Declining Endoscopic Care by Family Physicians in Both Rural and Urban Areas

Peterson, Lars E.; Nasim, Urooj; Madabhushi, Vashisht

doi:10.3122/jabfm.2019.04.190064

Cited by 9 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Family physicians may deliver endoscopy services, but prior research showed that fewer than 5% actually do so and that the percentages declined between 2014 and 2016. 26 In a study based on 2006 and 2007 Medicare Beneficiary Survey and Medicare claims, residents of metropolitan areas whose usual physician was a general internist had higher odds of colorectal screening than those whose usual physician was a family physician. 27 However, there was no association between physician specialty and colorectal screening among non-metropolitan residents.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act

Borders

Morgan

Peterson

2023

J Prim Care Community Health

Self Cite

View full text Add to dashboard Cite

Purpose: The Medicare Access and CHIP Reauthorization Act (MACRA) incentivized primary care practices to improve colorectal cancer screening rates. This study examined if colorectal screening rates improved among rural and urban primary care practices amid implementation of MACRA. Methods: Colorectal cancer screening data are from a national registry of 139 primary care practices. Repeated measures regression tested for rural/urban differences and changes in screening rates between 2016 and 2020, adjusting for county demographic factors and social deprivation. Results: Screening rates were 64% in both rural and urban practices in the first quarter of 2016 and increased to 80% and 83% in rural and urban practices, respectively, in the last quarter of 2020. In adjusted analyses, screening rates increased by 4% per year and there were no rural/urban differences. Lower screening rates were associated with higher county proportions of persons who were 45 to 74 years of age and Hispanic. Higher screening rates were associated with higher county proportions of persons who were White, Black, and Asian and higher social deprivation. Conclusions: Colorectal screening rates improved among rural and urban primary care practices during implementation of MACRA, but disparities persist among practices serving county populations that are relatively older, more Hispanic, and have higher social deprivation.

show abstract

Section: Discussionmentioning

confidence: 99%

Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act

Borders

Morgan

Peterson

2023

J Prim Care Community Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Fewer of us are delivering babies, inpatient rounding, or spending time in the operating room. [6][7][8] This is not to disparage an outpatient-only practice nor elevate a full-spectrum one; we deserve the career we have been trained to perform. As the health care landscape shifts, and advanced skills and procedures are squeezed out of family medicine, it's time to ask: Do we want to let go of this part of our practice?…”

Section: To the Editormentioning

confidence: 99%

Courage to Shape Our Future

Hougas,

Heidelbaugh,

Michelfelder

et al. 2024

Fam Med

View full text Add to dashboard Cite

“…33,34 As the subject-matter expert on patients themselves, it is perhaps concerning to witness decreases in many dimensions of comprehensiveness among family physicians, including declines in provision of inpatient, obstetric, pediatric and procedural care. [35][36][37][38] Educators revising residency guidelines should be aware that comprehensiveness, like continuity, has been recently demonstrated as measurable at the physician level and associated with lower medical costs and hospitalizations. 39 Also important is its association with lower levels of burnout, 40 and the finding that intended scope of practice among family medicine graduates is broader than actual practice.…”

Section: Comprehensivenessmentioning

confidence: 99%

Sailing the 7C’s: Starfield Revisited as a Foundation of Family Medicine Residency Redesign

Bazemore

Grunert

2021

Fam Med

View full text Add to dashboard Cite

Amidst a pandemic that has acutely highlighted longstanding failings of the US health care system and the graduate medical education (GME) enterprise that serves it, educators prepare to embark on another revision of the program requirements for family medicine GME. We propose in this article a conceptual framework to guide this endeavor, built on a foundation of the core functions that Barbara Starfield suggested might explain primary care’s salutary effects. We first revisit these “4C’s”—first Contact, Continuity, Comprehensiveness, and Coordination—and how they might inform design thinking in primary care GME guideline revision. We also propose the addition of Community engagement, patient-Centeredness, and Complexity. Training residents to deliver on these “7C’s,” functions critical to the delivery of high-performing primary care, is essential if family medicine residency graduates are to serve the clearly articulated, but unrealized, quadruple aim for US health care: improved patient experience and population health at lower costs while preserving clinician well-being. Finally, we highlight and illustrate examples of four critical enablers of these 7C core functions of primary care that must be accommodated in training guidelines and reform, suggesting a need for resident competencies in Team-based, Tool- and Technology-enabled, Tailored (“4T’s”) care of patients and populations.

show abstract

Declining Endoscopic Care by Family Physicians in Both Rural and Urban Areas

Cited by 9 publications

References 8 publications

Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act

Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act

Courage to Shape Our Future

Sailing the 7C’s: Starfield Revisited as a Foundation of Family Medicine Residency Redesign

Contact Info

Product

Resources

About