Table of Contents
PLAIN-LANGUAGE SUMMARIES
Embargoed until 5 p.m. Eastern Standard Time
Monday, January 27, 2025
Editorial
A Unified Framework for Responsible AI Use in Family Medicine Journals
Background: This editorial by editors of family medicine journals provides a unified stance on the use of artificial intelligence (AI) in family medicine research and publishing.
Editorial Stance: Family medicine journals must address the implications of AI, including ethical considerations, accuracy, and potential for bias. The authors recommend guiding principles for AI use in family medicine publishing, emphasizing:
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Full disclosure of AI tool use in research and manuscript preparation
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Accountability for content accuracy and originality by authors
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Understanding of AI limitations and awareness of bias
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Establishing transparent editorial policies to evaluate AI's role in the publication process
The editorial highlights the benefits of AI, such as improving efficiency and accessibility for non-native English speakers, alongside risks like perpetuating bias and generating inaccurate information. The authors stress the need for ongoing research to optimize AI's application while mitigating its limitations.
Why It Matters: With AI tools becoming increasingly prevalent in academic publishing, their responsible use is critical to uphold scientific integrity. This editorial serves as a call for unified action across family medicine journals to develop ethical, effective practices for integrating AI into research and publishing.
Use of AI in Family Medicine Publications: A Joint Editorial From Journal Editors
Caroline R. Richardson, MD, Editor, et al
Annals of Family Medicine
The Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Special Report
Before Implementing AI in Primary Care, Understand Where Clinicians Need the Most Help
Background and Goal: Primary care clinicians face significant burnout, driven by excessive administrative tasks and time spent on electronic health records (EHRs). This report emphasizes that generative AI tools must focus on addressing specific, impactful problems. Drawing on the failure of the Segway, the report argues that AI must avoid becoming a "solution looking for a problem."
Key Insights: The Segway, once expected to revolutionize transportation, failed because it did not solve a real need. Rentable scooters succeeded by addressing a narrow, specific problem: the “last-mile” challenge in urban commutes. Similarly, AI in primary care must tackle clinicians' “last-mile” issue—time. With over half of their 11-hour workdays spent on EHR tasks, clinicians need AI to target key areas like documentation, chart reviews, medication management, and patient communications. Collaboration between clinicians, innovators, and researchers is critical to ensure AI tools address real-world needs. Systemic challenges—such as overloaded schedules and ballooning patient panels—cannot be solved by technology alone. For AI to succeed, health care organizations must prioritize clinician well-being and align tools with practical needs.
Why It Matters:The failure of the Segway illustrates the risk of innovating without understanding the underlying fundamental problems that need to be addressed. AI has the potential to reduce primary care burdens and improve work-life balance, but only if implemented thoughtfully. Technology works only as well as the system in which it operates, and primary care clinicians will only reap the benefits of AI if implemented in organizations that prioritize clinician well-being and patient care.
For AI in Primary Care, Start With the Problem
John Thomas Menchaca, MD
Internal Medicine and Biomedical Informatics, University of Utah, Salt Lake City, Utah
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Editorial
How AI Could Transform Family Medicine—If Used Wisely
Background: The integration of artificial intelligence (AI) into family medicine presents significant opportunities to improve patient care and physician workflow. This editorial, written by Annals of Family Medicine associate editors, urges family physicians to articulate a vision of what they want from AI and make it into something that serves them and their patients.
Editorial Stance: The authors argue for a targeted approach to AI in family medicine, emphasizing tools that reduce administrative burdens and improve the physician-patient relationship. They advocate for AI-driven solutions like automated note-taking, multilingual patient communication, and streamlined care coordination. They caution against developing redundant diagnostic tools and risk calculators.
Why It Matters: AI has the potential to alleviate many pain points in family medicine, from reducing documentation tasks to creating accessible patient education tools. Thoughtful application of AI can restore joy in practice and help family physicians focus on their core mission: delivering compassionate, patient-centered care.
The AI Moonshot: What We Need and What We Do Not
José E. Rodríguez, MD, FAAP
Department of Family & Preventive Medicine, University of Utah, Salt Lake City, Utah
Yves Lussier, MD, FACMI
Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
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Original Research
AI-Based Voice Biomarker Tool Shows Promise in Detecting Moderate to Severe Depression
Background and Goal: Depression is a leading cause of disability, impacting an estimated 18 million Americans each year, with a lifetime prevalence of major depression approaching 30%. Despite recommendations for universal screening, depression screening rarely occurs in the outpatient setting with some estimates placing screening rates at less than 4% of primary care encounters. This study evaluated an AI-based machine learning biomarker tool that uses speech patterns to detect moderate to severe depression, aiming to improve access to screening in primary care settings.
