News Article | May 28, 2017
The American Board of Family Medicine (ABFM) is pleased to announce the election of four new officers and four new board members. The new officers elected at the ABFM’s spring board meeting in April are: Elizabeth Baxley, MD of Greenville, North Carolina elected as Chair; Jerry Kruse, MD of Springfield, Illinois as Chair-Elect; Montgomery Douglas, MD of West Hartford, Connecticut as Treasurer, and Joseph Gravel, Jr., MD of Lawrence, Massachusetts as Member-at-Large, Executive Committee. In addition, the ABFM welcomes this year’s new members to the Board of Directors: Beth Bortz of Richmond, Virginia; Lauren Hughes, MD, MPH, MSc of Philadelphia, Pennsylvania, John Mellinger, MD of Springfield, Illinois, and Daniel Spogen, MD of Sparks, Nevada. The new ABFM officers will each serve a one-year term: Dr. Baxley is a Professor of Family Medicine and Senior Associate Dean for Academic Affairs at the Brody School of Medicine at East Carolina University, where she has served since 2012. Before joining the faculty at Brody, she spent 18 years at the University of South Carolina School of Medicine, serving as Residency Director and later as Chair of the Department of Family and Preventive Medicine. Dr. Kruse is a Professor in both the Department of Family & Community Medicine and Medical Education as well as Dean and Provost of the Southern Illinois University School of Medicine. Prior to this, Dr. Kruse spent 9 years as the Executive Director of the Quincy Family Medicine Programs, and 19 years on the faculty of the Quincy Family Practice Residency Program; serving as Assistant Program Director for 9 years and as Program Director for 12 years. Dr. Douglas is Chair of the Department of Family Medicine at the University of Connecticut School of Medicine and Saint Francis Hospital and Medical Center. He previously served as Chairman of the Department of Family and Community Medicine and Associate Dean for Diversity and Inclusion at New York Medical College. Dr. Gravel is the Chief Medical Officer and the Chair of Family Medicine & Community Health at the Greater Lawrence Family Health Center. He served as a residency program director for 20 years. He is a Past President of the Association of Family Medicine Residency Directors, the Massachusetts Academy of Family Physicians, and the Family Medicine Education Consortium. He currently also serves as Chair of the Academic Family Medicine Advocacy Committee and on the Society of Teachers of Family Medicine's Board of Directors. Dr. Gravel is a Professor of Family Medicine & Community Health at the University of Massachusetts Medical School. The ABFM welcomes four new members to the Board of Directors: Ms. Bortz is the President and CEO of the Virginia Center for Health Innovation, a nonprofit established in 2012 to accelerate the adoption of value-driven health care in the Commonwealth. Ms. Bortz currently serves on the Board of Directors of Virginia Health Information, LEAD Virginia, and the Maggie L. Walker Governor’s School Foundation. Dr. Hughes is a practicing family physician and Deputy Secretary for Health Innovation in the Pennsylvania Department of Health. Prior to joining the Department, she was a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan where she studied health services research. Dr. Mellinger is a professor of surgery at Southern Illinois University, where he also serves as Chair of the Division of General Surgery and Program Director of the General Surgery Residency. He is a member of the Board of Directors of the American Board of Surgery. Dr. Spogen is a professor at the University of Nevada School of Medicine, where he also serves as Chair of the school’s Department of Family Medicine and as the Director of Medical Education. He is also the Medical Director and Faculty Advisor of the school’s Student Outreach Clinic. Dr. Spogen recently served as a Director on the AAFP’s Board of Directors. The remaining current members of the Board are: Wendy Biggs, MD of Overland Park, Kansas; John Brady, MD of Newport News, Virginia; Colleen Conry, MD of Aurora, Colorado; Christopher A. Cunha, MD of Crestview Hills, Kentucky; Lorna Anne Lynn, MD of Philadelphia, Pennsylvania; Michael K. Magill, MD of Salt Lake City, Utah; Robert J. Ronis, MD, MPH of Cleveland, Ohio; David E. Soper, MD of Charleston, South Carolina; Keith Stelter, MD of Mankato, Minnesota, and Melissa Thomason of Pinetops, North Carolina.
News Article | May 23, 2017
By all indications, and due to months of wet weather, there is a booming mosquito season underway in Sonoma County. While officials call for diligence, asking homeowners to scout for any open water sources that can be emptied or eliminated, healthcare providers are looking at potential health concerns. Along with the annoying buzz of mosquitos is the buzz associated with potential infections stemming from their itchy bites, namely Zika and West Nile. “One good thing is that we don’t need to be too concerned about Zika,” explains Dr. William A. Markoff NCMA Family Practice Physician. “This virus has been linked to birth defects in Central and South America but authorities tell us that the mosquitoes known to transmit this virus are not in our area. Concerns over mosquito transmitted viruses this year remains focused on West Nile Virus, which – while most people suffer few to no symptoms, can cause serious problems in others including neurological issues.” Last year there were 442 cases of West Nile reported in California, with 10 of those in the nine-county Bay Area. West Nile Virus generally results in mild flu-like symptoms in some people, while others have no symptoms and suffer no consequence at all. A small segment of the population seems to be vulnerable to the more serious symptoms that includes swelling of the brain and potentially; death. Although there is a vaccine to prevent it, West Nile Virus can also be fatal to horses, and particularly birds. Of the 176 known mosquito species in the United States there are roughly 20 mosquito varieties common to Northern California, and most of those will be out in force this year. Early mosquito prevention is key to protecting public health. This means scouting property for pools of standing water that mosquitos might find inviting and keeping an eye out for other potential incubating sites including wet tarps, tires, plastic containers, tin cans, jars, buckets, etc. District managers have also begun ground and aerial spraying to control mosquito activity where necessary. The best – and most difficult advice to take following a mosquito bite is; don’t scratch. Scratching creates openings on the surface of the skin which allows bacteria in and can cause infection. To relieve the itch and lower chances of an infection there are some time-honored techniques which include: “Although extremely rare, if a mosquito bite does result in a fever or causes vomiting, or shortness of breath it would be advisable to seek medical attention immediately,” adds Dr. Markoff. NCMA Family Medicine physicians provide services at offices in Lakeport, Santa Rosa, and Petaluma. NCMA philosophy is based on the fact that early screening and detection can result in less acute episodes of illness that can be devastating both physically and financially. Family medicine physicians provide primary health care for people at every stage of life. For more information about Dr. Markoff and all NCMA medical services visit the website at ncmahealth.com.
