Physicians

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

Yelp Reviews and Opioids

Apr. 10, 2018

Researchers are discovering that social media offers a window into the lived experience of patients and their caregivers. Using Yelp reviews about US hospitals, our team at Penn’s Center for Health Care Innovation attempted to give voice to these experiences related to pain management and opioids during recent hospital visits.

Moving Beyond Duty-Hours

Apr. 2, 2018

If you want to start an intense debate within the medical community, just talk about duty-hours – the length of a physician-in-training’s shift.

Education Outcomes in a Duty-Hour Flexibility Trial in Internal Medicine

Mar. 21, 2018

Sanjay V. Desai, David A. Asch, Lisa M. Bellini, Krisda H. Chaiyachati, Manqing Liu, Alice L. Sternberg, James Tonascia, Alyssa...

Abstract [from journal]

Background 
Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians.

Methods
We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off...

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...

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