The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Robert L. Phillips - One of the best experts on this subject based on the ideXlab platform.
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the future role of the Family Physician in the united states a rigorous exercise in definition
Annals of Family Medicine, 2014Co-Authors: Robert L. Phillips, Stacy Brundgardt, Sarah E Lesko, Nathan Kittle, Jason E Marker, Michael Tuggy, Jeffrey Borkan, Michael L. Lefevre, Frank V Degruy, Glenn A LoomisAbstract:As the US health care delivery system undergoes rapid transformation, there is an urgent need to define a comprehensive, evidence-based role for the Family Physician. A Role Definition Group made up of members of seven Family medi - cine organizations developed a statement defining the Family Physician's role in meeting the needs of individuals, the health care system, and the country. The Role Definition Group surveyed more than 50 years of foundational manuscripts including published works from the Future of Family Medicine project and Key- stone III conference, external reviews, and a recent Accreditation Council on Graduate Medical Education Family Medicine Milestones definition. They devel - oped candidate definitions and a "foil" definition of what Family medicine could become without change. The following definition was selected: "Family physi - cians are personal doctors for people of all ages and health conditions. They are a reliable first contact for health concerns and directly address most health care needs. Through enduring partnerships, Family Physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals. Family Physicians and their staff adapt their care to the unique needs of their patients and communities. They use data to monitor and manage their patient population, and use best science to prioritize services most likely to benefit health. They are ideal leaders of health care systems and partners for public health." This definition will guide the second Future of Family Medicine project and provide direction as Family Physicians, academicians, clinical networks, and policy-makers negotiate roles in the evolving health system.
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factors influencing Family Physician adoption of electronic health records ehrs
Journal of the American Board of Family Medicine, 2013Co-Authors: Imam M Xierali, Robert L. Phillips, Andrew Bazemore, Larry A Green, James C PufferAbstract:Background: Physician and practice characteristics associated with Family Physician adoption of electronic health records (EHRs) remain largely unexplored but may be important for tailoring policies and interventions. Methods: This was a cross-sectional study of EHR adoption using American Board of Family Medicine certification census data (2006–2011) for over 41,000 Family Physicians to test associations between demographic, geographic, and practice characteristics and EHR adoption. Results: EHR adoption rates for Family Physicians grew from 37% in 2006 to 68% in 2011. No significant association was found with rural status (odds ration [OR], 0.985; 95% confidence interval [CI], 0.932–1.042). Practicing in a medically underserved location (OR, 0.868; 95% CI, 0.822–0.917) or geographic health professional shortage areas (OR, 0.904; 95% CI, 0.831–0.984), or being an international medical graduate (OR, 0.769; 95% CI, 0.748–0.846) were negatively associated with adoption. Compared with Physicians in group practices, Physicians in solo practices (OR, 0.465; 95% CI, 0.439–0.493) and small practices (OR, 0.769; 95% CI, 0.720–0.820) were less likely to adopt EHRs, whereas those in health maintenance organizations (OR, 5.482; 95% CI, 4.657–6.454) or with faculty status (OR, 1.527; 95% CI, 1.386–1.684) were more likely. Conclusions: Variation in EHR adoption is associated with Physician and practice characteristics that may help guide intervention. These findings may be important to other specialties and could instruct interventions to improve adoption. Certification boards could play an important role in tracking EHR adoption and help target resources and facilitation.
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Family Physician participation in maintenance of certification
Annals of Family Medicine, 2011Co-Authors: Imam M Xierali, Robert L. Phillips, Andrew Bazemore, Warren P Newton, Larry A Green, Jason C B Rinaldo, Stephen Petterson, James C PufferAbstract:PURPOSE The American Board of Family Medicine has completed the 7-year transition of all of its diplomates into Maintenance of Certification (MOC). Participation in this voluntary process must be broad-based and balanced for MOC to have any practical national impact on health care. This study explores Family Physicians’ geographic, demographic, and practice characteristics associated with the variations in MOC participation to examine whether MOC has potential as a viable mechanism for dissemination of information or for altering practice. METHODS To investigate characteristics associated with differential participation in MOC by Family Physicians, we performed a cross-sectional comparison of all active Family Physicians using descriptive and multinomial logistic regression analyses. RESULTS Eighty-five percent of active Family Physicians in this study (n = 70,323) have current board certification. Ninety-one percent of all active board-certified Family Physicians eligible for MOC are participating in MOC. Physicians who work in poorer neighborhoods (odds ratio [OR] = 1.105; 95% confidence interval [CI], 1.038–1.176), who are US-born or foreign-born international medical graduates (OR = 1.221; 95% CI, 1.124–1.326; OR = 1.444; 95% CI, 1.238–1.684, respectively), or who are solo practitioners (OR = 1.460; 95% CI, 1.345–1.585) are more likely to have missed initial MOC requirements than those from a large, undifferentiated reference group of certified Family Physicians. When age is held constant, female Physicians are less likely to miss initial MOC requirements (OR = 0.849; 95% CI, 0.794–0.908). Physicians practicing in rural areas were found to be performing similarly in meeting initial MOC requirements to those in urban areas (OR = 0.966; 95% CI, 0.919–1.015, not significant). CONCLUSION Large numbers of Family Physicians are participating in MOC. The significant association between practicing in underserved areas and lapsed board certification, however, warrants more research examining causes of differential participation. The penetrance of MOC engagement shows that MOC has the potential to convey substantial practice-relevant medical information to Physicians. Thus, it offers a potential channel through which to improve health care knowledge and medical practice.