News Article | May 9, 2017
By employing a patient-centered medical home (PCMH) model of care, Boston Medical Center's (BMC) Adult Primary Care Practice successfully treated 66 patients with the hepatitis C virus (HCV), or one-fifth of those referred into the program, using new oral medications between March 2015 and April 2016. A PCMH is a model of primary care focused on comprehensive, team-based, and coordinated care that is accessible to all patients and centered on quality and safety. BMC's multidisciplinary team approach demonstrates that physicians in primary care settings can deliver HCV care and is important to expand HCV treatment. Previous studies have shown that general internists can successfully deliver HCV care for underserved patients in primary care settings. Historically, HCV was treated with injections of interferon, a treatment that often caused debilitating side effects. There are few studies, however, describing treatment models in the era of newer oral medications for HCV. The oral regimens are simple to prescribe, have few side effects, and treatment is effective across patient populations. These factors enable primary care providers (PCPs) to successfully deliver this type of treatment. Overall, 302 patients were referred to HCV treatment through the primary care program, and approximately 22 percent ended up receiving treatment - a substantial number considering some patients were immediately referred to specialists because of other health conditions, were already engaged in treatment, or were ineligible due to active substance use that affected patients' abilities to attend appointments and adhere to a daily regimen of medication. According to Clinical Infectious Diseases, HCV causes 15,000 liver deaths annually in the United States. Urban safety-net hospitals and other settings that serve large populations of patients with substance use disorders are a prime location for HCV treatment delivery. A 2015 study showed that treatment of HCV genotype 2 or 3 infection and patients with cirrhosis is cost-effective. BMC's PCMH team included a public health social worker, PCPs trained to treat HCV, a pharmacy technician and a pharmacist. The social worker's responsibilities were similar to those of patient navigators, who have played an important role in improving individual and population health over the past few years in various clinical settings. Patients approved for treatment met with their PCP provider three times during the program; the pharmacist also met with patients to provide education about the medication, the importance of adherence, and possible adverse effects, as well as to provide monitoring on treatment. "A multidisciplinary team was really the key to the program's success," said Karen Lasser, MD, MPH, the founding medical director of the program, an internal medicine physician at BMC, and corresponding author of a new paper on the PCMH model, which was published this week in the Annals of Family Medicine. "For example, the social worker played an integral role, guiding patients from referral through completion of treatment, and helping address several other social determinants of health that may have prevented these patients from getting treatment." The social worker also provided reminder calls about appointments, assistance with insurance and transportation issues, and addressed patients' income, housing, and other behavioral, emotional and social needs. Referrals to counseling, substance use treatment, and job training were made when appropriate. "This primary care HCV treatment program shows real promise through its impressive outcomes for curing selected patients of HCV," said Lasser, who is also is an associate professor of medicine and public health at Boston University Schools of Medicine and Public Health. "While our model employed general internists, family medicine physicians could implement a similar program." Dr. Lasser cautions that despite receiving enhanced social work services and using a PCMH model of care, substance use likely prevented many patients from engaging in and completing treatment.
