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Index by author

May/June 2025; Volume 23,Issue 3

PLAIN-LANGUAGE SUMMARIES

 Tuesday, May 27, 2025


Editorial

To Improve Screenings With Technology, Focus on People First

Background:Four original research studies published in Annals of Family Medicine illustrate valuable concepts to consider when incorporating technology in screening to improve early detection and management of disease.           

Editorial Stance:These studies highlight the importance of centering digital health intervention on the patients and their specific clinical needs. The authors emphasize that digital tools work best when they work with, rather than replace, clinicians, and that we must remember the human element while integrating digital tools into clinical practice. Even if digital tools work flawlessly to detect problems, barriers like lack of care coordination can still prevent follow-up. When that happens, it doesn’t lead to meaningful improvement.

Why It Matters: AI has the potential to boost the Quintuple Aims of improved patient experience: better outcomes, lower cost, clinician well-being, and health equity. Primary care clinicians, researchers, and health system stakeholders can ensure this happens by creating focused solutions that address the needs of patients and support clinical teams. 

Information Technology in Primary Care Screenings: Ready for Prime Time? 

Masahito Jimbo, MD, PhD, MPH, FAAFP, et al

Department of Family and Community Medicine, University of Illinois Chicago, Chicago, Illinois

_____________________________________________________________________________________

Original Research

AI-Enabled Tools for Cardiovascular Screening Show Promise in Identifying Heart Dysfunction in Women of Reproductive Age

Background and Goal:Cardiomyopathy, a disease that weakens the heart muscle and makes it harder to pump blood, is a major health threat during pregnancy and accounts for 40% to 60% of late maternal deaths. This study evaluated the performance of an artificial intelligence–enabled electrocardiogram (AI-ECG) and an AI-powered digital stethoscope to see how well they could detect early signs of heart dysfunction in women of reproductive age.

Study Approach: In this cross-sectional pilot study, researchers examined two groups of women aged 18 to 49 who were considering pregnancy. Women who were currently pregnant or within one year postpartum were also included. The first group included 100 women who were already scheduled for an echocardiogram. The second group of women had no indication for an echocardiogram and were seen at a primary care appointment for routine care. All participants received two tests: a standard 10-second 12-lead electrocardiogram (ECG) and a digital stethoscope recording that captured a 15-second, single-lead ECG and phonocardiogram (heart sounds) from up to three locations on the chest. AI models analyzed the ECG and stethoscope recordings to estimate each participant’s risk of having left ventricular systolic dysfunction (LVSD), a type of heart dysfunction. In the second group, patients flagged with LVSD by the 12-lead ECG were then referred to an echocardiogram. 

Main Results: 

Group 1 (diagnostic cohort, women scheduled for echocardiograms):

  • 5% of women had LVSD.

  • Negative results were highly reliable, with the AI-ECG showing a negative predictive value of 96.8% and the AI-stethoscope achieving 100%.

  • Among women who screened positive using the AI tools, 33.3% (using the AI-ECG) and 22.7% (using the AI-stethoscope) truly had LVSD.

Group 2 (screening cohort, women seen during routine primary care visits):

  • Using the AI-ECG, only 1% of women in this low-risk sample screened positive. A follow-up echocardiogram in that patient showed a normal ventricular ejection fraction. With the AI-stethoscope, 3.2% of the sample had a positive screen.    

Why It Matters:Many women of reproductive age do not receive routine heart screening before pregnancy. The findings from this study highlight the potential of quick, low-cost AI tools to help detect early signs of heart dysfunction during regular primary care visits.     

Artificial Intelligence Tools for Preconception Cardiomyopathy Screening Among Women of Reproductive Age

Demilade Adedinsewo, MD, MPH, et al 

Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida

_____________________________________________________________________________________

Original Research

App-Based Hearing Screenings May Improve Diagnosis of Hearing Disorders in Family Practice

Background and Goal:Hearing loss is a common deficit that remains underdiagnosed. Pure-tone audiometry, the gold standard for assessing hearing impairment, is costly and time-consuming. This study evaluated the acceptability and feasibility of hearing screening in the routine practice of private family medicine using two self-tests.  

