Annals of Family Medicine最新文献

{"title":"<i>Annals</i> Journal Club: Primary Care Access by Census Tract.","authors":"Jenna N Moser, Michael E Johansen","doi":"10.1370/afm.250229","DOIUrl":"10.1370/afm.250229","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"282"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Physicians in Focused Practice in Ontario, Canada: A Population-Level Study of Trends From 1993/1994 Through 2021/2022.","authors":"Hina Ansari, Richard H Glazier, Susan E Schultz, Michael E Green, Kamila Premji, Eliot Frymire, Maryam Daneshvarfard, Liisa Jaakkimainen, Tara Kiran","doi":"10.1370/afm.240377","DOIUrl":"10.1370/afm.240377","url":null,"abstract":"<p><strong>Purpose: </strong>An adequate supply of family physicians who deliver comprehensive care is critical for addressing evolving population health needs, fostering health equity, and ensuring a cost-effective health system. Little is known about current trends of family physicians choosing focused practice and concurrent changes in comprehensive family physician numbers relative to population growth.</p><p><strong>Methods: </strong>We conducted a repeated cross-sectional population-based study using administrative data to understand sex-stratified trends in focused practice from 1993/1994 through 2021/2022 in Ontario, Canada, accounting for population growth. For each fiscal year, we identified all active family physicians and classified them by practice type, leveraging a previously published algorithm on comprehensiveness.</p><p><strong>Results: </strong>The proportion of family physicians in focused practice increased from 7.7% (856/11,103) in 1993/1994 to 19.2% (3,351/17,413) in 2021/2022. The 3 most prevalent focused practice types at the end of the study period were emergency (37.0%), hospitalist (26.5%), and addiction (8.3%) medicine. A greater proportion of focused practice physicians were male (60.1%) vs female (39.9%) in 2021/2022. Over the study period, the number of family physicians increased from 104 to 118 per 100,000; however, the number of comprehensive family physicians decreased from 71 to 64 per 100,000. Of the additional 6,310 family physicians who entered the workforce, 39.5% (2,495/6,310) were in focused practice.</p><p><strong>Conclusions: </strong>Over the study period, there was a decrease in the percentage of comprehensive family physicians and a substantial increase in family physicians pursuing focused practice, particularly in emergency and hospitalist medicine. Research and policy work is needed to understand and address the complex factors driving these trends.</p>","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"181-190"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Difficulty, and Power, of Slowing Down.","authors":"Emily Dollar","doi":"10.1370/afm.240349","DOIUrl":"10.1370/afm.240349","url":null,"abstract":"<p><p>Primary care physicians often feel pressure to rush through the seemingly endless patient care and administrative work we are faced with daily. In residency, I learned how to be efficient, how to juggle multiple things at once, and how to think quickly: all valuable skills. I received positive reinforcement for taking on more responsibilities and roles. By the end of residency, I had forgotten how to slow myself down. When I started my first job, my developing relationship with a new patient showed me just how crucial slowing down can be. In this essay, I reflect on my post-residency efforts to be more deliberate, patient, and mindful. I think about why, in our current medical landscape, it can feel so hard to slow down.</p>","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"267-268"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authorship Inequity in Global Health Research Conducted in Low- and Middle-Income Countries and Published in High-Income Country Family Medicine Journals.","authors":"Alyssa Vecchio, Bridget Nandawula, Kelsey Sawyer, James Akiruga Amisi, Daria Szkwarko, Kathy Z Chang","doi":"10.1370/afm.240431","DOIUrl":"10.1370/afm.240431","url":null,"abstract":"<p><strong>Purpose: </strong>The current structures of global health research and academic authorship have resulted in underrepresentation of authors from low- and middle-income countries. Although authorship inequity has been shown in other specialties, the current status of authorship in family medicine has not been examined.</p><p><strong>Methods: </strong>We conducted a bibliometric analysis of World Organization of Family Doctors (WONCA) journals based in high-income countries for articles describing research conducted in low-income countries, lower-middle-income countries, and upper-middle-income countries from 2018 to 2023. Descriptive statistics were computed to summarize the proportion of first and senior authors by the articles' study location and publication characteristics.