Preventable Health Behaviors, COVID-19 Severity Perceptions, and Vaccine Uptake in Traditional Medicare and Medicare Advantage: a Survey-Based Study
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Guiding Academic Clinician Educators at Research-Intensive Institutions: a Framework for Chairs, Chiefs, and Mentors
We present a framework to guide chairs, chiefs, and mentors seeking to address clinician educator retention and satisfaction in academic medical centers. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Out-of-Pocket Spending Inequity Among High-Deductible Health Plan Members with Bipolar Disorder
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

The Efficacy and Safety of Disease-Modifying Osteoarthritis Drugs for Knee and Hip Osteoarthritis —a Systematic Review and Network Meta-Analysis
DiscussionGlucosamine and chondroitin yielded statistically significant but clinically questionable long-term benefit on structure and symptoms, though both had favorable safety profiles. Strontium improved structure, and vitamin D improved symptoms. Although doxycycline had a favorable efficacy ranking, its safety profile was poor. None of the 12 classes of drugs appears to have long-term clinically significant benefit. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

The Relationship Between Medicare Advantage Star Ratings and Enrollee Experience
AbstractBackgroundMedicare Advantage plans, private managed care plans that enrolled 34% of Medicare beneficiaries in 2019, received $6 billion in annual bonus payments on the basis of their performance on a 5-star rating system. Little is known, however, as to the extent these ratings adequately capture enrollee experience.ObjectivesTo measure the effect of exposure to higher rated Medicare Advantage contracts on enrollee experience.DesignAn instrumental variables analysis using MA contract consolidation as an exogenous shock to the quality of plan enrollees are exposed to.ParticipantsA total of 345,897 MA enrollees enrol...
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Towards Inclusion: a Guidebook for Championing Diversity for Internal Medicine Chief Medical Residents
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Peers Know Best: a Novel Curriculum for Onboarding Interns ’ Electronic Health Record Skills in Continuity Clinic
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Heterotaxy Syndrome with Polysplenism and Left Atrial Isomerism
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 12, 2021 Category: Internal Medicine Source Type: research

Teaching Medical Students to Help Patients Manage Their Weight: Outcomes of an Eight-School Randomized Controlled Trial
CONCLUSIONSThis trial revealed that medical students struggle with delivering weight management counseling to their patients who have overweight or obesity. Medical schools, though restrained in adding curricula, should incorporate should incorporate multiple WMC curricula components early in medical student education to provide knowledge and build confidence for supporting patients in developing individualized plans for weight management.NIH Trial Registry NumberR01-194787 (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Physician Practice Leaders ’ Perceptions of Medicare’s Merit-Based Incentive Payment System (MIPS)
ConclusionsPractice leaders reported several challenges related to MIPS, including irrelevant measures, administrative burden, frequent programmatic changes, and small incentives. They held mixed views on whether the program improves patient care. These findings may be useful to policymakers hoping to improve MIPS. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Validation of a 5-Item Tool to Measure Patient Assessment of Clinician Compassion in Hospitals
ConclusionWe validated two 5-item tools that can distinctly measure patient experience of physician and nurse compassion for use in the inpatient hospital setting in conjunction with HCAHPS. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

A Comparison of Web-Based Cancer Risk Calculators That Inform Shared Decision-making for Lung Cancer Screening
ConclusionSubstantial variability in the depiction of lung cancer risk for hypothetical patients exists across the web-based LCRCs due to their respective inputs and risk prediction models. To foster informed decision-making in the SDM-LDCT context, the input variables, risk prediction models, risk depiction, and screening recommendations must be standardized to best practice. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Discharge Practices for COVID-19 Patients: Rapid Review of Published Guidance and Synthesis of Documents and Practices at 22 US Academic Medical Centers
ConclusionAMCs studied showed strong consensus on discharge practices for COVID-19 patients related to post-discharge isolation and transmission mitigation for home and non-home settings. There was high concordance among AMCs that discharge practices should address COVID-19-specific factors in clinical, functional, and post-discharge monitoring domains although definitions and details varied. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Monitoring Health Effects of Vaping Discussed on Twitter in 2018 and 2019
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Mortality Among People Experiencing Homelessness in San Francisco 2016 –2018
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 9, 2021 Category: Internal Medicine Source Type: research

Racial and Ethnic Disparities in Access to Culturally Competent Care in Patients with Joint Pain in the United States
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 8, 2021 Category: Internal Medicine Source Type: research

Changing FDA Approval Standards: Ethical Implications for Patient Consent
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 8, 2021 Category: Internal Medicine Source Type: research

Disparities in Health Care Task Participation and Provider Communication by Family Caregiver Race
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 8, 2021 Category: Internal Medicine Source Type: research

