This practice-related insight article describes the experience of a genetic counselor being integrated into a multidisciplinary primary care clinic that provides care for a predominantly marginalized patient population in Victoria, British Columbia, Canada. Reflections on the lessons learned, including challenges and successes during this 1-year pilot integration are shared by the genetic counselor in the context of exploring the potential value a genetic counselor can provide while embedded in a primary care clinic. The relationship between clinical genetic counseling practice and a culturally safe and trauma-informed approach in primary care is explored, and additional steps are described that can be taken to facilitate more equitable and inclusive access to genetic counseling services for underserved and vulnerable patient populations.
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http://dx.doi.org/10.1159/000530683 | DOI Listing |
J Prim Care Community Health
January 2025
University of California, Davis, Division of Hospital Medicine, Sacramento, CA, USA.
Introduction: Nadezhda Clinic is a free student-run health clinic that provides culturally sensitive primary care services to the underserved Russian-speaking population of the greater Sacramento area. At the onset of the COVID-19 pandemic, the clinic suspended in-person services and solely offered telemedicine visits. Most patients were hesitant to utilize telemedicine due to poor technological literacy, privacy concerns, and a preference for in-person care.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Clinical Product Development, Waymark, San Francisco, California.
Importance: Rising prescription medication costs under Medicaid have led to increased procedural prescription denials by health plans. The effect of unresolved denials on chronic condition exacerbation and subsequent acute care utilization remains unclear.
Objective: To examine whether procedural prescription denials are associated with increased net spending through downstream acute care utilization among Medicaid patients not obtaining prescribed medication following a denial.
JAMA Netw Open
January 2025
S-SPIRE Center, Department of Surgery, Stanford University School of Medicine, Stanford, California.
Importance: Transportation insecurity and lack of social support are 2 understudied social determinants of health that contribute to excess morbidity, mortality, and acute health care utilization. However, whether and how these social determinants of health are associated with cancer screening has not been determined and has implications for preventive care.
Objective: To determine whether transportation insecurity or social support are associated with screening adherence for colorectal, breast, and cervical cancer.
J Prim Care Community Health
January 2025
Instituto de Investigación Biomédica de Málaga, Málaga, Spain.
Aim: To investigate the detection and initial management of first psychotic episodes, as well as established schizophrenia, within the primary care of the Andalusian Health System.
Background: Delay in detecting and treating psychosis is associated with slower recovery, higher relapse risk, and poorer long-term outcomes. Often, psychotic episodes go unnoticed for years before a diagnosis is established.
JAMA
January 2025
Departments of Family Medicine and Community Health and Psychiatry and Behavioral Sciences, Duke University Hospital, Durham, North Carolina.
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