Patrick Prince, Denisse Camille Dayto, Andrew Sephien, Marc Lozano, Robyn Tobillo, Natalie P Hurlock, Anil Ram, John Abernathy","doi":"10.14423/SMJ.0000000000001750","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001750","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of splanchnic vein thrombosis (SVT) is reported to be <25 times lower than that of deep vein thrombosis and pulmonary emboli, which occur in 70 to 270/100,000 cases in the general population. Current guidelines recommend initial treatment with therapeutic low-molecular-weight heparin followed by a transition to a vitamin K antagonist (VKA) or a direct oral anticoagulant (DOAC) in patients with cirrhosis who develop SVT without severe liver dysfunction. This, however, is based on observational data. This study aimed to evaluate the efficacy and safety of anticoagulant therapy in patients with cirrhosis who present with SVT and receive either a DOAC or a VKA.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study was conducted from December 2021 to November 2022. Patients between the ages of 18 and 75 years with cirrhosis and acute SVT who received either a VKA or a DOAC between July 2019 and July 2021 were eligible for inclusion. The primary outcome was the efficacy of treatment, defined as a new thrombotic event. The secondary outcome was the safety of treatment, defined as the development of major bleeding. Readmission data were followed up at 6 and 10 months. Bivariate analysis was conducted to assess the relationship between the medication groups and each outcome and summarized as odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was set at 5% for all of the comparisons.</p><p><strong>Results: </strong>A total of 80 patients from 50 hospitals were included in this study. Sixty-one patients (59.02% male) received DOACs and 19 (57.89% male) received a VKA. Of the patients who received DOACs, 41 (67.21%) received apixaban, one (1.64%) received dabigatran, and 19 (31.15%) received rivaroxaban. The results from the bivariate analysis revealed no significant differences between DOACs and warfarin for both the efficacy (OR 1.46, 95% CI 0.44-4.84, <i>P</i> = 0.53) and safety outcomes (OR 1.03, 95% CI 0.04-26.43, <i>P</i> = 1) at 10 months.</p><p><strong>Conclusions: </strong>The use of DOACs in patients with cirrhosis who present with SVT may be efficacious and safe compared with warfarin. The findings from our study may inform power analyses for well-conducted randomized trials to confirm these findings.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"662-665"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565121","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":"Neighborhood Ecologies, Cases, and Deaths during the Beginning of the COVID-19 Pandemic: Lessons for Current and Future Epidemics?","authors":"Peter T Baltrus, Chaohua Li, Megan Douglas, Robina Josiah Willock, Ashley Daniel, Dominic Mack, Anne H Gaglioti","doi":"10.14423/SMJ.0000000000001757","DOIUrl":"10.14423/SMJ.0000000000001757","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected Black and Latinx communities. Ecologic analyses have shown that counties with a higher percentage of Latinx and Black people have worse COVID-19 outcome rates. Few ecologic analyses have been published at the neighborhood (census tract) level. We sought to determine whether certain sociodemographic neighborhood ecologies were associated with COVID-19 case and death rates in metropolitan Atlanta, Georgia.</p><p><strong>Methods: </strong>We used census data and principal-component analysis to identify unique neighborhood ecologies. We then estimated correlation coefficients to determine whether the neighborhood profiles produced by a principal-component analysis were correlated with COVID-19 case and death rates. We conducted geographically weighted regression models to assess how correlation coefficients varied spatially for neighborhood ecologies and COVID-19 outcomes.</p><p><strong>Results: </strong>We identified two unique neighborhood profiles: (1) high percentage of residents, Hispanic ethnicity, without a high school diploma, without health insurance, living in crowded households, and lower percentage older than 65 years; and (2) high percentage of residents, Black race, living in poverty, unemployed, and households receiving Supplemental Nutrition Assistance Program benefits. Profile 1 was associated with COVID-19 case rate (Pearson <i>r</i> = 0.462, <i>P</i> < 0.001) and profile 2 was associated with COVID-19 death rate (Spearman <i>r</i> = 0.279, <i>P</i> < 0.001). Correlations between neighborhood profiles and COVID-19 outcomes varied spatially.