Annals of family medicine
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Annals of family medicine · Mar 2009
Comparative StudyDeclining trends in the provision of prenatal care visits by family physicians.
We wanted to measure trends in the proportion of prenatal visits provided by family physicians nationally for a 10-year period and determine characteristics of prenatal visits made to family physicians compared with visits made to obstetricians. ⋯ Family physicians reduced their provision of prenatal visits by nearly 50% during a 10-year period and at an even greater rate in rural, non-metropolitan statistical areas. These findings should be considered as family medicine considers the role of maternity care and strives to provide accessible prenatal services for all.
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Annals of family medicine · Mar 2009
Suffering, meaning, and healing: challenges of contemporary medicine.
This essay explores the thesis that changes in contemporary society have transformed the work of doctoring and challenge doctors to be physician-healers. Medical advances in the prevention and management of acute disease have wrought a growing population of chronically ill patients whose care obliges physicians to become holistic healers. Holistic healing involves the transcendence of suffering. ⋯ Physician-healers use the power of the doctor-patient relationship to help patients discover or create new illness narratives with fresh meanings that reconnect them to the world and to others and thereby transcend suffering and experience healing. Physician-healers equipped with the attitudes, skills, and knowledge to assist patients to transcend suffering are indispensable if contemporary medicine is to maintain its tradition as a healing profession. In the process, physicians may discover meaningful connections with patients that bring new and refreshing perspectives to their work.
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Annals of family medicine · Mar 2009
Comparative StudyPay for performance in primary care in England and California: comparison of unintended consequences.
We undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. ⋯ Our study findings suggest that unintended consequences of incentive programs relate to the way in which these programs are designed and implemented. Although unintended, these consequences are not necessarily unpredictable. When designing incentive schemes, more attention needs to be paid to factors likely to produce unintended consequences.
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Annals of family medicine · Mar 2009
Meta AnalysisThe effects of barley-derived soluble fiber on serum lipids.
We wanted to determine the association between consumption of barley and changes in plasma lipids in healthy and hypercholesterolemic men and women. ⋯ Barley-derived beta-glucan appears to beneficially affect total cholesterol, LDL-cholesterol, and triglycerides, but not HDL-cholesterol.
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Annals of family medicine · Mar 2009
Randomized Controlled Trial Multicenter StudyInfluence of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained complaints.
We undertook a study to determine whether test-ordering strategy and other consultation-related factors influence satisfaction with and anxiety after a consultation among patients seeking care for unexplained complaints. ⋯ Test-ordering strategy does not influence patients' satisfaction with and anxiety after a consultation. Instead, specific aspects of physician-patient communication are important. Apparently, primary care physicians underestimate how much they can contribute to the well-being of their patients by discussing their worries.