Ethics, Support for Care, Prevention, and What’s Important

This issue of the Annals addresses ethical issues,^1,2 the effects of implementing new models of care support,^3,4 prevention,⁵ screening,^6–8 and patients’ health information-seeking behaviors.⁹ It closes with a new approach for calculating the complexity of patient visits^10,11 and a community celebration of the life of a personal physician.¹²

An essay by bioethicist and family physician Howard Brody¹ argues the ethical issues surrounding the American Academy of Family Physicians (AAFP) receipt of a corporate donation from Coca-Cola to fund patient education. AAFP President Lori Heim presents a counterargument. We look forward to a thoughtful dialogue of this issue in the Annals’ online discussion and at state chapter meetings of the Academy around the country this summer preceding the AAFP’s fall Congress of Delegates.

The Annals Journal Club selection¹³ examines the effects of implementing a new model of support for care of chronically ill older adults. In a cluster-randomized trial,³ this Guided Care model shows promising outcomes from the physician’s point of view.

A qualitative study by Shield et al examines a different change in care processes—implementation of an electronic medical record in a residency-training practice.⁴ The authors find both expected and unanticipated effects on the process of care and on relationships with patients and among practice members.

A cluster of articles addresses disease prevention and early detection.

Abramson and colleagues help us to proactively plan for the next influenza season with a clinical trial evaluation of a multifaceted but feasible intervention to increase staff influenza vaccination rates.⁵

Another study takes a longitudinal perspective on the use of colorectal cancer screening. Doubeni and colleagues identify a constellation of factors associated with colorectal cancer screening in Medicare beneficiaries.⁶

The population prevalence of cardiovascular risk factors and cholesterol screening in young adults is examined by Kuklina et al, with the surprising finding of no difference in screening rates for those with and without risk factors.⁷

The largest exclusively primary care validation study of the Patient Health Questionnaire (PHQ) 2- and 9-item measures provides helpful and actionable information on the use of these measures to screen for depression in primary care.⁸

A qualitative study by Longo and colleagues examines how people with diabetes seek and use health information, identifying the interaction of both active and passive information receipt.⁹

In an article with important policy implications, Katerndahl and colleagues¹⁰ elucidate a new approach for calculating the complexity of patient visits. An editorial by Lee Green puts this work into context and draws out the implications.¹¹

Finally, a moving essay by Larry Green and Bill Phillips¹² helps us to focus on what is important about family medicine by witnessing the effect of a family doctor’s life through the eyes of his community.

Please join the online discussion of these articles at http://www.AnnFamMed.org.

• © 2010 Annals of Family Medicine, Inc.