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Sponsorship describes a set of actions wherein an influential champion (sponsor) uses their position to actively support a colleague's career by helping them gain visibility, recognition, and/or positions. There is growing awareness of the importance of sponsorship for career advancement in academic medicine, particularly for women and those who are historically underrepresented and excluded in medicine (UIM). This scoping review examines the current landscape of evidence, and knowledge gaps, on sponsorship as it relates to career advancement in academic medicine for women and UIM faculty. We searched peer-reviewed literature in PubMed, Embase, and Web of Science (WoS) over the past 50 years (from 1973 through July 2023). Sixteen studies were included in the final review. We found relative consensus on sponsorship definition and value to career advancement. Heterogeneity in study design limited our ability to directly compare study outcomes. All included studies focused on gender differences in sponsorship: two of four quantitative studies found men were more likely to receive sponsorship, one reported no gender differences, and one was insufficiently powered. All but one of the qualitative studies reported gender differences, with women less likely to access or be identified for sponsorship. The mixed-methods studies suggested sponsorship may vary by career stage. Only two studies analyzed sponsorship for UIM populations. The existing data are inconclusive regarding best ways to measure and assess sponsorship, what institutional support (e.g., structured programs, formal recognition, or incentives for sponsorship) should look like, and at what career stage sponsorship is most important. Addressing this knowledge gap will be critically important for understanding what sponsorship best practices, if any, should be used to promote equity in career advancement in academic medicine. We advocate for commitment at the institutional and national levels to develop new infrastructure for transparently and equitably supporting women and UIM in career advancement. [ABSTRACT FROM AUTHOR]

This Perspective presents a case study of multidimensional clinical transformation in an academic general internal medicine practice. In the face of increasing internal and external pressures, health systems and individual medical practices have pursued multiple strategies to improve quality, patient experience, and efficiency, while reducing staff and provider stress and burnout. We describe a Lean-informed approach that emphasizes the importance of organizational alignment in goals, evidence-based problem solving, and leadership behaviors to support a culture of continuous improvement. Our aim in this Perspective is to provide a real-world example of a feasible process for the planning, preparation, and execution of effective transformation, and to present lessons that may be useful to other academic health center practices seeking to develop innovative models to achieve the quadruple aim. [ABSTRACT FROM AUTHOR]

The authors reflect on the end of their tenure as editors of the "Journal of General Internal Medicine" (JGIM). Topics covered include the number of manuscript submissions and published articles between July 2009 and September 2017, impact factor of JGIM, and the value of the service of peer reviewers to the journal and the academic community.

The article focuses on the peer review approach of the "Journal of General Internal Medicine" and presents a list of the journal's reviewers for 2015-2016, including Christopher Bautista, Thomas Campion and Lovie Foster.

Healthcare workers would be thrilled to stay at workplaces that demonstrate respect for their tremendous sacrifices, value workers above financial incentives,[5] and acknowledge and address moral injury. In this context, Americans are leaving their jobs in an exodus called "The Great Resignation"; physicians and other healthcare workers (HCWs) are no exception.[1] Indeed, all types of HCWs are departing their jobs, thus putting additional pressure on physicians and healthcare organizations.[2] Healthcare leaders, trying to reestablish viable frameworks for care after the pandemic, may be unaware of these changes. Costs of leaving due to burnout are high, estimated at 4 billion dollars annually in the USA.[1] In addition, as reported by NPR, the job exodus is in part existential with many HCWs having "pandemic epiphanies" about how they want to live their lives. [Extracted from the article]

The article discusses the peer review in academic publishing in the "Journal of General Internal Medicine" in which accusations of haplessness and irrelevancy were cited as premature. It argues that accusations of former editor Richard Smith and rumors of demise are not universally embraced and peer review at the journal mirrors democracy. A list of JGIM reviewers who volunteered their time and expertise and have provided a total of 1061 reviews is also noted. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of peer review and several peer reviewers. A 2007 Cochrane Review noted that editorial peer review seems to make articles more readable and enhances reporting's general quality. It lists several peer reviewers who did at least two reviews from July 2010-June 2011, brought back the reviews in 30 days, and got a quality score on all reviews including Elmer Abbo, Barbara Berger, and Samantha Chao.

