scholarly journals Emotional Intelligence and Leadership Development: Implications for Family Medicine Residency Programs

2021 ◽  
Author(s):  
Seul Jee Ha ◽  
Sridhar Reddy Patlolla ◽  
Thomas Robert Wojda
Keyword(s):  
Primary Care ◽  
Emotional Intelligence ◽  
Leadership Development ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Leadership Skills ◽  
Medical Organization ◽  
Wellness Promotion ◽  
Family Medicine Residency ◽  
High Level

High-level emotional Intelligence (EI) and leadership skills are crucial for physicians to prioritize responsibilities and successfully interact with numerous stakeholders in an every-increasingly complex healthcare system. Although recent research has shown an association between emotional intelligence and leadership, few studies have examined this relationship among family and primary care physicians. Family physicians play an essential role in the evaluation and treatment of illnesses as well as health and wellness promotion. These providers are often the first point of contact with the patient and the use of emotional intelligence and development of leadership abilities of primary care physicians are vital to the maintenance, sustainability, and optimization of a medical organization. Furthermore, high- level emotional intelligence and sharpened leadership skills may aid the patient-provider relationship and dealings with coworkers. This chapter explores key themes of EI and physician leadership as it pertains to Family Medicine Residency.

Leadership training in family medicine residency: a scoping review

BMJ Leader ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 239-245
Author(s):  
Stephanie Godard ◽  
Savithiri Ratnapalan
Keyword(s):  
Leadership Development ◽  
Family Medicine ◽  
Small Group ◽  
Leadership Training ◽  
Leadership Skills ◽  
Ongoing Research ◽  
Family Medicine Residency ◽  
Select Group ◽  
Integrated Leadership ◽  
Training Programmes

BackgroundGraduate medical education, including family medicine residency, has historically focused on building clinical competencies with little attention paid to leadership skills, leaving residents feeling ill-prepared for leadership roles after training.ObjectiveTo analyse the format, content and outcomes of leadership training programmes offered to family medicine residents.MethodsA MEDLINE (OvidSP) literature search from 1976 to October 2018 for articles on Family Medicine AND Residency AND Leadership Programs retrieved 184 articles. After reviewing inclusion and exclusion criteria, 12 articles were chosen for full review and synthesis.ResultsThree articles described leadership training available to Family Medicine all residents while nine focused on a select group. Programme format and content varied, ranging from a 1-day programme on emotional intelligence to a 5-year integrated leadership track. The most comprehensive curricula were longitudinal and offered to a small group of residents. Inclusive programmes often taught leadership through the lens of a specific competency. Mixed teaching methods were valued including online learning, simulations, small group discussions, mentorship, reflection, placements and projects. Conceptual frameworks were inconsistently used and programme evaluation seldom addressed high-level or long-term outcomes.ConclusionsLeadership skills are important for all family physicians; however, there is limited literature on comprehensive leadership development during training. Existing curricula were described in this review and we suggest a longitudinal mixed-methods programme integrated throughout residency, covering basic comprehensive skills for all residents. However, evaluative data were limited, and a considerable gap remains in how to effectively approach leadership development in family medicine residency, warranting ongoing research.

scholarly journals Improving After-Clinic Work Workflow in a Family Medicine Residency

2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Nguyen V ◽  
◽  
Jaqua E ◽  
Oh A ◽  
Altamirano M ◽  
...  
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Patient Care ◽  
Primary Care Physicians ◽  
Training Session ◽  
P Value ◽  
Post Intervention ◽  
Family Medicine Residency ◽  
Resident Physicians ◽  
Family Medicine Residents