Glenn A Loomis - One of the best experts on this subject based on the ideXlab platform.
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the future role of the Family Physician in the united states a rigorous exercise in definition
Annals of Family Medicine, 2014Co-Authors: Robert L. Phillips, Stacy Brundgardt, Sarah E Lesko, Nathan Kittle, Jason E Marker, Michael Tuggy, Jeffrey Borkan, Michael L. Lefevre, Frank V Degruy, Glenn A LoomisAbstract:As the US health care delivery system undergoes rapid transformation, there is an urgent need to define a comprehensive, evidence-based role for the Family Physician. A Role Definition Group made up of members of seven Family medi - cine organizations developed a statement defining the Family Physician's role in meeting the needs of individuals, the health care system, and the country. The Role Definition Group surveyed more than 50 years of foundational manuscripts including published works from the Future of Family Medicine project and Key- stone III conference, external reviews, and a recent Accreditation Council on Graduate Medical Education Family Medicine Milestones definition. They devel - oped candidate definitions and a "foil" definition of what Family medicine could become without change. The following definition was selected: "Family physi - cians are personal doctors for people of all ages and health conditions. They are a reliable first contact for health concerns and directly address most health care needs. Through enduring partnerships, Family Physicians help patients prevent, understand, and manage illness, navigate the health system and set health goals. Family Physicians and their staff adapt their care to the unique needs of their patients and communities. They use data to monitor and manage their patient population, and use best science to prioritize services most likely to benefit health. They are ideal leaders of health care systems and partners for public health." This definition will guide the second Future of Family Medicine project and provide direction as Family Physicians, academicians, clinical networks, and policy-makers negotiate roles in the evolving health system.
Michelle T Weckmann - One of the best experts on this subject based on the ideXlab platform.
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the role of the Family Physician in the referral and management of hospice patients
American Family Physician, 2008Co-Authors: Michelle T WeckmannAbstract:Hospice is available for any patient who is terminally ill and chooses a palliative care approach. Because of the close relationship that primary care Physicians often have with their patients, they are in a unique position to provide end-of-life care, which includes recognizing the need for and recommending hospice care when appropriate. The hospice benefit covers all expenses related to the terminal illness, including medication, nursing care, and equipment. Hospice should be considered when a patient has New York Heart Association class IV heart failure, severe dementia, activity-limiting lung disease, or metastatic cancer. Timely referrals are beneficial to both patient and hospice because of the cost related to initiating services and the time required to form a therapeutic relationship. Once the decision to refer to hospice is made, the Family Physician typically continues to be the patient's primary attending Physician. The attending Physician is expected to remain in charge of the patient's care, write orders, see the patient for office visits, and complete and sign the death certificate. Hospice, in turn, is a valuable Physician resource when it comes to medication dosages, symptom management, and communication with patients and their families.
Patrick Brown - One of the best experts on this subject based on the ideXlab platform.
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a pilot study examining toronto area Family Physician perspectives on thyroid neoplasm evaluation
Journal of Otolaryngology-head & Neck Surgery, 2019Co-Authors: Arjun Kundra, David P Goldstein, Kimberly Wintemute, Sangeet Ghai, Richard W Tsang, Karuna Gupta, Donatus R Mutasingwa, Jeff Weissberger, E Huszti, Patrick BrownAbstract:Objective The incidence of thyroid cancer (TC) is known to be very high in the Greater Toronto Area of Ontario, Canada. We performed a pilot survey study examining Toronto-area Family Physician (FP) perspectives on thyroid neoplasm evaluation (i.e. thyroid nodules [TNs] or thyroid cancer [TC]) in this region, to explore for potential factors leading to overdiagnosis.
James C Puffer - One of the best experts on this subject based on the ideXlab platform.