Study Approach: 516 consecutive patients aged older than 10 years attending three private French family-practice clinics were invited to undergo hearing screening. After a brief explanation, patients wore calibrated Bluetooth headphones and completed two tablet-based hearing tests: SoTone, which measures pure-tone thresholds, and SoNoise, which assesses speech recognition in noise. Any positive result led the general practitioner to recommend an ear-nose-throat (ENT) consultation. Adherence was checked by phone 1–3 months later.

Main Results: 

  • Of 516 patients eligible for screening, 219 (42%) completed  the screening.

  • On average, it took six minutes and eight seconds for consent, instruction, and completion of testing.

  • Of the 219 people screened, 59 (27%) screened positive for some hearing impairment and were referred to an ENT specialist. Only 16 patients ultimately followed up, 14 of whom had confirmed hearing loss, and 8 received a prescription for hearing aids.

Why It Matters: Hearing problems are common, but often go undiagnosed in primary care. Even when hearing problems are identified, many patients don’t follow up with specialists. The findings from this study show that tablet-based hearing tests may help general practitioners improve the diagnosis of hearing disorders.

Hearing Screening in Private Family Practice Medicine Using Tablet Applications

Jean-Charles Ceccato, et al

Montpellier Neuroscience Institute, University of Montpellier, Montpellier, France

_____________________________________________________________________________________

Original Research

Digital Cognitive Assessment in Primary Care May Enable Early Dementia Detection and Next Step Care

Background and Goal: Many adults aged 65 and older never receive a cognitive check during regular primary care visits. This study  assessed the feasibility and acceptability of implementing a digital cognitive assessment for Alzheimer disease and related dementias (ADRD) screening into primary care. They also assessed the prevalence of positive screens and measured diagnostic and care outcomes after a positive digital cognitive assessment result. 

Study Approach: From June 2022 to May 2023, seven Indiana University Health clinics offered the five-minute Digital Clock & Recall test on an iPad to every patient 65 and older. Each site, after a series of pre-launch “sprint” meetings, set its own rules on which visit types and which staffers would run the screen, then uploaded results to the electronic record for the physician to review. In month three, researchers introduced a registered-nurse role to support patients for completing care pathways if they were flagged for cognitive impairment. Physicians retained discretion over follow-up, and investigators recorded every lab, imaging study, referral and new diagnosis ordered within 90 days of the screen.

Main Results                    

  • Of the 16,708 patients who were identified as eligible for screening, a total of 1,808 digital cognitive assessments (10.8%) were completed by 1,722 unique patients.

  • More than one-half (55.3%) of eligible visits never offered the digital cognitive assessment because PCPs declined or the encounter was deemed out of scope during sprint meetings.

  • Screening outcomes: Among 1,808 tests, 44.3% were categorized as unimpaired, 36.5% as borderline, and 13.7% as impaired.

  • Follow-up within 90 days for the impaired group: 2.1% received a new Alzheimer or related-dementia diagnosis; 5.1% received a new mild cognitive impairment diagnosis; 16.9% had brain imaging ordered; 62.7% were referred to the brain health navigator.

Why It Matters: Many cases of cognitive impairment go undetected in primary care. Digital cognitive assessments may offer a feasible way to screen older adults during routine visits, helping identify those who may benefit from early diagnosis, treatment, and care planning. However, without supportive workflows and follow-up systems in place, these tools alone aren’t enough to close the gap in dementia care.         

Feasibility and Acceptability of Implementing a Digital Cognitive Assessment for Alzheimer Disease and Related Dementias in Primary Care

Nicole R. Fowler, PhD, MHSA, et al                     

Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana

____________________________________________________________________________                

Original Research

Flexible Workflow Model Helps Primary Care Clinics Integrate Dementia Screening    

Background and Goal:Missed or delayed diagnosis of dementia can lead to worse outcomes for patients and families. A previous study across seven primary care clinics found that many older adults who completed a digital cognitive assessment showed possible signs of cognitive impairment. In this companion study, researchers assessed how agile implementation, an approach based on iterative improvements and tailored clinic workflows, could support the integration of digital cognitive assessment screening into routine care for patients aged 65 and older.    

