Osteopathic Family Physician最新文献_第8页

Use of Lean Management to Increase Efficiency and Osteopathic Manipulative Treatment in a Family Medicine Residency 运用精益管理提高效率及骨病手法治疗家庭医学住院

Osteopathic Family Physician Pub Date : 2021-03-01 DOI: 10.33181/13021

Facofp Andrew Eilerman Do, Ryan Jay Oms, Chelsey Smith PharmD, C. F. Do, Jill Porter Do, Tejal Patel Do, Jennifer Reynolds Lsw

{"title":"Use of Lean Management to Increase Efficiency and Osteopathic Manipulative Treatment in a Family Medicine Residency","authors":"Facofp Andrew Eilerman Do, Ryan Jay Oms, Chelsey Smith PharmD, C. F. Do, Jill Porter Do, Tejal Patel Do, Jennifer Reynolds Lsw","doi":"10.33181/13021","DOIUrl":"https://doi.org/10.33181/13021","url":null,"abstract":"Objectives: To determine Lean management's ability to improve the efficiency of residents and increase osteopathic manipulative treatment (OMT) in a family medicine residency clinic. \u0000\u0000Methods: A Key Performance Indicator Board (KPI), a process of Lean management, was created in a residency clinic by various staff. Patient wait times were chosen for the quality measure and daily huddles took place to track progress. A “5-why” was conducted to determine the reasons for failure to meet goals. Faculty used this information to create the 5 “S” of Efficiency method to help residents improve timeliness in caring for complicated patients. Comparisons of the number of patient visits failing wait time goals and total OMT performed before and after the intervention was analyzed. Chi-square was used for statistical analysis and the p-value was set at 0.05. \u0000\u0000Results: Implementation of the 5 “S” of Efficiency method resulted in a significantly lower percentage of days failing the wait time goal in comparison to months before the intervention (p = 0.00001): the average percentage of failed days decreased from 43.1% to 10.4% with the intervention. Enacting Lean management also resulted in a significantly greater percentage of billed OMT billing codes (6.8% vs. 5.3%) (p = 0.03). \u0000\u0000Conclusion: This study indicates that the use of Lean may reduce patient wait times and lead to increased OMT use among family medicine residents. Use of Lean or the 5 “S” of Efficiency method may help other osteopathic programs attempting to improve care; however, further research is indicated.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"1 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42326449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rapid Development and Deployment of Respiratory Evaluation Clinics in Response to the COVID-19 Pandemic to Keep Staff and Patients Safe 为应对新冠肺炎大流行，快速开发和部署呼吸评估诊所，以确保工作人员和患者的安全

Osteopathic Family Physician Pub Date : 2021-02-25 DOI: 10.33181/13025

C. Haddad, Do Christopher Scuderi, Judelle Haddad-Lacle, R. Grewal, Jeffery Jacqmein, Fasn Pradeep Kadambi

{"title":"Rapid Development and Deployment of Respiratory Evaluation Clinics in Response to the COVID-19 Pandemic to Keep Staff and Patients Safe","authors":"C. Haddad, Do Christopher Scuderi, Judelle Haddad-Lacle, R. Grewal, Jeffery Jacqmein, Fasn Pradeep Kadambi","doi":"10.33181/13025","DOIUrl":"https://doi.org/10.33181/13025","url":null,"abstract":"The world as we knew it changed at the beginning of 2020 with the explosion of the global pandemic caused by SARS-CoV-2, a.k.a. COVID-19. As of January 10, 2021, the novel coronavirus has infected over 89 million people worldwide and killed over 1.9 million. In the U.S., there have been 22 million people infected and 373,000 deaths. It has never been more important to protect our vulnerable patients and staff from infectious disease, especially during the time they spend in our offices and clinics. It quickly became apparent that there was a need for a dedicated location where patients could be seen that were too ill to be evaluated via telemedicine, but not ill enough to be sent to the Emergency Department (ED). To fill this need, our primary care network developed the Respiratory Evaluation Clinic (REC) concept. These were two geographical locations where the outlying clinics could send potentially infectious patients to evaluate and test COVID-19. Some recommendations, adaptations, lessons learned and the REC clinics' expansions to other locations throughout our network are discussed.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47843951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cannabidiol: Background and Literature Review of Potential Treatments 大麻二酚:潜在治疗的背景和文献综述

