Improving Patients ’ Choice of Clinician by Including Roll-up Measures in Public Healthcare Quality Reports: an Online Experiment
AbstractBackgroundPublic reports on healthcare quality typically include complex data. To lower the cognitive burden of interpreting these data, some report designers create summary, or roll-up, measures combining multiple indicators of quality into one score. Little is known about how the availability of roll-ups affects clinician choice.ObjectiveTo determine how presenting quality scores at different levels of aggregation affects patients ’ clinician choices.DesignWe conducted a simulated clinician-choice experiment, randomizing participants to three versions of a public reporting website and comparing their clinic...
Source: Journal of General Internal Medicine - November 16, 2018 Category: Internal Medicine Source Type: research

Inequalities in Young Adult Health Insurance Coverage Post-federal Health Reform
AbstractBackgroundUninsurance for young adults (YAs) was greatly reduced by the Affordable Care Act (ACA). However, reforms may not be equally beneficial for all YAs and certain policies may exacerbate, rather than resolve, pre-existing disparities.ObjectiveTo investigate inequalities in YAs ’ insurance coverage pre- (2000–2010) and post-federal health reforms (dependent coverage expansion, 2010–2013, and Medicaid/Marketplace expansions, 2014–2016), among a nationally representative sample.DesignA difference-in-differences estimator (controlling for sociodemographics) was used to determine the effec...
Source: Journal of General Internal Medicine - November 14, 2018 Category: Internal Medicine Source Type: research

The Care and Learn Model: a Practice and Research Model for Improving Healthcare Quality and Outcomes
AbstractThe Agency for Healthcare Research and Quality conducted internal work to formulate a model that could be used to analyze the Agency ’s research portfolio, identify gaps, develop and prioritize its research agenda, and evaluate its performance. Existing models described the structure and components of the healthcare system. Instead, we produced a model of two functions: caring and learning. Central to this model is the commitme nt to and participation of people—patients, communities, and health professionals—and the organization of systems to respond to people’s problems using evidence. As a...
Source: Journal of General Internal Medicine - November 14, 2018 Category: Internal Medicine Source Type: research

When Suicide Happens in the Medical Community
AbstractWhen suicide happens close to doctors, students, and faculty, to our families, friends, colleagues, students, residents, fellows and patients, it challenges us as individuals and as members of institutions that seek to provide safety and support. The US suicide rate has increased and suicide remains difficult to predict or to prevent despite its association with depression and addiction. It is less common in medical students and residents than in the general, age-matched population but generates troubling, complex aftershocks for us. Individuals react according to their history and style, through stages, psychologi...
Source: Journal of General Internal Medicine - November 13, 2018 Category: Internal Medicine Source Type: research

Medically Tailored Meal Delivery for Diabetes Patients with Food Insecurity: a Randomized Cross-over Trial
AbstractBackgroundFood insecurity, defined as inconsistent food access owing to cost, leads to poor health.ObjectiveTo test whether a medically tailored meal delivery program improved dietary quality in individuals with type 2 diabetes and food insecurity.DesignRandomized cross-over clinical trial.ParticipantsForty-four adults with diabetes, hemoglobin A1c  >  8.0%, and food insecurity (defined as at least one positive item on the two-item “Hunger Vital Sign”).InterventionIn the Community Servings: Food as Medicine for Diabetes cross-over clinical trial (NCT02426138), conducted from June 2015 t...
Source: Journal of General Internal Medicine - November 12, 2018 Category: Internal Medicine Source Type: research

Apple Watch Steps
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 12, 2018 Category: Internal Medicine Source Type: research

Equal Rights for General Internists
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 12, 2018 Category: Internal Medicine Source Type: research

Addressing Lifestyle Management During Visits Involving Patients with Prediabetes: NAMCS 2013 –2015
ConclusionsThe prevalence of addressing lifestyle management during office visits involving patients with prediabetes remained low in the USA. Patients ’ clinical characteristics, geographic region, and physician’s specialty were associated with addressing lifestyle management during the visits. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 12, 2018 Category: Internal Medicine Source Type: research

Keeping Pace with the Expanding Role of Health Coaching
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

Primary Care Transformation and Physician Burnout
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