Introduction: The broad range of patients and diagnoses addressed by primary care physicians lends to a larger after-work clinic load. The resulting after-clinic work, including various in-basket tasks, can be a substantial burden to physicians, and potentially leading to burnout. The goal of this study is to generate a standardized workflow to improve physician after-clinic work efficiency and patient care. Methods: A nine-question pre- and post-intervention survey about afterclinic work management was administered to family medicine residents at a multi-specialty FQHC in California. The intervention was done in June 2020 and included a twenty-minute training session explaining how to implement a standardized in-basket management flowchart in a family medicine residency clinic. Results: Pre- and post-intervention data were analyzed using nonindependent paired sample t-tests. The survey was sent to all 40 family medicine residents. Pre- and post-intervention survey response rate was 77.5% and 97.5% respectively. The result of the nine questions post intervention were statistically significant (p value of <0.001). The standardized flowchart addressed adequate supervision of resident physicians’ patient care. Conclusion: The post-intervention results showed that having a clear and standardized flowchart enhanced the overall knowledge and understanding by the resident physicians in how to management the in-basket workflow. With increased patient access via telehealth and enhanced electronic medical records, it is essential to have effective teaching and supervision of resident physician after-clinic work. Successful teaching of after-clinic work will improve work-life balance and the overall success of the new primary care physician.

scholarly journals Teaching Chronic Pain in the Family Medicine Residency

2018 ◽  
Vol 50 (1) ◽  
pp. 22-27
Author(s):  
Kimberly Zoberi ◽  
Kelly M. Everard
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Family Medicine ◽  
Pain Assessment ◽  
Primary Care Physicians ◽  
The United States ◽  
Care Physician ◽  
Family Medicine Residency

Background and Objectives: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. Methods: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors’ attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring). Attitudes were assessed by asking whether: (1) chronic pain is best managed by a primary care physician (PCP); (2) prescribing opioid medications is time consuming; (3) prescribing opioids is high-risk; (4) prescribing opioids contributes to opioid misuse; and (4) effective nonopioid treatments exist. An additional question assessed confidence in treating chronic pain. Results: The response rate was 53%. The average family medicine residency devotes about 33 hours to education about pain management topics including 5.4 hours on chronic pain assessment, 16.2 hours on therapy, and 11.4 hours on risk assessment. Residency directors’ belief that there are effective nonopioid treatments for chronic pain was the only attitude item that was associated with teaching about chronic pain. Conclusions: Residency directors’ attitudes do not predict the time devoted to teaching chronic pain in family medicine residencies.

scholarly journals A Longitudinal Curriculum for Quality Improvement, Leadership Experience, and Scholarship in a Family Medicine Residency Program

2020 ◽  
Vol 52 (8) ◽  
pp. 570-575
Author(s):  
Susan D. Pohl ◽  
Sonja Van Hala ◽  
Dominik Ose ◽  
Benjamin Tingey ◽  
Jennifer P. Leiser
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Residency Program ◽  
Leadership Skills ◽  
Family Medicine Residency ◽  
University Of Utah ◽  
Leadership Experience ◽  
High Level ◽  
The University ◽  
Scholarly Projects

Background and Objectives: The Accreditation Council for Graduate Medical Education (ACGME) requires all residents be trained in quality improvement (QI), and that they produce scholarly projects. While not an ACGME requirement, residents need leadership skills to apply QI knowledge. We developed the Skills-based Experiential Embedded Quality Improvement (SEE-QI) curriculum to integrate training in QI, leadership, and scholarship. Methods: The University of Utah Family Medicine Residency Program began using the novel curriculum in 2012. The aim of the curriculum is to tie didactic teaching in quality improvement, leadership, and scholarship with skills application on multidisciplinary QI teams. Coaching for resident leaders is provided by faculty. Third-year resident leaders prepare academic presentations. Results of the ACGME Practice-Based Learning and Improvement (PBLI) 3 scores and number of scholarship presentations are described as a measure of efficacy. Results: Two cohorts of residents completed the curriculum and all competency assessments. The average initial and final competency scores for competency PBLI-3 showed improvement and the average final competency for each cohort was above the proficient level. The residency requirements for QI scholarship did not change with introduction of the curriculum, but the amount of optional curricular QI scholarship and independent QI scholarship increased. Conclusions: The SEE-QI curriculum resulted in a high level of resident QI competency, opportunity for leadership training, and an increase in scholarship. We studied the results of this curriculum at one institution. Efforts to tie QI, leadership, and scholarship training should be evaluated at other programs.