</p><p><strong>Results: </strong>We retrieved 1,030 articles through our comprehensive search. A total of 431 articles from 16 family medicine journals remained after abstract and full-text review. Over time, there was an increase in publication of research articles from low- and middle-income countries in the family medicine journals, with the majority of the studies conducted in upper-middle-income countries (55.9%). The proportion of senior authors from high-income countries was highest in articles with research conducted in low-income countries (50%) compared with those reporting research done in lower-middle-income countries (37%) and upper-middle-income countries (21%).</p><p><strong>Conclusions: </strong>About one-quarter of articles with research conducted in low- and middle-income countries and published in family medicine journals have first and/or senior authors from high-income countries; this representation is even higher when analysis is restricted to research done in low-income countries. To support authorship equity, family medicine researchers should reconsider the definition of authorship criteria, promote culturally humble mentorship, and encourage institutions to adapt promotion criteria to empower equitable global health partnerships.</p>","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"223-230"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Match Day 2025: Family Medicine Sets Another Milestone.","authors":"David Mitchell","doi":"10.1370/afm.250230","DOIUrl":"10.1370/afm.250230","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"275-276"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1370/afm.250211","DOIUrl":"10.1370/afm.250211","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"281"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seven Opportunities for Artificial Intelligence in Primary Care Electronic Visits: Qualitative Study of Staff and Patient Views.","authors":"Susan Moschogianis, Sarah Darley, Tessa Coulson, Niels Peek, Sudeh Cheraghi-Sohi, Benjamin C Brown","doi":"10.1370/afm.240292","DOIUrl":"10.1370/afm.240292","url":null,"abstract":"<p><strong>Purpose: </strong>Increased workload associated with electronic visits (eVisits) in primary care could potentially be decreased by the use of artificial intelligence (AI); however, it is unknown whether this use of AI would be acceptable to staff and patients. We explored patient and primary care staff views on the use of and opportunities for AI during eVisits.</p><p><strong>Methods: </strong>We conducted semistructured interviews and focus groups with primary care staff (n = 16) and patients (n = 37) from primary care practices in northwest England and London (n = 14) using the Patchs eVisits system (Patchs Health Limited; <b>www.patchs.ai</b>) from May 2020 to September 2021. We analyzed verbatim transcripts using thematic analysis.</p><p><strong>Results: </strong>Misconceptions regarding AI were common, which led to initial reservations on its use during eVisits. Perceived potential AI benefits included decreased staff workload and faster response times for patients. Safety concerns stemmed from the complexity of primary care and fears of depersonalized service. The following 7 opportunities for AI during eVisits were identified: workflow, directing, prioritization, asking questions, writing assistance, providing self-help information, and face-to-face appointment booking. Despite staff concerns regarding patient acceptability, most patients welcomed the use of AI if it were used as an adjunct to (not replacement for) clinical judgment and could support them in getting help more quickly. Retention of clinical oversight and ongoing evaluation was key to staff acceptability.</p><p><strong>Conclusions: </strong>Patients and staff welcomed the use of AI and identified 7 potential uses during eVisits to decrease staff workload and improve patient safety. Successful implementation will depend on clear communication from practices, demonstrating and monitoring safety, clarifying misconceptions, and reassuring that it will not replace humans.</p>","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"214-222"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information Technology in Primary Care Screenings: Ready for Prime Time?","authors":"Bhrandon Harris, Karl Kochendorfer, Memoona Hasnain, Masahito Jimbo","doi":"10.1370/afm.250198","DOIUrl":"10.1370/afm.250198","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":" ","pages":"179-180"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Furthering Vision, Voice, and Leadership in Academic Family Medicine Through the Leads and BRC Fellowships.","authors":"JoBeth Hamon, Samantha Elwood, Amanda Weidner","doi":"10.1370/afm.250231","DOIUrl":"10.1370/afm.250231","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"280-281"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Institute for Program Director Development: Providing Foundations and Connections for 30 Years.","authors":"Donald Raj Woolever, Karen Weaver","doi":"10.1370/afm.250233","DOIUrl":"10.1370/afm.250233","url":null,"abstract":"","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 3","pages":"274-275"},"PeriodicalIF":4.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}