Preparing behavioral health clinicians for success and retention in rural safety net practices.

Purpose: This study assesses how, among behavioral health clinicians working in rural safety net practices, the amount of exposure to care in rural underserved communities received during training relates to confidence in skills important in their work settings, successes in jobs and communities, and anticipated retention.

Methods: This study uses survey data from Licensed Clinical Social Workers, Licensed Professional Counselors, and Psychologists working in rural safety net practices in 21 states while receiving educational loan repayment support from the National Health Service Corps, from 2015 to April 2022.

Findings: Of the 778 survey respondents working in rural counties, 486 (62.

Race-ethnicity and sex differences in 1-year survival following percutaneous coronary intervention among Medicare fee-for-service beneficiaries.

Rationale: Existing literature describing differences in survival following percutaneous coronary intervention (PCI) by patient sex, race-ethnicity and the role of socioeconomic characteristics (SEC) is limited.

Aims And Objectives: Evaluate differences in 1-year survival after PCI by sex and race-ethnicity, and explore the contribution of SEC to observed differences.

Methods: Using a 20% sample of Medicare claims data for beneficiaries aged 65+, we identified fee-for-service patients who received PCI from 2007 to 2015.

Scholarship Criteria for Promotion in the Age of Diverse Faculty Roles and Digital Media.

Background And Objectives: In academic medical centers, scholarship is essential to advancing scientific knowledge, clinical care, and teaching and is a requirement for faculty promotion. Traditional evidence of scholarship, such as publications in peer-reviewed academic journals, remains applicable to the promotions of physician and nonphysician researchers. Often, however, the same evidence does not fit the scholarly work and output of clinician-educators, whose scholarship is often disseminated through digital communications and social media.

Outcomes of States' Loan Repayment and Forgiveness Programs From the Perspective of Safety Net Practice Administrators.

OBJECTIVES: SUBJECTS: OUTCOME MEASURES: RESULTS: CONCLUSIONS:

Moral distress among clinicians working in US safety net practices during the COVID-19 pandemic: a mixed methods study.

Objective: To explore the causes and levels of moral distress experienced by clinicians caring for the low-income patients of safety net practices in the USA during the COVID-19 pandemic.

Design: Cross-sectional survey in late 2020, employing quantitative and qualitative analyses.

Setting: Safety net practices in 20 US states.

Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study.

Goal: Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians' mental health, burnout, and intention to leave patient care.

Methods: We conducted a cross-sectional national survey with an online panel of internal medicine physicians from the American College of Physicians in September and October of 2020.

A national study of moral distress among U.S. internal medicine physicians during the COVID-19 pandemic.

Background: There have been no studies to date of moral distress during the COVID-19 pandemic in national samples of U.S. health workers.

Students with global experiences during medical school are more likely to work in settings that focus on the underserved: an observational study from a public U.S. institution.

Background: Global health interest has grown among medical students over the past 20 years, and most medical schools offer global health opportunities. Studies suggest that completing global health electives during medical school may increase the likelihood of working with underserved populations in a clinical or research capacity. This study aimed to assess the association of global electives in medical school on subsequently working in global health and with underserved populations in the United States (U.

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic.

Objectives: The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC).

Methods: In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states.

Overall Work and Practice Satisfaction of Licensed Clinical Social Workers in the National Health Service Corps Loan Repayment Program.

Little is known about the job satisfaction of licensed clinical social workers (LCSWs) participating in the National Health Service Corps (NHSC) federal Loan Repayment Program (LRP). Employee satisfaction in organizations is important for organizational well-being and to decrease turnover. A satisfied NHSC LCSW workforce is also important given the array of services it provides, especially in rural and underserved areas.

Satisfaction of the Primary Care, Mental Health, and Dental Health Clinicians of the National Health Service Corps Loan Repayment Program.

