Subjects -> MEDICAL SCIENCES (Total: 8697 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (220 journals)
    - ANAESTHESIOLOGY (121 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (235 journals)
    - DENTISTRY (294 journals)
    - DERMATOLOGY AND VENEREOLOGY (163 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (124 journals)
    - ENDOCRINOLOGY (151 journals)
    - FORENSIC SCIENCES (42 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (189 journals)
    - GERONTOLOGY AND GERIATRICS (138 journals)
    - HEMATOLOGY (158 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (178 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (99 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2419 journals)
    - NURSES AND NURSING (371 journals)
    - OBSTETRICS AND GYNECOLOGY (208 journals)
    - ONCOLOGY (386 journals)
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    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

MEDICAL SCIENCES (2419 journals)                  1 2 3 4 5 6 7 8 | Last

Showing 1 - 200 of 3562 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 3)
3D Printing in Medicine     Open Access   (Followers: 5)
4 open     Open Access  
AADE in Practice     Hybrid Journal   (Followers: 6)
AAS Open Research     Open Access   (Followers: 2)
ABCS Health Sciences     Open Access   (Followers: 8)
Abia State University Medical Students' Association Journal     Full-text available via subscription   (Followers: 3)
AboutOpen     Open Access  
ACIMED     Open Access   (Followers: 1)
ACS Medicinal Chemistry Letters     Hybrid Journal   (Followers: 50)
Acta Bio Medica     Full-text available via subscription   (Followers: 2)
Acta Bioethica     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Acta Científica Estudiantil     Open Access  
Acta Facultatis Medicae Naissensis     Open Access   (Followers: 1)
Acta Herediana     Open Access  
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Medica (Hradec Králové)     Open Access  
Acta Medica Bulgarica     Open Access  
Acta Medica Colombiana     Open Access   (Followers: 1)
Acta Médica Costarricense     Open Access   (Followers: 2)
Acta Medica Indonesiana     Open Access  
Acta Medica International     Open Access  
Acta medica Lituanica     Open Access   (Followers: 1)
Acta Medica Marisiensis     Open Access   (Followers: 1)
Acta Medica Martiniana     Open Access  
Acta Medica Nagasakiensia     Open Access   (Followers: 1)
Acta Medica Peruana     Open Access   (Followers: 2)
Acta Médica Portuguesa     Open Access  
Acta Medica Saliniana     Open Access  
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 8)
Acupuncture and Natural Medicine     Open Access  
Addiction Science & Clinical Practice     Open Access   (Followers: 9)
Addictive Behaviors Reports     Open Access   (Followers: 9)
Adıyaman Üniversitesi Sağlık Bilimleri Dergisi / Health Sciences Journal of Adıyaman University     Open Access   (Followers: 1)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Biomedical Research     Open Access  
Advanced Health Care Technologies     Open Access   (Followers: 10)
Advanced Science, Engineering and Medicine     Partially Free   (Followers: 9)
Advanced Therapeutics     Hybrid Journal   (Followers: 1)
Advances in Bioscience and Clinical Medicine     Open Access   (Followers: 7)
Advances in Cell and Gene Therapy     Hybrid Journal   (Followers: 1)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 27)
Advances in Clinical Radiology     Full-text available via subscription   (Followers: 3)
Advances in Life Course Research     Hybrid Journal   (Followers: 11)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Medical Education and Practice     Open Access   (Followers: 32)
Advances in Medical Ethics     Open Access   (Followers: 5)
Advances in Medical Research     Open Access   (Followers: 2)
Advances in Medical Sciences     Hybrid Journal   (Followers: 10)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 6)
Advances in Medicine     Open Access   (Followers: 3)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 5)
Advances in Molecular Oncology     Open Access   (Followers: 2)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7)
Advances in Parkinson's Disease     Open Access   (Followers: 2)
Advances in Phytomedicine     Full-text available via subscription   (Followers: 2)
Advances in Preventive Medicine     Open Access   (Followers: 6)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 21)
Advances in Regenerative Medicine     Open Access   (Followers: 4)
Advances in Skeletal Muscle Function Assessment     Open Access  
