Rebooting the ambulatory enterprise in a community medical group in Kentucky following the initial surge of COVID-19.

The novel coronavirus disease 2019 (COVID-19) pandemic has intensified globally since its origin in Wuhan, China in December 2019. Many medical groups across the United States have experienced extraordinary clinical and financial pressures due to COVID-19 as a result of a decline in elective inpatient and outpatient surgical procedures and most nonurgent elective physician visits. The current study reports how our medical group in a metropolitan community in Kentucky rebooted our ambulatory and inpatient services following the guidance of our state's phased reopening.

Reduction in Schedule II opioid prescribing by primary care -providers, orthopedic and general surgeons, and pain -management specialists following the implementation of a State House Bill and an Institutional Controlled Substance Task Force.

Objective: Prescription opioid misuse represents a social and economic challenge in the United States. We evaluated Schedule II opioid prescribing practices by primary care providers (PCPs), orthopedic and general surgeons, and pain management specialists.

Design: Prospective evaluation of prescribing practices of PCPs, orthopedic and general surgeons, and pain management specialists over 5 years (October 1, 2014-September 30, 2019) in an outpatient setting.

Multidisciplinary approach to enhancing provider well-being in a metropolitan medical group in the United States.

Background: Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community.

Standardized warfarin monitoring decreases adverse drug reactions.

Background: While warfarin is the most commonly prescribed medication to prevent thromboembolic disorders, the risk of adverse drug reactions (ADR) poses a serious concern. This prospective study evaluated how primary care providers (PCP) and cardiologists at our Institution managed patients treated with warfarin with the goal of decreasing the number of warfarin ADRs.

Methods: A multidisciplinary anticoagulation task force was established at our Institution in 2014 to standardize warfarin monitoring and management.

Decline in primary care providers' prescribing of Schedule II opioids following the implementation of federal and state guidelines.

Objective: Prescription opioid misuse represents a social and economic dilemma in the United States. The authors evaluated primary care providers' (PCPs) prescribing of Schedule II opioids at our institution in Kentucky.

Design: Prospective evaluation of PCPs' prescribing practices over a 3-year period (October 1, 2014 to September 30, 2017) in an outpatient setting.

Multidisciplinary approach to low-dose CT screening for lung cancer in a metropolitan community.

Background: Lung cancer is the primary cause of cancer death in men and women in the USA, led by Kentucky. In 2015, the Centers for Medicare and Medicaid Services initiated annual lung cancer screening with a low-dose computed tomography (LDCT) scan. This observational cohort study evaluated the multidisciplinary approach to this screening in our metropolitan community.

Impact of parenting on the development of chronic diseases in adulthood.

The life course theory refers to a method developed in the 1960s that utilizes a multifaceted approach to evaluate people's lives, structural contexts, and social change. Adversities in childhood are associated with a heightened risk of chronic illnesses in adulthood. Parents play an important role in developing self-esteem, self-confidence, and effective coping mechanisms in their children.

The S-curve discontinuity theory predicts the path towards a "well" society and increased longevity.

The logistic function or logistic growth curve is an "S" shape (sigmoid curve) that has been applied to numerous fields, including geology, physics, biology, mathematics, chemistry, economics, sociology, oncology, and statistics. The S-curve initiates with exponential growth, followed by slowing of growth as saturation occurs, and completion of growth at maturity. The S-curve follows the law of natural growth with a limiting factor, whether it be a competition for resources, investigation and demand for new products, or an economic bubble.

Primary care providers' prescribing practices of opioid controlled substances.

Objective: Prescription opioid abuse poses a significant public health concern. House Bill 1 (HB1) was enacted in 2012 to address prescription drug abuse in Kentucky. The authors investigated the impact of HB1 on primary care providers' (PCPs) prescribing practices of Schedule II controlled substances.