Journal of the American Board of Family Medicine最新文献

{"title":"Lifetime Impact of the Gender Wage Gap in Family Medicine.","authors":"Kaplan Sanders, Yalda Jabbarpour, Andrew Bazemore","doi":"10.3122/jabfm.2024.240240R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240240R1","url":null,"abstract":"<p><p>The gender wage gap in early-career family medicine results in female physicians earning nearly $32,000 less annually than their male counterparts, with significant lifetime financial impacts. Modeling this disparity over a 25-, 30-, and 35-year career reveals that, without interventions, female physicians could accumulate $2.0 to $4.4 million less than male physicians, underscoring the need for systemic changes to address gender-based pay inequities in the medical profession.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"373-374"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512675","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":"Women's Health Care, Prevention in Practice, and Common Medical Illnesses.","authors":"Marjorie A Bowman, Dean A Seehusen, Jacqueline Britz, Caroline K Tietbohl, Christy J W Ledford","doi":"10.3122/jabfm.2025.250037R0","DOIUrl":"10.3122/jabfm.2025.250037R0","url":null,"abstract":"<p><p>This issue is informative on common family medicine concerns. There are several articles on women's health issues (family physicians providing obstetric care, COVID-19 and cervical cancer screening, the availability of in vitro fertilization, and digital preconception risk counseling). Other specific prevention topics include digital push notifications to patients, the relationship of primary care utilization and emergency department use, the Medicare Annual Wellness Visit, and shared decision making for prostate cancer screening. Two articles discuss pain management. State changes in physician licensure requirements are receiving increased interest, with potential long-term impact. Medication side effects are tied to adherence - what should we do? Patient-Activated Reliever-Triggered Inhaled Corticosteroid (PARTICS) is helpful.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"195-198"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512704","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 Owl.","authors":"Colleen T Fogarty","doi":"10.3122/jabfm.2024.240289R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240289R1","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"399"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512702","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 Unintentional Detection of Leukemias with Complete Blood Count.","authors":"Yung Gonzaga, Felipe Nogueira Barbara, Luis C L Correia, Arn Migowski","doi":"10.3122/jabfm.2024.240275R2","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240275R2","url":null,"abstract":"<p><p>The complete blood count (CBC) is the most requested medical test in the world and it is used for various clinical purposes. Due to its characteristic of quantifying red blood cells, white blood cells, and platelets, it assesses bone marrow function, where most leukemias originate. Therefore, the test has the potential to unintentionally detect different types of leukemia. Screening refers to the application of a diagnostic test to a population without signs or symptoms of the disease. Although the request of a CBC in clinical practice does not necessarily constitute screening, the premise that early detection allows more effective treatment, preventing deaths and allowing patients to live longer, may also apply to leukemias. In this article, leukemias and the CBC are used as a didactic platform to explain some aspects regarding potential benefits, harms, and limitations of incidental detection of diseases in asymptomatic individuals and its implications for the primary care clinician.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"355-359"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512703","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":"Maintenance of an Asthma Intervention Post-Trial: Use of a Patient-Activated Reliever-Triggered Inhaled Corticosteroid (PARTICS) Strategy in Black and Latinx Patients.","authors":"Juan Carlos Cardet, Jonathan M Bailey, Laura P Hurley, Nancy E Maher, Elizabeth W Staton, Barbara P Yawn, Sandra E Zaeh, Elliot Israel, Andrea J Apter, Phuong Bradford, Rafael A Calderon-Candelario, Jennifer K Carroll, Geoffrey L Chupp, Rubin Cohen, Brianna Ericson, Anne L Fuhlbrigge, Barbara M Kaplan, Jean M Kruse, Sylvette Nazario, Wilson D Pace, Magdalena Pasarica, Wanda Phipatanakul, Isaretta L Riley, Jacqueline Rodriguez-Louis, Kartik Shenoy, Paul M Stranges, Hazel Tapp, Michael E Wechsler","doi":"10.3122/jabfm.2024.240014R2","DOIUrl":"10.3122/jabfm.2024.240014R2","url":null,"abstract":"<p><strong>Purpose: </strong>A Patient-Activated Reliever-Triggered Inhaled Corticosteroid (PARTICS) strategy of enhancing usual care with rescue short-acting beta agonist (SABA) supplemented with inhaled corticosteroid (ICS) reduces asthma exacerbations vs. usual care alone in Black and Latinx adults with moderate-severe asthma. We investigated post-trial PARTICS usage and patient perceptions of efficacy.</p><p><strong>Methods: </strong>PREPARE trial participants randomized to the PARTICS intervention were surveyed an average of 29 months after trial exit.</p><p><strong>Results: </strong>Of 600 PARTICS-assigned PREPARE trial participants, 505 consented to future research. Fifty-two percent (262/505) completed this survey. Forty-one percent (108/262) continued using PARTICS post-trial. Of these, 97% (105/108) reported that PARTICS helped to control their asthma. Thirty-four percent (37/108) switched from the trial provided QVAR® to other ICS brands due to insurance coverage or clinician issues (e.g., unwillingness to prescribe or misunderstanding of PARTICS; 65%, 24/37). Of those who stopped using PARTICS post-trial (59% [154/262]), 62% (95/154) reported using PARTICS until the PREPARE-provided ICS inhaler ran out, and 31% (47/154) reported not knowing that their asthma care clinician could prescribe it. Only 2% (5/154) of those not using PARTICS reported that it had not been helpful for asthma.</p><p><strong>Conclusions: </strong>Continued PARTICS use was common >2 years post-trial despite minimal study instruction and was perceived as helpful for asthma, suggesting that patients will likely adopt this strategy if implemented at a healthcare system level.