Machine Learning to Identify Clusters in Family Medicine Diplomate Motivations and Their Relationship to Continuing Certification Exam Outcomes: Findings and Potential Future Implications.

Background: The potential for machine learning (ML) to enhance the efficiency of medical specialty boards has not been explored. We applied unsupervised ML to identify archetypes among American Board of Family Medicine (ABFM) Diplomates regarding their practice characteristics and motivations for participating in continuing certification, then examined associations between motivation patterns and key recertification outcomes.

Methods: Diplomates responding to the 2017 to 2021 ABFM Family Medicine continuing certification examination surveys selected motivations for choosing to continue certification.

Enhancing Patient Communication With Chat-GPT in Radiology: Evaluating the Efficacy and Readability of Answers to Common Imaging-Related Questions.

Purpose: To assess ChatGPT's accuracy, relevance, and readability in answering patients' common imaging-related questions and examine the effect of a simple prompt.

Methods: A total of 22 imaging-related questions were developed from categories previously described as important to patients, as follows: safety, the radiology report, the procedure, preparation before imaging, meaning of terms, and medical staff. These questions were posed to ChatGPT with and without a short prompt instructing the model to provide an accurate and easy-to-understand response for the average person.

Evidence for an adverse impact of remote readouts on radiology resident productivity: Implications for training and clinical practice.

After their rapid adoption at the onset of the coronavirus pandemic, remote case reviews (remote readouts) between diagnostic radiology residents and their attendings have persisted in an increasingly remote workforce, despite relaxing social distancing guidelines. Our objective was to evaluate the impact of the transition to remote readouts on resident case volumes after the recovery of institutional volumes. We tabulated radiology reports co-authored by first-to-third-year radiology residents (R1-R3) between July 1 and December 31 of the first pandemic year, 2020, and compared to the prior two pre-pandemic years.

A Novel Approach to Teaching Fundoscopy Using a Virtual Format.

Introduction: Ophthalmology education has been underemphasized in medical school curricula despite the fact that patient eye-related complaints are commonplace across primary care specialties. Although previous curricula used direct ophthalmoscopy to teach medical students the fundamentals of ophthalmic examination, there has been a growing call to teach these fundamentals through reading fundus photos due to the increasing prevalence and decreased costs of fundus cameras in primary care settings. We developed a virtual workshop to teach ophthalmoscopy to medical students using fundus photography.

Using Machine Learning to Predict Primary Care and Advance Workforce Research.

Purpose: To develop and test a machine-learning-based model to predict primary care and other specialties using Medicare claims data.

Methods: We used 2014-2016 prescription and procedure Medicare data to train 3 sets of random forest classifiers (prescription only, procedure only, and combined) to predict specialty. Self-reported specialties were condensed to 27 categories.

Primary Care Physician Characteristics Associated with Low Value Care Spending.

Background: Previous work has shown that $210 billion may be spent annually on unnecessary medical services and has identified patient and hospital characteristics associated with low value care (LVC). However, little is known about the association between primary care physician (PCP) characteristics and LVC spending. The objective of this study was to assess this association.

Characteristics of Young Family Physician Hospitalists.

Based on a 2016 survey of family physicians who were then three years out of residency training, we found that almost 9 percent self-identified as hospitalists. These family physician hospitalists were significantly more likely than their non-hospitalist peers to be male, work longer hours, be better paid, and be more satisfied with their work. These attributes may attract more family physicians to hospital medicine, with negative implications for the supply of primary care physicians.

The Growing Trend of Health Coaches in Team-Based Primary Care Training A Multicenter Pilot Study.

Background And Objectives: Team-based care with health coaches has improved the quality and cost effectiveness of chronic disease management and prevention. Clinical health coaches partner with patients to identify health goals, create action plans, overcome barriers to change, reinforce physician recommendations, and coordinate care. It is important to train resident physicians to practice in team-based settings.

Predictors of Attrition From Family Medicine Board Certification.

Board certification is associated with higher quality care. We sought to determine the rates and predictors of attrition from certification among family physicians who achieved initial certification with the American Board of Family Medicine from 1980 through 2000. In this period, 5.

Using Drug Prescribing Patterns to Identify Stewards of Cost-Conscious Care.

Purpose: To characterize family physicians (FPs) who are stewards of care by consistently prescribing omeprazole over esomeprazole.

