Journal of the American Board of Family Medicine最新文献

{"title":"Billing Medicaid for Community Health Worker Services: The Promise, Pitfalls, and Path Forward.","authors":"Mechelle R Sanders, Kevin Fiscella","doi":"10.3122/jabfm.2025.250301R1","DOIUrl":"https://doi.org/10.3122/jabfm.2025.250301R1","url":null,"abstract":"<p><p>This commentary examines the implications of the Community Health Worker (CHW) Access Act introduced by Congress. If passed, primary care practices would be able to receive reimbursement for CHW services. CHWs are lay members of the community that help people address the social determinants of health, understand their health, and get the health care they need, especially in communities where resources are scarce. They have been shown to improve health outcomes, yet many serve in unpaid positions and their services have not been readily reimbursable in the healthcare system. We highlight the potential of the Bill to facilitate the uptake of CHWs in primary care. This is particularly important at a time when the provision of primary care is scarce. We examine the potential and pitfalls of the Bill and recommend implementation strategies to support the uptake of CHWs into primary care. This commentary aims to inform stakeholders about the Bill's broader impact on primary care and future CHW sustainability.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Medicine in the House.","authors":"Stephen A Wilson, Erika Steinbacher, Tracey Conti","doi":"10.3122/jabfm.2026.260113R2","DOIUrl":"https://doi.org/10.3122/jabfm.2026.260113R2","url":null,"abstract":"<p><p>Family physicians should be providing care for hospitalized patients. This fulfills part of our mission and opens opportunities for us to improve patient care and metrics, advance in leadership, teach residents and medical students, and influence and do research; caring for hospitalized patients also brings value to the patients, the system, and family physicians generally. Some of the value we bring to hospital-based care includes addressing workforce shortages, continuity across care settings, cost-effective and high-value care, educational impact, enhanced career satisfaction, flexibility in career options, holistic patient care, improved health outcomes, support transitions of care, training and professional growth, and versatility and breadth of training. The question is not if we should deliver hospital-based care, but rather how we should deliver it.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POEMs and PROMs.","authors":"Dean A Seehusen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Improvement as a Foundational Component of the Clinical Model of Family Medicine: Rationale, Concerns, Ways Forward.","authors":"David W Price, Sarah Z Cole, Saroj Misra","doi":"10.3122/jabfm.2026.260025R0","DOIUrl":"https://doi.org/10.3122/jabfm.2026.260025R0","url":null,"abstract":"<p><p>In August 2025, leaders from family medicine organizations and representative patient stakeholders met for discussions regarding the evolution of the clinical model for family medicine. Performance improvement (PI), long a part of the continuing board certification process, was among the topics discussed. Pockets of concern or confusion remain about the relevance, importance, practicality, and administrative burden of PI for practicing family physicians. This discussion paper summarizes concerns about PI as commonly currently operationalized and outlines the rationale for inclusion of PI in the clinical model of family medicine. It outlines opportunities for the progression of PI to become less single-disease metric focused to practically focus on team-based care, complexity, and patient-centered outcomes, while accounting for the variety of contexts in which family physicians practice.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Health Care Gaps During the Fourth Trimester and Through One Year Postpartum.","authors":"Oguchi Nwosu, Kasey Crockett, Anne L Dunlop","doi":"10.3122/jabfm.2025.250289R1","DOIUrl":"https://doi.org/10.3122/jabfm.2025.250289R1","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality in the United States has risen over the past three decades, with over half of deaths occurring between one week and one year postpartum. Despite this, most clinical guidelines and care-delivery models focus on the initial 12 weeks after birth.</p><p><strong>Narrative: </strong>This narrative review examines barriers to care beyond the fourth trimester and highlights policy, health-system, and clinical strategies for optimizing maternal health across the first postpartum year, recognizing that structural challenges-including insurance loss, workforce shortages, and adverse social determinants of health-pose additional challenges for marginalized populations. Interventions ranging from the expansion of Medicaid to patient-centered medical homes, integration of maternal and pediatric care, standardized visit protocols, home blood pressure monitoring, patient navigation, and digital tools offer promise in improving maternal health and reducing preventable maternal morbidity.</p><p><strong>Conclusions: </strong>The provision of postpartum care beyond the fourth trimester is essential to reducing maternal morbidity and mortality and advancing health equity. Family physicians and primary care teams are uniquely positioned to provide longitudinal, multidisciplinary postpartum care through the postpartum year. Achieving this vision requires system-level reforms, expanded workforce capacity, clinical tools and support, along with improved transitions between obstetric, pediatric, and primary care providers and services.