scholarly journals Do patients contact their primary care providers before coming to the ER?

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Kaleb Ware ◽  
Josey Noell ◽  
Layla Wisser ◽  
Katelyn Ware ◽  
Peter Pang
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Care Physician ◽  
Self Report ◽  
Care Providers ◽  
Academic Level ◽  
Statistical Program ◽  
Study Population ◽  
Mode Of Transportation ◽  
Future Work

Background and Hypothesis: High emergency room (ER) use is considered a healthcare failure. Societal and healthcare structural hurdles are blamed for high ER utilization. One proposed solution is improving healthcare accessability; by having a primary care physician (PCP). With a PCP, patients may avoid utilizing the ER. Whether patients, who have a PCP, attempted to contact their PCP is not well known. Our objective: do patients who self-report having a PCP report attempting to contact their PCP prior to visiting the ER. Experimental Design or Project Methods: This was a prospective, convenience survey, of low acuity ED patients from two academic, level 1 trauma centers in Indianapolis. After providing verbal consent, eligible patients were prompted by research staff, who verbally administered the survey and recorded the answers. Data were entered into a secure, HIPAA compliant database [REDCap] and the study was approved by the IRB. Demographic questions included patient’s physician(s), mode of transportation to the ER, income, and habitation status. Baseline characteristics are analyzed with the statistical program SAS, reporting frequencies and proportions. Results: Of the 188 ER patients approached for the study, 144 (77.4%) participated. 49.3% of participants were under the age of 50, and 94 (65.3%) were female. 49 (34.5%) reported being racially white, with 86 (59.7%) declaring to be African American. Over 2/3rds of these patients, 72, had a yearly household income of 50,000 or less. 102 (70.8%) patients affirmed having a PCP, with 61 (59.8%) of that group reporting annual PCP visits. In the group stating annual PCP visits, only 23 (38%) attempted to contact their physician before arriving at the ED. Conclusion: Based from our survey, it appears that our study population shows a lack of utilization of their PCPs, particularly lower acuity patients, before utilizing the ER. Future work could be done to better identity reasons and trends behind this.

scholarly journals Primary Care Physician Experiences with Integrated Population-Scale Genetic Testing: A Mixed-Methods Assessment

2020 ◽  
Vol 10 (4) ◽  
pp. 165
Author(s):  
Amy A. Lemke ◽  
Laura M. Amendola ◽  
Kristine Kuchta ◽  
Henry M. Dunnenberger ◽  
Jennifer Thompson ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Genetic Testing ◽  
Data Privacy ◽  
Qualitative Interviews ◽  
Genomic Medicine ◽  
Primary Care Providers ◽  
The United States ◽  
Care Physician ◽  
Care Providers

The scalable delivery of genomic medicine requires collaboration between genetics and non-genetics providers. Thus, it is essential to investigate and address the perceived value of and barriers to incorporating genetic testing into the clinical practice of primary care providers (PCPs). We used a mixed-methods approach of qualitative interviews and surveys to explore the experience of PCPs involved in the pilot DNA-10K population genetic testing program. Similar to previous research, PCPs reported low confidence with tasks related to ordering, interpreting and managing the results of genetic tests, and identified the need for additional education. PCPs endorsed high levels of utility for patients and their families but noted logistical challenges to incorporating genetic testing into their practice. Overall PCPs were not familiar with the United States’ Genetic Information Nondiscrimination Act and they expressed high levels of concern for patient data privacy and potential insurance discrimination. This PCP feedback led to the development and implementation of several processes to improve the PCP experience with the DNA-10K program. These results contribute to the knowledge base regarding genomic implementation using a mixed provider model and may be beneficial for institutions developing similar clinical programs.

Medical Home: Is there a place for recreational therapy?

