The Personal Doctoring Manifesto: A Perspective from the Keystone IV Conference
The Keystone IV Conference was a touchstone moment for multigenerational conversations regarding our health care system and an opportunity to reconnect with the values of personal doctoring as a vocation. It inspired participants to renew commitments to relationships, healthy communities, and social change. Keystone IV was also a stark reminder of the need to rekindle family medicine's counterculture flame in today's tumultuous health care environment and reclaim the role of personal doctors in American society. Reimagining and reigniting the fire of personal relationship is today's counterculture movement for primary care...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: DeVoe, J. E., Barnes, K., Morris, C., Campbell, K., Morris-Singer, A., Westfall, J. M., Grumbach, K. Tags: Special Communications Source Type: research

Accelerating Momentum Toward Improved Health for Patients and Populations: Family Medicine as a Disruptive Innovation--A Perspective from the Keystone IV Conference
This paper was prepared in follow up to the G. Gayle Stephens Keystone IV Conference by authors who attended the conference and are also members of the Family Medicine for America's Health board of directors (FMAHealth.org). It connects the aspirations of the current strategic and communications efforts of FMAHealth with the ideas developed at the conference. The FMAHealth project is sponsored by 8 national family medicine organizations and seeks to build on the work of the original Future of Family Medicine project. Among its objectives are a robust family physician workforce practicing in a continually improving medical ...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Stream, G., DeVoe, J. E., Hughes, L. S., Phillips, R. L. Tags: Special Communications Source Type: research

Patient Relationships and the Personal Physician in Tomorrow's Health System: A Perspective from the Keystone IV Conference
A group of senior leaders from the early generation of academic family medicine reflect on the meaning of being a personal physician, based on their own clinical experiences and as teachers of residents and students in academic health centers. Recognizing that changes in clinical care and education at national and local systems levels have added extraordinary demands to the role of the personal physician, the senior group offers examples of how the discipline might go forward in changing times. Differently organized care such as the Family Health Team model in Ontario, Canada; value-based payment for populations in large h...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Colwill, J. M., Frey, J. J., Baird, M. A., Kirk, J. W., Rosser, W. W. Tags: Special Communications Source Type: research

The Generation in Between: A Perspective from the Keystone IV Conference
Keystone IV affirmed the value of relationships in family medicine, but each generation of family physicians took away different impressions and lessons. "Generation III," between the Baby Boomers and Millennials, reported conflict between their professional ideal of family medicine and the realities of current practice. But the Keystone conference also helped them appreciate core values of family medicine, their shared experience, and new opportunities for leadership. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Chen, F. M., Bliss, E., Dunn, A., Edgoose, J., Elliott, T. C., Maxwell, L. C., Morris, C. G., Phillips, R. L. Tags: Special Communications Source Type: research

A Countercultural Heritage: Rediscovering the Relationship-Centered and Social Justice Roots of Family Medicine--A Perspective from the Keystone IV Conference
The 2015 G. Gayle Stephens Keystone conference convened a cohort of primary care professionals to discuss what promises personal physicians will make to their patients going forward. New physicians were prompted to rediscover the foundational values of and historic context for family medicine. At the heart of this rediscovery was learning of the writings and teachings of Dr. G. Gayle Stephens, a founder of family medicine who emphasized the essentiality of relationship-centered care and social justice to the new specialty. Dr. Stephens viewed family medicine as being in a countercultural relationship to mainstream medicine...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Waters, R. C., Stoltenberg, M., Hughes, L. S. Tags: Special Communications Source Type: research

People Are Primary: A Perspective from the Keystone IV Conference
As a person invested in personal doctoring, what promises are you willing to make about when and where you will "be there" for others? Attendees of the G. Gayle Stephens Keystone IV Conference answered that question on submitted index cards and through ongoing conference discussions. Those data were analyzed using grounded theory and combined to develop the following answer in aggregate: We will be held accountable to those who need us. We understand the need for expertise and compassion as we help others to navigate the intersection of science and humanism. We will serve as leaders in personal, public, and polit...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Etz, R. S. Tags: Special Communications Source Type: research

Holding On and Letting Go: A Perspective from the Keystone IV Conference
This commentary examines what it might look like to be countercultural in the current era of health care change, and asks what we should hold onto and what we should let go of as we reinvent an ideal that gives meaning to family physicians and value to patients and populations – that primary health care is a relationship to be nurtured and supported, not just a commodity to be delivered and optimized, measured and incentivized, bought and sold. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Stange, K. C. Tags: Special Communications Source Type: research