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Model of Family Medicine: Debate and Dialogue About Our Future in Alexandria.","authors":"Warren P Newton","doi":"10.3122/jabfm.2026.260297R0","DOIUrl":"https://doi.org/10.3122/jabfm.2026.260297R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence for Diagnosing Images of Common Skin Disorders.","authors":"Dietrich von Kuenssberg Jehle, Micah K Browne, Hailey P Hoffmann, Krishna K Paul, Matthew M Talbott, Kendall M Campbell, Anthony W Linfante, Bjorn A Sorensen, Michael G Wilkerson","doi":"10.3122/jabfm.2025.250260R3","DOIUrl":"https://doi.org/10.3122/jabfm.2025.250260R3","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) and machine learning are increasingly used in dermatology, primarily for diagnosing skin cancer and classifying disease severity. Primary care providers (PCPs) and emergency physicians have higher error rates in diagnosing dermatologic conditions compared to dermatologists. This study evaluates the performance of an AI-driven dermatologic image analytics tool in identifying common skin disorders from classical images used in medical education.</p><p><strong>Methods: </strong>This prospective study analyzed 42 classical images of common skin disorders using the bellePro application (version 2.1.0; BelleTorus Corporation), trained on over 400,000 dermatologic images. A set of dermatologic images used in a national board review course underwent blinding and independent validation by an academic dermatology department. This module provides AI-powered predictions from cell phone photos, ranking them by \"image match scores\" (higher values indicate better predictions). The primary outcome was the accuracy of three image predictions in identifying known diagnoses, along with the corresponding image match scores.</p><p><strong>Results: </strong>The AI tool correctly predicted 38 out of 42 skin disorders (positive predictive value was 90.5%) as the top differential on the first attempt for all three attempts. Four conditions (angioedema, squamous cell carcinoma, hand foot and mouth disease, and chickenpox) were included in the prediction differential list each attempt but never ranked first, bringing the total to 42/42 (100%). None of the correctly identified disorders had an average image match score below 0.64. The average image match score for correct diagnoses was 0.896 (SD = 0.098).</p><p><strong>Conclusions: </strong>The findings suggest that this AI-based dermatologic image analytics tool performs effectively on classical images of common skin disorders typically seen in clinical practice. This has potential to serve as an adjunct for providers to improve patient outcomes in environments lacking timely access to dermatology resources.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not Just for Diabetes: The Next Frontier for GLP-1 Agonists.","authors":"Henry Colangelo, Ariana Nestler, Corey Lyon","doi":"10.3122/jabfm.2025.250473R1","DOIUrl":"https://doi.org/10.3122/jabfm.2025.250473R1","url":null,"abstract":"<p><p>A commonly used GLP-1 agonist, semaglutide, reduces the risk of adverse cardiovascular outcomes in non-diabetic individuals with obesity and pre-existing cardiovascular disease.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should the Discipline of Family Medicine Honor Its Commitment to the Health of the Public by Defining Its Central Mission as \"Continuity of Care\" or as \"Improving Health Outcomes\"?","authors":"Kate Rowland, Donald Raj Woolever, Richelle Koopman","doi":"10.3122/jabfm.2026.260044R0","DOIUrl":"10.3122/jabfm.2026.260044R0","url":null,"abstract":"<p><p>The discipline of family medicine has historically focused on longitudinal patient relationships and continuity of patient care as essential pillars of the discipline. Growing corporate involvement in health care and the drive for access and convenience challenge the value of the continuity relationships. Continuity of care is not on the roadmap of many newer initiatives in health care that strictly focus on health outcomes. The question arises whether family medicine should focus its commitment to society on the continuity relationship or whether it should grow that commitment to include outcomes, not only to address corporate interests but also to acknowledge patient and community needs. The evidence supporting both continuity of care and primary care effectiveness is robust and particularly relevant to family medicine. The question was debated whether the continuity relationship is practical or effective without being grounded in the outcome of improved health. If continuity stands as its own outcome, do family physicians still commit to health for patients, or is it enough to simply provide ongoing, continuous, longitudinal care? The case was made that every aspect of the relationship with patients depends on health being at the center. Family medicine leaders recognize the value of continuity as a foundational aspect of the specialty, but continue to debate the value of continuity as a means of improving health outcomes for patients and communities.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Family Medicine and Family Physicians Be Responsible for Addressing Population Health and the Social Drivers of Health?","authors":"Joseph Gravel, Melissa Stephens","doi":"10.3122/jabfm.2025.250465R1","DOIUrl":"10.3122/jabfm.2025.250465R1","url":null,"abstract":"<p><p>At the August 2025 Family Medicine Leadership Consortium meeting, the following question was discussed: \"Should family medicine and the family physician be responsible for addressing population health and the social drivers of health (SDH)?\" There was clear consensus that social drivers of health (SDH) such as poverty, housing instability, and food insecurity are powerful predictors of health outcomes. However, there was debate about the appropriate level of responsibility family physicians should assume in addressing these factors.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}