The National Health Service Corps (NHSC) aims to foster a positive service experience for its clinicians to promote long-term retention. We assess the satisfaction of primary care, dental, and mental health clinicians in the NHSC's Loan Repayment Program (LRP). Survey data are from 1,193 clinicians (72.

Relationship between Physicians' Uncertainty about Clinical Assessments and Patient-Centered Recommendations for Colorectal Cancer Screening in the Elderly.

Objective: The goal of this study was to examine associations between physicians' clinical assessments, their certainty in these assessments, and the likelihood of a patient-centered recommendation about colorectal cancer (CRC) screening in the elderly.

Methods: Two hundred seventy-six primary care physicians in the United States read 3 vignettes about an 80-year-old female patient and answered questions about her life expectancy, their confidence in their life expectancy estimate, the balance of benefits/downsides of CRC screening, their certainty in their benefit/downside assessment, and the best course of action regarding CRC screening. We used logistic regression to determine the relationship between these variables and patient-centered recommendations about CRC screening.

Academic outcomes of a community-based longitudinal integrated clerkships program.

Background: Longitudinal integrated clerkships (LICs) receive recognition internationally as effective, innovative alternatives to traditional block rotations (TBRs) in undergraduate medical education. No studies of LICs in the USA have assessed how students perform on all the standardized exams.

Aim: To compare performance on standardized tests of students in the first four years of LICs at the University of North Carolina School of Medicine-Asheville (UNC SOM-Asheville) with students from UNC SOM's Chapel Hill main campus in TBRs.

Physician assistants and nurse practitioners in the National Health Service Corps.

Objectives: This study describes the experiences of physician assistants (PAs) and nurse practitioners (NPs) in the National Health Service Corps' (NHSC) loan repayment program in 2010.

Methods: In 2011, a stratified random sample of NHSC clinicians was surveyed. Data from the 148 PA and 137 NP respondents were analyzed (52.

An evaluation of state-based support-for-service programs targeting nurse faculty.

Aim: The aim of the study was to assess how state-based support-for-service (SFS) programs are used by deans and directors of nursing programs and to evaluate their perceived impact.

Background: Given projected nurse faculty shortages, stakeholders are looking for ways to address the maldistribution and shortage of nurse faculty. One state-level strategy is the implementation of loan repayment and scholarship programs, which incentivize individuals with, or currently pursuing, graduate degrees to become or remain nurse faculty.

The association between body mass index and coronary artery disease severity: a comparison of black and white patients.

Introduction: Despite known associations between obesity and cardiovascular disease, the relationship between obesity as reflected by body mass index (BMI) and angiographic coronary artery disease (CAD) is not fully understood. Moreover, this relationship has not been adequately defined in black patients, a group demonstrated to have lower rates of angiographic CAD despite higher rates of CAD risk factors, cardiovascular events, and CAD-related mortality.

Methods: Using an angiography database from an academic hospital, we studied patients undergoing first-time, nonemergent coronary angiography.

What Makes Me Screen for HIV? Perceived Barriers and Facilitators to Conducting Recommended Routine HIV Testing among Primary Care Physicians in the Southeastern United States.

The Centers for Disease Control and Prevention have recommended routinely testing patients (aged 13-64) for HIV since 2006. However, many physicians do not routinely test. From January 2011 to March 2012, we conducted 18 in-depth individual interviews and explored primary care physicians' perceptions of barriers and facilitators to implementing routine HIV testing in North Carolina.

The contribution of "plasticity" to modeling how a community's need for health care services can be met by different configurations of physicians.

This article introduces the concept of "plasticity" to health care workforce modeling and policy analysis. The authors define plasticity as the notion that individual physicians within the same specialty each provide a different scope of service, while the scope of service of physicians in different specialties may overlap. This notion represents a departure from the current, silo-based conception of physician supply as physician headcounts by specialty; the implication is that multiple configurations of physicians (and, by further application, other health care professionals) can meet a community's utilization of health care services.