Study Approach: Researchers conducted a pragmatic clinical quality improvement project with seven primary care clinics in Indiana. The agile implementation process involved eight key steps: identifying opportunities for improvement, selecting the screening tool through a structured stakeholder evaluation, developing an implementation evaluation plan, mapping existing workflows, testing changes through time-bound training cycles called sprints, monitoring performance through weekly check-ins and dashboards, assessing organizational impact, and formulating a standardized operating procedure.

Main Results

  • The intervention engaged 69 of 108 clinicians across the seven clinics.

  • The screening rate increased over the course of the 12-month period.

  • Four clinics fully adopted the program, each reaching a screening completion rate of at least 20% and five clinics continued using the screening tool one year after implementation.

  • Each clinic adapted the process to fit its specific setting while maintaining alignment with a shared core model.

Why It Matters: The findings from this study demonstrate the successful implementation of a digital cognitive assessment tool in primary care using agile implementation principles, underscoring the value of iterative improvement and stakeholder engagement in health interventions.    

Agile Implementation of a Digital Cognitive Assessment for Dementia in Primary Care

Diana Summanwar, MD, et al 

Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana    

_____________________________________________________________________________________________    

Original Research 

Medication Attitudes, Decision Involvement, and Trust Shape Older Adults’ Willingness to Cut Back Prescriptions

Background and Goal:Polypharmacy, defined as taking 5 or more daily medications, raises the risk of adverse drug interactions and other health problems. Deprescribing means stopping or reducing drugs that no longer help or may cause harm. This study explored older adults’ perspectives on proactive deprescribing, identified barriers and enablers, and developed a typology of patient attitudes to inform patient-centered deprescribing interventions.

Study Approach: In this qualitative study, researchers conducted semistructured interviews with 20 patients in Japan aged 65 years or older who were receiving 5 or more oral medications. 

Main Results:

Enablers

  • Negative valuation of medication: patients noted pill burden, possible harm, and past success in stopping drugs.

  • Proactive decision making preference: a few patients wanted an active role and even started deprescribing talks.

  • Openness based on trust in the prescriber: many said they would cut back if a trusted clinician suggested it.

Barriers

  • Positive perspective on medication: satisfaction with current drugs or high expectations kept regimens unchanged.

  • Passive involvement and low perceived capability: patients deferred to doctors and felt unable to ask about deprescribing.

  • Caution driven by fear of change or comfort with the status quo: worry about symptom return discouraged stopping pills.

The researchers also developed a new typology with five types of patients: indifferent, satisfied and risk-averse, compliant, fearful but passive, and proactive.

Why it Matters:The findings from this study show that patients vary in their readiness to cut back on medications and underscore the importance of tailoring deprescribing discussions to each patient’s type and level of proactiveness.                     

Proactive Deprescribing Among Older Adults With Polypharmacy: Barriers and Enablers

Kenya Ie, MD, MPH, PhD, et al

Department of General Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa,  Japan 

__________________________________________________________________________________

Original Research 

More Ontario Family Physicians Focus on Narrow Specialties, Fewer Provide Comprehensive Care 

Background and Goal:Having family physicians who deliver comprehensive care is critical for addressing evolving population health needs. This study examined long‑term shifts toward focused practice among family physicians in Ontario, Canada, as well as changes in the number of comprehensive family physicians relative to population growth.

Study Approach: Researchers linked multiple Ontario health‑administrative data sets to track practice patterns for every general practitioner or family physician from fiscal years 1993/94 through 2021/22. Analyses were stratified by physician sex and years in practice. A physician was classified as providing comprehensive care if, in a given year, they worked at least 44 billed days, devoted more than 50% of billings to core primary care services, and met the threshold for diversity of primary care activity areas. Physicians who did not meet all three criteria were grouped as follows: focused practice (for example, hospitalist work or emergency medicine); low volume, with fewer than 44 billed days; other primary care roles; a fourth group had no billings for the year. 

