The supply, distribution, specialty mix, and other characteristics of the nearly 900,000 professionally-active U.S. physicians

Exploring Opportunities to Prevent Cirrhosis Admissions in the Emergency Department: A Multicenter Multidisciplinary Survey

Feb. 21, 2018

Shazia Mehmood Siddique, Meghan Lane-Fall, Matthew J. McConnell, Neha Jakhete, James Crismale, Stefanie...

In Hepatology Communications, Shazia Mehmood Siddique and colleagues investigate nonmedical factors that influence inpatient admission for patients with cirrhosis who present to the emergency department. They also explore provider perspectives on patients presenting to the emergency department with low-acuity conditions, such as ascites and hepatic encephalopathy. The authors survey emergency medicine and hepatology providers, including attending physicians, house staff, and advanced practitioners, in four liver transplant centers.

From the 186 responses analyzed, they...

When Physicians Support Financial Penalties to Reduce Low-Value Care (and When They Don’t)

Dec. 16, 2017

Despite professional consensus, guidelines, and national campaigns, physicians continue to provide many low-value services. These services are defined as having little to no benefit, little benefit relative to their cost, or outsized potential harm compared to their benefit. Policies have tried to promote high-value care by altering physician compensation, but have had limited success in part because they are rarely based on theories of physician behavior.

Physicians and Advanced Practitioners Specializing in Nursing Home Care, 2012-2015

Research Brief
Nov. 29, 2017

The number of clinicians specializing in nursing home care increased by 33.7% from 2012 to 2015, although nursing home specialists made up only 21% of nursing home clinicians in 2015. Most of these specialists were advanced practitioners (physician assistants and nurse practitioners) delivering post-acute care. The change in number of nursing home specialists varied significantly by geographic region.

What Every Graduating Resident Needs to Know About Quality Improvement and Patient Safety: A Content Analysis of 26 Sets of ACGME Milestones

Nov. 29, 2017

Meghan Lane-Fall, Joshua J. Davis, Justin Clapp, Jennifer S. Myers, Lee Ann Riesenberg

In the Journal of the Association of American Medical Colleges, Meghan Lane-Fall and colleagues analyze milestones – competency-based outcomes assessing graduate medical trainees – across 26 specialties to identify common expectations related to quality improvement (QI) and patient safety (PS). The purpose of this work is to move toward a consensus around what every medical trainee needs to know in QI and PS, irrespective of specialty.

The authors performed a content analysis of 612 published milestones from the Accreditation Council for Graduate Medical Education (ACGME)....

Changing Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success

Oct. 11, 2017

Suratha Elango, Julia E. Szymczak, Ian M. Bennett, Rinad S. Beidas, Rachel M. Werner

In the American Journal of Medical Quality, Suratha Elango and colleagues, including Rinad Beidas and Rachel Werner, studied factors important to combating overuse of broad-spectrum antibiotics in outpatient pediatric practices. Primary care clinics in the Children’s Hospital of Philadelphia network completed surveys and then semi-structured interviews on barriers and facilitators to improving their antibiotic prescribing practices, perceptions and reactions to the initiative, and the climate surrounding its implementation.

Practices with a high willingness...

A ‘Newfound Passion for Advocacy’

Sep. 26, 2017

The American College of Physicians (ACP), representing 152,000 internal medicine physicians and medical students, has been front and center in the national debates on health care reform, according to Robert Doherty, the ACP’s Senior Vice President of Governmental Affairs and Public Policy. The ACP is the largest physician specialty society and second largest medical organization in the United States.

Distribution of Medical Education Debt by Specialty, 2010-2016

Sep. 22, 2017

Justin Grischkan, Benjamin P. George, Krisda Chaiyachati, Ari B. Freidman, E. Ray Dorsey, David A. Asch

In JAMA Internal Medicine, Justin Grischkan and colleagues, including Krisda Chaiyachati and David A. Asch, analyze trends in the distribution of medical education debt. The increasing amount of graduate medical education debt is well known, yet a quieter upward trend in the number of graduates without debt also persists in the data.

The authors analyzed figures of self-reported debt from the 2010-2016 Association of American Medical Colleges Graduation Questionnaire. They find that the mean amount of debt increased from $161,739 in 2010 to $179,068 in 2016, and that the...

Public Awareness of and Contact With Physicians Who Receive Industry Payments: A National Survey

Jul. 27, 2017

Genevieve Kanter, Michelle M. Mello, Lisa Soleymani Lehmann, Eric G. Campbell, and Daniel Carpenter 

In the Journal of General Internal Medicine, Genevieve Kanter and colleagues investigate public awareness and physicians’ perceptions of industry payments to doctors. As part of the Affordable Care Act, pharmaceutical and medical device manufacturers are now required to report payments that they make to health care providers to a database called Open Payments. This provision was partially motivated by concerns that industry payments could sway physicians’ decisions on patient care, and that patients may not know about these payments when selecting a provider. The authors conducted...

Bringing Rounds Back to the Patient: A One-Year Evaluation of the Chiefs’ Service Model for Inpatient Teaching

Jul. 5, 2017

Nadia L. Bennett, Judd D. Flesch, Peter Cronholm, James B. Reilly, Jack Ende

In Academic Medicine, Nadia Bennett and colleagues, including Peter Cronholm and Jack Ende, evaluate the impact of a new approach to inpatient teaching on both patient care and resident education. This model, called the Chiefs’ Service (CS), is a structured approach to inpatient teaching rounds, and has five key elements: morning huddles, bedside rounds, diagnostic “time-outs”, day-of-discharge rounds, and postdischarge follow-up rounds. The authors conducted end-of-rotation evaluation questionnaires among 183 residents after the program’s first year, and compared residents’...