Women Accessing Care at a National Network of Retail Health Clinics.

Background: Retail health clinics offer easy access and lower costs in seeking nonemergent and usually focused care. The objective of this observational study was to describe the use of retail clinic services by women at MinuteClinic at CVS, the largest network of retail clinics in the United States. Methods: The retail clinic's large database included complete national data for every in-person encounter as recorded on the same electronic health record. Virtual care and pharmacist-delivered services like COVID-19 testing were excluded from the analysis. The primary reason for the visit and the patient's age group (<15, 15-44, 45-64, ≥65 years) and self-reported sex were recorded at each encounter from the most recent 5 years (January 1, 2018, to December 31, 2022). Results: There were 17,969,483 encounters by women seeking care, and women ≥15 years old were more likely than men to attend the clinics. Half of all encounters (50.6%) were for non-gynecologic acute care, whereas one-third (33.6%) dealt with either an infection or the need for a vaccination. Gynecologic reasons involved 5.6% of all encounters in women ≥15 years of age. No obstetrical care was provided except for pregnancy testing with referral, acute non-obstetric needs, or guideline-recommended vaccinations. Conclusion: Women, especially of reproductive age, are more inclined than men to seek care at retail clinics. Acute care is the most common need, although requests for immunizations, infection screening and treatment, and reproductive health issues occurred often.

Diversity in Academic Obstetrics and Gynecology.

Institutional transformation and moving diversity from the periphery to the core of excellence have increased the representation of both female and racial and ethnic minoritized populations in academic obstetrics and gynecology (OB/GYN). Enabling the recruitment and retention of diverse residents and faculty, measuring their contributions to the department academic and social missions, and providing a supportive environment will be important in the coming years as the changing OB/GYN workforce progresses through their careers.

Five Domains of a Conceptual Framework of Continuing Professional Development.

ABSTRACT: Continuing professional development (CPD) for health professionals involves efforts at improving health of individuals and the population through educational activities of health professionals who previously attained a recognized level of acceptable proficiency (licensure). However, those educational activities have inconsistently improved health care outcomes of patients. We suggest a conceptual change of emphasis in designing CPD to better align it with the goals of improving health care value for patients through the dynamic incorporation of five distinct domains to be included in learning activities. We identify these domains as: (1) identifying, appraising, and learning new information [New Knowledge]; (2) ongoing practicing of newly or previously acquired skills to maintain expertise [New Skills and Maintenance]; (3) sharing and transfer of new learning for the health care team which changes their practice [Teams]; (4) analyzing data to identify problems and drive change resulting in improvements in the health care system and patient outcomes [Quality Improvement]; and (5) promoting population health and prevention of disease [Prevention]. We describe how these five domains can be integrated into a comprehensive conceptual framework of CPD, supported by appropriate learning theories that align with the goals of the health care delivery system. Drawing on these distinct but interrelated areas of CPD will help organizers and directors of learning events to develop their activities to meet the goals of learners and the health care system.

Over-The-Counter Drugs and Pregnancy.

The obstetric provider should ask about over-the-counter drugs, although most are low dose, used only briefly, and any harm is unlikely and more theoretic than real.

Growing Need for Primary Care Physicians Caring for Cancer Survivors.

BACKGROUND: A rising population of cancer survivors is accompanied by a shortage of oncologists for continuity of care. This study examined the physicians who provided most of the care for cancer survivors, along with written information provided to the survivors before transfer of care. METHODS: Data were collected through the CDC-sponsored Behavioral Risk Factor Surveillance System. Our analysis involved states whose respondents completed a cancer survivorship module from 2016 to 2020. Primary measures were the proportions of physician specialists who provided most of their subsequent health care and the proportions of survivors who received written summaries of their care and instructions. RESULTS: The 36,737 cancer survivor respondents came from 33 states. Most of their health care came from primary care physicians [family physicians (42.3%, 95% CI: 41.3-43.2%) and general internists (26.0%, 95% CI: 25.2-26.9%)]. When seen by primary care physicians rather than subspecialists, a lower proportion of patients recalled receiving summaries of either their cancer treatments (44.3%, 95% CI: 42.5 to 46.2 vs 50.5%, 95% CI: 49.4 to 51.7%) or follow-up instructions (69.9%, 95% CI: 68.8 to 71.0% vs 78.7%, 95%CI 77.1 to 80.2%), regardless of their cancer type. CONCLUSIONS: Regardless of their cancer type, two-thirds of survivors received most of their health care from primary care physicians. Collaborative community-based care within a shared decision-making framework is essential to prioritize and individualize patients' understandings and needs in this growing population.

Diversity of Department Chairs in Family Medicine at US Medical Schools.

BACKGROUND: As designated department leader, chairs need to be sensitive to diversity and inclusiveness for recruitment and retention of faculty and visibility to medical students and resident physicians. The purpose of this analysis is to describe diversity by sex and race/ethnicity of family medicine (FM) chairs as a beginning to understand trends. METHODS: This cross-sectional, observational study involved 2018 to 2020 data from the Association of American Medical Colleges Faculty Roster. We compared this data with other department chairs, faculty, medical school matriculants, and the US general population. RESULTS: There were 407 FM chair observations. While many FM chairs were White males, this was lower than all other clinical departments combined. The proportion of chairs who were under-represented minorities was highest in FM (16.7%) compared with all other departments The distributions of FM chairs who were Black, Asian, and Native American were comparable with the US population. The proportions of Hispanic FM chairs, FM faculty, and medical school matriculants lagged behind the population. CONCLUSION: Diversity of department chairs in FM is greater than many other clinical departments and more representative of the US general population. Attention by chairs to leadership development of females and recruitment of Hispanic faculty are priorities.

Subspecialization in Obstetrics and Gynecology: Is It Affecting the Future Availability of Women's Health Specialists?

The growth in the number of obstetrics and gynecology resident graduates pursuing fellowships has exceeded growth in the number of resident graduates, because more fellowship programs are being developed in more subspecialties rather than additional residency programs. Approximately 1 in 4 residents pursues subspecialty training, compared with 1 in 12 in 2001. The number of fellowships remains competitive, because nearly all programs fill their match and the number of applicants exceeds the number of positions. Graduating residents who serve as frontline women's health specialists need to serve as leaders of interprofessional teams to better serve their patients, especially in underserved areas.