Study Approach: The study analyzed over 14,000 voice samples from U.S. and Canadian adults. Participants answered the question, “How was your day?” with at least 25 seconds of free-form speech. The tool analyzed vocal biomarkers associated with depression, including speech cadence, hesitations, pauses, and other acoustic features. These were compared to results from the Patient Health Questionnaire-9 (PHQ-9), a standard depression screening tool. A PHQ-9 score of 10 or higher indicated moderate to severe depression. The AI tool provided three outputs: Signs of Depression Detected, Signs of Depression Not Detected, and Further Evaluation Recommended (for uncertain cases).
Main Results:The dataset used to train the AI model consisted of 10,442 samples, while an additional 4,456 samples were used in a validation set to assess its accuracy.
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The tool demonstrated a sensitivity of 71%, meaning it correctly identified depression in 71% of people who had it.
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Specificity was 74%, indicating that the tool correctly ruled out depression in 74% of people who did not have it.
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In about 20% of cases, the tool flagged results as uncertain, recommending further evaluation by a clinician.
Why It Matters: While not a replacement for formal clinical interviews or assessments by qualified clinicians, the study findings suggest that machine learning technology could serve as a complementary decision-support tool. These findings are preliminary, and more work is needed to validate the tool and explore its integration into primary care workflows. This study represents a promising avenue for using physiologic voice biomarkers to assist clinicians in identifying and addressing depression, with future research needed to refine the technology and assess its broader applicability.
Alexa Mazur, BA, et al
Kintsugi Mindful Wellness, Inc, San Francisco, California
Visual Abstract:
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Original Research
Study Identifies 12 Response Strategies GPs Use to Address Patient-Reported Type 2 Diabetes Treatment Burdens
Background and Goal: Managing type 2 diabetes involves complex treatment-associated activities, workload, and costs, all of which impose a significant burden on individuals, impacting their physical and mental health. This study examines how general practitioners (GPs) in China identify and respond to these burdens during patient consultations.
Study Approach:The study examined video recordings of 29 GP-patient consultations in a primary care clinic in China. These consultations, recorded between 2018 and 2019, were reviewed for discussions related to treatment burdens in managing type 2 diabetes. Researchers analyzed the interviews to identify specific burdens and the strategies GPs employed to address them.
Main Results:A total of 29 GP-patient video consultations were examined. Analysis identified 77 segments that focused on discussions related to treatment burden.
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The median length of the 29 video-recorded consultations was about 24 minutes.
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In 37.66% of the segments, the GP initiated and responded to discussions about treatment burden; while in 23.38%, the patient initiated the discussion, and the GP responded to it; leaving 38.96% where the patient initiated the discussion, but the GP did not respond.
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Medication was the most frequently identified component of treatment burden by both patients and GPs, followed by personal resources, medical information and administrative burdens.
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A key finding was the identification of 12 response approaches used by GPs to address patients’ treatment burden. The most frequently used strategies were active listening and nonverbal skills, shared decision making, and confidence and self-efficacy support, which were broadly applied across various issues.
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Less commonly used strategies included health record management, motivational interviewing, patient background awareness, follow-up and referral, health education, emotional and psychosocial care, online and teleconsultation, the use of examples, and expressions of empathy.
Why It Matters: The findings from this study highlight the complexity of type 2 diabetes treatment burdens and emphasize the importance of tailored GP responses to improve patient engagement and reduce barriers to care. Optimizing these strategies could maximize the efficient use of consultation time, improve patient outcomes and alleviate burdens.
Yongsong Chen, MD, PhD, et al
The First Affiliated Hospital of Shantou University Medical College, Shantou, China
Visual Abstract:
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Original Research
Primary Care Support Program Achieves Fivefold Increase in Buprenorphine Prescribing to Treat Opioid Use Disorder
Background and Goal:Despite the removal of the X-waiver requirement, which once restricted clinicians from prescribing buprenorphine for opioid use disorder (OUD), only a small percentage of primary care clinicians currently prescribe medication for OUD (MOUD). This study evaluated a structured support program designed to help small, rural primary care clinics improve their capacity to provide this treatment.