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"378-382"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512696","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":"A Qualitative Implementation Study to Improve Medicare Annual Wellness Visits.","authors":"Joanne E Wilkinson, Roberta E Goldman, Jeffrey Borkan, Christine Ferrone, Philip Clark","doi":"10.3122/jabfm.2024.240217R4","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240217R4","url":null,"abstract":"<p><strong>Background: </strong>The Medicare Annual Wellness Visit (AWV) has high potential value depending on its implementation and clinical setting. We studied the perceived value of the AWV in a residency clinic providing care for underserved patients.</p><p><strong>Methods: </strong>Qualitative interviews with both physicians and patients with deidentified transcription and immersion-crystallization analysis.</p><p><strong>Results: </strong>Physicians and patients identified the following learning points: 1) preparing patients for the AWV; 2) aligning expectations and agenda; and 3) optimizing the value of the AWV given patients' competing demands.</p><p><strong>Discussion: </strong>The Medicare AWV is a promising tool but needs thoughtful implementation to make it valuable in underserved trainee settings.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"360-365"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512667","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":"Identifying Strategies to Improve Implementation of Integrative Pain Management in Primary Care.","authors":"E Marshall Brooks, Ashley Park, Karissa Tu, Wu-Hsun Tom Yang, Sebastian T Tong","doi":"10.3122/jabfm.2024.240181R2","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240181R2","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence supports the use of integrative pain management (IPM) in primary care settings. There is limited understanding of primary care clinicians' experiences, recommendations, and strategies for integrating IPM into clinical care.</p><p><strong>Methods: </strong>A total of 97 clinicians were contacted via e-mail from a listserv maintained by the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region Practice and Research Network, a practice-based research network. A total of 23 clinicians completed a recruitment survey and 21 were contacted to schedule an in-depth interview. Interviews addressed knowledge of and approaches to IPM, barriers and facilitators integrating IPM into clinical care, and recommendations for future program design. Interviews were completed until saturation was reached and then were transcribed and subjected to thematic analysis. Participants were offered $100 for their participation in the interview.</p><p><strong>Results: </strong>A total of 14 clinicians included 11 MDs, 1 PA, 1 LCSW, and 1 PharmD. Domains reported include strategies and perspectives on integrating IPM, system level improvements needed to increase access, clinical barriers to addressing chronic pain, and perceived patient level challenges. Key findings within these domains include the need for a paradigm shift in the approach to treating chronic pain, the importance of adaptability and flexibility, and challenges related to time, payment, and resource availability.</p><p><strong>Discussion: </strong>As a specialty that focuses on whole-person, comprehensive care, family medicine is uniquely situated to integrate IPM into routine practice. Furthermore, ongoing collaboration with primary care clinicians such as behavioral health providers and pharmacists are synergistic toward these goals. However, challenges related to knowledge, comfort, payment, and resource availability must first be overcome within family medicine. This requires improving education on pain management in medical school and residency, increasing access to community referral networks with specialized knowledge in chronic pain, and expanding payments for nonpharmacologic and team-based care.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"366-372"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512674","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":"Piroxicam Plus Plan B for Emergency Contraception.","authors":"J Scott Earwood, Shirley L Sharp, Ryan Cosby, Curtis M Smith","doi":"10.3122/jabfm.2024.240432R0","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240432R0","url":null,"abstract":"<p><p>Consider combination therapy using Levonorgestrel with Piroxicam as an option for female patients, seeking a noninvasive, affordable and practical option for emergency oral contraception.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"395-398"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512698","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":"Rethinking the Standards for State Licensure of Physicians.","authors":"Philip A Gruppuso, Eli Y Adashi","doi":"10.3122/jabfm.2024.240257R2","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240257R2","url":null,"abstract":"<p><p>The US faces a shortage of physicians that is going unmet by the current US medical education system. One option to address this shortfall is to increase the number of international medical graduates (IMGs) practicing medicine in the US. In April of 2023, Tennessee enacted a law that would afford IMGs provisional licensure to practice medicine in the state without undertaking graduate medical education. Passage of this law was followed soon after by passage of the \"<i>Physician Workforce Act</i>\" in Alabama, which reduced the requirement for domestic graduate education for IMGs from 3 to 2 years. The Alabama law also established a medical \"bridge year\" program aimed at US and Canadian medical graduates who went unmatched in the <i>National Residency Matching Program</i> The past year has seen a total of at least 15 states enacting or considering measures that reduce licensing barriers for IMGs. In some cases, provisional licensing of IMGs has replaced requirements for graduate medical education. All these moves, aimed at relieving physician shortages, have the potential to degrade the standards to which physicians are held for licensing and entry into the practice of medicine. It is incumbent on states to assure that IMGs and others who forego extant graduate medical education requirements are fully qualified for licensure and the practice of medicine.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 2","pages":"348-351"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512701","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":"Response: Re: Effectiveness of Long-Term Opioid Therapy for Chronic Low Back Pain.","authors":"John C Licciardone, Subhash Aryal","doi":"10.3122/jabfm.2024.240264R0","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240264R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"934-935"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755489","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}