BACKGROUND: 'Difficult visits' are common in primary care and may contribute to primary care provider (PCP) career dissatisfaction and burnout. Patient requests occur in approximately half of primary care visits and may be a source of clinician-patient miscommunication or conflict, contributing to perceived visit difficulty. OBJECTIVE: We aimed to determine associations between types of patient requests and PCP-perceived visit difficulty. DESIGN: This was an observational study, nested in a multicenter randomized trial of depression engagement interventions. SUBJECTS: We included 824 patient visits within 135 PCP practices in Northern California occurring from June 2010 to March 2012. MAIN MEASURES: PCP-perceived visit difficulty was quantified using a three-item scale (relative visit difficulty, amount of effort required, and amount of time required; Cronbach's α = 0.81). Using linear regression, the difficulty scale (score range 0-2 from least to most difficult) was modeled as a function of: patient requests for diagnostics tests, pain medications, and specialist referrals; PCP perception of likely depression or likely substance abuse; patient sociodemographics, comorbidity, depression; PCP characteristics and practice setting. RESULTS: Patients requested diagnostic tests, pain medications, and specialist referrals in 37.2, 20.0 and 30.0 % of visits, respectively. After adjustment for patient medical and psychiatric complexity, perceived difficulty was significantly higher when patients requested diagnostic tests [parameter estimate (PE) 0.11, (95 % CI: 0.03, 0.20)] but not when patients requested pain medications [PE −0.04 (95 % CI: −0.15, 0.08)] or referrals [PE 0.04 (95 % CI: −0.07, 0.25)]. CONCLUSIONS: PCP-perceived visit difficulty is associated with patient requests for diagnostic tests, but not requests for pain medications or specialist referrals. In this era of 'choosing wisely,' PCPs may be challenged to respond to diagnostic test requests in an evidence-based manner, while maintaining the provider-patient relationship and PCP career satisfaction. [ABSTRACT FROM AUTHOR]

People whom the editors would like to thank for their assistance in the creation of the journal are mentioned.

BACKGROUND: Despite improvements in the diagnosis and treatment of depression, primary care provider (PCP) discussion regarding suicidal thoughts among patients with depressive symptoms remains low. OBJECTIVE: To determine whether a targeted depression public service announcement (PSA) video or an individually tailored interactive multimedia computer program (IMCP) leads to increased primary care provider (PCP) discussion of suicidal thoughts in patients with elevated risk for clinical depression when compared to an attention control. DESIGN: Randomized control trial at five different healthcare systems in Northern California; two academic, two Veterans Affairs (VA), and one group-model health maintenance organization (HMO). PARTICIPANTS: Eight-hundred sixty-seven participants, with mean age 51.7; 43.9 % women, 43.4 % from a racial/ethnic minority group. INTERVENTION: The PSA was targeted to gender and socio-economic status, and designed to encourage patients to seek depression care or request information regarding depression. The IMCP was an individually tailored interactive health message designed to activate patients to discuss possible depressive symptoms. The attention control was a sleep hygiene video. MAIN MEASURES: Clinician reported discussion of suicidal thoughts. Analyses were stratified by depressive symptom level (Patient Health Questionnaire [PHQ-9] score < 9 [mild or lower] versus ≥ 10 [at least moderate]). KEY RESULTS: Among patients with a PHQ-9 score ≥ 10, PCP discussion of suicidal thoughts was significantly higher in the IMCP group than in the control group (adjusted odds ratio = 2.33, 95 % confidence interval = 1.5, 5.10, p = 0.03). There were no significant effects of either intervention on PCP discussion of suicidal thoughts among patients with a PHQ-9 score < 9. CONCLUSIONS: Exposure of patients with at least moderate depressive symptoms to an individually tailored intervention designed to increase patient engagement in depression care led to increased PCP discussion of suicidal thoughts. [ABSTRACT FROM AUTHOR]

People who the author would like to thank for their assistance in serving as peer reviewers for the "Journal of General Internal Medicine" are presented.

In this article, editors of the "JGIM: Journal of General Internal Medicine" acknowledge people including Michael Barrett, Karen Chacko and Gary Ellison who have served as peer reviewers for the journal over the past 12 month.

The article offers information related to the "Journal of General Internal Medicine" (JGIM). It states that the JGIM featured new columns which include From the Editor's Desk, Exercises in Clinical Reasoning, and Healing Arts. It says that JGIM will renew the Innovations in Medical Education, provide article series on health policy, and collaborate with the "Annals of Internal Medicine." It also presents the lists of JGIM reviewers from 2009-2010 including Elmer Abbo, Lisa Hess, and Jenny Yi.