The Time of Our Lives: A Perspective from the Keystone IV Conference
We often experience time as a commodity–in excess for those who suffer; in scarcity for those who minister to them. But it is also a teacher, a tool, and a generous yardstick for measuring one's career–if we take the time to reflect on it. This is an essay about time and timing as a doctor negotiates the practice of medicine. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Loxterkamp, D. Tags: Special Communications Source Type: research

Changing Places: Where Will We Be with Our Patients? A Perspective from the Keystone IV Conference
Dr. Stephens knew a lot about place—his place within family medicine and the place of family medicine as a catalyst for change in our communities. In "G. Gayle Stephen's Festschrift," the evolution of our profession is mirrored by Dr. Stephen's seminal contributions to practice and service to his discipline. He describes our place as healers, teachers, scholars, builders, moral agents, professionals, and reformers. Stephen's place-changing career and ethos pave the way for our place as advocates for our patients and change agents for family medicine in this newest millennium. (Source: Journal of the America...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Griswold, K. S. Tags: Special Communications Source Type: research

Unfilled Hunger: Seeking Relationships in Primary Care--A Perspective from the Keystone IV Conference
This article reviews the importance of healing relationships in the craft of family medicine and several of the forces that have undermined the ability to achieve effective healing relationships. Several directions forward are recommended and a promise shared. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Miller, W. L. Tags: Special Communications Source Type: research

Recharging Family Medicine: A Perspective from the Keystone IV Conference
This article provides reflections based on decades of observation and study and confirms that knowing something and doing something are not the same. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Stevens, R. A. Tags: Special Communications Source Type: research

G. Gayle Stephens and Wrestling the Bear: A Perspective from the Keystone IV Conference
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Frey, J. J. Tags: Special Communications Source Type: research

Reimagining Our Relationships with Patients: A Perspective from the Keystone IV Conference
Substantial efforts to redesign health care delivery are underway in the United States, including primary care, without attention to what has historically been known as "the personal physician." The American Board of Family Medicine Foundation convened the Keystone IV Conference to reflect on the nature of personal doctoring and particularly what promises personal physicians might appropriately make and keep with their patients, going forward in new systems of care. This commentary describes the conference and its participants and provides an overview of manuscripts prepared by attendees that together comprise a ...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Green, L. A., Puffer, J. C. Tags: Commentary Source Type: research

Reducing Burden, Ensuring Competence, Improving Quality, and Enhancing Professionalism: How Can ABFM Contribute to All?
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Phillips, R. Tags: Board News Source Type: research

Response: Re: Over Half of Graduating Family Medicine Residents Report More Than $150,000 in Educational Debt
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Bazemore, A. Tags: Correspondence Source Type: research

Re: Over Half of Graduating Family Medicine Residents Report More Than $150,000 in Educational Debt
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Westfall, J. M., Marvel, K. Tags: Correspondence Source Type: research

Evaluating the Evidence for Choosing WiselyTM in Primary Care Using the Strength of Recommendation Taxonomy (SORT)
Conclusion: We found that a majority of primary care–relevant Choosing Wisely recommendations are based on expert consensus or disease-oriented evidence. Further research is warranted to strengthen the evidence base supporting these recommendations in order to improve their acceptance and implementation into primary care. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Lin, K. W., Yancey, J. R. Tags: Brief Reports Source Type: research

The Performance of Fertility Awareness-based Method Apps Marketed to Avoid Pregnancy
Conclusion: Relying solely on an app to use an FABM, without appropriate training in the method, may not be sufficient to prevent pregnancy. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Duane, M., Contreras, A., Jensen, E. T., White, A. Tags: Brief Reports Source Type: research

Antibiotic Prophylaxis for Patients with a History of Total Joint Replacement
As the population ages and people remain active into the 7th and 8th decades of life, the frequency of total joint replacement is increasing. Following joint replacement surgery, patients inevitably require various invasive procedures as part of their routine health maintenance, including, but not limited to, dental care, colonoscopy, cystoscopy, and cardiac catheterization. There is scant evidence to support the use of periprocedural prophylactic antibiotics in the prevention of late total joint infection. The guidelines for the usage of periprocedural antibiotics have changed as knowledge of the pathophysiology of joint ...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: DeFroda, S. F., Lamin, E., Gil, J. A., Sindhu, K., Ritterman, S. Tags: Clinical Review Source Type: research

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable
Primary care panel sizes are an important component of primary care practices. Determining the appropriate panel size has implications for patient access, physician workload, and care comprehensiveness and will have an impact on quality of care. An often quoted standard panel size is 2500. However, this number seems to arise in the literature anecdotally, without a basis in research. Subsequently, multiple studies observed that a panel size of 2500 is not feasible because of time constraints and results in incomplete preventive care and health care screening services. In this article we review the origins of a panel size o...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Raffoul, M., Moore, M., Kamerow, D., Bazemore, A. Tags: Special Communication Source Type: research

