Journal of general internal medicine
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Comparative Study
Actual and potential effects of medical resident coverage on reimbursement for inpatient visits by attending physicians.
The impact of residents on hospital finance has been studied; there are no data describing the economic effect of residents on attending physicians. ⋯ Nonteaching attendings appear to document their visits more carefully from a billing perspective than do teaching attendings. Properly counter-documented, resident notes could substantially increase payments to attending physicians.
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To examine the association of socioeconomic barriers, familial barriers, and clinical variables with health-related quality of life (HRQL). ⋯ An independent, graded relationship was found between socioeconomic and familial barriers to care and HRQL. This relationship was at least as strong as the association between HRQL and the clinical variables more likely to be perceived by participants as causing symptomatic distress or impacting lifestyle.
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We developed an instructional program to teach aspiration and injection techniques of the knee and shoulder to medical students and residents. ⋯ The addition of this type of instruction to supplement a traditional internal medicine rotation can enhance a learner's ability to perform joint/soft-tissue injection and aspiration.
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This cross-sectional study sought to determine the prevalence of smoking, readiness to quit, and preferences for smoking cessation treatments among a sample of 236 homeless adults attending 9 sites serving homeless persons (mean age 41.8 years; 73% male). Two thirds (69%) were current smokers, of whom 37% reported readiness to quit smoking within the next 6 months. ⋯ Nicotine replacement was the most commonly preferred assistance method (44%), and self-efficacy to quit (10-point scale) was significantly greater if assistance was available (7.3 vs 4.9; P <.001). The findings suggest an urgent need to develop and implement smoking cessation programs for homeless persons.
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Comparative Study
Alcohol-related discussions during general medicine appointments of male VA patients who screen positive for at-risk drinking.
This study describes primary care discussions with patients who screened positive for at-risk drinking. In addition, discussions about alcohol use from 2 clinic firms, one with a provider-prompting intervention, are compared. ⋯ During discussions about alcohol, general medicine providers asked questions and offered information, but usually did not give explicit alcohol-related advice. Discussions about alcohol occurred more often when providers were prompted.