Abstract:
OBJECTIVE:To describe adult primary care physicians' and psychiatrists' approach to alcohol screening and treatment, and to identify correlates of more optimal practices. DESIGN:Cross-sectional mailed survey. PARTICIPANTS:A national systematic sample of 2,000 physicians practicing general internal medicine, family medicine, obstetrics-gynecology, and psychiatry. MEASUREMENTS:Self-reported frequency of screening new outpatients, and treatment recommendations in patients with diagnosed alcohol problems, on 5-point Likert-type scales. MAIN RESULTS:Of the 853 respondent physicians (adjusted response rate, 57%), 88% usually or always ask new outpatients about alcohol use. When evaluating patients who drink, 47% regularly inquire about maximum amounts on an occasion, and 13% use formal alcohol screening tools. Only 82% routinely offer intervention to diagnosed problem drinkers. Psychiatrists had the most optimal practices; more consistent screening and intervention was also associated with greater confidence in alcohol history taking, familiarity with expert guidelines, and less concern that patients will object. CONCLUSIONS:Most primary care physicians and psychiatrists ask patients about alcohol use, but fewer use recommended screening protocols or offer formal treatment. A substantial minority of physicians miss the opportunity to intervene in alcohol problems. Efforts to improve physicians' screening and intervention for alcohol problems should address their confidence in their skills, familiarity with expert recommendations, and beliefs that patients object to their involvement
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Friedmann PD,McCullough D,Chin MH,Saitz Rdoi
10.1046/j.1525-1497.2000.03379.xsubject
Has Abstractpub_date
2000-02-01 00:00:00pages
84-91issue
2eissn
0884-8734issn
1525-1497pii
jgi3379journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Decisions to forgo life-sustaining medical treatments in terminally ill patients are challenging, but ones that all doctors must face. Few studies have evaluated the impact of medical training on medical students' attitudes towards end-of-life decisions and none have compared them with an age-matched group o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0713-y
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are cate...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3309-3
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Population-based strategies can expand the reach of tobacco cessation treatment beyond clinical encounters. OBJECTIVE:To determine the effect of two population-based tobacco cessation strategies, compared with usual care, on providing tobacco treatment outside of clinical encounters. DESIGN:3-arm pragmatic...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-019-05079-3
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To decrease unnecessary antibiotic use for acute respiratory tract infections in adults in a point-of-service health care setting. DESIGN:Prospective, nonrandomized controlled trial. SETTING:An urban urgent care clinic associated with the major indigent care hospital in Denver, Colorado between October 2000...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章
doi:10.1046/j.1525-1497.2003.20410.x
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:To practice Evidence-Based Medicine (EBM), physicians must quickly retrieve evidence to inform medical decisions. Internal Medicine (IM) residents receive little formal education in electronic database searching, and have identified poor searching skills as a barrier to practicing EBM. OBJECTIVE:To design a...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-007-0387-x
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clini...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1437-3
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:In countries with public health system, hospital bed reductions and increasing social and medical frailty have led to the phenomenon of "outliers" or "outlying hospital in-patients." They are often medical patients who, because of unavailability of beds in their clinically appropriate ward, are admitted wher...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05008-4
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Early in medical education, physicians must develop competencies needed for tobacco dependence treatment. OBJECTIVE:To assess the effect of a multi-modal tobacco dependence treatment curriculum on medical students' counseling skills. DESIGN:A group-randomized controlled trial (2010-2014) included ten U.S. ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-015-3508-y
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To examine how Asian race/ethnicity affects patients' health care experiences and satisfaction with care. DESIGN:Telephone interview using random-digit dialing, stratified to over-sample adults living in areas with disproportionately large numbers of minorities. PARTICIPANTS AND SETTING:White (N = 3,205) an...