News Article | May 10, 2017
SOUTHAMPTON, 10-May-2017 — /EuropaWire/ — An interactive website developed by health psychology and primary care researchers at the University of Southampton has been shown to reduce dizziness amongst adults aged 50 and above. Results of a study into the effectiveness of the new Balance Retraining site show patients had significantly lower levels of dizziness symptoms after three and six months than those accessing standard care from their GP. After three months, 40 percent of people using the site reported that they felt ‘much better’ or ‘completely well’ – twice as many as in the GP care group. Dizziness affects nearly one in three people aged over 65 in the UK and is often caused by problems with the vestibular (balance) organ in the inner ear. Patients with ‘vestibular dizziness’, such as those examined in this study, can suffer severe symptoms, triggered by simple everyday movements like turning over in bed, or looking left and right to cross the road. These symptoms are very disruptive – leading to falls, anxiety, depression and loss of independence. The recommended treatment is a simple exercise-based therapy called vestibular rehabilitation, which involves nodding and shaking the head. Previous research has shown that patients using this therapy are nearly three times more likely to reduce their dizziness than those who don’t. However, very few people who report dizziness to their doctor are referred for this type of treatment, so there is a real need to improve access. Researchers at the University of Southampton developed Balance Retraining to address this problem and help people with dizziness to carry out vestibular rehabilitation exercises via the Web – using video demonstrations, instructions and personalised feedback and advice. Lucy Yardley, Professor of Health Psychology at the University of Southampton, says: “Balance Retraining has been designed to be very straightforward to use and provides individuals with information and instruction about techniques they can use to reduce their dizziness. The vestibular rehabilitation exercises are very quick and easy to carry out, and work by encouraging the body’s balance system to re-adjust to the movements that trigger dizziness symptoms.” The Balance Retraining study included 296 patients with vestibular-related dizziness. These patients were randomly assigned to either have immediate access to the website, or to continue with usual care from their GP. The complete findings are published in the journal Annals of Family Medicine. Dr Adam Geraghty, a research psychologist at the University of Southampton added: “Users were very positive about their experiences. They found it easy to use, visually appealing and encouraging. Overall, the results show that Balance Retraining is an effective and appealing method of delivering vestibular rehabilitation to those who need it. They also add to existing evidence that this is a safe and effective means of treating vestibular-related dizziness.” Professor Paul Little, a GP and Professor of Primary Care Research at the University of Southampton said: “Dizziness is both common and disabling and most sufferers don’t get access to effective treatment. The Balance Retraining intervention has huge potential to provide effective and easily accessible treatment for a really under-served patient group in primary care.” Balance Retraining can be accessed here and via The Meniere’s Society, or the Vestibular Disorders Association. Professor of Health PsychologyProfessor Lucy Yardley is Professor of Health Psychology at University of Southampton and University of Oxford. Dr Adam Geraghty is Senior Research Fellow within Medicine at the University of Southampton. His research involves the application of psychological science to challenging issues in primary medical care. As a research psychologist, Dr Geraghty has developed interventions to support patients in self-managing problems such as back pain, severe emotional distress and chronic dizziness. He is interested in how digital interventions can be used to deliver and increase access to treatment, and also how they can help researchers understand why interventions work. Dr Geraghty draws on a diverse range of approaches including randomised controlled trials, cross sectional studies and qualitative methods to address questions with the aim of improving the health of patients.
News Article | May 9, 2017
The analysis of more than 225,000 healthcare and medical job postings placed by 6,377 hospitals and healthcare organizations on Health eCareers during 2016 also reveals other encouraging trends such as the physician specialties with the most growth, the top 10 most in-demand non-physician positions, and other notable growth spots within the industry. The Physician Specialties with the Most Growth A whopping 53 percent of job postings on Health eCareers in 2016 were for physicians and surgeons, a 20 percent increase over 2015. Under the physician heading, the specialties with the most growth were Family Medicine, OB/GYN, and Gastroenterology. In today's highly competitive market, healthcare organizations are also adding a number of incentives to their physician contracts. According to the report, health, malpractice, and disability insurance are the three most common physician-recruitment incentives, although relocation expenses and signing bonuses are becoming more common as well. The Top 10 Most In-Demand Non-Physician Positions Nurses, Nurse Practitioners (NPs) and Physician Assistants (PAs) accounted for 31 percent of job postings on Health eCareers in 2016, with employers advertising more than 70,000 positions for these roles. Within Nursing, 75 percent of postings were for Registered Nurses, with General Medical/Surgical and Emergency Room Nurses being most in demand. Family Medicine topped the list for both PAs and NPs. The report concluded that, since U.S. states are easing practice laws for PAs and NPs, patients can expect more access to them in the future, along with expanded telemedicine options. Other Notable Growth Spots Physicians and nurses are not the only healthcare occupations enjoying continued growth. U.S. News and World Report recently ranked the top 100 jobs for 2017 and discovered that 21 of the top 25 spots (including the top three) belong to healthcare-related positions. Dentist, NP and PA are the top three; other top-25 healthcare positions include: Nurse Anesthetist (#6), Pediatrician (#7), Optometrist (#11), Midwife (#15), Registered Nurse (#22) and Occupational Therapist (#23). Conclusion Although Physician/Surgeon and Nursing positions continue to account for the majority of job postings on Health eCareers, all job seekers within the wide-ranging field of healthcare can be optimistic about 2017 and beyond. For more information on healthcare job trends, download the full 2016 Healthcare Jobs Snapshot. About the Survey The Health eCareers 2016 Healthcare Jobs Snapshot is based on data collected from the Health eCareers online database of job openings, which are placed by healthcare employers and recruiters all across the U.S. Data was collected from January 1 to December 31, 2016, and encompasses 225,529 healthcare and medical