Osteopathic Family Physician Pub Date : 2021-02-25 DOI: 10.33181/13022

Oms-Iii Beth Kolongowski, Do Mba Facoep Lindsay Tjiattas-Saleski

{"title":"Cannabidiol: Background and Literature Review of Potential Treatments","authors":"Oms-Iii Beth Kolongowski, Do Mba Facoep Lindsay Tjiattas-Saleski","doi":"10.33181/13022","DOIUrl":"https://doi.org/10.33181/13022","url":null,"abstract":"Cannabidiol, commonly abbreviated CBD, is one of the hundreds of compounds present in the flowering cannabis plant, along with its more well-known structural isomer, Δ9-tetrahydrocannabinol or THC. CBD can be extracted from the plant and utilized in many forms, from topical oils to smokable flowers. Recently, availability, interest in and use of CBD across the nation have grown exponentially, with internet searches for CBD increasing 160% between 2017 and 2018 and 14% of Americans citing current CBD use. Users of this compound endorse numerous perceived benefits, including anxiolysis, analgesia and much more. Most users claim to employ CBD to treat specific medical conditions spanning from autoimmune, to psychiatric, to musculoskeletal. Evidence supports some of these reported effects in recent studies, as CBD has demonstrated anticonvulsant, antipsychotic and antinociceptive properties, among others. However, the implications of these findings are still in their infancy. As of June 2018, one FDA-approved pure CBD product for seizure treatment, Epidiolex®, is available for prescription use and many more are in various stages of testing. However, numerous safety and legal concerns remain regarding off-label and over-the-counter CBD usage. Physicians and other health care professionals are likely to encounter CBD use by their patients. As usage continues to grow, so does the duty of care providers to understand its role and serve as a source of evidence-based information for their community on this relevant health topic.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47355718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Mindfulness: Principles and Application to Decrease Opiate Use in Primary Care With an Osteopathic Component 正念：用骨病成分减少初级保健中阿片类药物使用的原则和应用

Osteopathic Family Physician Pub Date : 2021-02-25 DOI: 10.33181/13023

D. Frasca

{"title":"Mindfulness: Principles and Application to Decrease Opiate Use in Primary Care With an Osteopathic Component","authors":"D. Frasca","doi":"10.33181/13023","DOIUrl":"https://doi.org/10.33181/13023","url":null,"abstract":"Mindfulness is a focused approach toward accepting one’s thoughts without judgment or perseveration, with ancient Indo-Sino-Tibetan philosophical origins. Many variations exist; however, they typically include focused attention where one concentrates on a specific sensation such as breathing and open monitoring where one concentrates on consciousness itself. Mindfulness-based interventions (MBIs) are specific, organized, targeted methods to teach mindfulness with specific goals. \u0000MBIs have shown benefit in pain patients. MBIs teach the individual the concept of pain coping, encouraging cognitive flexibility and attempting to discourage the fear or alarm reaction of pain, instead focusing on the quality of life and functionality. Mindfulness-based stress reduction (MBSR) showed a 30% significant improvement in pain intensity and pain coping at six months in patients with chronic low back pain, compared to opiates and NSAIDs, which showed no benefit. \u0000MBIs have also shown benefit in addiction, as they help the individual relearn to control cravings, habit modification and attempt to restore the natural reward system while improving regulation of emotions. Applications to opiate use disorder are significant as patients learn to enjoy the lifestyle of recovery and learn to believe they can improve. Additionally, other comorbid conditions are known to improve with MBIs and mindfulness-based principles support the holistic principle of mind, spirit and body consistent with osteopathic medicine.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"24-28"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45361487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nonalcoholic Steatohepatitis: Case-Based Focused on Pediatric and Adult Guidelines 非酒精性脂肪性肝炎：基于病例的儿科和成人指南

Osteopathic Family Physician Pub Date : 2021-02-25 DOI: 10.33181/13024

A. Maiden, Shannon C. Scott, Erin C. Raney, Marisa Strobridge

{"title":"Nonalcoholic Steatohepatitis: Case-Based Focused on Pediatric and Adult Guidelines","authors":"A. Maiden, Shannon C. Scott, Erin C. Raney, Marisa Strobridge","doi":"10.33181/13024","DOIUrl":"https://doi.org/10.33181/13024","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) comprises a continuum of conditions associated with insulin resistance and obesity in the absence of secondary causes of hepatic steatosis (alcohol, medication, genetic disorders, hepatitis, etc.) The milder, benign form of NAFLD is simple fatty liver or steatosis. Fatty infiltration affects more than 5% of the liver.1 This is determined by histologic exam, direct quantification or imaging. The range progresses to nonalcoholic steatohepatitis (NASH) and culminates in fibrosis and cirrhosis. Histologic changes include ballooning degeneration of hepatocytes, the presence of Mallory bodies, macrovesicular steatosis, lobular or portal inflammation.2 \u0000NAFLD is now the foremost cause of childhood, adolescent and adult chronic hepatic disease. The pediatric and adult obesity epidemic makes NAFLD a potentially ubiquitous hepatic pathology amongst all patients.3,4,5 The increase of obese children and adults with obesity correlates to the rise of NAFLD cases. In adults, the rate of NAFLD increase is paired with the epidemics of obesity and Type 2 Diabetes (T2DM).4,5 Data proposes hepatic-related mortality may be due to NASH ultimately progressing to cirrhosis.3,4 NAFLD is linked to pediatric and adult cardiovascular risk and morbidity.4,6 Non-invasive biomarkers and the gold standard of liver biopsy not only diagnose but assist in targeted therapies.6 Most pharmacologic therapy for NAFLD is in trial stages for patients of all ages. Pioglitazone is favored in adults who have NAFLD/NASH and T2DM.7 The gut biome is also impactful. Lifestyle modifications of diet and exercise can reduce the public health burden of this disease.7,8,9,10","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":"29-37"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46982428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adult Hearing Loss: Applying the Five Models of Osteopathic Medicine to Diagnose and Treat 成人听力损失:应用骨科医学的五种模式进行诊断和治疗