Physician Empathy Is Not Associated with Laboratory Outcomes in Diabetes: a Cross-sectional Study
ConclusionPhysician empathy was not associated with HgbA1c or LDL. While interventions to increase physician empathy may result in more patient-centered care, they may not improve clinical outcomes in patients with diabetes. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

Quantifying Social Reinforcement Among Family Members on Adherence to Medications for Chronic Conditions: a US-Based Retrospective Cohort Study
ConclusionsAdherence among family members appeared to be highly correlated, suggesting positive reinforcement by family or the sharing of unmeasured behaviors or characteristics associated with better adherence. Regardless, information about prior adherence among family members from routinely collected data could potentially inform adherence prediction or intervention efforts. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

A Cross-sectional Survey Using Clinical Vignettes to Examine Overdose Risk Assessment and Willingness to Prescribe Naloxone
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

Terminal
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 7, 2018 Category: Internal Medicine Source Type: research

Influence of Age, Health, and Function on Cancer Screening in Older Adults with Limited Life Expectancy
We examined the relationship between cancer screening and life expectancy predictors, focusing on the influence of age versus health and function, in older adults with limited life expectancy.DesignLongitudinal cohort studySettingNational Health and Aging Trends Study (NHATS) with linked Medicare claims.ParticipantsThree cohorts of adults 65+ enrolled in fee-for-service Medicare were constructed: women eligible for breast cancer screening (n = 2043); men eligible for prostate cancer screening (n = 1287); men and women eligible for colorectal cancer screening (n = 3759).Measurements...
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Time to Listen More and Talk Less
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Trends, Management Patterns, and Predictors of Leaving Against Medical Advice among Patients with Documented Noncompliance Admitted for Acute Myocardial Infarction
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Concentration of Opioid-Related Industry Payments in Opioid Crisis Areas
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Apple Watch Steps
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Older Adults ’ Perceptions of Healthcare Overuse
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - November 6, 2018 Category: Internal Medicine Source Type: research

Association of Structured Virtual Visits for Hypertension Follow-Up in Primary Care with Blood Pressure Control and Use of Clinical Services
ConclusionsAmong patients with reasonably well-controlled hypertension, virtual visit participation was associated with equivalent blood pressure control and reduced in-office primary care utilization. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 30, 2018 Category: Internal Medicine Source Type: research

Does a Year Have 6  Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 29, 2018 Category: Internal Medicine Source Type: research

The Impact of Social Media on Negative Online Physician Reviews: an Observational Study in a Large, Academic, Multispecialty Practice
AbstractBackgroundOnline reviews of physicians are becoming increasingly common, however no correlation of these reviews to formal patient satisfaction surveys. With the explosion of social media, it is unknown as to how this form of communication may have a role in potentially managing and addressing the search position of negative online reviews.MethodsWe obtained a list of 102 physicians with negative online reviews between September 2014 and December 2014. Social media uptake and average Google search position of the physician and their respective negative online reviews were assessed from January 2015 through January ...
Source: Journal of General Internal Medicine - October 29, 2018 Category: Internal Medicine Source Type: research

Living Fully with Sickle Cell Disease
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 29, 2018 Category: Internal Medicine Source Type: research

Primary Care Visit Regularity and Patient Outcomes: an Observational Study
AbstractBackgroundRegular primary care visits may allow an opportunity to deliver high-value, proactive care. However, no previous study has examined whether more temporally regular primary care visits predict better outcomes.ObjectiveTo examine the relationship between the temporal regularity of primary care (PC) visits and outcomes.DesignRetrospective cohort study.ParticipantsWe used Medicare claims for 378,862 fee-for-service Medicare beneficiaries, who received PC at 1328 federally qualified health centers from 2010 to 2014.Main MeasuresWe created five beneficiary groups based upon their annual number of PC visits. We ...
Source: Journal of General Internal Medicine - October 26, 2018 Category: Internal Medicine Source Type: research

The Affordable Care Act and Trends in Insurance Coverage and Disease Awareness Among Non-elderly Individuals with Kidney Disease
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 26, 2018 Category: Internal Medicine Source Type: research