Advances in Therapy     Hybrid Journal   (Followers: 5)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 8)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 15)
Advances in Virus Research     Full-text available via subscription   (Followers: 6)
Advances in Wound Care     Hybrid Journal   (Followers: 14)
Aerospace Medicine and Human Performance     Full-text available via subscription   (Followers: 13)
African Health Sciences     Open Access   (Followers: 5)
African Journal of Biomedical Research     Open Access   (Followers: 1)
African Journal of Clinical and Experimental Microbiology     Open Access   (Followers: 4)
African Journal of Laboratory Medicine     Open Access   (Followers: 2)
African Journal of Medical and Health Sciences     Open Access   (Followers: 3)
African Journal of Thoracic and Critical Care Medicine     Open Access  
African Journal of Trauma     Open Access   (Followers: 1)
Afrimedic Journal     Open Access   (Followers: 3)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 9)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
AJSP: Reviews & Reports     Hybrid Journal   (Followers: 1)
Aktuelle Ernährungsmedizin     Hybrid Journal   (Followers: 6)
Al-Azhar Assiut Medical Journal     Open Access   (Followers: 2)
Al-Qadisiah Medical Journal     Open Access   (Followers: 1)
Alerta : Revista Científica del Instituto Nacional de Salud     Open Access  
Alexandria Journal of Medicine     Open Access   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 3)
Alpha Omegan     Full-text available via subscription  
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 2)
Althea Medical Journal     Open Access   (Followers: 2)
American Journal of Biomedical Engineering     Open Access   (Followers: 15)
American Journal of Biomedical Research     Open Access   (Followers: 2)
American Journal of Biomedicine     Full-text available via subscription   (Followers: 7)
American Journal of Chinese Medicine, The     Hybrid Journal   (Followers: 4)
American Journal of Clinical Medicine Research     Open Access   (Followers: 8)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Law & Medicine     Full-text available via subscription   (Followers: 12)
American Journal of Lifestyle Medicine     Hybrid Journal   (Followers: 7)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
American Journal of Medical Case Reports     Open Access   (Followers: 3)
American Journal of Medical Sciences and Medicine     Open Access   (Followers: 5)
American Journal of Medicine     Hybrid Journal   (Followers: 50)
American Journal of Medicine and Medical Sciences     Open Access   (Followers: 1)
American Journal of Medicine Studies     Open Access   (Followers: 3)
American Journal of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American Journal of the Medical Sciences     Hybrid Journal   (Followers: 12)
American Journal on Addictions     Hybrid Journal   (Followers: 11)
American medical news     Free   (Followers: 3)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Amyloid: The Journal of Protein Folding Disorders     Hybrid Journal   (Followers: 5)
Anales de la Facultad de Medicina     Open Access  
Anales de la Facultad de Medicina, Universidad de la República, Uruguay     Open Access  
Anales del Sistema Sanitario de Navarra     Open Access   (Followers: 1)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 7)
Anatolian Clinic the Journal of Medical Sciences     Open Access  
Anatomica Medical Journal     Open Access  
Anatomical Science International     Hybrid Journal   (Followers: 3)
Anatomical Sciences Education     Hybrid Journal   (Followers: 2)
Anatomy     Open Access   (Followers: 3)
Anatomy Research International     Open Access   (Followers: 4)
Androgens : Clinical Research and Therapeutics     Open Access  
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3)
Ankara Medical Journal     Open Access   (Followers: 2)
Ankara Üniversitesi Tıp Fakültesi Mecmuası     Open Access  
Annales de Pathologie     Full-text available via subscription  
Annales des Sciences de la Santé     Open Access  
Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale     Full-text available via subscription   (Followers: 3)
Annals of African Medicine     Open Access   (Followers: 2)
Annals of Anatomy - Anatomischer Anzeiger     Hybrid Journal   (Followers: 3)
Annals of Bioanthropology     Open Access   (Followers: 5)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 19)
Annals of Biomedical Sciences     Full-text available via subscription   (Followers: 4)
Annals of Clinical Hypertension     Open Access  
