Directors Recognize Difficulties in Providing Medical Care to Residents But Few Implement Policies to Address Them.

Background And Objectives: Residents find it difficult to access medical care. Some seek care within their own program. Our objectives were to (1) determine whether family medicine program directors see their own resident physicians as patients, (2) describe whether they perceive the residency culture as actively encouraging of this practice, and (3) assess perceptions about reasons to encourage or discourage this.

Use of FRAX as a determinant for risk-based osteoporosis screening may decrease unnecessary testing while improving the odds of identifying treatment candidates.

Purpose: We have assessed the hypothetical impact of guideline-concordant osteoporosis screening on baseline behaviors utilizing two different guidelines and determined the relative ability of each to identify osteoporosis treatment candidates.

Methods: We conducted secondary analyses from the Fracture Risk Perception Study, which enrolled patients aged 50 to 75 years to complete questionnaires about their bone health. We determined our baseline screening rates and detection of treatment candidates and then assessed the hypothetical impact of adherence to U.

Fracture risk perception study: patient self-perceptions of bone health often disagree with calculated fracture risk.

Background: We sought to evaluate the concordance between self-assessed perceptions of fracture risk and actual risk calculated by World Health Organization's 10-year Fracture Risk Assessment Tool (FRAX).

Methods: We collected demographic data, lifestyle information, osteoporosis knowledge, bone density test results, and treatment history from patients aged 50 to 75 years. Subjects rated their perceptions of 10-year risk of sustaining fracture as low (0%-9%), intermediate (10%-19%), or high (≥20%).

Improving service quality in primary care.

A framework for improving health care service quality was implemented at a 12-provider family medicine practice in 2010. A national patient satisfaction research vendor conducted weekly telephone surveys of 840 patients served by that practice: 280 patients served in 2009, and 560 served during 2010 and 2011. After the framework was implemented, the proportion of "excellent" ratings of provider service (the highest rating on a 5-point scale) increased by 5% to 9%, most notably thoroughness (P = .

Improving hypertension control in diabetes: a multisite quality improvement project that applies a 3-step care bundle to a chronic disease care model for diabetes with hypertension.

Hypertension in diabetes patients leads to significant morbidity and mortality. Nonetheless blood pressure (BP) control in patients with diabetes remains disappointing. The authors applied a care bundle to decrease the proportion of patients with BP exceeding 130/80.

Urinary tract infection in women over the age of 65: is age alone a marker of complication?

Background: We were interested to know if our older female patients with urinary tract infections (UTIs) might have differing pathogens or rates of Escherichia coli antibiotic sensitivity and if our physicians managed them in a manner similar or dissimilar to the care provided to younger patients with no complications.

Methods: This was a secondary analysis from patients excluded from a previous retrospective study regarding uncomplicated UTIs.

Results: Twenty-six percent of total patients with UTIs were older than 65 and otherwise medically uncomplicated whereas 21% were older patients who did have complicating factors.

Diagnosis and treatment of Lyme disease.

Lyme disease is the most common tick-borne disease in the United States. This review details the risk factors, clinical presentation, treatment, and prophylaxis for the disease. Information was obtained from a search of the PubMed and MEDLINE databases (keyword: Lyme disease) for articles published from August 31, 1997, through September 1, 2007.

Assessing adherence to evidence-based guidelines for the diagnosis and management of uncomplicated urinary tract infection.

Objective: To assess adherence to evidence-based guidelines for the diagnosis and management of uncomplicated urinary tract infection (UTI) in a family medicine residency clinic setting.

Patients And Methods: We retrospectively reviewed the medical records of female patients seen in 2005 at the Mayo Clinic Family Medicine Center in Scottsdale, Ariz, who were identified by International Classification of Diseases, Ninth Revision code 599.0 (UTI).

The future of residency education: implementing a competency-based educational model.

Graduate medical programs are faced with increasing calls for competency-based education. All accredited residencies and fellowships must now demonstrate that graduates are competent in six key areas, and outcomes data must be used to improve each program. The transition to competency-based education has challenged programs in all specialties.

Characteristics of effective clinical teachers.

Objectives: Defining what makes an exceptional teacher is challenging. This study's objectives were to identify teaching attributes that residents and faculty value most and to determine whether the opinions of residents and faculty differed.

Methods: A list of 15 teaching attributes was distributed to residents and faculty at eight family medicine residency programs.

The 'Collaborative Care' curriculum: an educational model addressing key ACGME core competencies in primary care residency training.

Aim: The 'Collaborative Care' curriculum is a 12-month senior resident class project in which one evidence-based clinical guideline is designed, implemented and evaluated in our residency practice. This curriculum specifically addresses three of the six Accreditation Council for Graduate Medical Education (ACGME) core competencies: Practice-Based Learning and Improvement, Interpersonal and Communication Skills and System-Based Practices. Additionally, the project enhances the quality of patient care within the model family practice centre in a family practice residency.