Physician Coaching by Professionally Trained Peers for Burnout and Well-Being: A Randomized Clinical Trial.

Importance: Physician burnout is problematic despite existing interventions. More evidence-based approaches are needed.

Objective: To explore the effect of individualized coaching by professionally trained peers on burnout and well-being in physicians.

Epigenetics and type II diabetes mellitus: underlying mechanisms of prenatal predisposition.

Type II diabetes mellitus (T2DM) is a widespread metabolic disorder characterized by insulin resistance precipitating abnormally high blood glucose levels. While the onset of T2DM is known to be the consequence of a multifactorial interplay with a strong genetic component, emerging research has demonstrated the additional role of a variety of epigenetic mechanisms in the development of this disorder. Heritable epigenetic modifications, such as DNA methylation and histone modifications, play a vital role in many important cellular processes, including pancreatic cellular differentiation and maintenance of normal β-cell function.

Capital efficiency and integrated health system designs.

Community health system design plays a role in capital efficiency, including returns on invested capital. This role becomes important in a future healthcare world of pressured payments, increased consolidation, constrained resources, and stretched community service missions and budgets.

Quality, efficiency, and organizational structure.

Physicians and their practice patterns are the largest single determinant of the level of aggregate national health care expenditures. Integrated delivery systems (organizations linking a multispecialty physician groups and acute care hospitals) appear to be more efficient than other organizational structures while providing better clinical outcomes. To determine whether a subset of hospitals was more or less efficient than the national average, we relied on data from the Dartmouth Atlas Project, which included data from 4,346 hospitals.