job postings placed by 6,377 hospital and healthcare organizations. These organizations range from large health systems to single-specialty practices, with an average hospital size of 300 beds. About Health eCareers Healthcare is all about connection, and Health eCareers is the healthcare industry's career hub for professionals, employers and associations. With a network of more than 2.4 million job seekers, thousands of healthcare employers and more than 100 exclusive association partners, Health eCareers is designed to match qualified healthcare professionals – from physicians and nurses to non-clinical staff – with medical providers looking for top talent. And with the addition of SHIFT, Health eCareers has also become the destination to find temporary healthcare work. But Health eCareers is more than just a place to look for your next job — it's a resource to help you advance your career at every stage. That's why Health eCareers also includes industry news and career advice targeted to your healthcare specialty. For employers, Health eCareers offers innovative recruiting tools and services and healthcare hiring data that you won't find anywhere else. To learn more, visit healthecareers.com or find us on Facebook and Twitter. Health eCareers is a DHI Group, Inc. service. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/health-ecareers-predicts-healthcare-jobs-growth-in-2017-300453689.html
News Article | May 8, 2017
Evaluating the degree to which primary care across Canada comports with the goals of the Patient Medical Home model, researchers find considerable room for improvement. Researchers from the Manitoba Centre for Health Policy applied 10 measurable indicators of the PMH model across all 10 Canadian provinces and found an average national PMH composite score of 5.36 (range 4.75-6.23) out of 10 based on survey data from 772 primary care practices and 7,172 patients. Ontario was the only province to score significantly higher than Canada as a whole, whereas Quebec, Newfoundland/Labrador, and New Brunswick/Prince Edward Island scored below the national average. The researchers found little variation, however, among provinces in achieving the 10 PMH goals. The researchers point out that although the PMH is a pan-Canadian model, implementation is dependent on provincial and regional or local policies, and during the past 15 years, new primary care funding models have been introduced without consistency in timing, key model components or implementation strategies across provinces. The authors call for future research into the effects of reform on practice characteristics and processes, and assessment of health services utilization and quality measures for clinical conditions. The information gleaned from these activities, they posit, may motivate further uptake of the PMH model's attributes in all provinces. Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study Video visits are being adopted in a variety of health care settings, including primary care, because they offer increased care accessibility, decreased transportation barriers and patient empowerment. In a qualitative study of 19 adult patients interviewed following video visits with their primary care clinician, researchers found patients accept and even prefer video visits to in-person office visits. Participants reported feeling comfortable talking with their clinicians over a video call, and they identified convenience and decreased costs as the primary benefits of video visits. Some patients expressed a preference for receiving future serious news via a video visit citing reasons of comfort, social support and privacy. Primary concerns with video visits concerned privacy, including potential for work colleagues to overhear conversations, and questioning the ability of the clinician to perform an adequate physical examination. The authors conclude these findings add insight into the benefits of video visits in primary care, highlighting improved convenience, efficiency, privacy and comfort for patients. The findings also raise new considerations unique to telehealth that warrant discussion with patients before use, such as whether patients would consider using headphones or finding a private room to maintain privacy during video visits outside of the home. Chronic dizziness is highly prevalent in primary care, with nearly 7 million consultations per year in the United States. Researchers find a publicly-available, self-directed Internet-based vestibular rehabilitation program effectively reduces dizziness and dizziness-based disability in older primary care patients without requiring clinical support. The randomized controlled trial involving 296 patients aged 50 years and older with dizziness exacerbated by head movements found that compared with the usual care group, patients in the Internet-based rehabilitation group had less dizziness on the Vertigo Symptom Scale-Short Form at three months (difference 2.75 points) and at six months (difference 2.26 points). Dizziness-related disability was also lower in that group at three months (difference 6.15 points) and six months (5.58 points). Given the increasing Internet use being seen in older adults, the authors conclude Internet-based interventions may provide a promising means of greatly increasing the provision of evidence-based self-management strategies for adults in primary care. This article is featured in this issue's Annals Journal Club, which provides a template for groups to discuss and critically assess articles. It will also launch Annals' Twitter journal club. Those interested can participate in the conversation on Wednesday, May 31 from 12-1 p.m. EST (4 p.m. GMT), hashtag #AJC. This moderated Twitter chat will pose questions at regular intervals. Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care Researchers examine the potential of health information technology to systematically guide patients through decision making processes for three cancer screening choices and find that although automated decision aids have the potential to make office visits more efficient and effective, cultural, workflow and technical changes are needed before widespread implementation. Specifically, this observational cohort study evaluated how clinicians and patients at 12 primary care practices used an automated decision module that promoted the 2012 prostate, 2009 breast and 2008 colon cancer screening recommendations made by the U.S. Preventive Services Task Force, and how that module impacted care. They found practices had a large decision burden - with one in five patients facing a cancer screening decision over the one-year study period. Yet, of the 11,458 patients who faced a screening decision for colorectal cancer (6,329 patients), breast cancer (3,733 patients) or prostate cancer (1,396 patients), only 21 percent started and 8 percent completed the decision module. User data showed patients reviewed a range of topics while in the module and 47 percent of the module completers elected to forward a summary to their clinician. After their next office visit, both patients and clinicians reported that module completion helped with decisions: 41 percent said it made their appointment more