Search

Today's electronic health records provide electronic charting, Web-based communication, and clinical decision support--a triple convergence that is revolutionizing how health care is delivered. [ABSTRACT FROM AUTHOR]

From simple e-mail messages to integrated EMR systems, online communication can enhance your patient care. [ABSTRACT FROM AUTHOR]

Pregnancy in women older than 35 is usually considered 'high-risk,' but several recent studies suggest maternal age makes little difference in outcome. How can you pinpoint the genuine risks involved? [ABSTRACT FROM AUTHOR]

Find out what it takes to communicate successfully with patients online -- and get reimbursed for it. [ABSTRACT FROM AUTHOR]

Background and Objectives: Physicians routinely discuss adverse effects of medications, but whether discussions match older patients' desire for information is unexplored. This study compares patient preferences for adverse effect discussions with reported physician practice., Methods: Cross-sectional survey of a convenience sample of 100 practicing primary care physicians from 9 medical groups and 178 patients recruited from 11 senior centers in the Los Angeles metropolitan area. Physicians listed the adverse effects they typically discuss when prescribing an ACE inhibitor. Patients were given a hypothetical scenario about a new medication prescription, and were asked to circle the three adverse effects they most wanted to hear about from a list., Results: More than 90 % of patients wanted a physician to discuss medication adverse effects: they wanted information about both dangerous (75 % of patients) and common (66 % of patients) adverse effects. However, patients most commonly chose to hear about adverse effects occurring for < 1 % of patients and selected a wide range of adverse effects for discussion. Physicians reported most frequently educating patients about more common and life-threatening adverse effects. Patients who wanted to discuss more adverse effects were more worried about adverse effects than those wishing to hear fewer (4.0 vs. 3.4 on a 5-point Likert scale; p = 0.02)., Conclusions: For the studied medication, there was little concordance between the medication adverse effects physicians say they discuss and what patients want to hear. Physicians cannot practically verbally satisfy patients' information desires about the adverse effects of new medications during time-compressed office visits. Innovative solutions are needed.

These are historic times for family medicine. The profession is moving beyond the visionary blueprint of the Future of Family Medicine (FFM) report while working to harness the momentum created by the FFM movement. Preparing for, and leading through, the next transformative wave of change (FFM version 2.0) will require the engagement of multigenerational and multidisciplinary visionaries who bring wisdom from diverse experiences. Active group reflection on the past will potentiate the collective work being done to best chart the future. Historical competency is critically important for family medicine's future. This article describes the historical context of the development and launch of the FFM report, emphasizing the professional activism that preceded and followed it. This article is intended to spark intergenerational dialog by providing a multigenerational reflection on the history of FFM and the evolution that has occurred in family medicine over the past decade. Such intergenerational conversations enable our elders to share wisdom with our youth, while allowing our discipline to visualize history through the eyes of future generations., (© Copyright 2014 by the American Board of Family Medicine.)

Ian McWhinney, MD, who passed away 1 year ago this month, was a founder of family medicine in North America. As a social philosopher and a naturalist, he had a great influence on the development of family medicine.

A growing number of Americans will soon have a Web-based personal medical home with connectedness to their chosen providers of care. The personal health record will become integrated with the electronic health record. Like other services on the Internet, patients will be able to direct much of their health care using clinical guidelines, such as prevention, chronic illness care, behavior change, and arrangement for minor acute care. Physician control and autonomy will give way to greater patient control over their care, a major culture change in medicine away from paternalism. While the personal family physician will continue as a primary caregiver, there will be a shift toward greater patient involvement in the coordination of care. Family medicine educators should begin now to educate medical students and residents for this new model of care.

Hypothyroidism is a common disease that is often undiagnosed or misdiagnosed because the signs and symptoms are often confused with other conditions. These conditions include hyperlipidemia, depression, various gynecologic conditions, and even the normal aging process. While overt hypothyroidism is usually easily recognized, individuals with mild thyroid failure often present a greater diagnostic and therapeutic challenge.

Family Medicine residency programs must change substantially to prepare for new family physicians a model of practice for the 21st century. This article describes 10 essential skills that are part of a new model of family medicine and the educational changes and resources needed to obtain them. These skills include management of a population of patients, patient-centered care, personal medical home, best knowledge at the point of care, continuous access to multimodal communication, a new platform of care, time intensive visits, group visits, teamwork and interpersonal skills, and financial practice management.

Background and Objectives: There are few reports of systematic international physician development programs to create family medicine as a new specialty in a developing nation. This paper describes the process and outcomes of a large-scale effort to initiate new family medicine training through the Egyptian Ministry of Health and Population (MOHP) using a 12-week US-based program at the University of California, Irvine (UCI)., Methods: Generalist physicians (n=134) with 1 year of internship training, currently working under the MOHP in Egypt, were competitively selected to participate in a training program at UCI between 1998 and 2002. Participants were assessed before, during, and after the program using multiple measures of competencies in family medicine topics, practice, and teaching. Aggregate participant data, post-program quality surveys, and follow-up surveys of the program's influence on practice behaviors comprised the main measures used for program evaluation., Results: Participants showed improvement in knowledge and skills for family medicine practice and teaching for topics covered in the program. After returning to Egypt, 98% reported continued use of their newly acquired skills and knowledge. Participants reported that the program advanced their careers, they taught family medicine to other physicians, and they were likely to pursue certification under a newly established Family Medicine Board of Egypt. Self-reported practice in family medicine increased to 69% after the program versus 16% before., Conclusions: Overseas training programs are a viable method of introducing family medicine as a new clinical specialty. Ingredients for successful implementation and barriers are discussed.