BY LESLIE CHAMPLIN
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Sick patients don't want to go shopping for doctors. They don't want a first date or -- worse -- a blind date experience every time they see a doctor. They want to go home. Far too few do so because far too many are "medically homeless." Their plight underlies today's uneven quality in health care.
Patients need a personal medical home "that serves as the focal point through which all individuals -- regardless of age, sex, race or socioeconomic status -- receive a basket of acute, chronic and preventive medical care services," says the Future of Family Medicine project report, released March 30.
Building the concept with children
The American Academy of Pediatrics coined the term medical home in 1967. Over the decades, the concept has evolved to its current form, elucidated through the AAP's National Center of Medical Homes Initiatives for Children with Special Needs.
"When children have a complicated illness, they often have to travel for their care," says FP Leslie Waters, M.D., whose medical group in Colville, Wash., is a partner in the state's medical homes initiative.
"Often, the diagnosis was made a hundred miles away and that's where the follow-up appointments are," says Waters, noting that small communities don't have the panel of subspecialists a child may require.
Waters cares for a rural Washington community that includes about 50 children with special needs. Their conditions range from complex genetic syndromes to severe asthma.
A member of the children's medical home team, Waters ensures that subspecialists, rehabilitation therapists, mental health professionals and educators have a complete picture of each child's condition.
"We developed a team so some of the care for the child can be done locally," she says. "They may still have to travel for some of the care, but at least they can get their well-child services, physical therapy, speech therapy and other services at home. The system ensures that everyone involved in the child's care is on the same page."
Expanding to all populations
AAP's initiative succeeds because most agree that children, particularly those with complex problems, need medical homes, according to FP Steven Wolfe, M.D., medical director for the University of Iowa Community Medical Services Clinics in Iowa City.
"It's easier to sell children's issues than it is to sell other issues," says Wolfe, who works with the Iowa Medical Home Project, spearheaded by the Iowa AFP. "But once you understand the concept of a medical home, you can make it fit other populations."
FPs can build medical homes for their patients by adapting resources from AAP and the Center for Medical Home Improvement at Children's Hospital at Dartmouth-Hitchcock Medical Center in Lebanon, N.H.
Among them: the Medical Home Index, which enables physicians to assess their practices according to the medical home standards. (Go to http://www.medicalhomeimprovement.org/outcomes.htm, and click on "The Medical Home Index" under "Medical Home Measurements.")
The results can be eye-opening, says Wolfe. He compared the stringent standards of the Medical Home Index with the way his own 10-physician practice in Spencer, Iowa, operated.
"If you'd asked whether we did these things well, I'd have said yes. But if you look at how we did when compared to the Medical Home Index, I'd have to say we were probably in the 30th to 40th percentile," he says.
The Future of Family Medicine project's new model of practice -- which includes patient-centered care, a team approach, elimination of barriers to access, and a focus on quality and safety -- expands the medical home concept beyond children with special needs and includes all patients.
"It's an easy transition from providing those elements to special needs children to providing it to other populations," says Wolfe. "These key concepts are valid."
To reach writer Leslie Champlin, email lchampli@aafp.org.
BY TONI LAPP
What do AAFP members and others think of the new Future of Family Medicine project recommendations? Members are greeting the FFM report "with guarded enthusiasm," said AAFP President Michael Fleming, M.D., of Shreveport, La.
Last month, he discussed the FFM recommendations with California AFP members at their annual meeting. Their questions were all over the board:
"What is the Academy doing to help small practices get electronic health records?"
"How are we going to win respect in academic circles?"
"How do hospitalists fit into the FFM vision?"
On target
After the session, Fleming said, "The questions that were asked tell me we're right on target" with the FFM recommendations.
Regarding electronic health records: "The Academy is working on Partners for Patients (a program to make EHR systems available and affordable to all FPs) because it sees the importance of electronic health records to managing information," he said.
Regarding academia: "We've come to the conclusion that we have to have a research agenda to win respect in academic circles," Fleming said.
Regarding hospitalists: "AAFP supports the use of hospitalists in certain situations, provided there is a seamless transfer of information and care," Fleming said, harking back to the importance of EHR implementation. "Many of our members use hospitalists. Many of our members are hospitalists."
The FFM project's Task Force 6 is charged with formulating a financial model that sustains and promotes a thriving practice. The task force is bringing payers to the table for discussions on reimbursement issues.