Annals of Clinical Microbiology and Antimicrobials     Open Access   (Followers: 15)
Annals of Family Medicine     Open Access   (Followers: 18)
Annals of Health Research     Open Access   (Followers: 1)
Annals of Ibadan Postgraduate Medicine     Open Access  
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Medicine     Hybrid Journal   (Followers: 12)
Annals of Medicine and Surgery     Open Access   (Followers: 7)
Annals of Medicine and Surgery Case Reports     Open Access   (Followers: 1)
Annals of Medicine and Surgery Protocols     Open Access   (Followers: 1)
Annals of Microbiology     Hybrid Journal   (Followers: 13)
Annals of Musculoskeletal Medicine     Open Access   (Followers: 2)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Rehabilitation Medicine     Open Access   (Followers: 1)
Annals of Saudi Medicine     Open Access  
Annals of the College of Medicine, Mosul     Open Access   (Followers: 1)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5)
Annals of The Royal College of Surgeons of England     Full-text available via subscription   (Followers: 3)
Annals of the RussianAacademy of Medical Sciences     Open Access   (Followers: 1)
Annual Reports in Medicinal Chemistry     Full-text available via subscription   (Followers: 7)
Annual Reports on NMR Spectroscopy     Full-text available via subscription   (Followers: 5)
Annual Review of Medicine     Full-text available via subscription   (Followers: 18)
Anthropological Review     Open Access   (Followers: 25)
Anthropologie et santé     Open Access   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibodies     Open Access   (Followers: 2)
Antibody Reports     Open Access   (Followers: 1)
Antibody Technology Journal     Open Access   (Followers: 1)
Antibody Therapeutics     Open Access   (Followers: 1)
Anuradhapura Medical Journal     Open Access  
Anwer Khan Modern Medical College Journal     Open Access   (Followers: 2)
Apmis     Hybrid Journal   (Followers: 2)
Apparence(s)     Open Access   (Followers: 1)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal   (Followers: 2)
Applied Medical Informatics     Open Access   (Followers: 14)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arabian Journal of Scientific Research / المجلة العربية للبحث العلمي     Open Access   (Followers: 1)
Archive of Biomedical Science and Engineering     Open Access   (Followers: 1)
Archive of Clinical Medicine     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives Medical Review Journal / Arşiv Kaynak Tarama Dergisi     Open Access  
Archives of Asthma, Allergy and Immunology     Open Access  
Archives of Clinical Hypertension     Open Access   (Followers: 2)
Archives of Medical and Biomedical Research     Open Access   (Followers: 3)
Archives of Medical Laboratory Sciences     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Medicine and Surgery     Open Access   (Followers: 1)
Archives of Organ Transplantation     Open Access   (Followers: 2)
Archives of Preventive Medicine     Open Access   (Followers: 3)
Archives of Pulmonology and Respiratory Care     Open Access   (Followers: 2)
Archives of Renal Diseases and Management     Open Access   (Followers: 2)
Archives of Trauma Research     Open Access   (Followers: 4)
Archivos de Medicina (Manizales)     Open Access   (Followers: 1)
ArgoSpine News & Journal     Hybrid Journal  
Arquivos Brasileiros de Oftalmologia     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Arquivos de Medicina     Open Access   (Followers: 1)
Ars Medica : Revista de Ciencias Médicas     Open Access  
ARS Medica Tomitana     Open Access   (Followers: 1)
Art Therapy: Journal of the American Art Therapy Association     Hybrid Journal   (Followers: 19)
Arterial Hypertension     Open Access   (Followers: 1)
Artificial Intelligence in Medicine     Hybrid Journal   (Followers: 21)
Artificial Organs     Hybrid Journal   (Followers: 1)
ASHA Leader     Open Access   (Followers: 6)
Asia Pacific Family Medicine Journal     Open Access   (Followers: 4)
Asia Pacific Journal of Clinical Nutrition     Full-text available via subscription   (Followers: 13)
Asia Pacific Journal of Clinical Trials : Nervous System Diseases     Open Access   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
Annals of Family Medicine
Journal Prestige (SJR): 2.748
Citation Impact (citeScore): 3
Number of Followers: 18  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1544-1709 - ISSN (Online) 1544-1717
Published by Annals of Family Medicine Homepage  [1 journal]
  • Evaluation of Qualitative Study Investigating Telepsychiatric Consultation
           Model [Departments]