Background: Diagnostic and treatment delay in depression are due to physician and patient factors. Patients vary in awareness of their depressive symptoms and ability to bring depression-related concerns to medical attention.Objective: To inform interventions to improve recognition and management of depression in primary care by understanding patients' inner experiences prior to and during the process of seeking treatment.Design: Focus groups, analyzed qualitatively.Participants: One hundred and sixteen adults (79% response) with personal or vicarious history of depression in Rochester NY, Austin TX and Sacramento CA. Neighborhood recruitment strategies achieved sociodemographic diversity.Approach: Open-ended questions developed by a multidisciplinary team and refined in three pilot focus groups explored participants' "lived experiences" of depression, depression-related beliefs, influences of significant others, and facilitators and barriers to care-seeking. Then, 12 focus groups stratified by gender and income were conducted, audio-recorded, and analyzed qualitatively using coding/editing methods.Main Results: Participants described three stages leading to engaging in care for depression - "knowing" (recognizing that something was wrong), "naming" (finding words to describe their distress) and "explaining" (seeking meaningful attributions). "Knowing" is influenced by patient personality and social attitudes. "Naming" is affected by incongruity between the personal experience of depression and its narrow clinical conceptualizations, colloquial use of the word depression, and stigma. "Explaining" is influenced by the media, socialization processes and social relations. Physical/medical explanations can appear to facilitate care-seeking, but may also have detrimental consequences. Other explanations (characterological, situational) are common, and can serve to either enhance or reduce blame of oneself or others.Conclusions: To improve recognition of depression, primary care physicians should be alert to patients' ill-defined distress and heterogeneous symptoms, help patients name their distress, and promote explanations that comport with patients' lived experience, reduce blame and stigma, and facilitate care-seeking. [ABSTRACT FROM AUTHOR]

Introduction: The global medical technology industry brings thousands of devices to market every year. However, significant gaps persist in the scientific literature, in the medical device approval process, and in the realm of postmarketing surveillance. Although thousands of drugs obtain approval only after review in randomized controlled trials, relatively few new medical devices are subject to comparable scrutiny.Objective: To improve health outcomes, we must enhance our scrutiny of medical devices, and, without simply deferring to the Food and Drug Administration, we must ask ourselves: Who is responsible for evaluating the safety and effectiveness of medical devices?Conclusions: Technology assessments by independent organizations are a part of the solution to this challenge and may motivate further research focused on patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Providing antidepressant information to patients may foster greater adherence to therapy.Objective: To assess physician information-giving while prescribing antidepressants, and to identify factors that influence the provision of information.Design: Randomized experiment using standardized patients (SPs). Standardized patients roles were generated by crossing 2 clinical conditions (major depression or adjustment disorder) with 3 medication request types (brand-specific, general, or none).Participants: One hundred and fifty-two general internists and family physicians recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%.Measurements: We assessed physician information-giving by analyzing audio-recordings of interactions between physicians and SPs, and collected physician background information by survey. Generalized estimating equations were used to examine the influence of patient and physician factors on physicians' provision of information.Results: One hundred and one physicians prescribed antidepressants, accounting for 131 interactions. The mean age of physicians was 46.3 years; 69% were males. Physicians mentioned an average of 5.7 specific topics of antidepressant-related information (of a possible maximum of 11). The most frequently mentioned topic was purpose (96.1%). Physicians infrequently provided information about the duration of therapy (34.9%) and costs (21.4%). Standardized patients who presented with major depression received less information than those with adjustment disorder, and older and solo/private practice physicians provided significantly less information to SPs.Conclusions: Physicians provide limited information to patients while prescribing antidepressants, often omitting critical information that may promote adherence. Mechanisms are needed to ensure that patients receive pertinent antidepressant information. [ABSTRACT FROM AUTHOR]

Background: Referral from primary care to the mental health specialty sector is important but poorly understood.Objective: Identify physician characteristics influencing mental health referral.Design: Randomized controlled trial using Standardized Patients (SPs).Setting: Offices of primary care physicians in 3 cities.Participants: One hundred fifty-two family physicians and general internists recruited from 4 broad practice settings; 18 middle aged Caucasian female actors.Intervention: Two hundred and ninety-eight unannounced SP visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder.Measurements: Mental health referrals via SP written reports; physician and system characteristics through a self-administered physician questionnaire.Results: Among 298 SP visits, 107 (36%) resulted in mental health referral. Referrals were less likely among physicians with greater self-confidence in their ability to manage antidepressant therapy (adjusted odds ratio [AOR] 0.39, 95% confidence interval [CI] 0.17 to 0.86) and were more likely if physicians typically spent > or =10% of professional time on nonclinical activities (AOR 3.42, 95% CI 1.45 to 8.07), had personal life experience with psychotherapy for depression (AOR 2.74, 95% CI 1.15 to 6.52), or usually had access to mental health consultation within 2 weeks (AOR 2.94, 95% CI 1.26 to 6.92).Limitation: The roles portrayed by SPs may not reflect the experience of a typical panel of primary care patients.Conclusions: Controlling for patient and health system factors, physicians' therapeutic confidence and personal experience were important influences on mental health referral. Research is needed to determine if addressing these factors can facilitate more appropriate care. [ABSTRACT FROM AUTHOR]

