Background: Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that appropriate action can be taken (eg, biopsy/referral to dermatology or reassurance).
Objective: To assess the success of concise dermoscopy training among primary care providers.
Introduction: Patients often first present to their primary care provider for skin lesion concerns, and dermoscopy is a tool that enhances diagnostic acumen of both malignant and benign skin lesions. Physician assistants (PAs) frequently serve as primary care and dermatology providers, but to our knowledge, no current research on dermoscopy expertise with PAs exists. We hypothesize that PA students could be taught dermoscopy based on the triage amalgamated dermoscopic algorithm (TADA) to increase their diagnostic skill, as previously shown with medical students.
View Article and Find Full Text PDFBackground: Cotesting with the Papanicolaou (Pap) and human papillomavirus tests detects most precancerous and cancerous lesions and increases the sensitivity for detecting high-grade precancerous and invasive cervical cancers compared with human papillomavirus testing alone.
Objective: To compare the use of the Papette brush (hereafter Papette) to the traditional spatula with endocervical brush (cytobrush) for cervical cancer screening.
Design: Pragmatic observational study.
Objectives: Lupron 11.25 mg has both a narrow indication and a high cost compared to other Lupron presentations. Prior to our study initiation there was no clear distinction between presentations when ordering within the health-system's Electronic Health Record (EHR).
View Article and Find Full Text PDFMayo Clin Proc Innov Qual Outcomes
April 2022
Objective: To determine whether anticoagulation therapy is associated with an increased risk of complications after initiation of intrauterine contraception (IUC).
Patients And Methods: We retrospectively reviewed records of women receiving anticoagulation therapy at the time of IUC placement from 2000 to 2017 and records of controls (no anticoagulation), matched by race, age, and body mass index. The primary outcome was the cumulative incidence of bleeding (more than spotting [World Health Organization bleeding grades 2 to 4]), IUC expulsion, and IUC removal.
Objective: To understand the relationships between burnout, job satisfaction, and career plans among physician assistants in the United States.
Methods: The authors surveyed PAs in 2016. The survey included the Maslach Burnout Inventory and items on job satisfaction and career plans.
J Prim Care Community Health
June 2021
Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers' on available screening options and to review options for individualized patient management.
Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures.
Objective: To determine whether implementation of the Pregnancy Reasonably Excluded Guide (PREG) in a primary care gynecology clinic improves access to contraceptive procedures and affects the number of urine human chorionic gonadotropin (hCG) tests.
Patients And Methods: PREG was administered to 981 women aged 18 to 50 years (1012 visits) who were seen in a primary care gynecology clinic for contraceptive procedures from September 30, 2015, through April 30, 2018. Contraceptive procedures included insertion of an intrauterine contraceptive (IUC) or subdermal contraceptive implant.
Objective: To evaluate burnout and satisfaction with work-life integration among physician assistants (PAs) compared with other US workers.
Methods: We surveyed PAs and a probability-based sample of US workers. The survey included the Maslach Burnout Inventory and an item on satisfaction with work-life integration.
This prospective study focuses on professional satisfaction among advanced practice providers (APPs) in primary care. We aimed to determine whether incorporating specialty care clinics within primary care practices increases professional satisfaction. We administered the validated Misener Nurse Practitioner Job Satisfaction Scale and a self-developed demographic questionnaire to all primary care APPs before and one year after implementation of a gynecology practice within the primary care setting.
View Article and Find Full Text PDFPostpartum depression, which affects 10% to 20% of women in the United States, can significantly harm the health and quality of life for mother, child, and family. This article reviews the risk factors, pathophysiology, clinical manifestations, diagnosis, and treatment of postpartum depression with specific focus on women of advanced maternal age.
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