</p><p><strong>Conclusions: </strong>Neighborhoods were differentially at risk of COVID-19 cases or deaths depending on their sociodemographic ecology at the beginning of the COVID-19 pandemic. Prevention methods and interventions may need to consider different social determinants of health when addressing potential cases and deaths during future emergent epidemics.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 11","pages":"640-645"},"PeriodicalIF":1.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Hypertension and Diabetes Mellitus Control with a Dedicated Patient Navigator.","authors":"Justin Marsden, Jingwen Zhang, Chloe Bays, Samuel O Schumann, Andrew D Schreiner, Afifah Khan, Patrick D Mauldin, Kimberly S Davis, William P Moran","doi":"10.14423/SMJ.0000000000001745","DOIUrl":"10.14423/SMJ.0000000000001745","url":null,"abstract":"<p><strong>Objectives: </strong>Hypertension and diabetes mellitus (DM) are the leading causes of cardiovascular, cerebrovascular, and chronic kidney diseases. They affect an estimated 47% and 11% of Americans, respectively. In this study, we assessed whether a dedicated patient navigator embedded within a patient-centered medical home (PCMH) using a structured panel management and patient outreach strategy could improve blood pressure and glycemic control in primary care patients with uncontrolled hypertension and DM.</p><p><strong>Methods: </strong>We performed a prospective study comparing blood pressure and glycemic control in primary care patients before and after implementation of a patient navigator executing a hypertension and DM-focused panel management plan.</p><p><strong>Results: </strong>From January 2014 to October 2019, inclusion criteria were met 5164 times, which comprised 1958 unique patients within a PCMH. Multivariate regression analysis reveals a significant decrease in uncontrolled systolic blood pressure (SBP) over time, with an actual decrease of roughly 40% of uncontrolled episodes of SBP becoming controlled by 12 months. Multivariate regression analysis reveals a significant decrease in uncontrolled hemoglobin A1c (HbA1c) over time for each plot (<i>P</i> < 0.0001), with an actual decrease of roughly 30% of uncontrolled episodes of HbA1c becoming controlled by 12 months.</p><p><strong>Conclusions: </strong>This study demonstrated the benefit of a dedicated patient navigator embedded within a PCMH on improving BP and glycemic control in primary care patients with uncontrolled hypertension and DM. Glycemic control was achieved, with 30% of episodes reaching an HbA1c of <8% and BP control achieved for 40% of episodes with SBP <140 mm Hg at 12 months. There were no differences by the social determinants of race and poverty.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 10","pages":"571-576"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376066","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":"Association of Socioeconomic Variables with Primary Cesarean Section.","authors":"Katrina B Wilson, Joshua Fogel, Allan J Jacobs","doi":"10.14423/SMJ.0000000000001744","DOIUrl":"10.14423/SMJ.0000000000001744","url":null,"abstract":"<p><strong>Objectives: </strong>Socioeconomic characteristics may be associated with cesarean section (CS) rates. We probe the relationship between socioeconomic variables and primary cesarean section (PCS) by studying indicators of socioeconomic status (SES) in a population-based study in New York City.</p><p><strong>Methods: </strong>This was a retrospective study of all 80,506 women in New York City who gave birth to a live child during 2018, and who met inclusion and exclusion criteria. Data were drawn from the New York City Department of Health and Mental Hygiene and the US Census. The main outcome measure was performance of PCS as compared with vaginal birth.</p><p><strong>Results: </strong>Approximately 21% of neonates were delivered by PCS. Multivariate multilevel mixed-effects logistic regression analysis showed higher odds for PCS for women with an upper-middle class median household income of US$108,500 to $380,499 (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.07-1.76, <i>P</i> = 0.001), and the percentage enrolled in the Supplemental Nutrition Assistance Program (OR 1.01, 95% CI 1.001-1.012, <i>P</i> = 0.02). Lower odds for PCS occurred for all middle-class categories of per capita income: US$32,500 to $54,499 (OR 0.91, 95% CI 0.84-0.99, <i>P</i> = 0.02), US$54,500 to $108,499 (OR 0.76, 95% CI 0.66-0.88, <i>P</i> < 0.001), and US$108,500 to $380,499 (OR 0.80, 95% CI 0.66-0.96, <i>P</i> = 0.02). No significant association occurred for women receiving public assistance.