"Sometimes you have to be willing to talk with your enemies," said Fleming. "You want to keep the snake in front of you rather than beside you."
Task Force 6 will submit a report in August to leaders of the family medicine organizations that supported the FFM project.
Online discussion
The FFM report, published as a supplement to the March/April Annals of Family Medicine, is online at http://www.annfammed.org.
One of the first physicians to post commentary about the recommendations on the Annals discussion board was Allan Korn, M.D., senior vice president and chief medical officer of BlueCross BlueShield Association. Korn said he anticipated that the report would lead to intensified cooperative efforts between AAFP and BCBS.
Barbara Starfield, M.D., M.P.H., of Johns Hopkins University Bloomberg School of Public Health, using the discussion board, summed up the report as "bold but not brave."
Her advice? "Defensive stances are insufficient in promoting the future of primary care; an offense is necessary."
One chapter's response
Texas AFP President David Schneider, M.D., of San Antonio said in an interview that his chapter began prioritizing the FFM tactics in March to identify work for various chapter commissions.
"Every one of our commissions is involved with moving the recommendations forward," he said.
One Texas AFP commission is charged with implementing health information technology in residency programs. Another commission is looking for innovative ways to educate students to provide greater skills to enhance practice revenue.
Schneider said he feels a sense of urgency: "We need to make things happen or we are going to be in big trouble as family doctors. We need to take this head-on."
Next steps for AAFP
Similarly, the AAFP Board of Directors will prioritize the recommendations to identify goals that can be accomplished immediately and target others for short- and long-term completion.
"The question I get most is 'when?'" said Fleming.
"The bottom line is, doctors want to get control back in their lives," he said. "They want the physician-patient relationship to be preserved."
To reach writer Toni Lapp, e-mail tlapp@aafp.org.
Implementation of the Future of Family Medicine recommendations rests, in large part, on transformations in the specialty's training programs. That was the word from six panelists who discussed the FFM project's implications for training future FPs. The panel spoke to almost 700 participants at the Residency Assistance Program Workshop for Faculty and Staff of Family Practice Residencies March 30 in Kansas City, Mo.
"The people who are most important to the success of the Future of Family Medicine are those for whom you have the most responsibility," said panelist Kenneth Evans, M.D., of Stillwater, Okla., past president of the AAFP Foundation and past Board chair of the AAFP.
Evans focused on the new practice model in the FFM project report. "You, as educators, must learn what this new practice model is," he said. "It's your responsibility to make sure everyone who comes out of your programs has skills to work within the model into which we hope and believe this specialty will evolve."
Project recommendations
Panel members noted FFM recommendations include:
The implication: Medical school curricula and residency training programs must evolve to meet those expectations.
Academic environment
Moreover, panel members called for a teaching environment for medical students that refutes the negative comments about family medicine they are exposed to, said Denise Rodgers, M.D., of New Brunswick, N.J., a past president of the Society of Teachers of Family Medicine.Often, panelists said, the comments question the academic and clinical rigor of the specialty. "We ought to make sure that students doing family medicine rotations understand how family physicians are expert in managing complexity," said Rodgers. "Our rotations should be one of the most rigorous rotations."
BY SHERI PORTER
 Most office labs adhere to federal regulations and offer safe, convenient procedures such as blood draws so patients don't have to travel to an outside facility. |
If your office lab is categorized as a waived lab or a provider-performed microscopy lab -- and more than 35,000 AAFP members do have these facilities -- you'd best make sure your lab is up to snuff.
The Centers for Medicare & Medicaid Services has expressed growing concern over statistics it gathered from random, on-site laboratory surveys in 2002 and 2003. CMS surveyed 897 labs in 2002, and 2 percent had deficiencies of "immediate jeopardy," or imminent and serious risk to human health. The 2003 figures were worse: 3 percent of 1,756 labs surveyed fell into the immediate jeopardy category.
Barbara Mitchell, manager of laboratory issues and AAFP-PT, the Academy's proficiency testing program, recently attended a Clinical Laboratory Improvement Act Committee meeting in Atlanta as an unofficial liaison. She returned saying waived/PPM labs appear to be in trouble.
At that meeting, CLIAC heard that 70 percent of all medical decisions involve some type of laboratory result. Bottom line: Those results had better be accurate.
"I'm not trying to be an alarmist; I really see a problem here," said Mitchell. These numbers may lead CMS to the conclusion that labs need more oversight, she warned, adding that most labs do a good job and wouldn't welcome tighter federal regulation.