Leading with Love: Five Practical Tips
AbstractWe believe, as Donabedian taught us, that “the secret of quality is love.” It is possible to lead with love and discover abundance among teams who feel safe, cared for, and aligned toward common purpose and their own professional growth. We offer five practical tips for leaders’ consideration: (1) focus on the people; (2) develop a cu lture of professional diastole; (3) foster relational trust by reducing the vulnerability of others; (4) make sure the right people are in the right seats on the bus; and (5) administer policies with kindness and common sense. The return on this investment is non-lin...
Source: Journal of General Internal Medicine - April 8, 2021 Category: Internal Medicine Source Type: research

Brazil ’s Community Health Workers Practicing Narrative Medicine: Patients’ Perspectives
ConclusionThis study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider –colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and socie tal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence thei...
Source: Journal of General Internal Medicine - April 7, 2021 Category: Internal Medicine Source Type: research

Did the 2015 USPSTF Abnormal Blood Glucose Recommendations Change Clinician Attitudes or Behaviors? A Mixed-Method Assessment
ConclusionThe 2015 USPSTF abnormal blood glucose guideline had little to no effect on abnormal blood glucose screening or referral to behavioral interventions in North Carolina practices. Potential interventions to improve these rates could include clinical decision tools embedded in the electronic health record and better referral systems for community-based diabetes prevention programs. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 7, 2021 Category: Internal Medicine Source Type: research

Treatment of Refractory Opioid Use Disorder
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 7, 2021 Category: Internal Medicine Source Type: research

Racial/Ethnic Differences in Emergency Department Utilization and Experience
AbstractBackgroundPrevious work has demonstrated racial/ethnic differences in emergency department (ED) utilization, but less is known about racial/ethnic differences in the experience of care received during an ED visit.ObjectiveTo examine differences in self-reported healthcare utilization and experiences with ED care by patients ’ race/ethnicity.DesignAdult ED patients discharged to community (DTC) were surveyed (response rate: 20.25%) using the Emergency Department Patient Experience of Care (EDPEC) DTC Survey. Linear regression was used to estimate case-mix-adjusted differences in patient experience between raci...
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

In Reply to Wayne et al.
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

COVID-19 Exposure Risk by Speakers of Spanish and English Using a Web-Based Self-assessment Tool
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

Anti-Melanoma Differentiation-Associated Gene 5 Dermatomyositis with Inverse Gottron ’s Sign
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

Clinical Risk Score and COVID-19
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

Sex Disparities in COVID-19 Mortality Vary Across US Racial Groups
ConclusionWhile overall, men have higher COVID-19 mortality rates than women, our findings show that this sex disparity does not hold across racial groups. This demonstrates the limitations of unidimensional reporting and analyses and highlights the ways that race and gender intersect to shape COVID-19 outcomes. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 5, 2021 Category: Internal Medicine Source Type: research

An Early Invasive Strategy Is Not Superior to Medical Management Alone in Patients with Moderate-to-Severe Stable Ischemic Heart Disease
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 2, 2021 Category: Internal Medicine Source Type: research

Resource Use Among Diabetes Patients Who Mainly Visit Primary Care Physicians Versus Medical Specialists: a Retrospective Cohort Study
AbstractBackgroundIt is not uncommon for medical specialists to predominantly care for patients with certain chronic conditions rather than primary care physicians (PCPs), yet the resource implications from such patterns of care are not well understood.ObjectiveTo assess resource use of diabetes patients who predominantly visit a PCP versus a medical specialist.DesignRetrospective cohort study of diabetes patients aging into the traditional Medicare program. Patients were attributed to a PCP or medical specialist annually based on a preponderance of ambulatory care visits and categorized according to whether attribution ch...
Source: Journal of General Internal Medicine - April 1, 2021 Category: Internal Medicine Source Type: research

Letter to the Editor in Response to: Early Skill Decay After Paracentesis Training
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - April 1, 2021 Category: Internal Medicine Source Type: research