Study Approach: Researchers worked with 15 primary care practices in Colorado over a 12-month period, from January 2022 through January 2023. The program provided clinics with monthly educational sessions, direct access to an addiction medicine specialist, and support from practice facilitators to achieve specific milestones in MOUD implementation. Financial incentives were offered based on progress toward these goals. The researchers measured changes in buprenorphine prescribing and milestone completion rates at baseline and at 12 months.
Main Results:
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The average number of active buprenorphine prescriptions per practice (calculated over the preceding three months) increased significantly from 2.1 at the start of the program (baseline) to 11.3 at 12 months (P < .001).
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Clinic completion rates for MOUD implementation milestones also showed significant improvements:
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Core Aim 1 ("Build Your Team"): Increased from 40% at the start of the program to 93% at 12 months
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Core Aim 2 ("Engage and Support Patients"): Increased from 23% to 84%
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Core Aim 3 ("Connect with Recovery Support Services"): Increased from 28% to 93%
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Practices completing more intervention stages showed significant improvements in IBH integration, particularly in workflows, integration methods, and patient identification.
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No significant clinically relevant differences were found in patient health outcomes—including depression, anxiety, fatigue, sleep disturbance, pain, pain interference, and physical function—between the intervention and control groups.
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Primary care physicians report knowledge gaps and receive little training or resources on adult adoptees with limited family medical history and want guidance around appropriate preventative screening and genetic testing.
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Mental illness and trauma are under-recognized and under-addressed.
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Primary care physicians often obtain family medical history imprecisely, risking miscommunication, microaggressions, and damage to the patient-physician relationship.
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Navigators reduced structural barriers to affirming health care, improving access and alleviating stress for transgender and gender-diverse individuals.
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Clients valued the navigators’ shared lived experience, which fostered trust and understanding.
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Navigators provided tailored guidance, connected clients to affirming providers and resources, and supported health care practitioners with accurate information.
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The program positively impacted clients’ mental health by filling gaps in psychosocial support and reducing stress while awaiting formal counseling.
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The most problematic code appeared to be "acute upper respiratory infections of multiple and unspecified sites" (J06) which was frequently used interchangeably with other codes, especially "common cold" (J00) and "bronchitis" (J20)
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Significant differences were observed in how respiratory conditions were coded across counties, with no consistent regional patterns to explain these variations. Larger counties showed less variability, likely due to random factors canceling out.
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Only 39% (41/106) of responding departments offered financial incentives for scholarly activity, with 18% providing cash-based incentives.
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Those departments that offered financial incentives did not report high scholarly output rates.
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Faculty size was statistically significant: departments with fewer than 25 full-time faculty were 80% less likely to produce six or more presentations.
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The main barriers to offering financial incentives were institutional budget constraints and department culture or tradition.
Why It Matters: By providing structured support and resources, this program successfully increased the ability of clinics to prescribe MOUD and support patients in need, addressing critical gaps in opioid treatment access. The findings from this study highlight a potentially scalable and effective model to expand access to MOUD in rural communities, where treatment options for opioid use disorder are often limited.
Tristen L. Hall, PhD, MPH, et al
University of Colorado Anschutz Medical Campus, Aurora, Colorado
Visual Abstract:
Original Research
Flexible Practice-Centric Approach Improves Behavioral Health Integration in Primary Care Practices
Background and Goal: Many patients with mental health needs receive care in primary care settings rather than from specialized settings. Integrated behavioral health (IBH), which combines behavioral health and primary care, improves patient outcomes and experience. However, implementing IBH is challenging due to the need for practice-specific changes. This study evaluated whether a tailored, toolkit-based intervention could improve IBH and patient outcomes in primary care practices serving patients with multiple chronic medical and behavioral health conditions.
Study Approach: The study used a cluster randomized controlled trial design. Practices were randomized into two groups. The intervention arm received a comprehensive toolkit that included four components: workbooks to guide the quality improvement project, online education tailored to specific practice personnel roles, an online learning community to facilitate collaboration, and remote coaching provided by a trained quality improvement professional paired with a psychologist experienced in IBH. The control arm continued with their usual IBH services without receiving additional support. Completion of the toolkit stages—planning, workflow redesign, and implementation—was measured. Patient outcomes, including physical and mental health, and practice integration levels, assessed through Practice Integration Profile scores, were evaluated over a two-year period.