    • Authors: Rooney K.
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2593
      Issue No: Vol. 18, No. 5 (2020)
       
  • Recruiting, Educating, and Taking Primary Care to Rural Communities
           [Editorials]

    • Authors: Westfall, J. M; Byun, H.
      Pages: 386 - 387
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2601
      Issue No: Vol. 18, No. 5 (2020)
       
  • Returning to a Patient-Centered Approach in the Management of
           Hypothyroidism [Editorials]

    • Authors: Schneiderhan, J; Zick, S.
      Pages: 388 - 389
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2602
      Issue No: Vol. 18, No. 5 (2020)
       
  • Correction [Correction]

    • Pages: 389 - 389
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2581
      Issue No: Vol. 18, No. 5 (2020)
       
  • Peritonsillar Abscess and Antibiotic Prescribing for Respiratory Infection
           in Primary Care: A Population-Based Cohort Study and Decision-Analytic
           Model [Original Research]

    • Authors: Winter, J. R; Charlton, J, Ashworth, M, Bunce, C, Gulliford, M. C.
      Pages: 390 - 396
      Abstract: PURPOSETo quantify the risk of peritonsillar abscess (PTA) following consultation for respiratory tract infection (RTI) in primary care.METHODA cohort study was conducted in the UK Clinical Practice Research Datalink including 718 general practices with 65,681,293 patient years of follow-up and 11,007 patients with a first episode of PTA. From a decision tree, Bayes theorem was employed to estimate both the probability of PTA following an RTI consultation if antibiotics were prescribed or not, and the number of patients needed to be treated with antibiotics to prevent 1 PTA.RESULTSThere were 11,007 patients with PTA with age-standardized incidence of new episodes of PTA of 17.2 per 100,000 patient years for men and 16.1 for women; 6,996 (64%) consulted their practitioner in the 30 days preceding PTA diagnosis, including 4,243 (39%) consulting for RTI. The probability of PTA following an RTI consultation was greatest in men aged 15 to 24 years with 1 PTA in 565 (95% uncertainty interval 527 to 605) RTI consultations without antibiotics prescribed but 1 in 1,139 consultations (1,044 to 1,242) if antibiotics were prescribed. One PTA might be avoided for every 1,121 (975 to 1,310) additional antibiotic prescriptions for men aged 15 to 24 years and 926 (814 to 1,063) for men aged 25 to 34 years. The risk of PTA following RTI consultation was smaller and the number needed to treat higher at other ages and risks were lower in women than men.CONCLUSIONSThe risk of PTA may be lower if antibiotics are prescribed for RTI but even in young men nearly 1,000 antibiotic prescriptions may be required to prevent 1 PTA case. We caution that lack of randomization and data standardization may bias estimates.
      Keywords: Acute illness, Prevention, Community / population health, Quantitative methods
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2570
      Issue No: Vol. 18, No. 5 (2020)
       
  • Care Practices to Promote Patient Engagement in VA Primary Care: Factors
           Associated With High Performance [Original Research]

    • Authors: Katz, D. A; Wu, C, Jaske, E, Stewart, G. L, Mohr, D. C.
      Pages: 397 - 405
      Abstract: PURPOSEPatient engagement has been broadly defined as the process of actively involving and supporting patients in health care and treatment decision making. The aim of this study was to identify organizational factors that are associated with greater use of patient engagement care practices in Veterans Health Administration primary care clinics.METHODSWe conducted a cross-sectional analysis of data from the 2016 Patient-Aligned Care Team (PACT) national survey of direct care clinicians (primary care clinicians, registered nurses, and clinical associates). Exploratory factor analysis was used to group conceptually related patient engagement survey items into 3 subscales: planning and goal setting; motivational interviewing; and organizational strategies to promote self-management. Our independent variables included literature-based factors reported to promote team-based care and interdisciplinary collaboration in primary care. We used generalized estimating equations with multivariate logistic regression analysis to identify independent correlates of high performance on each patient engagement domain (top 25th vs bottom 25th percentile).RESULTSA total of 2,478 direct care clinicians from 609 clinics completed all patient engagement items in the PACT survey. For all patient engagement sub-scales, respondents at high-performing clinics were more likely to report having regular team meetings to discuss performance improvement and having leadership responsible for implementing PACT. For 2 of 3 patient engagement subscales, high performance was also associated with having fully staffed PACT teams (≥3 team members per primary care clinician) and role clarity.CONCLUSIONSSeveral desirable organizational and contextual factors were associated with high performance of patient engagement care practices. Strategies to improve the organizational functioning of primary care teams may enhance patient engagement in care.
      Keywords: Health promotion, Mixed methods, Professional practice, Personalized care, Communication / decision making, Organizational / practice change
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2569
      Issue No: Vol. 18, No. 5 (2020)
       
  • Effect of Access to After-Hours Primary Care on the Association Between
           Home Nursing Visits and Same-Day Emergency Department Use [Original
           Research]

