This case involves a patient who had been under the care of the same physician for 9 years. During this time he complained intermittently of back problems and fatigue. He was prescribed B12 injections, multivitamins, iron and folic acid over the ensuing years. In 1999 at the age of 43, the patient presented with complaints of rectal bleeding and had a hemoglobin of 14.6. His physician ordered a...

CONTEXT The 15-minute office visit to primary care clinicians cannot meet the health care needs of patients. Innovation is needed to address this limitation, but practice redesign is challenging in clinical settings. OBJECTIVE Here we describe the implementation of a practice innovation, the teamlet model, in a San Francisco safety-net clinic. The teamlet consists of a clinician and "health c...

BACKGROUND Patients with chronic rhinosinusitis are cared for by multiple specialties. Endoscopy and imaging are important diagnostic tools. However, because physicians vary in their access to imaging and endoscopy, testing may vary across specialties. The purpose of this study is to characterize differences in use of imaging and endoscopy between physician specialties. METHODS Using data fr...

BACKGROUND A core measure of the meaningful use of EHR incentive program is the generation and provision of the clinical summary of the office visit, or the after visit summary (AVS), to patients. However, little research has been conducted on physician perceptions and beliefs about the AVS. OBJECTIVES Evaluate physician perceptions and beliefs about the AVS and the effect of the AVS on workl...

OBJECTIVE If quality improvement interventions, value-based purchasing and/or certification are based on patient assessments, a common definition of quality should be shared by clinicians and patients. The study's objectives were to determine (i) how patients and clinicians define quality care, (ii) in what ways patients' and physicians' definitions differ and (iii) whether patients' definition...

BACKGROUND This study describes the relation between patient satisfaction with physician performance and seeing one's "own doctor" for a recent office visit. METHODS A cross-sectional, randomized, computer-assisted telephone interview survey was performed at an urban health maintenance organization; 1146 responses were analyzed. RESULTS Patients seeing their own physicians were significantl...

INTRODUCTION We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic study. MATERIALS AND METHODS 9,236 volunteers were invited by 20 general practitioners (GPs), using two different recruitment methods, i.e. by mail only, or during a subsequent visit to the GP's office. Factors influencing the response rates were analyzed. We also tested how much the rec...

OBJECTIVES We compared the likelihood that a tobacco user would receive treatment with the likelihood that an adult with another common chronic condition would receive treatment for that condition at an office visit. METHODS We analyzed data from the 2005-2007 National Ambulatory Medical Care Survey to compare the proportion of US office visits at which tobacco users and individuals with hype...