Chronic Daily Headache: Ten Steps for Primary Care Providers to Regain Control.

Background: Chronic daily headache (CDH) affects 2% to 4% of the North American and European population. Various pathways lead to this condition, although chronification of migraine and the occurrence of central sensitization in tension headache are the 2 most common. Medication overuse headaches complicate a substantial portion of other primary headaches that have become chronic and often make their treatment more complex and less successful.

Self-Reported Rationing Behavior Among US Physicians: A National Survey.

Background: Rationing is a controversial topic among US physicians. Understanding their attitudes and behaviors around rationing may be essential to a more open and sensible professional discourse on this important but controversial topic.

Objective: To describe rationing behavior and associated factors among US physicians.

Predictors of medical school clerkship performance: a multispecialty longitudinal analysis of standardized examination scores and clinical assessments.

Background: Evidence suggests that poor performance on standardized tests before and early in medical school is associated with poor performance on standardized tests later in medical school and beyond. This study aimed to explore relationships between standardized examination scores (before and during medical school) with test and clinical performance across all core clinical clerkships.

Methods: We evaluated characteristics of 435 students at Mayo Medical School (MMS) who matriculated 2000-2009 and for whom undergraduate grade point average, medical college aptitude test (MCAT), medical school standardized tests (United States Medical Licensing Examination [USMLE] 1 and 2; National Board of Medical Examiners [NBME] subject examination), and faculty assessments were available.

Teaching an experiential mind-body method to medical students to increase interpersonal skills: a pilot study.

Objective: The authors investigate whether inner relationship focusing increases self-awareness in medical students and, in the process, to give them experience with empathic listening.

Methods: Thirteen second-year medical students were randomized into experimental and control groups and surveyed pre-course and post-course about their self-awareness and perceived comfort with clinical interpersonal skills. Subjects attended a 20-h course on inner relationship focusing, followed by 5 months of weekly sessions.

Controlling health costs: physician responses to patient expectations for medical care.

Background: Physicians have dual responsibilities to make medical decisions that serve their patients' best interests but also utilize health care resources wisely. Their ability to practice cost-consciously is particularly challenged when faced with patient expectations or requests for medical services that may be unnecessary.

Objective: To understand how physicians consider health care resources and the strategies they use to exercise cost-consciousness in response to patient expectations and requests for medical care.

Shared decision-making as a cost-containment strategy: US physician reactions from a cross-sectional survey.

Objective: To assess US physicians' attitudes towards using shared decision-making (SDM) to achieve cost containment.

Design: Cross-sectional mailed survey.

Setting: US medical practice.

Specialty, political affiliation, and perceived social responsibility are associated with U.S. physician reactions to health care reform legislation.

Background: Little is known about how U.S. physicians’ political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation.

Views of US physicians about controlling health care costs.

Importance: Physicians' views about health care costs are germane to pending policy reforms.

Objective: To assess physicians' attitudes toward and perceived role in addressing health care costs.

Design, Setting, And Participants: A cross-sectional survey mailed in 2012 to 3897 US physicians randomly selected from the AMA Masterfile.

Specialty, Political Affiliation, and Perceived Social Responsibility Are Associated with U.S. Physician Reactions to Health Care Reform Legislation.

Background: Little is known about how U.S. physicians' political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation.

Avoidable after-hours calls to physicians in family medicine.

Objectives: To assess avoidability in after-hours telephone calls. Identification of predictors of avoidable calls is necessary so that system changes can be implemented in the interest of efficiency in patient care.

Background: A new after-hours family physician call service was established in a large group practice to replace some of the resident call shifts and meet patient expectations.

Naming migraine and those who have it.

Medical language has implications for both public perception of and institutional responses to illness. A consensus panel of physicians, academics, advocates, and patients with diverse experiences and knowledge about migraine considered 3 questions: (1) What is migraine: an illness, disease, syndrome, condition, disorder, or susceptibility? (2) What ought we call someone with migraine? (3) What should we not call someone with migraine? Although consensus was not reached, the responses were summarized and analyzed quantitatively and qualitatively. Panelists participated in writing and editing the paper.

Multidisciplinary approach to inpatient medication reconciliation in an academic setting.

Purpose: The effectiveness of a multidisciplinary medication reconciliation process was studied in an inpatient family medicine unit of an academic hospital center.

Methods: In phase 1 of this two-phase study, nurses, pharmacists, and physicians used an admission medication reconciliation form to reconcile patients' home medications on admission. The form was then reviewed by the pharmacist on the unit and by the attending physician, who reconciled the discharge medication list.

Clinical inquiries. What test is the best for diagnosing infectious mononucleosis?

Tests for antibodies to Epstein-Barr viral capsid antigen or Epstein-Barr nuclear antigen are the most sensitive, are highly specific, and are also the most expensive for diagnosing infectious mononucleosis (strength of recommendation [SOR]: C, based on validating cohort study). Heterophile antibody tests have similar specificity and are cheaper, but are less sensitive in children or in adults during the early days of the illness (SOR: C, based on validating cohort study). The polymerase chain reaction assay for Epstein-Barr virus DNA is more sensitive than the heterophile antibody test in children, is highly specific, but is also expensive (SOR: C, based on validating cohort study).

Accuracy of rapid strep testing in patients who have had recent streptococcal pharyngitis.

Background: Some clinicians have questioned the accuracy of rapid diagnosis of group A streptococcal pharyngitis by commercial immunochemical antigen test kits in the setting of recent streptococcal pharyngitis, believing that the false-positive rate was increased because of presumed antigen persistence.

Methods: We studied 443 patients--211 cases--who had clinical pharyngitis diagnosed as group A beta-hemolytic streptococcus infection in the past 28 days and compared them with 232 control patients who had symptoms of pharyngitis but no recent diagnosis of streptococcal pharyngitis. Our aim was narrowly focused to compare the rapid strep test with the culture method we used in our clinical practice.