    • Authors: Jones, A; Bronskill, S. E, Schumacher, C, Seow, H, Feeny, D, Costa, A. P.
      Pages: 406 - 412
      Abstract: PURPOSEPrevious work has demonstrated that home care patients have an increased risk of visiting the emergency department after a home nursing visit on the same day. We investigated whether this association is modified by greater access to after-hours primary care.METHODSWe conducted a population-based case-crossover study of home care patients in Ontario, Canada in 2014-2016. Emergency department visits after 5:00 pm were selected as case periods and matched, within the same patient, to control periods within the previous week. The association between home nursing visits and same-day emergency department visits was estimated with conditional logistic regression. Access to after-hours primary care, measured on the patient and practice level, was tested for effect modification using an interaction term approach. Analysis was performed separately for all emergency department visits and a less urgent subset not admitted to hospital.RESULTSA total of 11,840 patients contributed cases to the analysis. Patients with a history of after-hours primary care use had a smaller increased risk of a same-day after-hours emergency department visit (OR = 1.18; 95% CI, 1.06-1.30) compared with patients with no after-hours care (OR = 1.31; 95% CI, 1.25-1.39). The modifying effect was stronger among emergency department visits not admitted to hospital (OR = 1.11; 95% CI, 0.97-1.28 vs OR = 1.41; 95% CI, 1.31-1.51).CONCLUSIONGreater access to after-hours primary care reduced the risk of less-urgent emergency department use associated with home nursing visits. These findings suggest increasing access to after-hours primary care could prevent some less-urgent emergency department visits.
      Keywords: Older adults, Vulnerable populations, Health services, Access
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2571
      Issue No: Vol. 18, No. 5 (2020)
       
  • Perspectives Among Canadian Physicians on Factors Influencing
           Implementation of Mifepristone Medical Abortion: A National Qualitative
           Study [Original Research]

    • Authors: Munro, S; Guilbert, E, Wagner, M.-S, Wilcox, E. S, Devane, C, Dunn, S, Brooks, M, Soon, J. A, Mills, M, Leduc-Robert, G, Wahl, K, Zannier, E, Norman, W. V.
      Pages: 413 - 421
      Abstract: PURPOSEAccess to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals and how these factors relate to abortion policies, systems, and service access throughout Canada.METHODSWe conducted 1-on-1 semistructured interviews with a national sample of abortion-providing and nonproviding physicians and health system stakeholders in Canadian health care settings. Our data collection, thematic analysis, and interpretation were guided by Diffusion of Innovation theory.RESULTSWe conducted interviews with 90 participants including rural practitioners and those with no previous abortion experience. In the course of our study, Health Canada removed mifepristone restrictions. Our results suggest that Health Canada’s initial restrictions discouraged physicians from providing mifepristone and were inconsistent with provincial licensing standards, thereby limiting patient access. Once deregulated, remaining factors were primarily related to local and regional implementation processes. Participants held strong perceptions that mifepristone was the new standard of care for medical abortion in Canada and within the scope of primary care practice.CONCLUSIONHealth Canada’s removal of mifepristone restrictions facilitated the implementation of abortion care in the primary care setting. Our results are unique because Canada is the first country to facilitate provision of medical abortion in primary care via evidence-based deregulation of mifepristone.
      Keywords: Women's health, Quantitative methods, Health policy, Health services, Professional practice
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2562
      Issue No: Vol. 18, No. 5 (2020)
       
  • Assessing the Longitudinal Impact of Physician-Patient Relationship on
           Functional Health [Original Research]

    • Authors: Olaisen, R. H; Schluchter, M. D, Flocke, S. A, Smyth, K. A, Koroukian, S. M, Stange, K. C.
      Pages: 422 - 429
      Abstract: PURPOSEAccess to a usual source of care is associated with improved health outcomes, but research on how the physician-patient relationship affects a patient’s health, particularly long-term, is limited. The aim of this study was to investigate the longitudinal effect of changes in the physician-patient relationship on functional health.METHODSWe conducted a prospective cohort study using the Medical Expenditure Panel Survey (MEPS, 2015-2016). The outcome was 1-year change in functional health (12-Item Short-Form Survey). The predictors were quality of physician-patient relationship, and changes in this relationship, operationalized with the MEPS Primary Care (MEPS-PC) Relationship subscale, a composite measure with preliminary evidence of reliability and validity. Confounders included age, sex, race/ethnicity, educational attainment, insurance status, US region, and multimorbidity. We conducted analyses with survey-weighted, covariate-adjusted, predicted marginal means, used to calculate Cohen effect estimates. We tested differences in trajectories with multiple pairwise comparisons with Tukey contrasts.RESULTSImproved physician-patient relationships were associated with improved functional health, whereas worsened physician-patient relationships were associated with worsened functional health, with 1-year effect estimates ranging from 0.05 (95% CI, 0-0.10) to 0.08 (95% CI, 0.02-0.13) compared with –0.16 (95% CI, –0.35 to –0.03) to –0.33 (95% CI, –0.47 to –0.02), respectively.CONCLUSIONThe quality of the physician-patient relationship is positively associated with functional health. These findings could inform health care strategies and health policy aimed at improving patient-centered health outcomes.
      Keywords: Family, Quantitative methods, Health policy, Relationship
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2554
      Issue No: Vol. 18, No. 5 (2020)
       