scholarly journals Let’s Talk About Sex: A Survey of Patients’ Preferences When Addressing Sexual Health Concerns in a Family Medicine Residency Program Office

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Katie L. Ryan ◽  
Veronica Arbuckle-Bernstein ◽  
George Smith ◽  
Julie Phillips
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Sexual Health ◽  
Residency Program ◽  
Primary Care Physicians ◽  
Health Concerns ◽  
Family Medicine Residency ◽  
Sexual Concerns ◽  
Physician Relationship ◽  
Pearson Correlations

Introduction: Comprehensive medical care should embody the biopsychosocial care model and encompass all aspects of health. Sexual health topics may be overlooked or avoided because of patient and provider discomfort. Our purpose was to better understand patients’ preferences about discussing sexual concerns in primary care. We hypothesized that most individuals have sexual concerns, but many barriers prevent them from seeking care. Method: We surveyed patients at a family medicine residency program office. The survey explored whether patients had experienced sexual concerns, preferences for addressing concerns in the office, and barriers and facilitators to addressing concerns. Results were analyzed using counts and proportions. Pearson correlations, Pearson 𝜒2 analyses, and independent samples t-tests were used to explore demographic differences in responses. Results: Most participants indicated that physicians should ask all patients about having sexual concerns and that physicians should initiate these conversations. Younger participants were more likely to have this preference. Participants identified embarrassment as the most common barrier to sexual health conversations. Participants indicated it was easier to discuss sexual concerns with physicians of the same gender and/or a physician they had seen before. Conclusions: The majority of patients prefer active inquiry about sexual health concerns from primary care physicians. However, because a large minority prefer not to be asked about sexual health, physicians should inquire sensitively, particularly with older patients. Continuity of patient-physician relationship and allowing patients to choose their provider based on gender may also help facilitate these discussions.

scholarly journals Primary Care Tracks in Medical Schools

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Maribeth P. Williams ◽  
Denny Fe Agana ◽  
Benjamin J. Rooks ◽  
Grant Harrell ◽  
Rosemary A. Klassen ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Response Rate ◽  
Positive Impact ◽  
Medical Schools ◽  
Clerkship Director ◽  
Medicine Clerkship ◽  
Faculty Mentorship

Introduction: With the estimated future shortage of primary care physicians there is a need to recruit more medical students into family medicine. Longitudinal programs or primary care tracks in medical schools have been shown to successfully recruit students into primary care. The aim of this study was to examine the characteristics of primary care tracks in departments of family medicine.  Methods: Data were collected as part of the 2016 CERA Family Medicine Clerkship Director Survey. The survey included questions regarding the presence and description of available primary care tracks as well as the clerkship director’s perception of impact. The survey was distributed via email to 125 US and 16 Canadian family medicine clerkship directors.  Results: The response rate was 86%. Thirty-five respondents (29%) reported offering a longitudinal primary care track. The majority of tracks select students on a competitive basis, are directed by family medicine educators, and include a wide variety of activities. Longitudinal experience in primary care ambulatory settings and primary care faculty mentorship were the most common activities. Almost 70% of clerkship directors believe there is a positive impact on students entering primary care.  Conclusions: The current tracks are diverse in what they offer and could be tailored to the missions of individual medical schools. The majority of clerkship directors reported that they do have a positive impact on students entering primary care.

Billing Codes Determine Lower Physician Income for Primary Care and Non-Procedural Specialties

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Arielle L. Langer ◽  
Miriam Laugesen
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Direct Consequence ◽  
Medical Specialties ◽  
Income Differences ◽  
Income Gap ◽  
Physician Income ◽  
The Difference ◽  
The Relationship