Objective: To determine whether internists in the United States and China have different ideas and behaviors regarding informing patients of terminal diagnoses and HIV/AIDS, the role of the family in end-of-life decision making, and assisted suicide.Design: Structured questionnaire of clinical vignettes followed by multiple choice questions.Setting: University and community hospitals in San Francisco and Beijing, China.Subjects: Forty practicing internists were interviewed, 20 in China and 20 in the United States.Measurements and Main Results: Of the internists surveyed, 95% of the U.S. internists and none of the Chinese internists would inform a patient with cancer of her diagnosis. However, 100% of U.S. and 90% of Chinese internists would tell a terminally ill patient who had AIDS, rather than advanced cancer, about his diagnosis. When family members' wishes conflicted with a patient's preferences regarding chemotherapy of advanced cancer, Chinese internists were more likely to follow the family's preferences rather than the patient's preferences (65%) than were the U.S. internists (5%). Thirty percent of U.S. internists and 15% of Chinese internists agreed with a terminally ill patient's request for sufficient narcotics to end her life.Conclusions: We found significant differences in clinical ethical beliefs between internists in the United States and China, most evident in informing patients of a cancer diagnosis. In general, the Chinese physicians appeared to give far greater weight to family preferences in medical decision making than did the U.S. physicians. [ABSTRACT FROM AUTHOR]

The article explores the evolution of medical education in the U.S. The author reflects on her own medical school education as she approaches nearly 30 years since her graduation from the University of California School of Medicine in San Francisco. She discusses changes to the curriculum of medical schools and the promotion of diversity in medical education.

The article reflects on dropping primary care practitioner or primary care physician as it no longer indicates current and emerging roles as general internists in primary care. Topics discussed include focus of generalist physicians on high-acuity and high-complexity presentations and collaboration by primary care teams; changes in medical decision making and rise in medical care demand; and need of a new term that can do the same for ambulatory-based generalists.

An introduction is presented, in which the author discusses various reports within the issue on topics including reduction of patient requests for overused medical services in altruism, imaging for acute low back pain, and public awareness of and exposure to physicians.

An introduction to the journal is presented in which the editors discuss various articles published within the issue on topics which include medical care strategies, access to medical care, and caring for older people.

An introduction is presented in which the editor discusses articles in the issue on topics including primary care reinvention, patient-centered care, and improvement of the quality of mental health services delivery.

Burnout is prevalent among primary care physicians and contributes to job turnover and poor patient care.[1] Interventions addressing adverse work conditions may reduce burnout.[2] We evaluated the impact of workflow and workload interventions targeted to physician-reported concerns following participation in a national academic general internal medicine burnout survey.[1] Mini-Z Burnout and Work Conditions Survey Responses Before and After Implementation of Interventions Targeted to Physician Concerns. [Extracted from the article]

An introduction is presented in which the editor discusses various reports within the issue on topics including the risks of having guns at home, anger and mental depression management, and gun violence as public health issue.

An introduction to articles in this issue is presented including systematic review of the effectiveness of motivational interviewing (MI) on medication adherence, a randomized trial of 3006 current smokers at four Veterans Affairs Medical Centers (VA) and a randomized trial of an organ donation video.

An introduction is presented in which the editor discusses reports within the issue including a study on prescribing of opioid at hospital discharge to opioid-naïve patients, and a study of adult patients who screened positive for use of illicit drug or misuse of prescription drug.

An introduction is presented in which the editor discusses various reports within the issue on topics including the religious and spiritual concerns of medical inpatients, the instruments used to evaluate spirituality in clinical research, and the Cucumber Purification at Gochizan Renge-ji Temple in Kyoto, Japan.

An introduction is presented wherein the editor discusses various reports in the issue on topics regarding the importance of an international perspective in clinical practice and research in general internal medicine and the factors influencing HTN care in rural Kenya.