  • Trends in Total and Out-of-Pocket Expenditures for Visits to Primary Care
           Physicians, by Insurance Type, 2002-2017 [Original Research]

    • Authors: Johansen, M. E; Yun, J. D. Y.
      Pages: 430 - 437
      Abstract: PURPOSETotal and out-of-pocket visit expenditures for primary care physician visits may affect how primary care is delivered. We determined trends in these expenditures for visits to US primary care physicians.METHODSUsing the 2002-2017 Medical Expenditure Panel Survey, we ascertained changes in total and out-of-pocket visit expenditures for primary care visits for Medicare, Medicaid, and private insurance. We calculated mean values for each insurer using a generalized linear model and a 2-part model, respectively.RESULTSAnalyses were based on 750,837 primary care visits during 2002-2017. Over time, the proportion of primary care visits associated with private insurance or no insurance decreased, while Medicare- or Medicaid-associated visits increased. The proportion of visits with $0 out-of-pocket expenditure increased, primarily from an increase in $0 private insurance visits. Total expenditure per visit increased for private insurance and Medicare visits, but did not notably change for Medicaid visits. Out-of-pocket expenditures rose primarily from increases in private insurance visits with higher expenditures of this type. Medicare and Medicaid had minimal change in out-of-pocket expenditure per visit.CONCLUSIONSBetween 2002 and 2017, mean total expenditures and out-of-pocket expenditures increased for primary care visits, but at notably lower rates than those previously documented for emergency department visits. A rise in total expenditure per visit was identified for private insurance and Medicare, but not for Medicaid. Out-of-pocket expenditures increased marginally related to changes in out-of-pocket expenditures for private insurance visits. We would expect increasing difficulty with primary care physician access, particularly for Medicaid patients, if the current trends continue.
      Keywords: Community / population health, Quantitative methods, Health policy, Health services, Access
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2566
      Issue No: Vol. 18, No. 5 (2020)
       
  • Telepsychiatric Consultation as a Training and Workforce Development
           Strategy for Rural Primary Care [Original Research]

    • Authors: Al Achkar, M; Bennett, I. M, Chwastiak, L, Hoeft, T, Normoyle, T, Vredevoogd, M, Patterson, D. G.
      Pages: 438 - 445
      Abstract: PURPOSEThere is a shortage of rural primary care personnel with expertise in team care for patients with common mental disorders. Building the workforce for this population is a national priority. We investigated the feasibility of regular systematic case reviews through telepsychiatric consultation, within collaborative care for depression, as a continuous training and workforce development strategy in rural clinics.METHODSWe developed and pilot-tested a qualitative interview guide based on a conceptual model of training and learning. We conducted individual semistructured interviews in 2018 with diverse clinical and nonclinical staff at 3 rural primary care sites in Washington state that used ongoing collaborative care and telepsychiatric consultation. Two qualitative researchers independently analyzed transcripts with iterative input from other research team members.RESULTSA total of 17 clinical, support, and administrative staff completed interviews. Participants’ feedback supported the view that telepsychiatric case review-based consultation enhanced skills of diverse clinical team members over time, even those who had not directly participated in case reviews. All interviewees identified specific ways in which the consultations improved their capacity to identify and treat psychiatric disorders. Perceived benefits in implementation and sustainability included fidelity of the care process, team resilience despite member turnover, and enhanced capacity to use quality improvement methods.CONCLUSIONSWeekly systematic case reviews using telepsychiatric consultation served both as a model for patient care and as a training and workforce development strategy in rural primary care sites delivering collaborative care. These are important benefits to consider in implementing the collaborative care model of behavioral health integration.
      Keywords: Chronic illness, Mental health, Qualitative methods, Professional practice, Access, Coordination / integration of care, Education, Organizational / practice change
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2561
      Issue No: Vol. 18, No. 5 (2020)
       
  • Effect of Access to Obstetrical Care in Rural Alabama on Perinatal,
           Neonatal, and Infant Outcomes: 2003-2017 [Original Research]

