Established primary care provider improves odds of survival to discharge for injured patients

Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.

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36. Primary Care Provider Behaviors, Attitudes and Beliefs In the Diagnosis and Management of Polycystic Ovary Syndrome in Adolescents

Journal of Pediatric and Adolescent Gynecology ◽

10.1016/j.jpag.2021.02.040 ◽

2021 ◽

Vol 34 (2) ◽

pp. 253

Author(s):

J. Leocadia Conlon ◽

Sharyn Malcolm ◽

Maureen Monaghan

Keyword(s):

Primary Care ◽

Polycystic Ovary Syndrome ◽

Care Provider ◽

Primary Care Provider ◽

Polycystic Ovary ◽

Attitudes And Beliefs ◽

Ovary Syndrome ◽

Diagnosis And Management

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Interventions to improve primary care provider management of atopic dermatitis: A systematic review

Pediatric Dermatology ◽

10.1111/pde.14667 ◽

2021 ◽

Author(s):

Emily A. Croce ◽

Fabiana C. P. S. Lopes ◽

Jennifer Ruth ◽

Jonathan I. Silverberg

Keyword(s):

Systematic Review ◽

Primary Care ◽

Atopic Dermatitis ◽

Care Provider ◽

Primary Care Provider

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Parent and Primary Care Provider Priorities for Wellness in Early Childhood: A Discrete Choice Experiment

Journal of Child and Family Studies ◽

10.1007/s10826-021-02044-9 ◽

2021 ◽

Author(s):

Stephanie L. Mayne ◽

Chloe Hannan ◽

Jennifer Faerber ◽

Rupreet Anand ◽

Ella Labrusciano-Carris ◽

...

Keyword(s):

Primary Care ◽

Early Childhood ◽

Discrete Choice Experiment ◽

Discrete Choice ◽

Care Provider ◽

Primary Care Provider ◽

Choice Experiment

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The Digital Divide: A Retrospective Survey of Digital Rectal Examinations during the Workup of Rectal Cancers

Healthcare ◽

10.3390/healthcare9070855 ◽

2021 ◽

Vol 9 (7) ◽

pp. 855

Author(s):

Omar Farooq ◽

Ameer Farooq ◽

Sunita Ghosh ◽

Raza Qadri ◽

Tanner Steed ◽

...

Keyword(s):

Primary Care ◽

Rectal Cancer ◽

Care Provider ◽

Primary Care Provider ◽

Demographic Data ◽

Significant Proportion ◽

Digital Rectal Examination ◽

Patient Questionnaire ◽

Rectal Examination ◽

Rectal Cancers

Background: Digital rectal examination (DRE) is considered an important part of the physical examination. However, it is unclear how many patients have a DRE performed at the primary care level in the work-up of rectal cancer, and if the absence of a DRE causes a delay to consultation with a specialist. Methods: A retrospective patient questionnaire was sent to 1000 consecutive patients with stage II or stage III rectal cancer. The questionnaire asked patients to recall if they had a DRE performed by their general practitioner (GP) when they first presented with symptoms or a positive FIT test. Demographic data, staging data, and time to consultation with a specialist were also collected. Results: A thousand surveys were mailed out, and a total of 262 patients responded. Of the respondents, 46.2% did not recall undergoing a digital rectal examination by their primary care provider. Women were less likely to undergo a DRE than men (28.6% vs. 44.3%, p = 0.019). While there was a trend towards longer times to specialist consultation in patients who did not undergo a DRE (27.0 vs. 12.2 weeks), this was not statistically significant (p = 0.121). Conclusion: A significant proportion of patients who are FIT positive or have symptomatic rectal bleeding do not recall having a DRE by their primary care provider. Barriers may include lack of comfort with performing DRE or lack of time. Clearer guidelines and more support for GP’s may increase uptake of DRE.

