Family physicians' perspectives on outcomes, processes, and policies in dementia care.

The rapid rise in numbers of people living with Alzheimer's disease and related disorders (ADRD) poses major challenges to health systems and policy. Although primary care clinicians provide ongoing medical care for 80% of affected individuals, they face persistent barriers to providing high-quality dementia care. We conducted qualitative interviews with family physicians ( = 20) to understand what core outcomes they consider most important and what care processes and systems and policy strategies they propose to achieve them.

Opioid Prescribing Has Significantly Decreased in Primary Care.

Prescription opioids continue to be commonly used for chronic non-cancer pain, despite inherent risks. Primary care physicians and advanced practice clinicians have been integral to driving change in opioid prescribing, preventing overuse, and reducing risk. The authors of this article assessed the current extent of opioid prescribing using publicly available data to identify which specialties are most likely to prescribe opioids and to what extent.

An Estimate of Preventable Harms Associated With Screening Colonoscopy Overuse in the U.S.

Introduction: Screening colonoscopy is often performed on patients who are younger or older than the ages specified in national guidelines or at shorter intervals than recommended. The annual incidence of harms associated with overuse of screening colonoscopy in the U.S.

"I consider myself to be a leader": a qualitative exploration of early career women family physicians' intentions to assume a leadership role.

Background: Despite the increasing presence of women in US medical schools over the past 25 years, gender equity in medical leadership remains elusive. This qualitative study delves deeper into definitions of institutional leadership roles, who they are designed for, and how women currently contribute in unrecognized and uncompensated leadership positions.

Methods: We recruited family physicians who responded to the American Board of Family Medicine 2022 or 2023 graduate survey.

The Impact of Primary Care Physician Capacity on Preventable Hospitalizations: Identifying Bright Spots in the Appalachian & Mississippi Delta Regions.

Introduction: Several studies have documented that higher rates of primary care physicians are associated with lower rates of preventable hospitalizations. Counties with higher rates of preventable hospitalizations are found in the Appalachian and Mississippi (MS) Delta Regions.

Purpose: (1) To determine if the association of primary care capacity with preventable hospitalizations is different in the Appalachian and MS Delta regions compared to the rest of the U.

US Primary Care Workforce Growth: A Decade of Limited Progress, and Projected Needs Through 2040.

Background: Despite efforts to mitigate a projected primary care physician (PCP) shortage required to meet an aging, growing, and increasingly insured population, shortages remain, compounded by the COVID-19 pandemic, growing inequity, and persistent underinvestment.

Objective: We examined primary care workforce trends over the past decade and revisited projected primary care clinician workforce needs through the year 2040.

Design And Participants: Using data from the AMA Masterfile and Medical Expenditure Panel Survey (MEPS), we analyzed trends in the number of primary care physicians (PCPs) and in outpatient PCP visits by age and gender over the past decade.

A Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries.

Purpose: Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.

Methods: This descriptive cross-sectional study used 2016 Medicaid claims data from the Transformed Medicaid Statistical Information System and from 2016-2017 American Board of Family Medicine certification questionnaire responses to examine the diversity and Medicaid participation of FPs.

How Early Career Family Medicine Women Physicians Negotiate Their First Job After Residency.

Background: Nested within a growing body of evidence of a gender pay gap in medicine are more alarming recent findings from family medicine: a gender pay gap of 16% can be detected at a very early career stage. This article explores qualitative evidence of women's experiences negotiating for their first job out of residency to ascertain women's engagement with and approach to the negotiation process.

Methods: We recruited family physicians who graduated residency in 2019 and responded to the American Board of Family Medicine 2022 graduate survey.

Relationship Between Primary Care Physician Capacity and Usual Source of Care.

Background: The NASEM Primary Care Report and Primary Care scorecard highlighted the importance of primary care physician (PCP) capacity and having a usual source of care (USC). However, research has found that PCP capacity and USC do not always correlate. This exploratory study compares geographic patterns and the characteristics of counties with similar rates of PCP capacity but varying rates of USC.

Quantifying Population Characteristics Within and Outside a 30-Minute Drive-Time to Health Resources and Services Administration-Supported Health Centers.

