The family physician's role in long COVID management.

A paucity of both data and therapeutics presents obstacles to care and makes your role in symptom management, psychological support, and referral-all described here-essential.

Factors Associated With Resident Continuity in Ambulatory Training Practices.

BACKGROUND: Continuity of care is a critical element of residents' educational experience in primary care programs. OBJECTIVE: We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures. METHODS: We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014. We defined continuity from both clinician and patient perspectives, and used logistic regression models to examine the influence of factors on continuity while controlling for postgraduate year, patient age, gender, race, and insurance. RESULTS: Continuity was greater at nonteaching sites compared to resident practices (87.3% versus 56.2%, P < .001). Resident continuity ranged from 33.1% to 83.7% among resident sites. Factors associated with improved resident continuity included absence of advanced practice providers (71.5% versus 52.3%); consistent use of scheduling protocols (77.5% versus 33.1%); rescheduling policies (71.5% versus 41.3%); increased faculty clinical time (71.5% versus 46.3%); and dismissal policies for excessive missed appointments (71.5% versus 62.5%, P < .001 for all). Increased continuity was associated with improved rates of diabetic control (62.8% versus 54.6%); hypertension control (82.8% versus 57.5%); screening colonoscopy (69.2% versus 31.9%); and mammography (74.8% versus 38.2%, P < .001 for all). CONCLUSIONS: Increased clinical faculty time, scheduling protocols, and absence of advanced practice providers were most strongly associated with increasing continuity. Increased continuity was associated with improved quality measures.

The seventh element of quality: the doctor-patient relationship.

BACKGROUND AND OBJECTIVES: National experts have defined the elements of quality health care, but community-based physicians have not been systematically asked their opinions about quality. This study explored primary care clinicians' beliefs about the elements of quality care. METHODS: Responses from structured interviews with 12 primary care clinicians and open-ended comments in a subsequent survey of 85 clinicians, all employed by a large urban federally qualified community health center, were coded independently by two researchers and analyzed for major themes. After discovering that these themes resembled the six elements advanced by the Institute of Medicine, the data were recoded to identify additional perceptions about quality. RESULTS: Clinicians believe that the relationship with patients is a core element of quality health care. They also reconfirm the elements of quality advanced by the Institute of Medicine--safety, timeliness, effectiveness, efficiency, equity, and patient centeredness, with safety mentioned infrequently. The clinicians also emphasized preventive care. CONCLUSIONS: While primary care clinicians' beliefs about quality are generally consistent with experts' definitions, they emphasize relationships and rarely mention safety. Successful efforts to promote quality in primary care should be consistent with clinicians' beliefs about what constitutes high quality.

Use physical therapy to head off this deformity in infants. Consider early PT to prevent severe deformational plagiocephaly.

Identify infants with positional preference early and consider referral to pediatric physical therapy at 7 or 8 weeks to prevent severe deformational plagiocephaly.