Compliance with CDIM-APDIM Guidelines for Department of Medicine Letters: an Opportunity to Improve Communication Across the Continuum
ConclusionsAdherence to published guidelines for DOM LORs varies but is generally low. For program directors desiring transparent data to use in application review, clearly defined data on student performance, stratification groupings, and common language across schools could improve the utility of DOM LORs. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Establishing Crosswalks Between Common Measures of Burnout in US Physicians
ConclusionsOur findings allow healthcare organizations using the PFI or MZSIB to compare group-level scores to historical, regional, or national MBI scores (and vice-versa). (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Disparities in H1N1 Vaccination Rates: a Systematic Review and Evidence Synthesis to Inform COVID-19 Vaccination Efforts
DiscussionEfforts to avoid disparities in COVID-19 vaccination uptake should prioritize vaccine accessibility and convenience in African American/Black, Latino, and low-SES communities; engage trusted stakeholders to share vaccine information; and address concerns about vaccine safety and efficacy.Primary Funding SourceDepartment of Veterans Affairs, Veterans Health Administration, Health Services Research& Development.Protocol RegistrationPROSPERO CRD42020187078 (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Increased Driving Distance to Screening Colonoscopy Negatively Affects Bowel Preparation Quality: an Observational Study
ConclusionsIncreasing driving distance to screening colonoscopy was negatively associated with adequate bowel preparation but not adenoma detection. Among an academic medical center population, the likelihood of adequate bowel preparation was highest in patients traveling 30 miles or less to their screening colonoscopy. Patient driving distance to colonoscopy is an important consideration in optimizing screening colonoscopy quality. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Comparison of National Data Sources to Assess Preventive Care in the US Population
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Death of the Hypothesis: Researchers Do Not Report A Priori Beliefs in General Medicine Journals
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

Leveraging patient-centered approaches to discuss firearm storage safety
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 31, 2021 Category: Internal Medicine Source Type: research

State Legislators ’ Divergent Social Media Response to the Opioid Epidemic from 2014 to 2019: Longitudinal Topic Modeling Analysis
AbstractBackgroundThe opioid epidemic is widely recognized as a legislative priority, but there is substantial variation in state adoption of evidence-based policy. State legislators ’ use of social media to disseminate information and to indicate support for specific initiatives continues to grow and may reflect legislators’ openness to opioid-related policy change.ObjectiveWe sought to identify changes in the national dialogue regarding the opioid epidemic among Democratic and Republican state legislators and to estimate changing partisanship around understanding and addressing the epidemic over time.DesignLo...
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Advanced Inpatient Management of Opioid Use Disorder in a Patient Requiring Serial Surgeries
This report includes a presentation of the case and a discussion of the clinical decision making and relevant literature to give hospitalbased providers a perspective on management of peri-operative patients on MOUD. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

The Patient Care Ownership Scale: External Validation of an Instrument that Measures Patient Care Ownership Among Internal Medicine Trainees —a Multi-Institutional Study
AbstractBackgroundPatient care ownership improves accountability, clinical skills, and quality of patient care among resident physicians, but appears to be gradually eroding. Research is limited by the lack of a reliable, objective measure of ownership.ObjectiveTo validate the Patient Care Ownership Scale, an instrument that measures decision ownership among internal medicine residents.DesignMulti-institutional, cross-sectional study using a 66-item, online survey that queried residents on ownership ’s key constructs (advocacy, responsibility, accountability, follow-through, knowledge, communication, initiative, cont...
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Post-traumatic Stress Disorder Among COVID-19 Survivors at 3-Month Follow-up After Hospital Discharge
AbstractBackgroundPost-traumatic stress disorder (PTSD) is a severe but treatable mental disorder that develops after a life-threatening traumatic event. Coronavirus disease 19 (COVID-19) hospitalisation is a potentially traumatic experience, especially in severe cases. Furthermore, the unprecedented context of the severe acute respiratory syndrome coronavirus 2 pandemic, with daily media bombardment about COVID-19 mortality, may have amplified life-threatening perception also in patients with moderate infection. The aim of this study was to assess the prevalence and risk factors of PTSD at 3-month follow-up in patients ho...
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

“This happens all the time”: a Qualitative Study of General Internists’ Experiences with Discriminatory Patients
ConclusionsGeneral internists practicing in academic settings reported observing or experiencing discrimination from patients based on the physician ’s race, ethnicity, gender (or their intersection), and disability status and the ethical dilemma of providing care to such patients. These results contribute to growing evidence of the need for institutions to better support an increasingly diverse physician workforce with policies and specific g uidance to help physicians respond to discrimination from patients while still providing quality care. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Medical Spanish in US Medical Schools: a National Survey to Examine Existing Programs
ConclusionsRecommended next steps for medical schools include formalizing medical Spanish courses as electives or required curricula; hiring and/or training faculty educators; incorporating learner assessment; and granting credit for student course completion. Future studies should evaluate implementation strategies to establish best practice recommendations beyond basic standards. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Primary Care Practices Providing a Broader Range of Services Have Lower Medicare Expenditures and Emergency Department Utilization
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Exploring Medication Abortion Training in an Internal Medicine Primary Care Residency Program
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Preventing Chronic Diseases After Complicated Pregnancies in the COVID-19 Era: a Call to Action for PCPs
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

Physician Perceptions of Catching COVID-19: Insights from a Global Survey
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

An Approach to Selecting Single or Multiple Social Risk Factors for Clinic-Based Screening
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research

See One, Do One, Edit One: the JGIM Editorial Fellowship
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - March 29, 2021 Category: Internal Medicine Source Type: research