Journal of general internal medicine
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This study examines the use of career ladders for medical assistants (MAs) in primary care practices as a mechanism for increasing wages and career opportunity for MAs. A growing body of research on primary care suggests that successful expansion of support staff roles such as MAs may have positive organizational and quality of care outcomes, but little is known about worker outcomes. ⋯ Investing in career ladders in primary care clinics can improve MA job quality while also potentially addressing issues of equity, efficiency, and quality in the health care sector.
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Clinician perceptions before and after inviting patients to read office notes (open notes) are unknown. ⋯ Following implementation, more primary and specialty care clinicians agreed that sharing notes with patients online was beneficial overall. Fewer had concerns about more time needed for office visits or documentation. Most thought patients would worry more and reported being less candid in documentation.
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Because many hospitals have no mechanism for written translation, ED providers resort to the use of automated translation software, such as Google Translate (GT) for patient instructions. A recent study of discharge instructions in Spanish and Chinese suggested that accuracy rates of Google Translate (GT) were high. ⋯ GT for discharge instructions in the ED is inconsistent between languages and should not be relied on for patient instructions.
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Robotic prostatectomy is a costly new technology, but the costs may be offset by changes in treatment patterns. The net effect of this technology on Medicaid spending has not been assessed. ⋯ A full accounting of the costs of a new technology will depend on when it is used and the payment rate for its use relative to payment rates for substitutes.
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Long-acting reversible contraceptives (LARCs) such as intrauterine devices (IUDs) and implants are highly effective and increasingly popular. Internal Medicine (IM) clinics and residency curricula do not routinely include LARCs, which can limit patient access to these methods. In response, internists are integrating LARCs into IM practices and residency training. ⋯ The model for integration of LARCs into IM clinics and resident education depends upon the clinical resources, patient needs, stakeholder support, and educational goals of the program.