Main Results:

  • The proportion of family physicians working in focused roles rose to 19.2% in 2021/22, up from 7.7% in 1993/94.

  • Emergency medicine accounted for 37% of focused doctors in 2021/22, followed by hospitalist care at 26.5% and addiction medicine at 8.3%.

  • Although the overall supply of family physicians climbed from 104 to 118 per 100,000 residents during the study period, the supply offering comprehensive care fell from 71 to 64 per 100,000. 

  • Of the additional 6,310 family physicians who entered the workforce during the study period, 39.5% were in focused practice.

  • In 2021/22, 60% of focused practice physicians were male and 40% were female. The focused practice group had fewer average days worked at 156 days compared with 196 days for the comprehensive practice group.

Why it Matters:Amid ongoing efforts to address current and impending challenges in access to primary care, findings from this study underscore the limitations of using family physician head counts in workforce planning. Knowing how many family physicians move into focused roles and how the proportion providing comprehensive care has declined can guide policy and practice changes, including better payments aligned with system goals, practice support, job flexibility, team-based care and cross-sectoral workforce planning to make comprehensive family practice the most attractive option to family physicians.     

Family Physicians in Focused Practice in Ontario, Canada: A Population-Level Study of Trends From 1993/1994 Through 2021/2022

Hina Ansari, PhD, MSc, et al

MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada 

_____________________________________________________________________________________

Original Research 

Patients and Staff Identify Seven Opportunities for Artificial Intelligence To Decrease Staff Workload and Improve Patient Safety in Primary Care eVisits 

Background and Goal: Although remote or electronic visits (eVisits) can increase access to health care for certain groups of patients, their use can increase staff workload and patient demand. Artificial intelligence (AI) may mitigate these outcomes. This study explored the views of staff and patients in primary care to inform the development of artificial intelligence (AI) features for eVisits.

Study Approach: Researchers conducted interviews and focus groups with 16 primary care staff and 37 patients from 14 primary care practices in northwest England and London. Interviewees were asked about their views on the potential uses of AI during eVisits, risks, benefits, and likely challenges to its adoption into clinical practice. Transcripts were thematically analyzed to identify key themes.

Main Results:         

  • Initial misconceptions and reservations: both groups were unsure what AI could or could not do; patients worried it might diagnose or prescribe without input from their physician, and staff questioned safety.

  • Perceived benefits included faster responses for patients and lighter workload for staff if AI handled routine tasks. Perceived risks included depersonalised care, data‑privacy fears, and the possibility that patients would have to enter symptoms perfectly for AI triage to work safely.

Seven specific opportunities for AI during eVisits were identified and generally welcomed if they complemented (not replaced) clinician judgment: 

  • Workflow routing – AI could direct each request to the appropriate team member quickly.

  • Directing – It could reroute emergencies to emergency services and send non-urgent issues to pharmacies.

  • Prioritization – Urgent requests could be flagged so clinicians see them first.

  • Follow-up questions – AI could automatically request photos, questionnaires, or clarification after a submission.

  • Writing assistance – It could suggest editable response templates for common concerns like mental health.

  • Self-help information – Trusted educational links could be sent to patients without clinician effort.

  • Face-to-face booking – AI could automatically schedule in-person visits when a physical exam is likely needed.

Why It Matters:These findings highlight seven AI opportunities, identified by patients and staff, that could decrease staff workload and improve patient safety. The results of this study may serve as guidance for developing and testing AI tools in primary care settings.

Seven Opportunities for Artificial Intelligence in Primary Care Electronic Visits: Qualitative Study of Staff and Patient Views

Susan Moschogianis, PhD, et al

School of Health Sciences, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom 

_____________________________________________________________________________________

Original Research

Authorship Inequity in Global Health Research Published in Family Medicine Journals in High-Income Countries

Background and Goal:Authors from low- and middle-income countries are underrepresented in published family medicine work. This study examined authorship inequities for research that was conducted in low- and middle-income countries and published in family medicine journals based in high-income countries.

