The Scholarly Upside to MOC4.

Background: Many medical boards require quality improvement (QI) projects for Maintenance of Certification Part IV (MOC4) credits. The American Board of Medical Specialties (ABMS) allows health care organizations that can demonstrate sufficient QI standards to become Portfolio Program Sponsors. This enables internal review and approval of QI projects, crediting all sufficiently contributing physicians.

Psychologists' Opportunities for Fostering Leadership Skills in Academic Medicine: The Rothenberger Leadership Academy.

Healthcare leaders must increasingly attend to the monumental challenges facing their organizations (Angood and Falcone, American Association for Physician Leadership, 2023). As such, leadership in healthcare settings demands new skills sets amongst healthcare professionals that transcend the technical skills of any given profession. Academic health center psychologists are well-positioned to contribute to the leadership of academic health centers due to knowledge, skills, and attitudes fostered in doctoral psychology education, practice, and research through the focus on Profession-Wide Competencies.

Overcoming challenges of prescribing long-term opioid therapy in residency clinics.

Objectives: To describe the impact of a standardized opioid prescribing intervention when implemented in three family medicine (FM) residency training - clinics-environments that face operational challenges including regular resident turnover.

Design: We performed a retrospective cohort study to compare patterns of long-term opioid prescribing between residency and nonresidency clinics.

Setting: This study took place within a large, academic, health system.

It's a spiral staircase, not just two steps: An iterative approach to assessing patient capacity for medical decision-making.

The assessment of medical decision-making capacity as part of the process of clinical informed consent has been considered a bioethical housekeeping matter for decades. Yet in practice, the reality bears little resemblance to what is described in the medical literature and professed in medical education. Most literature on informed consent refers to medical decision-making capacity as a precondition to the consent process.

Dermatology Life Quality Index survey in patients with Down syndrome and caregivers.

Down syndrome (DS) is associated with many dermatological conditions, including hidradenitis suppurativa, folliculitis, and alopecia areata. Despite the high incidence of skin conditions in this population, there are no quality of life (QoL) studies in the dermatology literature focused on patients with DS or their caregivers. The frequently used QoL assessment tool, the Dermatology Life Quality Index (DLQI), has yet to be studied in this population.

Bias and Conflict of Interest in the Underreporting of Sexual Abuse in Competitive Sports: A Literature Review.

The prevalence of sexual abuse in competitive sports is increasing worldwide and requires a united call to action. The underreporting of such abuses gained media attention resulting from recent high-profile cases. In this article, we report the results of a systematic literature review, identifying root causes of underreporting sexual abuse in competitive sports.

Academic and Wellness Outcomes Associated with use of Anki Spaced Repetition Software in Medical School.

Objectives: Medical students are increasingly using a spaced repetition software called Anki to study. There are limited studies evaluating the relationship between Anki and learner outcomes. In this study, we describe the history of Anki use in medical school and assess the potential relationships between use of Anki and medical student academic, extracurricular, and wellness outcomes.

The role of pay-for-performance in reducing healthcare disparities: A narrative literature review.

As American healthcare shifts to value-based payment, Pay-for-Performance (P4P) has become an important and controversial topic. One of the main controversies pertains to its potential to narrow or widen existing healthcare disparities depending on how the program is designed and implemented. It is thus imperative to understand which design features are most likely to reduce disparities.

PRescribing Interventions for Chronic pain using the Electronic health record (PRINCE): Study protocol.

Background: Primary care is a frequent source of pain treatment and opioid prescribing. The objective of the Prescribing Interventions for Chronic Pain using the Electronic health record (PRINCE) study is to assess the effects of two behavioral economics-informed interventions embedded within the electronic health record (EHR) on guideline-concordant pain treatment and opioid prescribing decisions in primary care settings.

Methods: Setting: The setting for this study is 43 primary care clinics in Minnesota.

Effect of Integrating Access to a Prescription Drug Monitoring Program Within the Electronic Health Record on the Frequency of Queries by Primary Care Clinicians: A Cluster Randomized Clinical Trial.