Main Results: A total of 42 practices were randomized in the study with one practice unable to provide eligible patient data and therefore not included in the patient-level analysis.
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Practices completing more intervention stages showed significant improvements in IBH integration, particularly in workflows, integration methods, and patient identification.
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No significant clinically relevant differences were found in patient health outcomes—including depression, anxiety, fatigue, sleep disturbance, pain, pain interference, and physical function—between the intervention and control groups.
Why It Matters: The findings from this study suggest that a practice-centered, flexible intervention may help primary care practices tailor behavioral health integration to their specific needs, which may lead to better systems of care.
Kari A. Stephens, PhD, et al
Department of Family Medicine, University of Washington, Seattle, Washington
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Original Research
Primary Care Physicians Face Gaps in Caring for Adopted Adults With Limited Family Medical History
Background and Goal: Adopted individuals often have limited access to their family medical history, which complicates their health care. This study explored the knowledge, training, and approaches of primary care physicians when caring for adult adopted patients with limited family medical history.
Study Approach: Researchers conducted in-depth interviews with 23 primary care physicians from Rhode Island and Minnesota to understand their experiences and practices when addressing limited family medical history and adoption-related issues. The interviews included hypothetical clinical scenarios to assess physicians' knowledge, practices, and training gaps.
Main Results:
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Primary care physicians report knowledge gaps and receive little training or resources on adult adoptees with limited family medical history and want guidance around appropriate preventative screening and genetic testing.
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Mental illness and trauma are under-recognized and under-addressed.
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Primary care physicians often obtain family medical history imprecisely, risking miscommunication, microaggressions, and damage to the patient-physician relationship.
Why It Matters: The findings of this study highlight the significant gaps in knowledge and training for primary care physicians caring for adult adopted patients with limited family medical history. Addressing these gaps may improve the quality of care and strengthen physician-patient relationships. Additionally, improved training and resources help primary care physicians provide more competent, compassionate, and inclusive care for adopted adults.
A Qualitative Study of Primary Care Physicians' Approaches to Caring for Adult Adopted Patients
Jade H. Wexler, BA, et al
Warren Alpert Medical School of Brown University, Providence, Rhode Island
An accompanying Annals of Family Medicine podcast episode features the study’s lead author, Jade Wexler, a fourth-year medical student at Brown University, and one of her co-authors, Dr. Elizabeth Toll, a professor of pediatrics and medicine and a clinician educator at Brown University. Together, they discuss the study’s findings and implications in detail. The episode will be available starting Jan. 28 at 9 a.m. EST here.
Visual Abstract:
Original Research
Peer Health Navigators Improve Access to Affirming Health Care for Transgender and Gender-Diverse Patients
Background and Goal: Transgender and gender-diverse individuals often experience additional difficulties navigating health care systems due to a variety of factors, including but not limited to a lack of knowledgeable and/or culturally competent practitioners, discrimination, and structural or socioeconomic barriers. This study examined the effectiveness of a peer health navigator pilot program in Saskatchewan, Canada. The program aimed to improve access to affirming health care for transgender and gender-diverse individuals by employing navigators with lived experience to provide guidance and support.
Study Approach:Two peer health navigators were recruited to pilot the program. The navigators were required to be transgender or gender diverse and have experience in health care or community-based organizations. They were trained informally by the research team and through mentorship with another Canadian navigator program. Navigators supported clients by providing information on gender transition and identities, connecting them to affirming health care professionals and community resources, booking appointments, advocating on their behalf, assisting with legal name and gender marker changes, and educating health care providers through individual and group sessions. Researchers conducted semi-structured interviews with clients and health care practitioners from May to July 2022 to explore their experiences with the navigators.
Main Results:
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Navigators reduced structural barriers to affirming health care, improving access and alleviating stress for transgender and gender-diverse individuals.
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Clients valued the navigators’ shared lived experience, which fostered trust and understanding.
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Navigators provided tailored guidance, connected clients to affirming providers and resources, and supported health care practitioners with accurate information.
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The program positively impacted clients’ mental health by filling gaps in psychosocial support and reducing stress while awaiting formal counseling.
Why It Matters: The study findings highlight the critical role of peer health navigators in improving access to affirming health care for transgender and gender-diverse individuals and suggest that making peer navigator roles a permanent part of the health care system may significantly benefit health care equity and patient well-being.