Study Approach:Researchers analyzed journals listed on the World Organization of Family Doctors (WONCA) Global family doctor website that focused on low-income countries, lower-middle-income countries, and upper-middle-income countries. They selected journals with editorial offices in high-income-countries. Inclusion criteria included research conducted in low- or middle-income countries, available in English language, and had human study participants. They summarized the proportions of first and senior authors by country income level and other publication characteristics.

Main Results: 431 of 1,030 articles met criteria for research conducted in low- or middle-income countries.                                           

  • Over time, there was an increase in publication of research articles from low- and middle-income countries in the family medicine journals, with the majority of the studies conducted in upper-middle-income countries (55.9%).          

  • The proportion of senior authors from high-income countries was highest in articles with research conducted in low-income countries (50%) compared with those reporting research done in lower-middle-income countries (37%) and upper-middle-income countries (21%). 

  • There was a trend toward higher average citation rate for articles having high-income countries first and senior authors compared with articles having lower-middle-income countries first and senior authors. 

Why It Matters: Quantifying authorship inequities highlights systemic barriers to research leadership in low- and middle-income settings. To support authorship equity, family medicine researchers should reconsider the definition of authorship criteria, promote culturally humble mentorship, and encourage institutions to adapt promotion criteria to empower equitable global health partnerships. 

Authorship Inequity in Global Health Research Conducted in Low- and Middle-Income Countries and Published in High-Income Country Family Medicine Journals

Alyssa Vecchio, MD, et al 

University of New Mexico, Albuquerque, New Mexico

The Warren Alpert Medical School of Brown University, Providence, Rhode Island

_____________________________________________________________________________________

Original Research

Rural Location and Racial Segregation Drive Gaps in Primary Care Access in Virginia

Background and Goal:Primary care improves the health of communities and decreases health inequities, yet workforce shortages have worsened in the United States. This study aimed to identify geographic disparities of the primary care workforce in Virginia and identify factors associated with primary care physician (PCP) access. 

Study Approach:Researchers used the 2019 Virginia All-Payers Claims Database to identify PCPs and the number of patients seen by each physician. They then measured how many PCPs each census tract could reach within a 30‑minute drive, flagging tracts with too few as having poor access. Associations between PCP access and predisposing (age, race), enabling (income, insurance), need and structural (rurality, segregation) factors were assessed. 

Main Results: 

  • Nearly half (44%) of Virginia’s census tracts lacked adequate PCP access.

  • Racial segregation and rurality had the greatest associations with PCP access: tracts with higher proportions of Black residents had significantly greater PCP access than those with higher proportions of White residents, while rural tracts had significantly less access. 

Why It Matters:The findings of this study can guide policymakers in focusing incentive programs and clinic expansions on underserved areas, such as rural communities with predominantly White residents in Virginia, to increase primary care physician access, which may in turn reduce preventable hospitalizations.

Neighborhood Determinants of Primary Care Access in Virginia

Hannah M. Shadowen, PhD, et al 

Department of Health Policy, Virginia Commonwealth University, Richmond, Virginia

Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia

Medical Scientist Training Program, Virginia Commonwealth University, Richmond, Virginia 

An accompanying episode of the Annals of Family Medicine Podcast, featuring study authors Hannah Shadowen, PhD, and Alexander Krist, MD, MPH, will be available here beginning 9am EDT May 28.

_____________________________________________________________________________________

Theory

Adherence Labeling in Primary Care: Ethical Risks of Diagnosing Nonadherence

Background and Theory Overview:Promoting adherence to medical recommendations remains one of the oldest yet most persistent challenges of modern medicine. Traditional models treat nonadherence as a quality belonging to patients, which can undermine patients’ autonomy and assign blame for poor health outcomes. The authors draw on sociological labeling theory to argue that “nonadherent” is not a neutral clinical finding but a social judgment made by clinicians. They describe a three-step process of issuing a recommendation, observing or inferring patient behavior, and recording a label of either adherent or nonadherent. This process can hide the true drivers of patient behavior.