The Health Resources and Services Administration's (HRSA) Health Center Program provides health care to vulnerable persons across the US, regardless of their ability to pay for health care. We examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers to establish a baseline to better understand the differences in these populations. Using a descriptive, cross-sectional study design and geographic information systems, we found that 94% of persons in the US live within a 30-minute drive-time of a health center.

Screening for Unhealthy Alcohol Use Among Patients With Multiple Chronic Conditions in Primary Care.

Introduction: Unhealthy alcohol use increases the risk for and exacerbation of chronic health conditions. As such, screening, prevention, and management of unhealthy alcohol use is especially critical to improving health outcomes for patients with multiple chronic health conditions. It is unclear to what extent multiple chronic condition status is a barrier to screening for unhealthy alcohol use in the primary care setting.

Family physicians provide maternity care in and around the maternity care shortage areas, particularly rural.

Purpose: This study examined demographic, practice, and area-level characteristics associated with family physicians' (FP) provision of maternity care.

Methods: Using the American Board of Family Medicine Certification examination application survey data, we investigated the relationship between FPs' maternity care service provision and (1) demographic (gender, years in practice, race/ethnicity), (2) practice characteristics (size, ownership, rurality), and (3) county-level factors (percentage of reproductive-age women, the number of obstetrician-gynecologists (OBGYNs) and certified nurse midwives (CNMs) per 100,000 reproductive-age women). We performed summary statistics and multivariate logistic regression analyses.

Deciphering the Neighborhood Atlas Area Deprivation Index: the consequences of not standardizing.

The Area Deprivation Index (ADI) is a widely used measure recently selected for several federal payment models that adjusts payments based on where beneficiaries live. A recent debate in focuses on seemingly implausible ADI rankings in major cities and across New York. At the root of the issue is the importance of standardization of measures prior to calculating index scores.

The Gender Wage Gap Among Early-Career Family Physicians.

Purpose: Numerous studies have documented salary differences between male and female physicians. For many specialties, this wage gap has been explored by controlling for measurable factors that influence pay such as productivity, work-life balance, and practice patterns. In family medicine where practice activities differ widely between physicians, it is important to understand what measurable factors may be contributing to the gender wage gap, so that employers and policymakers and can address unjust disparities.

Racial Inequities in Female Family Physicians Providing Women's Health Procedures.

Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities in care received by minority women.

Integrated Behavioral Health Adaptations During the COVID-19 Pandemic.

Introduction: COVID-19 pandemic lockdowns threatened standard components of integrated behavioral health (IBH) such as in-person communication across care teams, screening, and assessment. Restrictions also exacerbated pre-existing challenges to behavioral health (BH) access.

Methods: Semistructured interviews were completed with clinicians from family medicine residency programs on the impact of the pandemic on IBH care delivery along with adaptations employed by care teams to ameliorate disruption.

Increased Organizational Stress in Primary Care: Understanding the Impact of the COVID-19 Pandemic, Medicaid Expansion, and Practice Ownership.

Background: Primary care is the foundation of health care, resulting in longer lives and improved equity. Primary care was the frontline of the COVID-19 pandemic public response and essential for access to care. Yet primary care faces substantial structural and systemic challenges.

Integrated Behavioral Health Implementation and Training in Primary Care: A Practice-Based Research Network Study.

Introduction: Integrating behavioral health services into primary care has a strong evidence base, but how primary care training programs incorporate integrated behavioral health (IBH) into care delivery and training has not been well described. The goal of this study was to evaluate factors related to successful IBH implementation in family medicine (FM) residency programs and assess perspectives and attitudes on IBH among program leaders.

Methods: FM residency programs, all which are required to provide IBH training, were recruited from the American Academy of Family Physicians National Research Network.

Migraine care practices in primary care: results from a national US survey.

Background: Primary care clinicians play a critical role in diagnosis and treatment of migraine, yet barriers exist. This national survey assessed barriers to diagnosis and treatment of migraine, preferred approaches to receiving migraine education, and familiarity with recent therapeutic innovations.

Methods: The survey was created by the American Academy of Family Physicians (AAFP) and Eli Lilly and Company and distributed to a national sample through the AAFP National Research Network and affiliated PBRNs from mid-April through the end of May 2021.