journal_title:Journal of general internal medicine
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更新日期:2004-02-01 00:00:00
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更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The Department of Veterans Affairs (VA) mandates disclosure of large-scale adverse events to patients, even if risk of harm is not clearly present. Concerns about past disclosures warranted further examination of the impact of this policy. OBJECTIVE:Through a collaborative partnership between VA leaders, po...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3034-3
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:Community physicians in the United States prescribe antibiotics to 80% to 90% of smokers with acute bronchitis. We performed a systematic review of the literature to determine the efficacy of antibiotics for smokers with acute bronchitis. DESIGN:A medline search was done using the keywords bronchitis, cough,...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1497.2002.10405.x
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Previous studies indicate that medical trainees frequently experience discrimination by patients. Little is known about effective strategies to teach trainees to respond to this discrimination. AIM:To create a workshop for first-year residents utilizing standardized patients to improve skills in responding ...
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doi:10.1007/s11606-019-04881-3
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE:We measured PCMH capabilities in a diverse nationwide sample of FQHCs and asse...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-4078-y
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To compare specialist and primary care physician participation in California's Medicaid fee-for-service and managed care programs. DESIGN:Cross-sectional survey. PARTICIPANTS:A probability sample stratified by county and by race of 962 specialist physicians and 713 primary care physicians practicing in the ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:eConsult programs have been instituted to increase access to specialty expertise. Opt-in choice eConsult programs maintain primary care physician (PCP) autonomy to decide whether to utilize eConsults versus traditional specialty referrals, but little is known about how this intervention may impact PCP eConsu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06101-9
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE:To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfac...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-017-3997-y
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Little is known about pain care offered to patients discontinued from long-term opioid therapy (LTOT) by their prescriber due to aberrant behaviors versus other reasons. OBJECTIVE:This study aimed to compare rates of non-opioid analgesic pharmacotherapy initiation and clinician referrals for non-pharmacolog...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-018-4329-6
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To assess a new technique for the detection of free pleural fluid. DESIGN:118 consecutive inpatients with radiologic evidence of free pleural fluid and a control group of 175 randomly selected inpatients were examined over a three-year period in a prospective blind study by auscultatory percussion (AP) for e...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02600204
更新日期:1994-02-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
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abstract::Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture tha...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:African-American women have had higher rates of female sterilization compared to white women since its emergence as a contraceptive method. The reasons underlying this observed racial difference are unknown. OBJECTIVES:The goals of this study were to (1) explore what factors shape black and white women's de...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-008-0887-3
更新日期:2009-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599133
更新日期:1994-01-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06132-2
更新日期:2020-08-20 00:00:00
abstract::Our institution has instituted "short-call" and "nightfloat" systems to reduce the number of admissions to the traditional "long-call" housestaff. However, the nightfloat system introduces increased discontinuity to patient care, and interns may spend less time with short-call patients because they are nor required to...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.012005308.x
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:The objective of the study is to examine the association between ambulatory care sensitive hospitalizations (ACSH) and dual Medicare/Veteran Health Administration use. PARTICIPANTS:A nationally representative sample of Medicare beneficiaries, who participated in the Medicare Current Beneficiary Survey (MCBS)...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1788-4
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To compare the ability of 3 brief alcohol screens (Alcohol Use Disorders Identification Test [AUDIT], CRAFFT, and CAGE) to identify adolescents and young adults with a current alcohol use disorder (AUD) and to determine whether there are gender-based or race-based differences in screening performance. DESIGN...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40052.x
更新日期:2005-01-01 00:00:00
abstract::The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case re...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00328.x
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Clinical and community samples indicate that eating disorders (EDs) and disordered eating behaviors (DEBs) may co-occur among adolescents and young adults at a weight status classified as overweight or obese. OBJECTIVE:To determine the prevalence of EDs and DEBs among young adults at a weight status classif...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4465-z
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To measure and compare patient satisfaction with care in resident and attending physician internal medicine ambulatory care clinics. DESIGN:A cross-sectional survey using a questionnaire derived from the Visit-Specific Satisfaction Questionnaire (VSQ) and Patient Satisfaction Index (PSI) distributed from Mar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2001.91005.x
更新日期:2001-11-01 00:00:00