What is New: The authors name and model “adherence labeling” as the process by which clinicians produce “nonadherence” data rather than diagnose a self-evident patient trait. Rather than locating nonadherence solely in the patient, the authors show that the clinician’s decision to observe, interpret, and record behavior is what generates the concept. This shift from patient to clinician reveals how these labels can obscure structural barriers such as underinsurance or systemic racism, stigmatize vulnerable patients, and potentially skew care decisions. 

Why It Matters: Labels of “nonadherent” can embed stigma and bias into patient records, potentially resulting in delayed therapy escalation, clinic dismissal, and poorer health outcomes. If clinicians can view terms such as nonadherence as opportunities to build a stronger therapeutic alliance with patients, adherence terminology could possibly be leveraged to help close rather than exacerbate gaps in health equity. 

Adherence Labeling: Understanding the Origins, Limitations, and Ethical Challenges of “Diagnosing” Nonadherence        

Sourik Beltrán, MD, MBE, et al             

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts            

The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts 

______________________________________________________________________________________

Special Report

AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR): A New Home for Primary Care Research

Background and Goal:For more than two decades, support from the Agency for Healthcare Research and Quality (AHRQ) for primary care research was dispersed across multiple centers, making it difficult to view the work as a unified effort. In 2022, the National Center for Excellence in Primary Care Research (NCEPCR) was funded to act as the home for primary care research at AHRQ. This special report aims to increase the awareness of AHRQ’s NCEPCR among primary care clinicians, researchers, and partners. 

Key Insights:NCEPCR aims to strengthen the nation’s primary care system by sponsoring research to generate the evidence, tools, and other resources that can be used by researchers, clinical teams, health care organizations, and other stakeholders in their efforts to improve the quality and safety of care. An early accomplishment was developing a new NCEPCR website which features more than 60 curated tools, resources, and data sets. The website hosts a practice-based research network registry with 130 active networks and interactive training modules that equip practice facilitators to drive practice changes and improve patient outcomes. In addition to hosting webinar series to further disseminate primary care research findings and insights, NCEPCR has issued funding announcements focused on advancing the science of primary care. The center’s framework comprises six activities: coordinating primary care research, curating and synthesizing findings across the Department of Health and Human Services, communicating key results, cultivating a robust research workforce, convening stakeholders, and catalyzing innovative primary care studies.

Why It Matters:By connecting previously scattered programs under one roof and securing dedicated funding, NCEPCR can more effectively coordinate research efforts, curate and disseminate essential tools, and cultivate researchers who will tackle critical challenges such as workforce shortages, rising costs and health access issues. Its six “C” framework establishes a roadmap for translating research into practice-improving policies and interventions that can strengthen primary care delivery nationwide.

AHRQ’s National Center for Excellence in Primary Care Research (NCEPCR): A New Home for Primary Care Research

Aimee R. Eden, PhD, MPH, et al

Agency for Healthcare Research and Quality, Rockville, Maryland

_____________________________________________________________________________________

Innovations in Primary Care

Using a Little Free Library to Improve Rural Mental Health Access

Mental health disorders and suicide rates have risen steadily over the past 20 years, with rural areas seeing the sharpest increases. To broaden access to mental health resources for adults, physicians placed a Little Free Library containing 10–15 books on anxiety, depression, post‑traumatic stress disorder, and related conditions near the entrance of a rural primary care clinic in Minnesota. A flyer with a QR code directs visitors to a community‑run webpage that offers additional resources. Patients who take a book are asked to complete a short survey capturing demographics, referral source, and the usefulness of the materials. The authors are still studying the intervention’s utility and impact. This is a low cost, patient-centered, community-informed innovation that can be adopted by other primary care and community settings. 