Bricks and Morals —Hospital Buildings, Do No Harm
AbstractThe volume and rigor of evidence-based design have increasingly grown over the last three decades since the field ’s inception, supporting research-based designs to improve patient outcomes. This movement of using evidence from engineering and the hard sciences is not necessarily new, but design-based health research launched with the demonstration that post-operative patients with window views towards nature versus a brick wall yielded shorter lengths of hospital stay and less analgesia use, promoting subsequent investigations and guideline development. Architects continue to base healthcare design decisions...
Source: Journal of General Internal Medicine - October 25, 2018 Category: Internal Medicine Source Type: research

Finding Joy in the Practice of Implementation Science: What Can We Learn from a Negative Study?
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 24, 2018 Category: Internal Medicine Source Type: research

Go Slow to Go Fast: Successful Engagement Strategies for Patient-Centered, Multi-Site Research, Involving Academic and Community-Based Organizations
ConclusionsMajor funding institutions (e.g., NIH, PCORI) recognize that community engagement leads to higher quality, more meaningful research (7, 21). Our results support that assumption and in addition, suggest an investment in engagement strategies at the onset of a research project and the use of cultural brokers can greatly contribute to the success of implementing a large, multi-site research project. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 23, 2018 Category: Internal Medicine Source Type: research

A Qualitative Study of Spanish-Speakers ’ Experience with Dense Breast Notifications in a Massachusetts Safety-Net Hospital
ConclusionsNot having previous knowledge of breast density and receiving notifications in English contributed to confusion about its meaning and inaccurate interpretations of key messages by Spanish speakers. Tools that promote understanding should be leveraged in seeking equity in risk-based breast cancer screening for women with dense breasts. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

Association of Back Pain with All-Cause and Cause-Specific Mortality Among Older Women: a Cohort Study
AbstractBackgroundThe impact of back pain on disability in older women is well-understood, but the influence of back pain on mortality is unclear.ObjectiveTo examine whether back pain was associated with all-cause and cause-specific mortality in older women and mediation of this association by disability.DesignProspective cohort study.SettingThe Study of Osteoporotic Fractures.ParticipantsWomen aged 65 or older.MeasurementOur primary outcome, time to death, was assessed using all-cause and cause-specific adjusted Cox models. We used a four-category back pain exposure (no back pain, non-persistent, infrequent persistent, or...
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

Cancer Screening Results and Follow-up Using Routinely Collected Electronic Health Data: Estimates for Breast, Colon, and Cervical Cancer Screenings
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

Internists Support Global Human Rights, One Patient at a Time
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

The Importance of Addressing Depression and Diabetes Distress in Adults with Type 2 Diabetes
AbstractPeople with type 2 diabetes often experience two common mental health conditions: depression and diabetes distress. Both increase a patient ’s risk for mortality, poor disease management, diabetes-related complications, and poor quality of life. The American Diabetes Association and the U.S. Preventive Services Task Force recommend routine evaluations for these conditions in adults for optimal disease management and prevention of life -threatening complications. However, barriers exist within primary care and specialty settings that make screening for depression and diabetes distress challenging. Depression a...
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

The Association Between Mentor-Mentee Network Features and Publication Productivity Among Early Career Academic Generalists
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 22, 2018 Category: Internal Medicine Source Type: research

Lost in Transition: a Qualitative Study of Patients Discharged from Hospital to Skilled Nursing Facility
ConclusionsResults indicate problematic transitions stemming from insufficient care coordination and failure to appropriately prepare patients and their family members. Previous research suggests that problematic or hurried transitions from hospital to SNF are associated with medication errors and unnecessary rehospitalizations. Interventions to improve transitions from hospital to SNF that include a focus on patients and families are needed. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 18, 2018 Category: Internal Medicine Source Type: research

Evaluation of the Association of Public Reporting of Patient Ratings of US Primary Care Providers with Inappropriate Care
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 18, 2018 Category: Internal Medicine Source Type: research