productive, 48 percent said it helped engage them in the decision, 48 percent said it broadened their knowledge and 38 percent said it improved communication. The authors conclude that while the model is appealing, a clear challenge is getting patients to use such a system. If future research confirms the benefits of this approach - yielding more informed patients, better decisions and wiser use of encounter time - the return on investment could offset the implementation costs and improve care. A content analysis of Medicare's new Merit-Based Incentive Payment System, set to be fully implemented this year, reveals gaps related to the measurement of access, patient experience, and interpersonal care raising concerns that MIPS may fail to measure the broader aspects of health care quality and even risk worsening existing health disparities. Researchers found a total of 143 of the 270 MIPS measures applied to primary care, and most were related to aspects of clinical experience; most of the domains that reflected quality of primary care were not represented. Notably, their analysis showed five of 12 domains had no applicable measures, and only 10 percent of the measures fell into another five domains of primary care. They conclude that for MIPS and similar pay-for-performance programs to have a positive effect on health outcomes for marginalized populations, there is a need for policy makers to apply a theoretical framework to the measures in order to ensure the broad domains of quality, equality in particular, are encapsulated. By applying a theoretical framework, they assert, it is possible to identify gaps and subsequently develop measures that incentivize addressing health disparities. In neglecting to do so, they warn, pay-for-performance measures may fail in their objective to deliver better quality health outcomes to all members of society regardless of wealth, color, or personal circumstances. Impact of Gaps in Merit-Based Incentive Payment System Measures on Marginalized Populations The University of Auckland, New Zealand Primary care patients who have harmed themselves are at a greatly increased risk of dying prematurely by natural and unnatural causes, especially within a year of a self-harm episode. Using electronic health records data from 385 primary care practices in England linked to national mortality records, researchers investigated the risk of dying prematurely from any cause after a recorded episode of self-harm in a cohort of 30,017 patients aged 15 to 64 years. They estimated the relative risks of natural and unnatural mortality using a comparison cohort of 600,258 individuals matched for age, sex and general practice. They found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio, 3.6). In particular, suicide risk was especially high in the first year (adjusted hazard ratio, 54.4). Although it declined sharply after one year, it remained much higher than in the comparison cohort. Large elevations of risk throughout the 10-year follow-up period were also observed for accidental, alcohol-related and drug-poisoning deaths. After 10 years of follow-up, cumulative incidence values were 7 percent for all-cause mortality and 1 percent for suicide. The authors point out that patients with a history of self-harm visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. They call for national guidelines that provide more specific recommendations and training on how primary care teams can more effectively intervene, manage, and monitor risk in these patients. They conclude that patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require a concerted, multi-pronged, multidisciplinary collaborative care approach to effectively manage their complex health needs. Premature Death Among Primary Care Patients With a History of Self-Harm China's commitment to develop a strong primary care system through the establishment of community health centers has succeeded in creating more than 8,600 centers, however researchers seeking to evaluate the current quality of these facilities, find they are underused in part because of public mistrust of the physicians and because few centers are equipped to provide comprehensive primary care for a wide range of common physical and mental conditions. A nationally representative survey of the structure and organization of the Chinese primary care system involving 158 community health centers and 3,580 primary care practitioners found less than one-half (46 percent) of the physicians employed by CHCs were registered as PCPs and few nurses had training specifically for primary care. Moreover, although virtually all clinics were equipped with basic primary care equipment such as stethoscopes (98 percent) and sphygmomanometers (97 percent), only 43 percent had opthalmoscopes and 64 percent had facilities for gynecologic examination. Most CHCs had inpatient beds for their patients; however, only 38 percent had microbiology support and only 53 percent offered Pap screening. Clinical care was selectively skewed toward certain diseases. Although virtually all CHCs provided management of common ailments, chronic diseases, hypertension, diabetes, traditional Chinese medicine, maternal and infant health care, and vaccinations, large proportions did not provide management for other common conditions such as dyslipidemia (38 percent), mental illness (66 percent), sexually transmitted infections (66 percent), and chronic obstructive pulmonary disease (70 percent). Use of services by patients was poor at each CHC: despite serving 50,000 people, the centers had an average of only 41,000 patient contacts a year, and each physician saw a median of only 12.5 patients per day. Based on these findings, the authors conclude that Chinese policymakers need to reconceptualize health care training and policy in order to alter the public perception of primary care in the country. There is a need, they write, to develop tools to evaluate primary care activities more clearly, integrate community-oriented thinking into primary care, and teach an integrated comprehensive approach (such as multidisciplinary teams), rather than selected care with a purely biomedical approach. Bridging the Gaps Between Patients and Primary Care in China: A Nationwide Representative Survey By William C. W. Wong, MD and Sunfang Jiang, MD, et al With major depressive disorder projected to become the single leading cause of global disease burden in high-income countries by 2030, interest in depression prevention has grown in recent decades. Primary care is an ideal setting in which to undertake disease prevention strategies for depression, yet little is known about the effectiveness of psychological and educational interventions to prevent depression in primary care. Researchers in Spain conducted a systematic review of 14 randomized controlled trials involving 7,365 patients to examine the effect of interventions to prevent depression in nondepressed primary care patients and found a modest though statistically significant preventive effect. Specifically, they found a pooled standardized mean difference of -0.163. Based on these findings, the authors conclude the incidence of new episodes of depression could be reduced on average