    • Authors: Waits, J. B; Smith, L, Hurst, D.
      Pages: 446 - 451
      Abstract: PURPOSETo evaluate differential mortality outcomes in rural Alabama counties with or without access to a local labor and delivery (L&D) unit.METHODSThis retrospective cohort study used county-level data from the Alabama Department of Public Health. Rural counties in Alabama were categorized into those with an L&D unit and those without. The 2 groups were compared based on infant mortality rate, perinatal mortality rate, neonatal mortality rate, and low birth weight.RESULTSThe infant mortality rate from 2003-2017 in the rural counties in Alabama with no local obstetrical care was 9.23 per 1,000 live births, whereas the infant mortality rate during the same period in the rural counties with continuous access to local obstetrical units was 7.89 (relative risk [RR] = 1.1679; 95% CI, 1.0643-1.2817, P = 0.0011). The percentage of low birth weight babies from the time period 2003-2014 in the rural counties in Alabama with no local obstetrical care was 10.61%, compared with 9.86% in the rural counties with continuous access to local L&D services (RR = 1.0756; 95% CI, 1.0424-1.1098, P
      Keywords: Prevention, Children's health, Vulnerable populations, Community / population health, Quantitative methods, Health services, Access, Continuity
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2580
      Issue No: Vol. 18, No. 5 (2020)
       
  • Thyroid Stimulating Hormone Stability in Patients Prescribed Synthetic or
           Desiccated Thyroid Products: A Retrospective Study [Research Briefs]

    • Authors: Kuye, R; Riggs, C, King, J, Heilmann, R, Kurz, D, Milchak, J.
      Pages: 452 - 454
      Abstract: The purpose of this retrospective matched-cohort study was to evaluate the stability of thyroid stimulating hormone (TSH) in patients using synthetic compared with desiccated thyroid products. Patients using a thyroid product for the treatment of hypothyroidism were matched 1:1 on age, sex, race/ethnicity, and had a follow-up period of 3 years after the index date. The primary outcome was percent of in-range TSH values. Over 3 years, TSH values in both groups were in-range 79% of the time (P = 0.905). Our results showed no difference in longitudinal TSH stability between desiccated thyroid products and synthetic levothyroxine.
      Keywords: Quantitative methods
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2545
      Issue No: Vol. 18, No. 5 (2020)
       
  • Use of Chronic Care Management Among Primary Care Clinicians [Research
           Briefs]

    • Authors: Reddy, A; Marcotte, L. M, Zhou, L, Fihn, S. D, Liao, J. M.
      Pages: 455 - 457
      Abstract: The Centers for Medicare and Medicade Services (CMS) initiated chronic care management (CCM) codes to reimburse clinicians for coordination activities, but little is known about uptake over time. We find that primary care clinicians drove increasing use over 4 years—a trend that may reflect either new coordination activities or new reimbursements for existing activities. That 5% of chronic care management was denied by Medicare underscores the need for future work evaluating facilitators and barriers to use. Such insight is especially vital given the large number of eligible beneficiaries that have not received chronic care management to date, as well as the limited number of clinicians who currently deliver these services.
      Keywords: Chronic illness, Women's health, Quantitative methods, Health services, Coordination / integration of care
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2573
      Issue No: Vol. 18, No. 5 (2020)
       
  • Immigrant Health and Changes to the Public-Charge Rule: Family Physicians
           Response [Reflections]

    • Authors: Haq, C; Hostetter, I, Zavala, L, Mayorga, J.
      Pages: 458 - 460
      Abstract: As the US federal government pursues immigration reform, changes to the federal public-charge rule have triggered confusion and concerns among patients who are immigrants. Although federal judges temporarily blocked implementation, a decision by the Supreme Court in January 2020 allowed the proposed changes to take effect. These policy changes have resulted in many legal immigrants and their family members becoming more reluctant to apply for health insurance, food, housing, and other benefits for which they are qualified. This article summarizes the changes and exclusions. Family physicians can effectively respond to patient and immigrant community concerns about these changes by providing outreach education, access to primary health care, and referrals to legal and social services.
      Keywords: Health promotion, Vulnerable populations, Participatory / action research, Health policy, Health services, Access, Disparities in health and health care
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2572
      Issue No: Vol. 18, No. 5 (2020)
       
  • In, But Out of Touch: Connecting With Patients During the Virtual Visit
           [Reflections]

    • Authors: Kelly, M. A; Gormley, G. J.
      Pages: 461 - 462
      Abstract: Covid-19 has rapidly changed physician-patient interaction, from hands-on to hands-off medicine. In this essay, 2 family physicians on different continents reflect on the meaning of touch in clinical practice and how virtual care is transforming this tacit aspect of patient care. Although technology enables physicians to stay in touch with patients verbally, we have lost the ability to physically touch. Traditionally, touch is central to medical practice, physical examination guides diagnosis and informs management. But the silent language of touch fulfills a deeper symbolic function, enabling physicians to acknowledge patient concerns in a tangible way. Touch expresses healing, extending beyond skin-to-skin contact to express humanity, caring, and connection. As we adapt to novel technologies, we wonder how, as family physicians, we will adapt our clinical acumen to extend our ability to connect with patients.
      Keywords: Access, Relationship, Mindfulness and reflection, COVID-19
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2568
      Issue No: Vol. 18, No. 5 (2020)
       