</p><p><strong>Conclusions: </strong>Patient preferences in favor or against CS may be related to SES. There may be conflicts between obstetric care that is maximally beneficial and a patient's desire for delivery mode. Clinicians should be aware of the potential implications of this dilemma.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 10","pages":"591-598"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376051","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":"Numismedica II: Health Problems Caused by Coins.","authors":"Kenneth E Olive","doi":"10.14423/SMJ.0000000000001741","DOIUrl":"10.14423/SMJ.0000000000001741","url":null,"abstract":"<p><p>Coins occasionally cause health problems. These problems have a wide range of presentations and can affect multiple organ systems. This article updates a 2009 review of the medical literature addressing health problems caused by coins in several ways. The spectrum of clinical findings is expanded by describing new entities associated with coin ingestion, including laryngeal impaction in adults, gastric perforation, and pancreatic disease. Guidelines for differentiating swallowed coins from the potentially life-threatening mimic of swallowed button batteries are summarized. Multiple new case series better define outcomes and management approaches in coin ingestion. Metal toxicity from coins remains rarely reported. The evidence that systemic allergic reactions can result from ingested coins is strengthened by new case reports. Maintaining the perspective that coin ingestion can cause obscure symptoms may lead to both a diagnosis of the cause of such symptoms and the description of clinical findings not yet reported.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 10","pages":"582-586"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376068","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":"Skin Biopsies and Diagnostic Outcomes at a Multisite Family Medicine Residency Network.","authors":"Alice J Lin, Laura K Ferris, John Maier, Robin Maier","doi":"10.14423/SMJ.0000000000001739","DOIUrl":"10.14423/SMJ.0000000000001739","url":null,"abstract":"<p><strong>Objectives: </strong>Physicians other than dermatologists evaluate nearly 60% of all skin diseases, and 22% of these physicians are family physicians. Dermatology education is therefore an important aspect of Family Medicine training. Dermatologic procedural training in Family Medicine residency is not standardized, however, so family physicians graduate with highly variable skills. This study describes the scope and diagnostic outcomes of skin biopsies performed by residents at a multisite Family Medicine residency network in comparison with those performed by attendings at a Family Medicine faculty community practice.</p><p><strong>Methods: </strong>We performed a retrospective chart review of patients evaluated at eight Family Medicine residency training sites and one Family Medicine faculty community practice within a regional academic health system between January 2020 and October 2022. Patients with a skin finding who underwent at least one skin biopsy during their visit were included in the study.</p><p><strong>Results: </strong>Among all of the skin findings, the incidence of skin biopsy was 3.6% (258/7104) for residents and 1.8% (175/9917) for attendings (<i>P</i> < 0.001). Family Medicine residents performed fewer shave biopsies (57.8% vs 77.7%, <i>P</i> < 0.001) and more punch biopsies (25.6% vs 11.4%, <i>P</i> < 0.001) compared with attendings. Most biopsies performed by residents and attendings were benign, although residents biopsied significantly more benign (79.1% vs 64.6%, <i>P</i> < 0.001) and malignant lesions (11.2% vs 5.7%, <i>P</i> = 0.049). Attendings biopsied significantly more low-to-moderate-grade dysplastic (22.3% vs 5.0%, <i>P</i> < 0.001) and high-grade atypical lesions (4.0% vs 0.8%, <i>P</i> = 0.034).</p><p><strong>Conclusions: </strong>Family Medicine residents at this residency network receive training in a variety of skin biopsy types. Distinct skin biopsy practices and outcomes between residents and attendings may reflect differences in patient populations, clinical expertise, and dermatology referral patterns.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"117 10","pages":"609-611"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376071","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}