North Dakota assistance program for dementia caregivers lowered utilization, produced savings, and increased empowerment.

North Dakota's state-funded Dementia Care Services Program provides individualized assistance to caregivers of persons with dementia. Caregivers can contact program representatives at any time and may continue to contact them throughout the years they are caring for the person with dementia. During the program's first forty-two months of operation (January 2010 to June 2013), care consultants assisted 1,750 caregivers, primarily family members, of 951 persons with dementia.

Reducing health care costs for dementia patients: estimating savings from a caregiver support program.

Objective: Estimating cost savings based on limited health care events within a short time span for a dementia care program.

Method: Data on health care utilization of persons with dementia (PWDs) and caregivers were gathered in the Dementia Care Services Program in North Dakota from January 2010 to January 2012. Data were aggregated into 3-month intervals and compared to 3 months before program intervention.

Deciding when to put grandma in the nursing home: measuring inclinations to place persons with dementia.

For caregivers of persons with dementia, estimating when that person should be placed in long-term care is difficult. Health care providers also find it hard to give an exact time as to when the person should be placed. Using data from 197 caregivers working with the Dementia Care Services Project in North Dakota, we show that asking the caregiver about their inclination to place can be equated to asking them for a specific time to place (κ = .

Learning professionalism during the third year of medical school in a 9-month-clinical rotation in rural Minnesota.

Background: Professionalism is now an explicit part of the medical school curricula.

Aim: To examine the components that are part of developing professionalism during the Rural Physician Associate Program (RPAP) experience, a 9-month rotation in a rural community during the third year of medical school.

Methods: Two researchers analysed 3 years of essays for themes.

Recruitment and retention of rural physicians: outcomes from the rural physician associate program of Minnesota.

Context: Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation.

Management of foreign bodies in the skin.

Although puncture wounds are common, retained foreign bodies are not. Wounds with a foreign body sensation should be evaluated. The presence of wood or vegetative material, graphite or other pigmenting materials, and pain is an indication for foreign body removal.

Comparing rural-trained medical students with their peers: performance in a primary care OSCE.

Background: Although it is well-established and considered successful, there is limited data on how the graduates of a Minnesota rural medical education program (Rural Physician Associate Program [RPAP]) compare with their peers.

Purpose: To compare the performance of RPAP students with their peers on a primary care observed structured clinical examination (OSCE).

Methods: The performances of RPAP students and a group of non-RPAP Year 4 medical students were compared on the same OSCE.

Defining a future for fee-for-service Medicare.

The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) provides economic incentives that favor health plans over traditional fee-for-service (FFS) Medicare. This reflects an ideological preference for private plans rather than government-administered pricing and recognition that private plans can use tools effectively to improve quality. However, enrollment projections indicate that FFS will continue to attract the majority of beneficiaries for years to come.

The rural physician associate program: new directions in education for competency.

The Rural Physician Associate Program (RPAP) has 34 years experience in training 1097 medical students as independent distance learners in a 36-week, community-based continuity primary care experience. This program has been successful in preparing competitive students who select primary care residencies and return to rural practice. The RPAP program has been based on traditional apprentice-style clinical teaching with the support of computer-based resources to enhance distance learning.