System Transformation in Patient-Centered Medical Home (PCMH): Variable Impact on Chronically Ill Patients' Utilization
Conclusions: Because the association of health care utilization with PCMH transformation varied by transformation domain and patient diagnosis, practice leaders need to be supported by research incorporating detailed measures of PCMH transformation. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Carlin, C. S., Flottemesch, T. J., Solberg, L. I., Werner, A. M. Tags: Original Research Source Type: research

Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?
Conclusions: These findings support the usefulness of the PCMH model in managing patients with CP, but patient outcomes need to be addressed in future studies. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Elder, N., Penm, M., Pallerla, H., Vonder Meulen, M. B., Short, A. D., Diers, T., Imhoff, R. J., Wilson, B., Boone, J. M. Tags: Original Research Source Type: research

Communicating Findings of Delayed Diagnostic Evaluation to Primary Care Providers
Conclusion: Strategies to communicate to PCPs information on delayed follow-up of findings suspicious for cancer were useful, but not fail-safe. Additional back-up strategies, such as using case coordinators, might be needed. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Meyer, A. N. D., Murphy, D. R., Singh, H. Tags: Original Research Source Type: research

C-Reactive Protein Level as Diagnostic Marker in Young Febrile Children Presenting in a General Practice Out-of-Hours Service
Conclusions: In general practice CRP has little clinically relevant value in discriminating febrile children in need of medical care from those who are not. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Kool, M., Elshout, G., Koes, B. W., Bohnen, A. M., Berger, M. Y. Tags: Original Research Source Type: research

Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension
Conclusions: Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Manard, W., Scherrer, J. F., Salas, J., Schneider, F. D. Tags: Original Research Source Type: research

Family Medicine Panel Size with Care Teams: Impact on Quality
Purpose: The demand for comprehensive primary health care continues to expand. The development of team-based practice allows for improved capacity within a collective, collaborative environment. Our hypothesis was to determine the relationship between panel size and access, quality, patient satisfaction, and cost in a large family medicine group practice using a team-based care model. Methods: Data were retrospectively collected from 36 family physicians and included total panel size of patients, percentage of time spent on patient care, cost of care, access metrics, diabetic quality metrics, patient satisfaction surveys,...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Angstman, K. B., Horn, J. L., Bernard, M. E., Kresin, M. M., Klavetter, E. W., Maxson, J., Willis, F. B., Grover, M. L., Bryan, M. J., Thacher, T. D. Tags: Original Research Source Type: research

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention
The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care–based childhood obesity intervention. Methods: A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Jortberg, B. T., Rosen, R., Roth, S., Casias, L., Dickinson, L. M., Coombs, L., Awadallah, N. S., Bernardy, M. K., Dickinson, W. P. Tags: Original Research Source Type: research

Who is Using Telehealth in Primary Care? Safety Net Clinics and Health Maintenance Organizations (HMOs)
Despite rapid advancements in telehealth services, only 15% of family physicians in a 2014 survey reported using telehealth; use varied widely according to the physician's practice setting or designation. Users were significantly more likely than nonusers to work in federally designated "safety net" clinics and health maintenance organizations (HMOs) but not more likely than nonusers to report working in a patient-centered medical home (PCMH) or accountable care organization. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Coffman, M., Moore, M., Jetty, A., Klink, K., Bazemore, A. Tags: Policy Brief Source Type: research

Telehealth: A Very Useful Tool That Enables and Improves Patient Access
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Doarn, C. R. Tags: Commentary Source Type: research

Research in Family Medicine by Family Physicians for the Practice of Family Medicine
This issue lays out challenges for family medicine researchers. Each article increases our understanding of solutions to common problems in family medicine, yet with each, one can readily see the next challenge based on the newly gained knowledge. One of the goals of the JABFM is to encourage research in family medicine for family medicine. Here we combine our usual editors' notes with thoughts about what the next research studies could, and hopefully will, be. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Bowman, M. A., Neale, A. V., Seehusen, D. A. Tags: Editors ' Note Source Type: research

"The End of the Beginning" for Clinical Simulation in the ABFM Self-Assessment Modules (SAMs)
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Hagen, M. D., Sumner, W., Roussel, G. H. Tags: Board News Source Type: research

Re: The Diversity of Providers on the Family Medicine Team
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Pippitt, K., Gunning, K., Traylor, K. Tags: Correspondence Source Type: research