2010 ◽  
Vol 9 (2) ◽  
pp. 13-20
Author(s):  
Mary Ann Keogh Hoss, PhD, CTRS, FACHE, FDRT ◽  
Kari Kensinger, PhD, CTRS
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Clinical Skills ◽  
Primary Care Providers ◽  
Care Physician ◽  
Recreational Therapy ◽  
Care Providers ◽  
Complex Needs ◽  
Community Skills ◽  
Medical Home Model

The purpose of this article is to explore the role of recreational therapy within a medical home model. Medical home is a movement to manage the care of individuals with complex and chronic health needs through their primary care physician and the physician’s team. The concepts of medical home are discussed. These concepts are the same as those on which recreational therapists have been trained. This article demonstrates the various ways in which recreational therapists can meet the challenges posed by serving individuals with chronic disease.The medical home model provides a rare opportunity for recreational therapists to combine clinical skills with community skills to meet the needs of those individuals in the community with chronic and complex needs. This article demonstrates that recreational therapists are already engaged and invested in this model. What is lacking is the promotion of skills and services of the recreational therapists to market and communicate this to primary care providers.

Factors influencing the use of electronic health record systems to provide follow-up care to cancer survivors.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 182-182
Author(s):  
Guadalupe R. Palos ◽  
Maria Alma Rodriguez ◽  
Paula A. Lewis-Patterson ◽  
Rachel Harris ◽  
Lewis E. Foxhall
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Clinical Information ◽  
Primary Care Providers ◽  
Self Report ◽  
Care Providers ◽  
Convenience Sample ◽  
Major Barrier ◽  
Care Plans ◽  
Electronic Health

182 Background: One of the expected benefits of electronic health records (EHRs) is their interoperability to remotely access and exchange clinical information across systems and clinicians. Cancer survivors’ treatment summaries (TSs) and care plans (CPs) are documents that can be electronically transferred from oncologists to primary care providers. We conducted a needs assessment to identify factors which influenced EHRs in meeting these expectations in rural and underserved primary care settings. Methods: Clinicians from 2 family practice health care systems, located in central and northeast Texas were surveyed. REDCap, a web-based system, was used to develop, manage, and distribute the survey to a convenience sample of clinical staff from both settings. Survey questions focused on respondents’ demographic and clinical practice characteristics, current experience with TSs and CPs, and type of EHR used. Results: A total of 26 surveys were included in this analysis. Respondents were primarily physicians (73%). Overall 61.5% reported that ≤ 25% of their patients were diagnosed with cancer or currently had cancer. A patient’s self-report was the primary method used by majority of respondents to determine if a patient had a history of cancer. 80.8% indicated they would be interested in learning more about the use and development of TSs and CPs. Barriers reported towards the use of EHRs to deliver TSs and CPs included: EHRs interference with workflow (60%); limited knowledge on how to develop TSs and CPs (48%), inadequate access to IT resources (48%), and inefficient EHR systems (44%). In these settings, EHRs used were: Epic (61.6%), Aria (30.8%), and Medit (7.7%). Respondents’ comments on EHRs weaknesses included: “the two systems…do not completely communicate with each other” or “no place where a cancer treatment summary or survivorship plan is documented”. Conclusions: Primary care providers identified limitations in EHR operability as a major barrier to retrieving health information required for TSs and CPs. Clinicians in rural or underserved regions may benefit from education and retraining in EHR systems.

scholarly journals Matching Inhaler Devices with Patients: The Role of the Primary Care Physician

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alan Kaplan ◽  
David Price
Keyword(s):  
Primary Care ◽  
Treatment Success ◽  
Primary Care Providers ◽  
Care Physician ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Care Providers ◽  
Obstructive Pulmonary Disease ◽  
Inhaler Devices

Poor inhaler technique and nonadherence impair the efficacy of medications for asthma and chronic obstructive pulmonary disease (COPD). A range of factors, including age, dexterity, inspiratory capacity, cognitive ability, health literacy, and ethnicity, can impact a patient’s ability and intention to use their device. Treatment success can also be influenced by patient preferences and perceptions. Therefore, it is important that healthcare professionals effectively match inhaler devices to individual patients’ needs and abilities and empower patients by including them in treatment decisions. Physicians must, therefore, fully understand the characteristics of each device, as well as their patients’ demographic characteristics and comorbidities. Following device selection, patient training and education, including a physical demonstration of the device, are key to eliminate any critical errors that may impact on health outcomes. Inhaler technique should be frequently rechecked. This review will examine the important role of primary care providers in the selection of appropriate inhaler devices and provision of training for patients with COPD and asthma to optimize correct inhaler use and adherence. An overview of the key features of available devices and of the factors to consider when selecting devices will be provided in the context of current asthma and COPD guidelines.