The author reflects on the publication of articles on health disparities and their impact on racial and ethnic minorities by the "Journal of General Internal Medicine" to emphasize the need to eliminate them. He discusses the results of a study conducted by researcher H. R. Perez and colleagues on the health care experiences of adults who stutter and the prevalence of stuttering. He states that the study suggests the need for people to observe the possible manifestations of health disparities. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses various reports within the issue on topics including health communication, physicians' experiences with training, and the effect of antibiotics on acute upper respiratory infections.

An introduction is presented in which the editor discusses various reports within the issue on topics including internal medicine, physician education and competence, and patients care.

An introduction is presented in which the editor discusses various reports within the issue on topics including intimate partner violence (IPV), opioid prescribing in primary medical care, and screening for IPV.

An introduction is presented in which the editor discusses various reports published within the issue on topics including the challenges facing general internal medicine, innovations in health care practice and policy, and health information and communication technology.

The article discusses a new approach to medical/ behavioral integration by primary care behaviorist (PCB) in the U.S. The prevalence and organizational demands of three different approaches to integration of depression care in primary care practices in the Department of Veteran Affairs (VA) has been reported. PCBs are needed to help care for the great majority of patients with these problems who because of stigma, poor access to behavioral health providers.

An introduction is presented in which the editor discusses stress management and resiliency-training programs (SMART) for medicine physicians and the impact of the 2003 duty hour reform in the U.S. on resident burn-out and well-being.

An introduction is presented in which the editors discuss reports within the issue on topics including the improvement of patient depression follow-up by online messaging, proposed standards for patients' do not resuscitate (DNR) medical status, and the effect of health care reform to general internists.

An introduction is presented in which the editor discusses various reports within the issue on topics including deficient evidence to guide medical care for elderly, biases and limitations of observational studies, and the paid non-family caregivers' ability to provide elderly with appropriate care.

The article discusses various reports published within the issue including one by Roslyn Weaver on the principles of clear communication, building safe and reliable systems, one on the factors that influence rejecting opportunities to enroll in hospice and on the process of medical decision making for incapacitated and hospitalized adults.

An introduction is presented in which the editor discusses various reports within the issue on topics including medical care for older people, health literacy, and health care communication.

An introduction to the journal is presented in which the editor discusses various reports within the issue on topics including mentoring in academic medical education, mentoring relationship, and Japanese medical model.

The author discusses the current issue of the periodical "Journal of General Internal Medicine." He reports that readers expectations and quality bar has been raised during the tenure of earlier editors. He discusses the introduction of several new features including the "Exercises in Clinical Reasoning" and "Healing Arts" features in the periodical. He further discusses an article submitted by writer Abraham Verghese in the "Text and Context" feature of the periodical.

The article presents an overview of the author's views on the new challenges in graduate medical education published in "Journal of General Internal Medicine." The Accreditation Council for Graduate Medical Education (ACGME), first responded in the 1990s with loosely enforced work hours limitations, which varied widely by specialty. The ACGME "outcomes project" changed the accreditation currency from process and structure to outcome. Program directors must now provide more than a schedule of rotations, a written curriculum and agreements with clinical training venues.

An introduction is presented in which the editor discusses various reports within the issue on topics including a clinical trial relating to primary care, the impact of the patient-centered medical home (PCMH), and a randomized controlled trial to reduce readmissions.

An introduction is presented in which the editor discusses various reports within the issue on topics including communication behaviors of academic hospitalists in Baltimore, Maryland, significant use of electronic health records, and health problems of returning veterans from Iraq and Afghanistan.

A response by Mitchell D. Feldman to a letter to the editor about his article "From the Editor's desk: Physician heal thyself" in the 2011 issue is presented.

An introduction is presented in which the editor discusses various reports within the issue on topics including the importance of obtaining access to a source of care for insured patients, the relationship between quality of care and socio-economic characteristics of Medicare patients, and on an intensive and condensed literacy-adapted self-management course.

An introduction is presented in which the editor discusses various reports within the issue on topics including mental health needs and barriers to care among older Asian Americans in the U.S., psychotherapy for patients with treatment resistant depression, and predictors and outcomes of difficult patient encounters in primary care.

An introduction to the journal is presented in which the editor discusses various reports published within the April 1, 2011 issue including one on clinical decision-making, one on extent to which practicing doctors in Geneva, Switzerland, use disease prevalence when interprets a positive test result and one on audiotape code status discussions between patients and physicians.