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Establishing an Effective Primary Care Provider Referral Network for the National Diabetes Prevention Program

AADE in Practice ◽

10.1177/2325160316647707 ◽

2016 ◽

Vol 4 (4) ◽

pp. 20-25 ◽

Cited By ~ 9

Author(s):

Natalie D. Ritchie ◽

Tamara J. Swigert

Keyword(s):

Primary Care ◽

Care Provider ◽

Prevention Program ◽

Primary Care Provider ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Referral Network

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Who are we missing with EHR-based smoking cessation treatments? A descriptive study of patients who smoke and do not regularly visit primary care clinics

The Journal of Smoking Cessation ◽

10.1017/jsc.2020.21 ◽

2020 ◽

Vol 15 (4) ◽

pp. 175-180

Author(s):

Margaret Nolan ◽

Deejay Zwaga ◽

Danielle McCarthy ◽

Christian Kastman ◽

Timothy Baker ◽

...

Keyword(s):

Primary Care ◽

Care Provider ◽

Primary Care Provider ◽

The United States ◽

Primary Care Visit ◽

Patient Portal ◽

The Past ◽

Healthcare Settings ◽

Care Visit ◽

Tobacco Treatment

AbstractIntroductionMost tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.AimsTo describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.MethodsTobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.ResultsOf 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).ConclusionsA substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.

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The Nephrologist as a Primary Care Provider for the Hemodialysis Patient

International Urology and Nephrology ◽

10.1007/s11255-004-0875-4 ◽

2005 ◽

Vol 37 (1) ◽

pp. 113-117 ◽

Cited By ~ 12

Author(s):

Nina Shah ◽

Naomi V. Dahl ◽

Toros Kapoian ◽

Richard A. Sherman ◽

John A. Walker

Keyword(s):

Primary Care ◽

Care Provider ◽

Primary Care Provider ◽

Hemodialysis Patient

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Follow-Up Rates at a Free Ophthalmology Clinic at a Homeless Shelter

Journal of Academic Ophthalmology ◽

10.1055/s-0041-1726288 ◽

2021 ◽

Vol 13 (01) ◽

pp. e51-e56

Author(s):

Lauren Hennein ◽

Kimberly A. Spaulding ◽

Veronika Karlegan ◽

Ogonna N. Nnamani Silva ◽

Alejandra G. de Alba Campomanes

Keyword(s):

High School ◽

Primary Care ◽

Care Provider ◽

Primary Care Provider ◽

Nonprofit Organization ◽

County Hospital ◽

Categorical Variables ◽

Homeless Shelter ◽

High School Diploma

Abstract Objective Eye health among the homeless community is important, as poor vision makes this population vulnerable and adds significantly to the social and health burden. There is limited knowledge on patient follow-up rates for their eye conditions and barriers to accessing care in this population. The purpose of this retrospective chart review study is to examine follow-up rates and barriers to care for patients referred from a free, medical-student run ophthalmology clinic at a homeless shelter. Methods All patients evaluated at a free ophthalmology clinic from September 2017 to September 2018 were included; no patients were excluded. If indicated, patients were referred for advanced ophthalmologic care at a local county hospital and free eyeglasses at a nonprofit organization. Primary outcomes were follow-up rates at the county hospital and nonprofit organization. Secondary outcomes included prespecified baseline variables hypothesized to be associated with follow-up rates. These categorical variables were compared with Chi-square testing to determine their association with follow-up rates. The hypothesis being tested was formulated before data collection. Results Of the 68 patients, 84% were males with a mean age of 50 years. Overall, 40 patients were referred for free eyeglasses and 17 to the county hospital. Of those referred, 14 patients presented for free eyeglasses and 7 presented to the county hospital. About 79% of patients with a pre-established primary care provider presented to their appointment compared with 20% of those without one (p = 0.03). The 44% of patients with a high school diploma presented while all patients without a high school diploma failed to present (p = 0.04). Vision-threatening conditions identified at the shelter clinic did not affect follow-up rates (p = 0.79). Conclusion Less than half of referred patients in our study presented to their appointments. Barriers to presentation included no primary care provider and lower educational status, with no improvement in follow-up rates among those referred for vision-threatening conditions. Interventions such as health coaching with particular attention to educating patients on the effects of vision-threatening conditions may be warranted, particularly for those not looped into the health care system and those of lower educational attainment.

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