Referral for Adolescent Idiopathic Scoliosis by Pediatric Primary Care Providers

2016 ◽  
Vol 56 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Joey P. Johnson ◽  
Alan H. Daniels ◽  
Zach J. Grabel ◽  
Samuel M. Miller ◽  
Craig P. Eberson
Keyword(s):  
Primary Care ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Primary Care Providers ◽  
Care Physician ◽  
Pediatric Primary Care ◽  
Insurance Status ◽  
Care Providers ◽  
Referral Practices ◽  
The Mean

This study sought to examine primary care physician opinions regarding referral practices for patients with adolescent idiopathic scoliosis (AIS) and to determine if curve severity at the time of referral is correlated with insurance status. A survey was distributed to pediatric primary care providers to determine referral practices. A chart review of patients referred to a pediatric spine specialist for AIS was performed. A total of 59.3% of respondents stated their referral threshold for AIS patients was <20°. The mean curve size in privately insured patients was 27° (range 6°-68°), whereas the mean curve size in the publicly insured group was 27.6° (range = 6°-58°; P = .9). Large disparities among referral practices exist among pediatric primary care providers, although insurance status did not seem to affect curve size at the time of referral. Encouraging education initiatives for pediatric primary care providers may encourage appropriate referral for AIS.

scholarly journals After COVID-19: Improving the Patient's Outpatient Appointment Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352110393
Author(s):  
Helen Y. Gant-Farley ◽  
Miriam K. Ross ◽  
Ronald P. Hudak
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Care Physician ◽  
Care Providers ◽  
Missed Appointments ◽  
Outpatient Appointment ◽  
Study Results ◽  
Outpatient Appointments ◽  
Advanced Access

As the COVID-19 pandemic diminishes, it is expected that patients will seek more outpatient appointments resulting in adverse patient and clinic experiences if there is a corresponding increase in missed appointments. This study's purpose was to determine if there was an association between advanced access scheduling, also known as open access or same day scheduling, and missed appointment rates for patients scheduled with preferred primary care physicians vis-a-vis nonpreferred primary care physicians. Patients prescheduled with primary care providers and over the age of 18 years were included in the study, which totaled 4815 visits. Study results demonstrated a statistically significant mean proportion difference between the national no-show rate and the study's no-show rate as well as a significant association between physician type and visit status. The results suggested the potential for improving the patient experience with advanced access scheduling if patients are scheduled with their preferred primary care physician. This study may promote positive patient experiences by providing patients and clinicians with an understanding of the significance surrounding advanced access scheduling thus decreasing missed appointments.

scholarly journals The Role of the Primary Care Physician in Alzheimer’s Disease

2011 ◽  
Vol 6 (1) ◽  
pp. 21
Author(s):  
Hélène Villars ◽  
Bruno Vellas ◽  
◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Early Diagnosis ◽  
Primary Care Physicians ◽  
Psychological Symptoms ◽  
Primary Care Providers ◽  
Care Physician ◽  
Care Providers ◽  
Her Family

The increased incidence of Alzheimer’s disease (AD) and related dementias in European and other northern countries is creating a real challenge for primary care providers. Primary care physicians (PCPs) must follow the general objectives of identifying dementia and allowing early diagnosis, disclosing diagnosis to both the patient and his or her family, preventing and treating, if possible, the complications of AD (falls, malnutrition and behavioural and psychological symptoms) and implementing a follow-up plan. It is essential for PCPs to develop interactions with specialist physicians and community professionals who intervene in the management of AD patients. The need for better education and training programmes for PCPs has been demonstrated in the literature in both the early diagnosis and management of AD. Clear guidelines specifically addressed to PCPs are needed.