Stéphanie J. Madill, PhD, et al
University of Saskatchewan, School of Rehabilitation Sciences, Saskatoon, Saskatchewan, Canada
Visual Abstract:
Original Research
Ambiguities in International Disease Classification Codes Create Challenges in Comparing Respiratory Infection Diagnoses Across Regions
Background and Goal: The International Classification of Diseases (ICD) system is designed to standardize diagnostic codes globally, enabling accurate comparisons of health data. However, variability in how ICD codes are applied can hinder their effectiveness. This study investigated regional differences in respiratory infection diagnoses in Poland to identify potential ambiguities in ICD coding and their implications for data comparability.
Study Approach:Researchers analyzed over 292 million primary care visits for acute respiratory infections in Poland between 2010 and 2019, using ICD-10 codes (J00–J22). Diagnosis data were grouped by age (children, working-age adults, elders) and analyzed at the county level. Statistical methods and visualizations were used to uncover regional differences in how ICD codes were applied. These inconsistencies were further analyzed to determine whether they reflected genuine differences in diagnoses or systemic issues with code usage.
Main Results:
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The most problematic code appeared to be "acute upper respiratory infections of multiple and unspecified sites" (J06) which was frequently used interchangeably with other codes, especially "common cold" (J00) and "bronchitis" (J20)
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Significant differences were observed in how respiratory conditions were coded across counties, with no consistent regional patterns to explain these variations. Larger counties showed less variability, likely due to random factors canceling out.
Why It Matters:Variation in physician coding practices requires particular attention during analyses to avoid conclusions about differences that may simply be coding variation. The study findings highlight the need for clearer guidelines and better training to reduce variability in ICD code application.
Marcin Piotr Walkowiak, PhD, et al
Department of Preventive Medicine, Poznan University of Medical Sciences, Poznań, Poland
Visual Abstract:
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Original Research
Family Medicine Department Chairs Report Increased High Patient Care Demands and Lack of Funding Support as Barriers to Their Department’s Involvement in Scholarly Activity
Background and Goal:Research in family medicine is vital for improving patient care, health care systems, and population health. However, family medicine faces barriers to producing scholarly work, including high patient care demands and limited funding. Financial incentives have been suggested as a way to increase research productivity, but their impact remains unclear. This study examined whether financial incentives and department size influence the amount and type of scholarly activity produced by family medicine departments.
Study Approach: Researchers surveyed family medicine department chairs across the U.S. and Canada using a Council of Academic Family Medicine Educational Research Alliance (CERA) questionnaire. The survey gathered data on scholarly activities (e.g., research articles, presentations) and whether departments offered financial incentives for such work. Statistical analysis was used to explore associations between financial incentives, department size, and scholarly output.
Main Results:Of 225 department chairs invited, 106 responded.
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Only 39% (41/106) of responding departments offered financial incentives for scholarly activity, with 18% providing cash-based incentives.
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Those departments that offered financial incentives did not report high scholarly output rates.
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Faculty size was statistically significant: departments with fewer than 25 full-time faculty were 80% less likely to produce six or more presentations.
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The main barriers to offering financial incentives were institutional budget constraints and department culture or tradition.
Why It Matters:Institutions aiming to increase scholarly productivity in family medicine departments may benefit from focusing on increasing faculty size or investing in support resources, such as consultants, statistical analysts, grant writers, or other research staff.
Impact of Financial Incentives and Department Size on Scholarly Activity Output
Dominique D. Munroe, MD, MPH, et al
Emory University, Department of Family and Preventive Medicine, Atlanta, Georgia
Visual Abstract:
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Special Report
Affirmative Action and Higher Education: Challenges and Paths Forward
Background and Goal:In 2023, the Supreme Court of the United States (SCOTUS) struck down race-conscious admissions in higher education, reshaping affirmative action policies. While applicants can still discuss race in personal essays, these discussions must be tied to specific personal attributes or unique contributions to the institution. This special report examines the ruling’s wide-reaching effects, particularly on underrepresented minority (URM) students, and proposes strategies for preserving diversity in higher education and professional fields, including medicine.