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community size and organization of practice predict Family Physician recertification success
Journal of the American Board of Family Medicine, 2014Co-Authors: Bradley M Schulte, David M Mannino, Kenneth D Royal, Sabrina L Brown, Lars E Peterson, James C PufferAbstract:Objective: Health disparities exist between rural and urban areas. Rural Physicians may lack sufficient medical knowledge, which may lead to poor quality of care. Therefore, we sought to determine whether medical knowledge differed between Family Physicians (FPs) practicing in rural areas compared with those practicing in metropolitan areas. Methods: We studied 8361 FPs who took the American Board of Family Medicine maintenance of certification (MOC) examination in 2009. Data sources were examination results and data from a demographic survey of practice structure and activities, completed as part of the examination application process. FPs9 location of practice was categorized as either rural or metropolitan using a moderate and conservative definition based on reported community size. Univariate statistics assessed differences in FP characteristics between rural and metropolitan areas. Logistic regression analyses determined the adjusted relationship between rural status and the odds of passing the MOC examination. Results: Metropolitan FPs were less likely than their rural counterparts to pass the MOC examination using both the moderate (odds ratio, 0.67; 95% confidence interval, 0.54–0.83) and conservative (odds ratio, 0.56; 95% confidence interval, 0.42–0.74) definitions. Physicians in solo practice were less likely to pass the examination than Physicians in group practice. Conclusion: Rural Physicians were more likely to pass the MOC examination, suggesting that rural health disparities do not result from a lack of provider knowledge.
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factors influencing Family Physician adoption of electronic health records ehrs
Journal of the American Board of Family Medicine, 2013Co-Authors: Imam M Xierali, Robert L. Phillips, Andrew Bazemore, Larry A Green, James C PufferAbstract:Background: Physician and practice characteristics associated with Family Physician adoption of electronic health records (EHRs) remain largely unexplored but may be important for tailoring policies and interventions. Methods: This was a cross-sectional study of EHR adoption using American Board of Family Medicine certification census data (2006–2011) for over 41,000 Family Physicians to test associations between demographic, geographic, and practice characteristics and EHR adoption. Results: EHR adoption rates for Family Physicians grew from 37% in 2006 to 68% in 2011. No significant association was found with rural status (odds ration [OR], 0.985; 95% confidence interval [CI], 0.932–1.042). Practicing in a medically underserved location (OR, 0.868; 95% CI, 0.822–0.917) or geographic health professional shortage areas (OR, 0.904; 95% CI, 0.831–0.984), or being an international medical graduate (OR, 0.769; 95% CI, 0.748–0.846) were negatively associated with adoption. Compared with Physicians in group practices, Physicians in solo practices (OR, 0.465; 95% CI, 0.439–0.493) and small practices (OR, 0.769; 95% CI, 0.720–0.820) were less likely to adopt EHRs, whereas those in health maintenance organizations (OR, 5.482; 95% CI, 4.657–6.454) or with faculty status (OR, 1.527; 95% CI, 1.386–1.684) were more likely. Conclusions: Variation in EHR adoption is associated with Physician and practice characteristics that may help guide intervention. These findings may be important to other specialties and could instruct interventions to improve adoption. Certification boards could play an important role in tracking EHR adoption and help target resources and facilitation.
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Family Physician participation in maintenance of certification
Annals of Family Medicine, 2011Co-Authors: Imam M Xierali, Robert L. Phillips, Andrew Bazemore, Warren P Newton, Larry A Green, Jason C B Rinaldo, Stephen Petterson, James C PufferAbstract:PURPOSE The American Board of Family Medicine has completed the 7-year transition of all of its diplomates into Maintenance of Certification (MOC). Participation in this voluntary process must be broad-based and balanced for MOC to have any practical national impact on health care. This study explores Family Physicians’ geographic, demographic, and practice characteristics associated with the variations in MOC participation to examine whether MOC has potential as a viable mechanism for dissemination of information or for altering practice. METHODS To investigate characteristics associated with differential participation in MOC by Family Physicians, we performed a cross-sectional comparison of all active Family Physicians using descriptive and multinomial logistic regression analyses. RESULTS Eighty-five percent of active Family Physicians in this study (n = 70,323) have current board certification. Ninety-one percent of all active board-certified Family Physicians eligible for MOC are participating in MOC. Physicians who work in poorer neighborhoods (odds ratio [OR] = 1.105; 95% confidence interval [CI], 1.038–1.176), who are US-born or foreign-born international medical graduates (OR = 1.221; 95% CI, 1.124–1.326; OR = 1.444; 95% CI, 1.238–1.684, respectively), or who are solo practitioners (OR = 1.460; 95% CI, 1.345–1.585) are more likely to have missed initial MOC requirements than those from a large, undifferentiated reference group of certified Family Physicians. When age is held constant, female Physicians are less likely to miss initial MOC requirements (OR = 0.849; 95% CI, 0.794–0.908). Physicians practicing in rural areas were found to be performing similarly in meeting initial MOC requirements to those in urban areas (OR = 0.966; 95% CI, 0.919–1.015, not significant). CONCLUSION Large numbers of Family Physicians are participating in MOC. The significant association between practicing in underserved areas and lapsed board certification, however, warrants more research examining causes of differential participation. The penetrance of MOC engagement shows that MOC has the potential to convey substantial practice-relevant medical information to Physicians. Thus, it offers a potential channel through which to improve health care knowledge and medical practice.