by 26 percent if primary care managers and physicians were to implement programs and interventions to prevent depression. They call for further randomized controlled trials to determine which programs and interventions are most efficient in primary care. Effectiveness of Psychological and Educational Interventions to Prevent Depression in Primary Care: A Systematic Review and Meta-Analysis Hepatitis C virus is a growing public health problem, causing 15,000 deaths annually in the United States. New oral treatment regimens that have few side effects and are effective across genotypes have opened up the possibility of treatment in the primary care setting, but models for doing so in the era of oral therapies are lacking. Researchers in Boston describe a successful HCV treatment program embedded in an urban, safety-net hospital. The program utilizes a novel multidisciplinary approach with primary care physicians, a pharmacist, pharmacy technician, and public health social workers working together to facilitate patient engagement and provide treatment. Funding support for the multidisciplinary staffing model was also novel, emanating from revenue from the 340b drug discount program, which allows providers to generate revenue when patients fill prescriptions at pharmacies in safety-net settings, as insurance reimbursements for medications exceed the cost at which safety-net providers purchase medications. The authors report that over the course of one year, the program received 302 referrals, approximately 23 percent of whom have received treatment. In dueling point/counterpoint articles, researchers debate the value of quality reporting. Internist David R. Scrase, MD, contends that quality reporting can lead to better outcomes for patients but only if stakeholders follow a six-step model he outlines in his editorial. In contrast, family physician David L. Hahn, MD, MS, argues that quality measurement has made him a worse doctor. He calls for improved measures that provide actionable information, align with good clinical practices, promote patient-centered care and shared decision making, encourage reflection and continuous quality improvement, undergo regular evaluation and allow for changes in response to provider input, and do not arbitrarily and spuriously reward or punish clinicians. Point: How Quality Reporting Made Me a Better Doctor The University of New Mexico Medical School, Albuquerque University of Wisconsin School of Medicine and Public Health, Madison In contrast to the high-tech interventions elucidated in the May/June issue, an essay by Edgoose and Edgoose reexamines the human interactions at the core of medicine: the face-to-face encounter. Using the framework provided by the French philosopher and Holocaust survivor Emmanuel Levinas (1906-1995), the authors explore the unique responsibility and potential for hope found only in face-to-face encounters. They write that although these encounters are at the heart of the patient-clinician relationship, their singular significance is often lost amid the demands of today's high-tech, metric-driven health care systems. They conclude that revisiting this most fundamental attribute of medicine is likely clinicians' greatest chance to reclaim who they are and why they do what they do. By Jennifer Y. C. Edgoose, MD, MPH, and Julian M. Edgoose, PhD University of Wisconsin School of Medicine and Public Health, Madison With the May/June issue, Annals of Family Medicine introduces a new feature on Innovations in Health Care - brief one-page articles that describe novel innovations from the front lines of primary care. Each article describes how the innovation works, who implemented it and where it was carried out - information readers need to make decisions about how to transport or reinvent the innovation in their own setting. Articles close with takeaway lessons. Readers can find additional detail in online appendixes and hyperlinks. This issue's innovations include: - Providing "Just-in-Time" Preventive Care Advice - an intervention providing individualized preventive care information to patients when they are waiting to see their health professional so they can act upon it then and there. - Overcoming Obesity One Patient at a Time - an office-based weight loss program that inspires patients to achieve long-term weight loss by making small, incremental diet and lifestyle changes. - Using QR Codes to Connect Patients to Health Information - an initiative to generate and display around the clinic Quick Response codes for online information about common health issues to entertain and educate patients. - Engaging Complex Patients with Drop-In Group Medical Appointments - a program that offers patients with complex social, behavioral health and medical needs drop-in group medical appointments that include a physician, nurse care manager, behavioral health counsel, peer support, a consulting occupational therapist, and a clinical pharmacist. - Blood Pressure Screening in the Dental Office - an initiative that makes blood pressure screening a part of the intake process for oral health patients in member health centers because many patients see a dentist more frequently than a physician. - A Change Model for GPs Serving Deprived Areas - an initiative funded by the Scottish government in response to the "GP crisis" brought about by increasing demands on general practice and difficulties recruiting and retaining GPs particularly in rural areas and areas of socioeconomic deprivation. - Radical Redesign: The Power of Team-Based Care - a team-based care prototype that allows employees to work at the top of their skill sets and meet patients' needs more efficiently and with higher quality and lower cost. Annals of Family Medicine is a peer-reviewed, indexed research journal that provides a cross-disciplinary forum for new, evidence-based information affecting the primary care disciplines. Launched in May 2003, Annals is sponsored by seven family medical organizations, including the American Academy of Family Physicians, the American Board of Family Medicine, the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the College of Family Physicians of Canada. Annals is published six times each year and contains original research from the clinical, biomedical, social and health services areas, as well as contributions on methodology and theory, selected reviews, essays and editorials. Complete editorial content and interactive discussion groups for each published article can be accessed free of charge on the journal's website, http://www.
News Article | February 15, 2017