Response: Re: The Use of Medical Scribes in Health Care Settings: A Systematic Review and Future Directions
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Shultz, C. G., Holmstrom, H. L. Tags: Correspondence Source Type: research

Re: The Use of Medical Scribes in Health Care Settings: A Systematic Review and Future Directions
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Martel, M. L., Imdieke, B. H. Tags: Correspondence Source Type: research

Community Vital Signs: Taking the Pulse of the Community While Caring for Patients
In 2014 both the Institute of Medicine and the National Quality Forum recommended the inclusion of social determinants of health data in electronic health records (EHRs). Both entities primarily focus on collecting socioeconomic and health behavior data directly from individual patients. The burden of reliably, accurately, and consistently collecting such information is substantial, and it may take several years before a primary care team has actionable data available in its EHR. A more reliable and less burdensome approach to integrating clinical and social determinant data exists and is technologically feasible now. Comm...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Hughes, L. S., Phillips, R. L., DeVoe, J. E., Bazemore, A. W. Tags: Special Communication Source Type: research

Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico
Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinic...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Page-Reeves, J., Kaufman, W., Bleecker, M., Norris, J., McCalmont, K., Ianakieva, V., Ianakieva, D., Kaufman, A. Tags: Brief Reports Source Type: research

Vanished Twins and Misdiagnosed Sex: A Case Report with Implications in Prenatal Counseling Using Noninvasive Cell-Free DNA Screening
Cell-free DNA testing is a recently introduced method for screening pregnant women for fetal trisomy, which is associated with some common significant genetic diseases, as well as the sex of the fetus. The case described here demonstrates the connection between the ultrasound "vanishing twin" phenomenon and the misdiagnosis of prenatal sex using cell-free DNA testing. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Kelley, J. F., Henning, G., Ambrose, A., Adelman, A. Tags: Brief Reports Source Type: research

"Basal Cell Blanche": A Diagnostic Maneuver to Increase Early Detection of Basal Cell Carcinomas
Basal cell carcinomas represent one of the most common skin cancers and often present initially in the primary care setting. Subtle basal cell carcinomas may be difficult to detect, and early detection of these carcinomas remains important in limiting patient morbidity. In this article, we present a simple diagnostic maneuver, "basal cell blanche," to increase early detection of basal cell carcinomas. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Quach, O. L., Barry, M., Roberts Cruse, A., Wilson, B. B. Tags: Brief Reports Source Type: research

Signs of Insufficiency Fractures Overlooked in a Patient Receiving Chronic Bisphosphonate Therapy
We present a case study of a patient taking bisphosphonate with 2 years of chronic pain, and characteristic clinical signs of bisphosphonate-associated incomplete stress fractures that went untreated until the patient suffered from a right subtrochanteric complete fracture. Our goal is to make physicians aware of the signs of insufficiency fractures associated with chronic bisphosphonate therapy such that appropriate clinical decisions are made to optimize the quality of patient care. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Shaikh, W., Morris, D., Morris, S. Tags: Brief Reports Source Type: research

Hearing Loss Health Care for Older Adults
This article reviews hearing health care for older adults, focusing on what is most relevant for family physicians. The objective of hearing loss treatment is to ensure that a patient can communicate effectively in all settings. We present the 5 major obstacles to obtaining effective hearing and rehabilitative care: awareness, access, treatment options, cost, and device effectiveness. Hearing technologies are discussed, along with recommendations on when it is appropriate to screen, refer, or counsel a patient. The purpose of this article is to provide pragmatic recommendations for the clinical management of the older adul...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Contrera, K. J., Wallhagen, M. I., Mamo, S. K., Oh, E. S., Lin, F. R. Tags: Clinical Review Source Type: research

Integrating Behavioral Health in Primary Care Using Lean Workflow Analysis: A Case Study
The objectives of this study were to observe BH integration into primary care and to measure its impact. Methods: This was a prospective, mixed-methods case study in a primary care practice that served 8,426 patients over a 17-month period, with 652 patients referred to BH services. Secondary measures included primary care visits resulting in BH referrals, referrals resulting in scheduled appointments, time from referral to the scheduled appointment, and time from the referral to the first visit. Providers and staff were surveyed on the Lean method. Results: Referrals increased from 23 to 37 per 1000 visits (P
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: van Eeghen, C., Littenberg, B., Holman, M. D., Kessler, R. Tags: Original Research Source Type: research