Importance: Tools that are directly integrated with the electronic health record (EHR) workflow can reduce the hassle cost of certain guideline-concordant practices, such as querying a prescription drug monitoring program (PDMP) before prescribing opioids.

Objective: To investigate the effect of integrating access to a PDMP within the EHR on the frequency of program queries by primary care clinicians.

Design Settings And Participants: The PRINCE (Prescribing Interventions for Chronic Pain Using the Electronic Health Record) randomized trial used a factorial cluster design at the clinic level in 43 primary care clinics in Minnesota.

How Does Cognitive Bias Affect Conversations With Patients About Dietary Supplements?

Many patients use dietary supplements but do not inform their clinicians. Some allopathic clinicians' conscious and unconscious cognitive and emotional biases against complementary and alternative medicine can affect whether patients disclose details about dietary supplement use, the quality of communication during clinical encounters, and the information clinicians draw upon to make decisions and recommendations. This article describes 6 cognitive biases that can influence patient-clinician communication and shared decision making about dietary supplements and suggests 6 ways to mitigate biases' negative effects on patient-clinician relationships.

The language of less-lethal weapons.

It has been over 1 year since we observed the policing of the George Floyd protests in the United States [R. R. Hardeman, E.

Diverse community leaders' perspectives about quality primary healthcare and healthcare measurement: Qualitative community-based participatory research.

Background: Healthcare quality measurements in the United States illustrate disparities by racial/ethnic group, socio-economic class, and geographic location. Redressing healthcare inequities, including measurement of and reimbursement for healthcare quality, requires partnering with communities historically excluded from decision-making. Quality healthcare is measured according to insurers, professional organizations and government agencies, with little input from diverse communities.

Race and Gender Differences in Medical Student Perspectives on Social Determinants of Health Education: A Single-Institution Survey Study.

Purpose: The field of medicine is becoming increasingly aware of the role that social determinants of health (SDH) play in shaping health and health outcomes. Organized medicine - including prominent physician groups and accreditation bodies - has endorsed SDH education as an integral component of medical school curricula. This study sought to describe medical student perspectives on the current state of SDH in preclinical curricula.

The Consent Continuum: A New Model of Consent, Assent, and Nondissent for Primary Care.

The practice around informed consent in clinical medicine is both inconsistent and inadequate. Indeed, in busy, contemporary health care settings, getting informed consent looks little like the formal process developed over the past sixty years and presented in medical textbooks, journal articles, and academic lectures. In this article, members of the Society of Teachers of Family Medicine (STFM) Collaborative on Ethics and Humanities review the conventional process of informed consent and its limitations, explore complementary and alternative approaches to doctor-patient interactions, and propose a new model of consent that integrates these approaches with each other and with clinical practice.

Docs with their eyes on the clock? The effect of time pressures on primary care productivity.

This paper examines how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. We generate empirical predictions by incorporating time pressure into a model of physician behavior by Tai-Seale and McGuire (2012). We use data from the electronic health records of a large integrated delivery system and leverage unexpected schedule changes as variation in time pressure.

"An epoch-making and blessed moment in the history of medicine" -thoughts on international health equity and the Nobel prize in medicine.

The Nobel Prize in Physiology or Medicine is a prestigious award given every year for ostensibly the most important discovery in the field. Prizes in Medicine have typically gone to honor foundational knowledge rather than measurable impact. Two recent examples from global health (a rotavirus vaccine, child growth standards) offer alternatives for what might be lauded in medicine.

Financial Impact of Universal Precepting in Family Medicine Residency Clinics.

Background And Objectives: Precepting methods have significant impact on the financial viability of family medicine residency programs. Following an adverse event, four University of Minnesota Family Medicine residency clinics moved from using Medicare's Primary Care Exception (PCE) and licensure precepting (LP) to a "universal precepting" method in which preceptors see every patient face to face. Variation in the implementation of universal precepting created a natural experiment of its financial impact.