(PRLEAP.COM)Louisville orthopedic surgeon and sports medicine physician Dr. Stacie Grossfeld is launching a video series focused on ACL Injuries and ACL Injury Prevention. The video series is an adaptation of the Santa Monica ACL Prevention Program. The Santa Monica ACL Prevention Program was created by Dr. Bert Mendelbaum from Santa Monica Sports Medicine. Studies completed in 2001 and again in 2005 showed a 60% reduction rate of ACL injuries in Division 1 female soccer players after implementing the program. Dr. Stacie Grossfeld is double board certified in orthopedic surgery and sports medicine. As a sports medicine physician, Dr. Grossfeld treats many patients suffering from ACL injuries . As reported by the American Academy of Orthopaedic Surgeons there are around 200,000 ACL injuries in the U.S. every year. The majority of these injuries occur in youth athletes participating in soccer, basketball, lacrosse, and football. Dr. Grossfeld wants to focus on ACL Injury Prevention in order to keep young people interested and active in sports while also avoiding an injury that while preventable, sidelines many kids. In fact, 63% of athletes who experience an ACL injury never return to the same level of athletic play that they were competing in prior to injury.Interestingly, the most common reason that athletes do not return to the same level of sports play is psychological. Athletes fear that they will reinjure themselves and after 5 to 6 months of recovery from the initial ACL injury, do not want to risk another tear. Once an ACL injury occurs in an athlete, 20% of them will have recurring ACL injuries and up to 80% of them will develop early onset arthritis. ACL tears most often occur in young athletes who play sports that require a lot of twisting, jumping, and contact. It is also proven that females are 8 times more likely to tear their ACL after they hit puberty. Why? It is thought that the change in neuro muscular development controls the jump in the ACL tear rate.The only way to confirm an ACL injury is through an MRI, but there are three symptoms that are common among ACL injuries. The symptoms include:If you or someone you love is suffering from any of these symptoms, you should seek qualified medical attention for diagnosis and treatment.Dr. Grossfeld's ACL Injury Prevention Program is comprised of 20 to 25 minutes of exercise. If this workout is done 2-3 times a week, as a warm up, it will prevent ACL injuries in both male and female athletes. Not only will it help prevent ACL injuries, but it will also help those who have already suffered from an ACL injury who want to return to sports avoid a second injury.As explained by Dr. Grossfeld: "It is so important in this time and date and age for any athlete who is planning on playing a high risk sport for ACL injury such as soccer, basketball, lacrosse, football, they should be involved in an ACL prevention program. It's so easy. It's only 20 mins three times a week. Use it as a warm up and reduce your athlete's rate of ACL injury at least 50%."There are five components to the ACL Injury Prevention Program:Each component of the program includes multiple exercises that are covered in the video series produced by Dr. Grossfeld. Interestingly, Dr. Grossfeld also discusses a case study that was done on two groups of young adults who had all undergone ACL surgery. One group did the ACL Injury Prevention Program while participating in sports and the other group did not. The group who did the preventative exercises had a recurring injury rate of 5 times less than the group who did not perform the exercises.Dr. Stacie L. Grossfeld is a graduate of the University Of Louisville School Of Medicine. She served her internship and residency at the University of Minnesota, and completed a fellowship in Sports Medicine at the Fowler- Kennedy Sports Medicine Center. Dr. Grossfeld works as an orthopedic surgeon at Orthopaedic Specialists in Louisville, Kentucky. She is Board Certified in both Sports Medicine and in Orthopedic Surgery by the American Board of Orthopedic Surgery (ABOS). Dr. Grossfeld also serves as an Assistant Clinical Professor at the University of Louisville in the Department of Family Medicine.Dr. Grossfeld's special interests as an orthopedic surgeon and sports medicine physician include ACL injuries, knee and shoulder reconstruction, shoulder injuries, and sports medicine. Along with her work at Orthopaedic Specialists and the University of Louisville, Dr. Grossfeld also serves on the Board of Directors for the YMCA at Norton Commons and the Louisville Sports Commission. If you or someone you know needs treatment for an ACL injury, Dr. Grossfeld can help. For more information about the ACL Injury Prevention Program, or to schedule an appointment, call Orthopaedic Specialists at: 502-212-2663 today.
News Article | February 20, 2017
BOISE, Idaho, Feb. 20, 2017 (GLOBE NEWSWIRE) -- The Idaho Center for Integrative Medicine (ICIM) (http://idahointegrativemedicine.com/), a leader in functional and holistic healthcare, is hosting a Customer Appreciation Day on February 21, 2017, from 4 p.m. to 7 p.m. The clinic is located at 3271 N. Milwaukee Street. In addition to complimentary refreshments and supplement samples, the staff will be available for free therapy, chair massages, office tours, and answer questions for participants. "We are excited to host this event as it gives us an opportunity to thank our patients for their support and let them know how important they are to us," said Dr. Noah Edvalson, Founder of ICIM. "This event will also allow us to introduce therapies to our customers that they may be unaware we have. Patients are our top priority and we look forward to providing them with the best care possible." In addition to celebrating customer appreciation, ICIM will present new members of the team, including Greg Howard and Randi Roark. Greg Howard, Nurse Practitioner, comes with a broad background working in both Family Medicine and Urgent Care settings. While most of his background and training is in traditional medicine, he has always been open minded about alternative medicine, and recognizes the need to support the body through nutrition and lifestyle modifications. Randi Roark, a nationally certified massage therapist and Bodyworker, practices a variety of massage techniques including Swedish, Deep Tissue, NMT/Trigger Point, Shiatsu, Cranial-Sacral Fascial Release, Tai/Yoga, and Integrative/Mindful Expression. Randi believes that every body is different and there is no one massage that suits all; therefore, her approach is tailored to each individual. She loves helping others and is enthusiastic about health and overall well-being. ICIM strives to use a functional and holistic approach to provide competent and progressive health care encompassing physical, nutritional, emotional, and energetic vitality in a compassionate and collaborative environment. The clinic treats the cause of disease using safe, natural, and effective therapies, while enriching the community with education, self-reliance, and self-empowerment. About The Idaho Center for Integrative Medicine The Idaho Center for Integrative Medicine effectively helps their clientele find the healthcare they need. Dr. Edvalson, founder and owner of ICIM, is trained in Chiropractic (a Certified Chiropractic Sports Physician and has received the Distinguished Service Award by the American Chiropractic Association Council on Sports Injuries and Physical Fitness), Naturopathy, Functional Medicine, Acupuncture, Ultraviolet Blood Irradiation, and much more. He is a Fellow of the American Academy of Ozone therapies, with the distinguished honor of being certified as an Advanced Prolozone Therapist. It is his passion and ICIM's goal to help offer a new hope to those suffering unnecessarily with chronic diseases.
