Abstract：
OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control group design. SETTING:A university hospital and an affiliated county hospital where the guidelines were implemented and an affiliated VA medical center where they were not. PARTICIPANTS:Sixty-one full-time faculty who had attended on the general medical wards for at least 1 month for 2 of 3 consecutive years prior to July 1996 and for at least 1 month during the 18 following months. MEASUREMENTS AND MAIN RESULTS:We evaluated standardized, confidential evaluations of attending physicians that are routinely completed by residents and students after clinical rotations at all three sites. Comparing 863 evaluations completed before July 1, 1996 and 497 completed after that date, there were no significant differences at any of the hospitals on any items assessed. There were also no differences between the university and county hospitals as compared with the VA. Eighty-seven percent of 39 university and county attending physicians returned a survey about their perceptions of inpatient teaching activities before and after July 1, 1996. They reported highly significant increases in time devoted to attending responsibilities but diminished time spent on teaching activities. CONCLUSIONS:Physicians reported a dramatic increase in overall time spent attending but a decrease in time spent teaching following implementation of the revised E&M guidelines. Yet, evaluations of their teaching effectiveness did not change.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Fihn SD,Schleyer AM,Kelly-Hedrick H,Martin DBdoi
10.1046/j.1525-1497.2000.07001.xsubject
Has Abstractpub_date
2000-07-01 00:00:00pages
451-6issue
7eissn
0884-8734issn
1525-1497pii
jgi07001journal_volume
15pub_type
杂志文章,多中心研究abstract：:Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596366
更新日期：1987-11-01 00:00:00
abstract：INTRODUCTION:With the increasing number of women Veterans enrolling in the Veterans Health Administration (VA), there is growing demand for reproductive health services. Little is known regarding the on-site availability of reproductive health services at VA and how this varies by site location and type. OBJECTIVE:To ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-012-2289-9
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:In 2000 a diverse group of clinicians/educators at an inner-city safety-net hospital identified relational skills to reduce disparities at the point of care. DESCRIPTION:The resulting interviewing and precepting model helps build trust with patients as well as with learners. RESPECT adds attention to the re...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1274-4
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Patient-provider language barriers may play a role in health-care disparities, including obtaining colorectal cancer (CRC) screening. Professional interpreters and language-concordant providers may mitigate these disparities. DESIGN, SUBJECTS, AND MAIN MEASURES: We performed a retrospective coh...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1512-9
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. OBJECTIVE:To better unde...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1525-1497.2006.00485.x
更新日期：2006-06-01 00:00:00
abstract：:Our aim was to improve clinical reasoning skills by applying an established theory of memory, cognition, and decision making (fuzzy-trace theory) to instruction in evidence-based medicine. Decision-making tasks concerning chest pain evaluation in women were developed for medical students and internal medicine resident...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2001.00214.x
更新日期：2001-02-01 00:00:00
abstract：:This paper was inadvertently published with open access; the authors have requested the copyright revert to the society. It has been re-published with appropriate licensing. ...
journal_title：Journal of general internal medicine
pub_type： 已发布勘误
doi：10.1007/s11606-018-4692-3
更新日期：2018-12-01 00:00:00
abstract：:We describe a half-day workshop to teach third-year medical students three focused end-of-life care skills: breaking bad news, discussing advance directives, and assessing and managing pain. Our workshop included a readers' theater exercise and three role-play exercises. In two of the workshops, faculty members played...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30115.x
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:Doctor rating websites are a burgeoning trend, yet little is known about their content. OBJECTIVE:To explore the content of Internet reviews about primary care physicians. DESIGN:Qualitative content analysis of 712 online reviews from two rating websites. We purposively sampled reviews of 445 primary care ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-011-1958-4
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:There are currently roughly 10,000 Germans on the organ waiting list, and that number is over 113,000 in the USA. There is a clear need to increase support for organ donation in general and to increase the number of registered donors in particular. OBJECTIVE:The current study examines the relationship betwe...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05734-0
更新日期：2020-08-01 00:00:00
abstract：:To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-016-3843-7
更新日期：2017-05-01 00:00:00
abstract：OBJECTIVE:To determine how accurately preventive care reported in the medical record reflects actual physician practice or competence. DESIGN:Scoring criteria based on national guidelines were developed for 7 separate items of preventive care. The preventive care provided by randomly selected physicians was measured p...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1046/j.1525-1497.2000.91007.x
更新日期：2000-11-01 00:00:00
abstract：OBJECTIVE:To evaluate the association between chronic illness with complexity (CIC) and optimal glycemic control. PARTICIPANTS:Cross-sectional and longitudinal analyses of Diabetes Epidemiologic Cohort database of Veterans Health Administration (VHA) users with diabetes, less than 75 years old, with HbA1c tests in fis...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-007-0310-5
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings. OBJECTIVE:To explore attitudes toward antidepressants in a sample of depressed, communi...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.00296.x
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Residents demonstrate scholarly activity by presenting posters at academic meetings. Although recommendations from national organizations are available, evidence identifying which components are most important is not. OBJECTIVE:To develop and test an evaluation tool to measure the quality of case report pos...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-008-0860-1
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Obesity and its related co-morbidities place a huge burden on the health care system. Patients who know they are obese may better control their weight or seek medical attention. Self-recognition may be affected by race/ethnicity, but little is known about racial/ethnic differences in knowledge of obesity's h...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-010-1623-3
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:A large proportion of deaths and chronic illnesses can be attributed to three modifiable risk factors: tobacco use, overweight/obesity, and physical inactivity. OBJECTIVE:To test whether telephone-based health coaching after completion of a comprehensive health risk assessment (HRA) increases patient activa...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-018-4398-6
更新日期：2018-09-01 00:00:00
abstract：OBJECTIVE:Overall suicide mortality rates are higher among American Indians than in the general population and are particularly high among Indians residing in the upper Midwest. The identification, during encounters with health care providers, of individuals at high risk of suicide is a potential intervention strategy....