Abstract The income gap between specialists and primary care physicians and among specialists is well established, but the drivers of this difference are not well delineated. Using the Community Tracking Study (CTS) Physician Survey, we sought to isolate and compare premiums paid to physicians for specialization and the proportion of time spent on offices visit rather than procedures. We divided medical subspecialties according the proportion of Medicare billing for Evaluation and Management (E&M) codes for the specialty as a whole. We report substantial differences in income across physician specialty, and over 70 percent of the difference in income remained controlling for factors that may confound the relationship between income and specialty including gender, location and type of practice, and hours. We note a large variation in premiums for specialization: 11.3–46.8 percent above family medicine after controlling for confounders. Classifying medical subspecialties by E&M billing as procedural versus non-procedural specialties revealed clear income differences. Controlling for confounders, procedural medical specialties earned 37.5 percent more than family medicine, as compared with 15.3 percent for non-procedural medical specialties. This analysis suggests that differences in physician income and resulting incentives are a direct consequence of the payment structure itself, rather than compensation for additional years of training or a reflection of different underlying demographics.

scholarly journals Multimorbidity and Polypharmacy in Family Medicine Residency Practices

2017 ◽  
Vol 33 (6) ◽  
pp. 219-224
Author(s):  
Kenya Ie ◽  
Maria Felton ◽  
Sydney Springer ◽  
Stephen A. Wilson ◽  
Steven M. Albert
Keyword(s):  
Older Adults ◽  
Family Medicine ◽  
Chronic Conditions ◽  
Interdisciplinary Collaboration ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Family Medicine Residency ◽  
The Mean ◽  
Few Data ◽  
High Level

Background: Prescription-related problems among older adults have been of great interest. However, few data are available regarding the prevalence of these problems in US family medicine residency practices (FMRPs). Objective: The aim of this research was to examine the prevalence of multimorbidity, polypharmacy, and potentially inappropriate medications (PIMs) use among older adults who visited 5 FMRPs more than once a year. Methods: A cross-sectional hospital record review for patients 65 years or older who visited 1 of the 5 university-affiliated FMRPs at least twice during January 1 to December 31, 2014, was conducted. The prevalence of multimorbidity (24 chronic index conditions), polypharmacy, and PIMs use was examined. Results: A total of 1084 patients were included in the analyses. The most common chronic conditions were hypertension (87.8%), hyperlipidemia (69.7%), and osteoarthritis (56.1%). The mean number of chronic conditions was 5.3 (SD 2.6). The prevalence of multimorbidity (≥2 chronic conditions) was 95.6%. Among these multimorbid older adults (N = 1036), the mean number of medication orders was 9.04 (SD 4.36) and 1.57 (SD 0.92) for PIMs, 86.1% met polypharmacy standards (≥5 medications), and 33.4% were prescribed one or more PIMs. The proportion of patients with fewer prescriptions at the last visit was 45.4% in the polypharmacy group and 38.0% in the PIMs group. Conclusion: Our results suggest a high level of morbidity and complexity among older adults receiving care in FMRPs. Improving the continuity of care as well as promoting interdisciplinary collaboration would have potential to reduce these prescription-related problems. Further research and education to address polypharmacy and PIMs among this population at FMRPs are required.

scholarly journals The Role of Primary Care Physicians (DLP) in Community Care

2018 ◽  
Vol 1 (1) ◽  
pp. 3
Author(s):  
Dhanasari Vidiawati Trisna Sanyoto ◽  
Nur Afrainin Syah
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Medical Training ◽  
The United States ◽  
Care Physician ◽  
Main Body ◽  
Family Doctors ◽  
Postgraduate Medical Training ◽  
Care Services

Dokter Layanan Primer (DLP) or Primary Care Physician (PCP) is a newly introduced term by the Indonesian government in 2013 since the enforcement of Medical Education Law 20/2013. DLP is a physician who solidifies his/ her education and career in primary care. They have postgraduate medical training in primary care and are experts in this field. In most countries, to be a generalist physician practising at primary care facilities such as health centres and primary care clinics, medical school graduates have to take postgraduate medical training to be proficient in terms of knowledge and skills in primary care services. Family medicine is the main body of knowledge of the primary care postgraduate training program in those countries even though their graduates are called differently among countries. These physicians are called family doctors or family physicians in the United States of America (USA), general practitioners (GPs) in Commonwealth countries, huisarts in the Netherlands. In Indonesia, where social, economic, and cultural diversity is very high in various regions, in addition to Family Medicine, Community Medicine and Public Health....

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