Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial.

Background: No-shows, or missed appointments, are a problem for many medical practices. They result in fragmented care and reduce access for all patients.

Objective: To determine whether telephone reminder calls targeted to patients at high risk of no-show can reduce no-show rates.

Shared Decision Making in Common Chronic Conditions: Impact of a Resident Training Workshop.

Problem: Physicians must be competent in several different kinds of communication skills in order to implement shared decision making; however, these skills are not part of routine medical student education, nor are they formally taught during residency training.

Intervention: We developed a 1- and 2-hour workshop curriculum for internal medicine residents to promote shared decision making in treatment decisions for four common chronic conditions: diabetes, depression, hypertension, and hyperlipidemia. The workshops included a written case exercise, a short didactic presentation on shared decision-making concepts and strategies for risk communication, and two role-playing exercises focused on decision making for depression and hyperlipidemia treatment.

Balancing clinical experience in outpatient residency training.

Background: To receive adequate training experience, resident panels in teaching clinics must have a sufficiently diverse patient case-mix. However, case-mix can differ from one resident panel to another, resulting in inconsistent training.

Method: Encounter data from primary care residency clinics at Massachusetts General Hospital from July 2008 to May 2010 (64 residents and ~3800 patients) were used to characterize patients by gender, age, major disease category (both acute and chronic, e.

Ambulatory-based education in internal medicine: current organization and implications for transformation. Results of a national survey of resident continuity clinic directors.

Background: Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clinics nationwide.

Objective: We wished to describe the infrastructure and educational milieu at resident continuity clinics and assess clinic readiness to meet new IM-RRC requirements.

Performance on preventive cancer screening tests in the ambulatory setting by internal medicine resident physicians.

Background: Limited information exists about the quality and determinants of ambulatory care by resident physicians.

Description: This study investigated whether year of training and primary care versus traditional categorical status for internal medicine residents influenced preventive cancer screening rates. Ambulatory patients cared for by 143 internal medicine residents in one program over a 1-year period were assessed.