J Am Board Fam Med
-
In 2020, as a 24-year-old MD PhD student studying cardiovascular population health, I suffered a non-ST elevated myocardial infarction while playing basketball. It was confirmed the cause was familial hypercholesterolemia leading to 95%+ occlusions of both the left anterior descending and left circumflex arteries. The following reflective essay describes my experience as a patient grappling with his own mortality and how those experiences have shaped how I now view my purpose as a future physician. The purpose of this essay is to encourage all physicians and physicians in training to practice reflection and to allow themselves to fully experience the pain and suffering of the patients for whom they care, even amidst times of personal uncertainty.
-
The COVID-19 pandemic has added further urgency to the need for primary care payment reform. Fee-for-service payments limit the flexibility of practices to respond to crises and leave practices without sufficient revenues when visit volumes decrease. ⋯ Evidence suggests setting primary care investment at 10% to 12% of the total cost of care, approximately translating to an average $85 per member per month, with significant variation based on age and adjustment for medical and social measures of risk. Enhanced investment in primary care should be aligned across payers and support practice transformation to advanced models of care.
-
The objective of this study was to assess the 11-year mortality risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization in community-dwelling adults aged 40 to 85 years. ⋯ MRSA colonization in middle-aged and older adults in the community is associated with a significantly increased mortality risk. Considering that this effect was in the community and not in hospitalized patients, this finding of increased mortality risk is especially troubling.