Higher Referrals for Diabetes Education in a Medical Home Model of Care
Background: The medical home model has been gaining attention from the health care community as a strategy for improved outcomes for management of chronic disease, including diabetes. The purpose of this study was to compare referrals for diabetes education among patients receiving care from a medical home model versus a traditional practice. Methods: Data were obtained from a large, university-affiliated primary care patient data registry. All patients (age 18–96 years) with a diagnosis of prediabetes or diabetes and seen by a physician at least twice during 2011 to 2013 were selected for inclusion. Multivariate re...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Manard, W. T., Syberg, K., Behera, A., Salas, J., Schneider, F. D., Armbrecht, E., Hooks-Anderson, D., Crannage, E., Scherrer, J. Tags: Original Research Source Type: research

Use of Point-of-Care Tests (POCTs) by US Primary Care Physicians
Conclusions: Findings show that a variety of point-of-care tests are used by US family physicians for immediate diagnosis and monitoring. With continuing technical improvements and decreasing costs, it is highly likely that POCT use will increase dramatically. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Sohn, A. J., Hickner, J. M., Alem, F. Tags: Original Research Source Type: research

Impact of Social Determinants of Health on Patients with Complex Diabetes Who Are Served by National Safety-Net Health Centers
Conclusions: There is still unexplained variability relating to both baseline HbA1c values and change over time in the model. SDHs, such as insurance status and primary language, are associated with HbA1c, and results suggest that these relationships vary with disease status among patients with diabetes in safety-net centers. It is important to recognize that there are complex relationships among demographic and SDH measures in complex patients, and there is work to be done in correctly modeling and understanding these relationships. We also recommend prioritizing the collection of SDH and enabling services data for safety...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Li, V., McBurnie, M. A., Simon, M., Crawford, P., Leo, M., Rachman, F., Cottrell, E., Dant, L., Oneha, M., Chang Weir, R. Tags: Original Research Source Type: research

Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care
Conclusion: Collecting data on social determinants of health through a self-administered survey, and linking them to a patient's chart, is feasible and acceptable. A modified survey is now administered to all patients. Such data are already being used to identify health inequities, develop novel interventions, and evaluate their impact on health outcomes. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Pinto, A. D., Glattstein-Young, G., Mohamed, A., Bloch, G., Leung, F.-H., Glazier, R. H. Tags: Original Research Source Type: research

The Adolescent "Expanded Medical Home": School-Based Health Centers Partner with a Primary Care Clinic to Improve Population Health and Mitigate Social Determinants of Health
We describe the implementation of an "expanded medical home" partnering a primary care practice (the Ypsilanti Health Center [YHC]) with local school-based health centers (the Regional Alliance for Healthy Schools [RAHS]), and to assess whether this model improves access to and quality of care for shared patients. Methods: Using the Consolidated Framework for Implementation Research, we define the steps in, barriers to, and facilitating factors in implementing the expanded medical home model. Visits and quality measures were assessed for patients seen by YHC only versus YHC/RAHS at baseline and during the interv...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Riley, M., Laurie, A. R., Plegue, M. A., Richarson, C. R. Tags: Original Research Source Type: research

The Impact of Community Engagement on Health, Social, and Utilization Outcomes in Depressed, Impoverished Populations: Secondary Findings from a Randomized Trial
Conclusions: A coalition approach to improving outcomes for low-income clients with depression, particularly those involved in the justice system, may offer additional benefits over standard technical assistance programs. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Lam, C. A., Sherbourne, C., Tang, L., Belin, T. R., Williams, P., Young-Brinn, A., Miranda, J., Wells, K. B. Tags: Original Research Source Type: research

Primary Care Continuity Improves Diabetic Health Outcomes: From Free Clinics to Federally Qualified Health Centers
Conclusions: This study demonstrates the utility of a linkage program from free clinics to FQHCs. Those individuals with diabetes receiving health care from an FQHC demonstrated improved glycemic control. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Mehta, P. P., Santiago-Torres, J. E., Wisely, C. E., Hartmann, K., Makadia, F. A., Welker, M. J., Habash, D. L. Tags: Original Research Source Type: research

Disrupting the Pathways of Social Determinants of Health: Doula Support during Pregnancy and Childbirth
Conclusions: Access to doula services for pregnant women who are at risk of poor birth outcomes may help to disrupt the pervasive influence of social determinants as predisposing factors for health during pregnancy and childbirth. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Kozhimannil, K. B., Vogelsang, C. A., Hardeman, R. R., Prasad, S. Tags: Original Research Source Type: research

Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study
Conclusions: Incorporation of ACE screening during routine care is feasible and merits further study. ACE screening offers clinicians a more complete picture of important social determinants of health. Primary care–specific interventions that incorporate treatment of early life trauma are needed. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Glowa, P. T., Olson, A. L., Johnson, D. J. Tags: Original Research Source Type: research