Using a Little Free Library to Improve Access to Mental Health and Wellness Resources at a Primary Care Clinic

Marijo Botten, DO, and Erin Westfall, DO

Mayo Clinic Family Medicine Residency, Mankato, Minnesota 

_____________________________________________________________________________________

Essay 

The Power of Slowing Down to Build New Patient Relationships 

Background:Dr. Emily Dollar describes how, during residency, she mastered efficiency—rushing through patient visits and administrative tasks—but lost the ability to slow down. Upon starting her first job on the Navajo Nation, she reflects on the value of being present, patient, and mindful to build relationships with her new patients. 

Key Argument:While modern medical training emphasizes urgency and multitasking, the act of deliberately slowing one’s pace—taking the time to listen, sit face-to-face, and resist the pull of productivity metrics—yields richer patient narratives and stronger therapeutic relationships. She illustrates this through her encounter with an elderly patient whose life story, shared only when given space, provided critical context for his care. 

Why It Matters: With 15- to 20-minute visits and mountains of paperwork, primary care clinicians are burning out—and patients risk feeling like just numbers. Taking a pause is not wasted time—it’s an investment in understanding, trust, and better outcomes. The author challenges health systems and colleagues to value depth over speed and to build structures that honor the human side of medicine.

The Difficulty, and Power, of Slowing Down

 Emily Dollar, MD 

Northern Navajo Medical Center, Shiprock, New Mexico

_____________________________________________________________________________________

Essay 

Considering Ethnicity and Genetic Ancestry Can Improve Patient Safety   

Background:Jaewon Yoon recounts how her Korean-American father suffered a severe drug reaction after starting allopurinol, a risk heightened by the HLA-B*5801 allele common in Koreans—information routinely used in South Korea but often overlooked in U.S. practice.

Key Argument:Yoon argues that, although race is a social construct, self-identified ethnicity and genetic ancestry can signal real safety risks or treatment responses; disentangling these from crude racial categories allows clinicians to target tests—like HLA genotyping—to prevent harm.

Why It Matters:Ignoring ethnic and ancestral factors endangers patients and deepens health inequities—as Yoon’s father’s life-threatening reaction, preventable by preemptive testing, demonstrates. Respectful, standardized collection of ethnicity and ancestry data, coupled with trainee education, sharpens diagnostic precision and honors patient diversity. Yoon challenges educators and health systems to balance dismantling racist practices with leveraging ancestry-based insights for safer, personalized care.

Drug Toxicity and My Dad’s Ethnicity

Jaewon Yoon 

Harvard Medical School, Boston, Massachusetts 

David A. Hirsh, MD

Harvard Medical School, Boston, Massachusetts

Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts 

______________________________________________________________________

Essay 

Training the Physician’s Eye: How Art Observation Teaches Self-Discovery and Patient Care to Medical Students

Background:The author recalls visiting a museum to relax and reflect before returning to her work as a chaplain at the community hospital and trauma center where she had just witnessed three deaths. She describes how viewing the paintings helped her process the loss and pain she’d experienced and shift from distress to calm. She later became a docent at the Philadelphia Museum of Art and developed her Training the Physician’s Eye: Enhancing Clinical Skills Through Art Observation course to teach medical students observational skills, emotional intelligence, and empathy.

Key Argument:The author argues that the habits trained by art observation (slow, repeated looking, noticing one’s emotional reactions, and sharing observations with the group) translate directly into better clinical practice. By learning to describe what they truly see and feel in a painting, students build the same attentiveness, respect for difference, and communication skills essential to their future roles as physicians.

Why It Matters:Regular “deep looking” at art, paired with group reflection, builds self-awareness, openness to different perspectives, and genuine curiosity. Facilitated museum visits can help integrate compassion and clinical reasoning—bringing together heart and mind to enrich patient care.    

How Looking at Art Teaches Self-Discovery and Patient Care to Medical Students

Florence Gelo, DMin, NCPsyA

College of Medicine, Drexel University, Philadelphia, Pennsylvania 

  View article

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