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599598
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:Many seniors rely on paid non-familial caregivers to maintain their independence at home. Caregivers often assist with medication reminding and activities of daily living. No prior studies have examined the health literacy levels among paid non-familial caregivers. OBJECTIVES:To determine health literacy le...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-010-1596-2
更新日期：2011-05-01 00:00:00
abstract：:Because of the financial incentives of prepaid care, the quality of care for Medicare enrollees in Health Maintenance Organizations (HMOs) is a concern. Therefore, the care in 150 newly diagnosed cases of colorectal cancer in eight HMOs was compared with that in 180 similar fee-for-service (FFS) cases. As part of the ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600509
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Veterans commonly receive care from both Veterans Health Administration (VA) and non-VA sources (i.e., dual use). A major challenge in comparing health outcomes between dual users and VA-predominant users is applying an accurate method of risk adjustment. OBJECTIVE:To determine how different comorbidity ind...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-017-4064-4
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:To determine whether echocardiography affects the decisions to use beta blockers or to recommend bacterial endocarditis prophylaxis in patients suspected of having mitral valve prolapse (MVP). DESIGN:Retrospective review of echocardiograms and clinical records. SETTING:Military tertiary care hospital. PATI...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02600871
更新日期：1990-11-01 00:00:00
abstract：BACKGROUND:Process measures of healthcare quality are usually formulated as the number of patients who receive evidence-based treatment (numerator) divided by the number of patients in the target population (denominator). When the systems being evaluated can influence which patients are included in the denominator, it ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-015-3558-1
更新日期：2016-04-01 00:00:00
abstract：OBJECTIVE:To determine the impact of prospective payment by diagnosis-related groups (DRGs) on length of stay in the hospital, ambulatory status, and level of post-hospital care needed for patients hospitalized with hip fracture. DESIGN:Retrospective chart review of a consecutive series of cases before and after the r...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02599687
更新日期：1989-09-01 00:00:00
abstract：OBJECTIVES:To characterize prostate-specific antigen (PSA) testing practices in a hospital-based primary care clinic, and to determine the outcomes of PSA testing, including urology referrals, biopsies, cancers detected, and cancer treatments. DESIGN:Retrospective cohort study. Data were obtained from computerized Dep...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1998.00026.x
更新日期：1998-02-01 00:00:00
abstract：:The study of expressed proteins in neoplasia is undergoing a revolution with the advent of proteomic analysis. Unlike genomic studies where individual changes may have no functional significance, protein expression is closely aligned with cellular activity. This perspective will review proteomics as a method of detect...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,评审
doi：10.1007/s11606-007-0411-1
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Lack of regular physical activity is highly prevalent in U.S. adults and significantly increases mortality risk. OBJECTIVE:To examine the clinical impact of a newly implemented program ("Exercise as a Vital Sign" [EVS]) designed to systematically ascertain patient-reported exercise levels at the beginning o...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,多中心研究
doi：10.1007/s11606-013-2693-9
更新日期：2014-02-01 00:00:00
abstract：:African Americans and Latinos use services that require a doctor's order at lower rates than do whites. Racial bias and patient preferences contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2003.20532.x
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:Development of electronic health record (EHR) prediction models to improve palliative care delivery is on the rise, yet the clinical impact of such models has not been evaluated. OBJECTIVE:To assess the clinical impact of triggering palliative care using an EHR prediction model. DESIGN:Pilot prospective be...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05169-2
更新日期：2019-09-01 00:00:00
abstract：INTRODUCTION:Whether the clinical vignettes presented at the Society of General Internal Medicine (SGIM) annual meeting could be of educational value to third year students in the Internal Medicine clerkship has not been studied. OBJECTIVE:To explore the relevance and learning value of clinical vignettes from the SGIM...
journal_title：Journal of general internal medicine
pub_type：
doi：10.1111/j.1525-1497.2006.00596.x
更新日期：2006-11-01 00:00:00