Key Insights:Institutions such as MIT and Amherst College have reported significant declines in Black and Latino student enrollment, a trend that underscores the challenge of maintaining diversity without race-conscious policies. In medical school admissions, the lack of standardized guidelines for evaluating applicants’ experiences tied to race risks further marginalizing students who are Black, Indigenous, or people of color (BIPOC), potentially worsening disparities in the health care workforce. To address these challenges, institutions must innovate and engage at all levels. Critical strategies include expanding STEM enrichment programs, strengthening K-16 recruitment efforts, and maintaining holistic admissions processes. Admissions committees must receive robust training on implicit bias, cultural humility, and structural racism to ensure objective evaluations of applicants’ lived experiences. Institutional safeguards are also needed to maintain compliance with legal requirements and support consistent implementation of these efforts.
Why It Matters:A diverse higher education and health care workforce is critical for achieving equity and improving societal outcomes. Research consistently shows that diverse medical teams lead to better patient care, stronger provider-patient relationships, and reduced health disparities. Addressing these challenges requires immediate action, systemic reforms, and sustained commitment to fostering equity and inclusion.
Affirmative Action—A Crack in the Door to Higher Education
Billy Thomas, MD, MPH
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Essay
The Auditory Day in the Life of a Family Physician
Background:This reflective essay captures the sensory experience of a family physician’s day, emphasizing the often-overlooked sounds that define the rhythm and emotion of clinical practice. The author vividly illustrates how auditory cues—from the hum of clinic equipment to the sighs of patients—form a backdrop for human encounters in primary care.
Key Argument:Through detailed descriptions, the essay highlights how sound shapes the clinical environment, offering insights into patient care and physician experiences. From the joyful exclamations of a child discovering clinic tools to the somber silence following a terminal diagnosis, these sounds serve as a poignant reminder of the spectrum of life and emotion in family medicine.
Why It Matters:This essay underscores the role sensory experiences play in the physician-patient relationship, inviting readers to reflect on the emotional and relational depths of primary care. It offers a window into the humanity that permeates clinical practice, reaffirming the value of connection in family medicine.
The Soundtrack of a Clinic Day
Martina Ann Kelly, MB, BCh, BAO, PhD,
Cumming School of Medicine, University of Calgary, Calgary, Canada
Gerard Gormley, MB, BCh, BAO, MD
Queen’s University Belfast, Northern Ireland, United Kingdom
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Essay
The Vanishing Skills of Medicine: Restoring Procedural Competency in Medical Training
Background:This essay reflects on the decline of procedural competency among medical trainees, attributing the trend to changes in work-hour restrictions, evolving staffing models, and reliance on advanced technology. The author contrasts the rigorous procedural training of previous generations with the limited opportunities available to today’s medical residents.
Key Argument:The reduction in procedural training has far-reaching consequences for patients, physicians, and the health care system. Physicians’ inability to perform core procedures leads to fragmented care, increased costs, and health care inequities, especially in under-resourced settings. The author argues for reinvigorating medical training by incorporating simulation, supervised practice, and mentorship from experienced clinicians.
Why It Matters: This essay highlights an urgent need to address gaps in medical training. Procedural skills are essential not only for patient care but also for physicians’ confidence and professional satisfaction. The author calls for systemic changes, including creating new learning opportunities and leveraging the expertise of senior clinicians before their knowledge is lost.
Not Like They Used To: The Decline of Procedural Competency in Medical Training
Eleanor R. Menzin, MD
Department of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
Harvard Medical School, Boston, Massachusetts
Longwood Pediatrics, Boston, Massachusetts
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Innovations in Primary Care
Transforming Primary Care Conversations to Tackle Unhealthy Alcohol-Use Stigma
The AHRQ EvidenceNOW initiative implemented a comprehensive approach to help primary care practices reduce stigma and better serve patients with risky or harmful alcohol use through training, implementation support, and innovative materials. Launched in 2019, the program engaged practice facilitators (PFs) to support primary care practices in integrating universal screening, brief interventions, and medication-assisted therapy/medication for alcohol use disorders. PFs trained clinicians to use person-centered communication, modeled empathetic and nonjudgmental interactions, and provided materials such as the “We Ask Everyone” poster to normalize unhealthy alcohol use screenings. Providers were taught motivational interviewing techniques and how to address stigma through respectful language. Universal screenings were reframed as routine preventive care, reducing the likelihood of patient discomfort or feelings of being singled out. Through these techniques, trainings, and materials, PFs helped practices cultivate a culture of universal screening, which normalized the discussion for both providers and patients, thereby reducing stigma.
Reducing Stigma Through Conversations in Primary Care About Unhealthy Alcohol Use
Hildie Cohen, MEd, MA
NORC at the University of Chicago, Chicago, Illinois