News Article | February 15, 2017
The Psychobiological Approach to Couple Therapy® (PACT) Institute has officially announced that its 2017 PACT training sessions are open for registration. The PACT Institute has trained more than 1,000 marriage and family therapists, social workers, counselors, psychologists and psychiatrists from all over the world in the PACT methodology. PACT is a fusion of attachment theory, developmental neuroscience and arousal regulation, which aims to promote secure-functioning relationships based on the principles of sensitivity, fairness, justice, collaboration and true mutuality. PACT specifically focuses on evoking experience for couples through social cues, movement exercises, conflict enactments, and other psychodramatic techniques. “We train PACT therapists to find the root of the problem quickly and efficiently so that couples can restore their relationship to secure-functioning condition as attentive and supportive partners for one another,” explained The PACT Institute’s founder, Dr. Stan Tatkin, PsyD, MFT, a best-selling author, therapist and researcher. The PACT Institute’s faculty members are all highly skilled therapists with successful private practices and have undergone extensive PACT training with Tatkin. The full training comprises three levels, spanning three years. The Level I (beginner) course is taught by the PACT core faculty. The Level II (advanced) and Level III (practicum) courses are taught by Dr. Tatkin. These courses are offered at various locations in the United States. Some levels are also available internationally. Dr. Tatkin will be also teaching PACT Level I and II trainings in Melbourne, Australia with the Australian Psychological Society. The schedule has been arranged so practitioners who want to do the full PACT program can take both levels in July. About Stan Tatkin, PsyD, MFT Stan Tatkin, PsyD, MFT, has a clinical practice as a couple therapist in Calabasas, CA, and is assistant clinical professor at the UCLA David Geffen School of Medicine, Department of Family Medicine. He and his wife, Tracey Boldemann-Tatkin, PhD, founded the PACT Institute and lead therapist training programs in cities across the United States and around the world. Tatkin is the author of three well-received books about relationships—Wired for Dating, Wired for Love, and Your Brain on Love—and is coauthor of Love and War in Intimate Relationships. Learn more about Dr. Tatkin at http://www.stantatkin.com. About the PACT Institute The PACT Institute is a leading global organization that offers trainings for clinical professionals in a method designed to help secure-functioning relationships flourish. The Psychobiological Approach to Couple Therapy® (PACT) draws on more than three decades of research on developmental neuroscience, attachment theory, and arousal regulation. Since 2008, the PACT Institute has trained more than 1,000 practitioners across North America, Europe, and Australia and has expanded the training to three levels. PACT has gained a reputation for effectively treating even the most challenging couples. For more information, visit: http://www.thepactinstitute.com.
News Article | February 22, 2017
The chocolates have been eaten. The flowers have wilted. The cards have been put in the drawer. The romance and passion of Valentine’s Day may have come and gone, but there’s still opportunity to keep love live and thriving. Leading couple therapist Dr. Stan Tatkin, PsyD, MFT, author of Wired for Love and Wired for Dating, lends his expertise on ways to rekindle the romantic connection, even for those who think the flame has burnt out. The eyes play an important role in igniting real love. Gazing into a partner’s eyes enables one to see not only his or her essence, but the entire play of the nervous system. While it is an unavoidable fact that the body shows signs of deterioration with age, when looking closely into the eyes of a partner, aging and deterioration fade through the eyes of the beholder. As long as people are mentally and emotionally healthy, they remain beautiful, vibrant, and vital. “It’s as though, through the eyes, we have the means to fall in love at our disposal — permanently,” explained Dr. Tatkin. “A few minutes of sustained gazing at your partner (or anyone) can lead to relaxation, a sense of safety, and full, here-and-now engagement.” Attachment expert Daniel Stern terms this concept, “moments of meeting.” It’s easy for two people to settle into dull familiarity when they’re living off static notions of one another, notions that are easily maintained at a distance. Dr. Tatkin continued, “When we look into one another’s eyes close up, it becomes impossible to remain in a total state of familiarity. This is because at close range, as we look into another’s eyes, what we see is inherently strange and complex. We become aware of each other’s otherness, which makes us cognizant again of novelty and unpredictability. This allows for just enough familiarity and stranger-ness to coexist, rekindling love and excitement.” Dr. Tatkin offers an exercise to the rekindle romantic connection: Try this exercise with a partner. A large room or outdoor area to be alone together is necessary. 1. Stand or sit in close proximity, no more than two feet apart. Ask your partner how his or her day was. As you listen and ask questions for clarification, pay attention to your partner’s eyes. What cues do you glean from them? See if you can listen and attend to the eyes at the same time. Don’t stare! Keep scanning your partner’s eyes for information. 2. After a few minutes, before your partner has finished talking, move apart from each other. If possible, have at least 20 feet between you. Again, attend to your partner’s eyes. Do you feel as connected as before? 3. Finally, conclude the conversation back in close proximity. This time, however, keep your eyes closed and use only your other near senses, such as smell and touch, and, of course, hearing. 4. Switch roles, and repeat steps 1 through 3 with the second partner asking about the first's day. Dr. Tatkin has a clinical practice in Calabasas, CA and is best-selling author of Wired for Love and Wired for Dating. Dr. Tatkin and his wife, Tracey Boldemann-Tatkin, PhD, are cofounders of the PACT Institute. They travel the world training therapists in their unique approach to couple therapy. The Tatkins also provide Wired for Love and Wired for Relationship retreats for couples and individuals. Learn more about Dr. Tatkin at http://www.stantatkin.com. About Stan Tatkin, PsyD, MFT Stan Tatkin, PsyD, MFT, has a clinical practice as a couple therapist in Calabasas, CA, and is assistant clinical professor at the UCLA David Geffen School of Medicine, Department of Family Medicine. He and his wife, Tracey Boldemann-Tatkin, PhD, founded the PACT Institute and lead therapist training programs in cities across the United States and around the world. Tatkin is the author of three well-received books about relationships—Wired for Dating, Wired for Love, and Your Brain on Love—and is coauthor of Love and War in Intimate Relationships. Learn more about Dr. Tatkin at http://www.stantatkin.com. About the PACT Institute The PACT Institute is a leading global organization that offers trainings for clinical professionals in a method designed to help secure-functioning relationships flourish. The Psychobiological Approach to Couple Therapy® (PACT) draws on more than three decades of research on developmental neuroscience, attachment theory, and arousal regulation. Since 2008, the PACT Institute has trained more than 1,000 practitioners across North America, Europe, and Australia and has expanded the training to three levels. PACT has gained a reputation for effectively treating even the most challenging couples. For more information visit: http://www.thepactinstitute.com.