An Exploration of Barriers Facing Physicians in Diagnosing and Treating Obesity

2018 ◽  
Vol 33 (2) ◽  
pp. 217-224 ◽  
Author(s):  
Ashley Hite ◽  
David Victorson ◽  
Rita Elue ◽  
Beth A. Plunkett
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Treatment Options ◽  
Visual Assessment ◽  
Primary Care Providers ◽  
Survey Study ◽  
Care Providers ◽  
Dietary Counseling ◽  
Diagnosis And Management ◽  
Study Population

Purpose: To determine whether primary care physicians can accurately assess body mass index (BMI) by visual inspection and to assess barriers related to the diagnosis and management of obesity. Design: Prospective Survey Study. Setting: Hospitals and Clinics. Subjects: Primary care providers in the fields of Internal Medicine, Family Medicine and Obstetrics/Gynecology. Measures: Measures investigated included providers visual assessment of BMI, BMI knowledge, diagnosis and management of obese patients, and perceived barriers to treatment. Analysis: Top and bottom quartiles and total scores were determined for responses regarding the reported management of obesity, reported comfort with care, and reported barriers to care and used as the cut point. Statistical analyses were utilized to examine relations and compare groups. Results: 206 (74%) of the 280 eligible providers completed the survey. The accuracy of visual assessment of BMI was 52%. Physicians were more likely to underestimate BMI than overestimate (36% ± 4% vs 12% ± 6%, respectively, P < .001). Although 91% of providers report routinely calculating BMI, only 61% routinely discuss BMI. Providers feel comfortable providing exercise (72%) and dietary counseling (61%). However, fewer are comfortable prescribing medical (16.4%) and surgical options (36%). Conclusion: Visual assessment of BMI is not reliable. Primary care physicians in our study population do not consistently discuss obesity with their patients and many report insufficient knowledge with regard to treatment options. Further studies are needed to determine whether these results are valid for other physicians in various practice settings and to mid-level providers. In addition, research is needed that investigate how collaboration with providers outside the medical field could reduce the burden on physicians in treating patients with overweight or obesity.

Medical Issues in Adolescent Substance Use: Background and Role of the Primary Care Physician

2016 ◽  
pp. 574-592
Author(s):  
Miriam Schizer ◽  
Elissa R. Weitzman ◽  
Sharon Levy
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Specific Treatment ◽  
Primary Care Providers ◽  
Evidence Base ◽  
Care Physician ◽  
Care Providers ◽  
Adolescent Substance ◽  
Medical Issues

Use of psychoactive substances is both common during adolescence and highly associated with acute and chronic health risks. Routine health care provides an opportunity to provide a range of interventions—from primary prevention to assisting adolescents with substance use disorders in accessing treatment. In particular, primary care offers a unique opportunity to intervene with adolescents who have developed substance use problems but do not meet criteria or are unwilling to enter specific treatment for a substance use disorder, and thus provide a level of service for adolescents who would otherwise likely receive no intervention. This chapter reviews the evidence base for primary care interventions and explores the role for primary care providers.

Addressing Academic Concerns: A Survey of Primary Care Providers

2020 ◽  
Vol 59 (14) ◽  
pp. 1265-1273
Author(s):  
Michelle Curtin ◽  
Melissa Butler ◽  
Brett A. Enneking ◽  
Meagan Kelley ◽  
Rebecca McNally Keehn
Keyword(s):  
Primary Care ◽  
Positive Relationship ◽  
Final Analysis ◽  
Primary Care Providers ◽  
Self Report ◽  
Practical Implementation ◽  
Care Providers ◽  
Specialty Area ◽  
Significant Positive Relationship ◽  
Clinical Recommendations

Given new clinical recommendations, we sought to better understand the perspectives and practices of primary care providers (PCPs) around pediatric academic concerns. Practicing PCPs were recruited to complete an 8-item self-report survey; 163 PCPs were included in the final analysis. Results indicated that 84% of PCPs perceived their role in addressing patients’ academic concerns as highly important; yet there was variability in the frequency with which PCPs reported engaging in activities around these educational needs. There was a significant positive relationship between perception of role importance and engagement in clinical supports. Some differences were present in responses across PCP specialty area. More information about practice differences between provider types, rural versus urban practices, and how perceptions/practices differ based on provider demographics are likely to be useful areas for future consideration. Our findings highlight the need to advance PCP instruction for practical implementation to increase rates of engagement in these activities.

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