Annals of family medicine
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Annals of family medicine · Nov 2005
How experiencing preventable medical problems changed patients' interactions with primary health care.
We wanted to explore how patients' experiences with preventable problems in primary care have changed their behavioral interactions with the health care system. ⋯ Understanding how patients react to their experiences with preventable problems can assist health care at both the physician-patient and system levels. We propose an association of mistrust with the behaviors of avoidance and advocacy, and suggest that further research explore the potential impact these patient behaviors have on the provision of health care.
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Annals of family medicine · Nov 2005
Randomized Controlled TrialPhysicians answer more clinical questions and change clinical decisions more often with synthesized evidence: a randomized trial in primary care.
Clinicians need evidence in a format that rapidly answers their questions. DynaMed is a database of synthesized evidence. We investigated whether primary care clinicians would answer more clinical questions, change clinical decision making, and alter search time using DynaMed in addition to their usual information sources. ⋯ Using DynaMed, primary care clinicians answered more questions and changed clinical decisions more often, without increasing overall search time. Synthesizing results of systematic evidence surveillance is a feasible method for meeting clinical information needs in primary care.
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Annals of family medicine · Nov 2005
Quick assessment of literacy in primary care: the newest vital sign.
Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish. ⋯ NVS is suitable for use as a quick screening test for limited literacy in primary health care settings.
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Annals of family medicine · Nov 2005
Time spent in face-to-face patient care and work outside the examination room.
Contrary to physicians' concerns that face-to-face patient time is decreasing, data from the National Ambulatory Medical Care Survey (NAMCS) indicate that between 1988 and 1998, durations of primary care outpatient visits have increased. This study documented how physicians spend time during the workday, including time outside the examination room, and compared observed face-to-face patient care time with that reported in NAMCS. ⋯ Nearly one half of a primary care physician's workday is spent on activities outside the examination room, predominately focused on follow-up and documentation of care for patients not physically present. National estimates of visit duration overestimate the combination of face-to-face time and time spent on visit-specific work outside the examination room by 41%.