  • Enhanced Care Team Nurse Process to Improve Diabetes Care [Innovations in
           Primary Care]

    • Authors: Herges, J. R; Ruehmann, L. L, Matulis, J. C, Hickox, B. C, McCoy, R. G.
      Pages: 463 - 463
      Keywords: Acute illness, Health promotion, Community / population health, Participatory / action research, Professional practice, Coordination / integration of care
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2553
      Issue No: Vol. 18, No. 5 (2020)
       
  • Development and Implementation of a COVID-19 Respiratory Diagnostic Center
           [Innovations in Primary Care]

    • Authors: Barzin, A; Wohl, D. A, Daaleman, T. P.
      Pages: 464 - 464
      Keywords: Prevention, Community / population health, Health services, Professional practice, Access, COVID-19
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2558
      Issue No: Vol. 18, No. 5 (2020)
       
  • Begin the Turn: A Mobile Recovery Program for a Targeted Urban Population
           [Innovations in Primary Care]

    • Authors: OGurek, D. T; Strand, N, Gibbs, J, Hoover-Hankerson, B, Jegede, V. O.
      Pages: 465 - 465
      Keywords: Prevention, Vulnerable populations, Health services, Access, Coordination / integration of care
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2565
      Issue No: Vol. 18, No. 5 (2020)
       
  • Wellness Wheel Mobile Outreach Clinic: A Community-Led Care Model
           Improving Access to Care in Indigenous Communities [Innovations in Primary
           Care]

    • Authors: Pandey, M; Nicolay, S, Clark, M, Desjarlais, V, Clay, A, Skinner, S.
      Pages: 466 - 466
      Keywords: Health promotion, Vulnerable populations, Access, Social / cultural context
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2567
      Issue No: Vol. 18, No. 5 (2020)
       
  • Innovative Family Medicine and Behavioral Health Co-Precepting via
           Telemedicine [Innovations in Primary Care]

    • Authors: Kowalski, A; Gupta, A, Pellegrino, T, Petrides, J, Sepede, J, Vermeulen, M.
      Pages: 467 - 467
      Keywords: Mental health, Comprehensiveness, Coordination / integration of care, Education, Organizational / practice change, COVID-19
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2577
      Issue No: Vol. 18, No. 5 (2020)
       
  • HOW THE ABFM WILL ADDRESS HEALTH EQUITY [Family Medicine Updates]

    • Authors: Newton, W. P; Baxley, E, Peterson, L, Brady, J, Phillips, R, Magill, M, ONeill, T.
      Pages: 468 - 470
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2599
      Issue No: Vol. 18, No. 5 (2020)
       
  • STFM LAUNCHES INITIATIVE TO POSITION ACADEMIC FAMILY MEDICINE IN HEALTH
           SYSTEMS [Family Medicine Updates]

    • Authors: Theobald M.
      Pages: 470 - 471
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2595
      Issue No: Vol. 18, No. 5 (2020)
       
  • PUSHING BOUNDARIES FROM THE MIDAIR SUSPENSION OF A PANDEMIC [Family
           Medicine Updates]

    • Authors: Westfall, J; Tapp, H, Sutter, J.
      Pages: 471 - 472
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2596
      Issue No: Vol. 18, No. 5 (2020)
       
  • WHAT ADFM LEARNED FROM BRINGING A PUBLIC MEMBER ONTO ITS BOARD OF
           DIRECTORS [Family Medicine Updates]

    • Authors: Davis, A; Gilchrist, V, Moretz, J, Weidner, A, Grumbach, K, Holland, N.
      Pages: 472 - 473
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2598
      Issue No: Vol. 18, No. 5 (2020)
       
  • IDENTIFYING TRENDS AND AREAS FOR IMPROVEMENT USING REPORTS FROM THE
           NATIONAL GRADUATE SURVEY FOR FAMILY MEDICINE [Family Medicine Updates]

    • Authors: Barr, W; Pettit, J. M.
      Pages: 473 - 475
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2597
      Issue No: Vol. 18, No. 5 (2020)
       
  • AAFP LAUNCHES NEW WEBSITE AND MOBILE APP [Family Medicine Updates]

    • Pages: 475 - 475
      PubDate: 2020-09-14T13:13:14-07:00
      DOI: 10.1370/afm.2600
      Issue No: Vol. 18, No. 5 (2020)
       
 
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