Methods: Cross-sectional analysis of physicians prescribing omeprazole or esomeprazole under Medicare Part D in 2014.

Results: There was a regional trend with 49% of Western FPs but only 6% of Southern FPs rarely prescribing esomeprazole.

Mobility of US Rural Primary Care Physicians During 2000-2014.

Purpose: Despite considerable investment in increasing the number of primary care physicians in rural shortage areas, little is known about their movement rates and factors influencing their mobility. We aimed to characterize geographic mobility among rural primary care physicians, and to identify location and individual factors that influence such mobility.

Methods: Using data from the American Medical Association Physician Masterfile for each clinically active US physician, we created seven 2-year (biennial) mobility periods during 2000-2014.

Funding Instability Reduces the Impact of the Federal Teaching Health Center Graduate Medical Education Program.

The Teaching Health Center Graduate Medical Education (THCGME) program is a decentralized residency training component of the Affordable Care Act, created to combat critical shortages and maldistribution of primary care physicians. The Accreditation Council of Graduate Medical Education and federal data reveal that the THCGME program accounted for 33% of the net increase in family medicine residency positions between 2011 and 2015. However, amid concerns about the program's stability, the contribution of the THCGME program to the net increase fell to 7% after 2015.

Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

Introduction: Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors.

Regional Variation in Primary Care Involvement at the End of Life.

Purpose: Variation in end-of-life care in the United States is frequently driven by the health care system. We assessed the association of primary care physician involvement at the end of life with end-of-life care patterns.

Methods: We analyzed 2010 Medicare Part B claims data for US hospital referral regions (HRRs).

The Effects of Training Institution Practice Costs, Quality, and Other Characteristics on Future Practice.

Purpose: Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated.

Changes in Primary Care Graduate Medical Education Are Not Correlated With Indicators of Need: Are States Missing an Opportunity to Strengthen Their Primary Care Workforce?

Purpose: Federal and state graduate medical education (GME) funding exceeds $15 billion annually. It is critical to understand mechanisms to align undergraduate medical education (UME) and GME to meet workforce needs. This study aimed to determine whether states' primary care GME (PCGME) trainee growth correlates with indicators of need.

You can't treat what you don't diagnose: An analysis of the recognition of somatic presentations of depression and anxiety in primary care.

Background: Research suggests that 13-25% of primary care patients who present with physical complaints have underlying depression or anxiety.

Objective: The goal of this paper is to quantify and compare the frequency of the diagnosis of depression and anxiety in patients with a somatic reason for visit among primary care physicians across disciplines.

Method: Data obtained from the National Ambulatory Medical Care Survey (NAMCS) from 2002 to 2010 was used to quantify primary care patients with somatic presentations who were given a diagnosis of depression or anxiety.

Office Visits for Women Aged 45-64 Years According to Physician Specialties.

Background: The increase in access to healthcare through the Affordable Care Act highlights the need to track where women seek their office-based care. The objectives of this study were to examine the types of physicians sought by women beyond their customary reproductive years and before being elderly.

Methods: This retrospective cohort study involved an analysis of national data from the Medical Expenditure Panel Survey (MEPS) between 2002 and 2012.

Medicare Part D: Patients Bear The Cost Of 'Me Too' Brand-Name Drugs.

Prescription drugs are a major source of US health care expenditure. "Me too" brand-name medications contribute to the cost of drugs, which is substantial for consumers. In 2013 patient copayments averaged 10.

Over Half of Graduating Family Medicine Residents Report More Than $150,000 in Educational Debt.

Primary care workforce shortages are thought to result not only from lower remuneration than other specialties but also from increasing amounts of debt at graduation. A census of 3083 graduating family medicine residents found that 58% reported having >$150,000 in educational debt and 26% reported having >$250,000-levels that may deter students' interest in primary care and constrain the practice location choices of those who do choose primary care.

The Diversity of Providers on the Family Medicine Team.

Family physicians are increasingly incorporating other health care providers into their practice teams to better meet the needs of increasingly complex and comorbid patients. While a majority of family physicians report working with a nurse practitioner, only 21% work with a behavioral health specialist. A better understanding of optimal team composition and function in primary care is essential to realizing the promise of a patient-centered medical home and achieving the triple aim.