Osteopathic Family Physician Pub Date : 2021-01-01 DOI: 10.33181/13012

Oms-Iii Adel Elnashar, Oms-Iii Zachary Lodato, Do Faao Sheldon Yao

{"title":"Adult Hearing Loss: Applying the Five Models of Osteopathic Medicine to Diagnose and Treat","authors":"Oms-Iii Adel Elnashar, Oms-Iii Zachary Lodato, Do Faao Sheldon Yao","doi":"10.33181/13012","DOIUrl":"https://doi.org/10.33181/13012","url":null,"abstract":"Hearing loss is a common complaint with extensive cognitive, physical, emotional, social and financial implications. Many adults are expected to present with varying degrees of hearing loss by the age of 60 to 69 years old that can be classified according to the cause into conductive, sensorineural and mixed. There can be associated symptoms, like tinnitus, vertigo and otalgia and/or abnormal behaviors such as social withdrawal and difficulty with interpersonal communication. Somatic dysfunctions can accompany hearing troubles and range from fluid problems such as fluids accumulation in the middle ear, lymphatic congestion of the head and neck, and structural dysfunctions in the eustachian tube, neck musculature, thoracic spine, ribs and the cranial rhythmic impulse in addition to other neurologic dysfunctions such as sympathetic hyperactivity and viscerosomatic changes. In this review, we provide several suggestions that may assist the osteopathic family physician in identifying the various causes behind the hearing loss, especially life-threatening or quality-of-life limiting causes. We will also provide an effective treatment addressing the cause of the hearing loss presentation and associated somatic dysfunctions, alone or in conjunction with other appropriately trained health care providers, based on the understanding of the five models of osteopathic medicine and how they can apply toward the anatomical and physiological components of adult hearing loss.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69516648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Nighttime Blue Light Exposure and Breast Cancer 夜间蓝光照射与乳腺癌

Osteopathic Family Physician Pub Date : 2021-01-01 DOI: 10.33181/13013

David Jaynes, P. Switzer

引用次数: 1

Lateral Epicondylitis: A Common Cause of Elbow Pain in Primary Care 外上髁炎:初级保健中肘关节疼痛的常见原因

Osteopathic Family Physician Pub Date : 2021-01-01 DOI: 10.33181/13014

Donald J Fleming, D. Muller, D. Lambert

{"title":"Lateral Epicondylitis: A Common Cause of Elbow Pain in Primary Care","authors":"Donald J Fleming, D. Muller, D. Lambert","doi":"10.33181/13014","DOIUrl":"https://doi.org/10.33181/13014","url":null,"abstract":"Lateral epicondylitis (LE) is an overuse injury of the lateral elbow. LE is caused by repetitive motion leading to micro-injury of the wrist extensor muscles that originate along the elbow's lateral aspect. Although LE is commonly referred to as “tennis elbow” many cases are observed in non-athletes. Due to its prevalence in the general population, primary care physicians must be prepared to diagnose and treat LE. Physicians should look for a history of repetitive activities involving patient’s jobs or recreational activities. Exam findings are characterized by pain and tenderness just distal to the lateral epicondyle of the humerus. Resisted movement with an extension of the wrist will typically elicit pain. Ultrasonography is considered the imaging modality of choice for diagnosing LE. Standard radiographs and magnetic resonance imaging (MRI) may be helpful. However, diagnosis can usually be made by history and physical examination alone. Most cases of LE respond favorably to conservative therapy. There are several nonoperative options for treatment, but a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy that utilizes eccentric muscle stretching is considered first-line. Osteopathic manipulative medicine is also useful in the treatment of LE. Muscle energy (ME) and joint mobilization techniques have been shown to be particularly effective. If non-surgical therapy fails, surgical intervention may provide patients with an additional benefit. This article will review some of the treatment options described above and discuss other diagnostic and therapeutic considerations relevant to LE's management in the primary care setting.","PeriodicalId":53642,"journal":{"name":"Osteopathic Family Physician","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69516687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Implications of False Positive SARS-CoV-2 by PCR Test in the Health Care Work Force 卫生保健工作人员中PCR检测的严重急性呼吸系统综合征冠状病毒2型假阳性的意义

Osteopathic Family Physician Pub Date : 2021-01-01 DOI: 10.33181/13015

DO Julie Kim, Javier Romero, DO Amanda Frugoli, Graal Diaz, Mlis Janet Hobbs

引用次数: 0

Bilateral Foot Pain and Swelling 双侧足部疼痛和肿胀

Osteopathic Family Physician Pub Date : 2021-01-01 DOI: 10.33181/13016

DO William Forgach, Oms-Iii Erik Krueger, Do Mba Facoep Lindsay Tjiattas-Saleski

引用次数: 0