Effect on VA Patient Satisfaction of Provider ’s Use of an Integrated Viewer of Multiple Electronic Health Records
AbstractPurposeTo examine associations between patient perceptions that their provider was knowledgeable of their medical history and clinicians ’ early adoption of an application that presents providers with an integrated longitudinal view of a patient’s electronic health records (EHR) from multiple healthcare systems.MethodThis retrospective analysis utilizes provider audit logs from the Veterans Health Administration Joint Legacy Viewer (JLV) and patient responses to the Survey of Patient Healthcare Experiences Patient-Centered Medical Home (SHEP/PCMH) patient satisfaction survey (FY2016) to assess the relat...
Source: Journal of General Internal Medicine - October 18, 2018 Category: Internal Medicine Source Type: research

Crisis Pregnancy Centers: Faith Centers Operating in Bad Faith
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 18, 2018 Category: Internal Medicine Source Type: research

Correction to: Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record
In the HTML version of this paper, Ms. Goddu was incorrectly listed. The correct citation should be AP Goddu. Exposure to the stigmatizing language note was associated with more negative attitudes towards the patient (20.3 stigmatizing vs. 25.1 neutral, p
Source: Journal of General Internal Medicine - October 18, 2018 Category: Internal Medicine Source Type: research

Predicting Fracture Risk in Younger Postmenopausal Women: Comparison of the Garvan and FRAX Risk Calculators in the Women ’s Health Initiative Study
ConclusionsIn postmenopausal women aged 50 –64 years, the FRAX and Garvan fracture risk calculator discriminate poorly between women who do and do not experience fracture during 10-year follow-up. There is no useful threshold for either tool. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 17, 2018 Category: Internal Medicine Source Type: research

A Curriculum for Diagnostic Reasoning: JGIM ’s Exercises in Clinical Reasoning
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 17, 2018 Category: Internal Medicine Source Type: research

Capsule Commentary on Ashburner et al., Electronic Physician Notifications to Improve Guideline-Based Anticoagulation in Atrial Fibrillation: a Randomized Controlled Trial
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 17, 2018 Category: Internal Medicine Source Type: research

Out-of-pocket Spending on Orphan Drug Prescriptions Among Commercially Insured Adults in 2014
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 15, 2018 Category: Internal Medicine Source Type: research

Impact of Industry Payments on Prescribing Patterns for Tumor Necrosis Factor Inhibitors Among Medicare Beneficiaries
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 15, 2018 Category: Internal Medicine Source Type: research

Hospitalists ’ Role in Improving Prescriptions of Nicotine Replacement Therapy Among Tobacco Users During Hospitalization and at Discharge
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 15, 2018 Category: Internal Medicine Source Type: research

Schools Matter? Contextual Factors That May Affect Bias in Clinical Decision-making
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 10, 2018 Category: Internal Medicine Source Type: research

Correction to: Vascular Ehlers-Danlos Syndrome Presenting as a Pulsatile Neck Mass: a Case Report and Review of Literature
This paper was inadvertently published with open access; the authors have requested the copyright revert to the society. It has been re-published with appropriate licensing. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 10, 2018 Category: Internal Medicine Source Type: research

Test Result Management Practices of Canadian Internal Medicine Physicians and Trainees
AbstractBackgroundMissed test results are a cause of medical error. Few studies have explored test result management in the inpatient setting.ObjectiveTo examine test result management practices of general internal medicine providers in the inpatient setting, examine satisfaction with practices, and quantify self-reported delays in result follow-up.DesignCross-sectional survey.ParticipantsGeneral internal medicine attending physicians and trainees (residents and medical students) at three Canadian teaching hospitals.Main MeasuresMethods used to track test results; satisfaction with these methods; personal encounters with r...
Source: Journal of General Internal Medicine - October 8, 2018 Category: Internal Medicine Source Type: research

Community Health Centers Could Provide Better Outsourced Primary Care for Veterans
AbstractThe “VA Mission Act of 2018” will expand the current “Choice Program” legislation of 2014, which has enabled outsourcing of VA care to private physicians. As the ranks of Veteran patients swell, Congress intended that the Mission Act will help relieve the VHA’s significant access problems. We contend that this new legislation will have negative consequences for veterans by diverting support from our VA system of 1300 hospitals and clinics. We recommend modification of this legislation, promoting much greater utilization of Community Health Centers (CHCs) for veterans outsourced primary...
Source: Journal of General Internal Medicine - October 5, 2018 Category: Internal Medicine Source Type: research