The Clinical Laboratory Improvement Amendments were enacted in 1988 to provide government oversight of medical labs. The Academy began its proficiency testing program in 1990 and fought hard to exclude many family physicians' office labs from CLIA regulations (for example, by supporting expansions in lists of waived tests). The CLIA regulations took effect in 1992. Currently, nearly 150,000 waived/PPM labs exist in the United States.
Education is the key
Don't worry about increased federal oversight, said Judith Yost, director of the Division of Laboratories Services for CMS. "That's not the goal at all." The CLIA program's desire is to improve the safety of lab testing through education, she said.
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Laboratory resources available The Academy has tools available to help physicians operating office labs. Check into these possibilities:
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According to Yost, poorly trained lab technicians are often at the root of the problem. These are people "not trained in laboratory medicine," she said, and low wages contribute to a 40 percent annual turnover rate. The end result is employees who fail to follow manufacturers' instructions for how to perform tests and who don't adopt quality control measures.
Much to Yost's surprise, CMS' random surveys have been positive teaching opportunities at labs across the country. "These folks are just happy that somebody is coming to show them what to do, and how to do it right," she said.
Mitchell agreed that education is the key. "We need to be proactive," she said. If this situation goes unchecked, she added, "It's just a matter of time before a bad outcome is tracked back to one of these waived/PPM labs."
Time to take action
CLIAC recommended the following actions:Publish CMS' survey results. CLIAC members -- in their capacity as the advisory board to these labs -- are appalled by the CMS data, said Mitchell.
Send a letter to HHS Secretary Tommy Thompson outlining the committee's alarm at the poor state of some waived/PPM labs.
CLIAC also discussed the need to develop best-practice guidelines for performing laboratory medicine.
In addition, Mitchell suggested these steps:
Explore ways for the Academy to advocate for physician office labs and make certain the AAFP has representation at the next CLIAC meeting to argue that waived/PPM labs are integral to the practice of medicine.
Highlight educational opportunities available through the AAFP (see box to the right).
To reach writer Sheri Porter, e-mail sporter@aafp.org.
BY CINDY BORGMEYER
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*Because of the patient-centered nature of the modules on performance in practice (Part IV), patient satisfaction/communication will be a significant component of Part IV, as well. Editor's note: Go to https://www.abfp.org/moc/about.aspx for details on the program. |
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A chilly reception greeted the Maintenance of Certification Program for Family Physicians, or MC-FP, when the American Board of Family Practice announced it in 2003. Many FPs cried foul, arguing against adding another morsel to FPs' already full plates.
Despite FPs' objections -- voiced during the 2003 Annual Assembly and in dozens of letters, e-mails and phone calls to AAFP -- the ABFP pushed ahead with program implementation this year. Though still evolving, MC-FP is basically a done deal. That won't change. But you can find help preparing for it.
AAFP course targets MC-FP
"I think whenever you have something new, there's going to be some anxiety associated with it," said Eloka Ikedionwu, M.D., of Justice, Ill., during AAFP's new Case Studies in Family Medicine course Feb. 26 - 28 in San Francisco. "But it's just like every other thing in medicine -- you have to wait. Don't discount it until you see how it plays out."
For a quick review of the MC-FP process, see the box at right.
The AAFP course, to be repeated annually, was designed with MC-FP in mind and featured case-based learning sessions. Topics included those slated for inclusion as self-assessment modules, or SAMs, under Part II of MC-FP. Among them were diabetes, hypertension, asthma and coronary artery disease. MC-FP uses case studies, as do various AAFP and constituent chapter CME offerings.
"I usually prefer a case studies format, and this has been very helpful," said Ikedionwu. "It's more like a roundtable discussion, where you have the ability to ask questions."
"It's far more interesting than didactic presentations, and you get just as much information, especially when you have a good course leader," agreed Martin Brauweiler, M.D., of Sandwich, Ill., who also attended the course. Being able to interact with course facilitators and with other participants created a potent learning environment, he said.
Interaction is key to learning
Interaction is the cornerstone of an initiative the Illinois AFP hopes will help its members gear up for MC-FP. Beginning this fall, SAM study groups will piggyback on an existing quality improvement program, Medicine for Today, said Vincent Keenan, C.A.E., executive vice president of the IAFP.
A collaboration between the IAFP and the Medicare and Medicaid programs, Medicine for Today offers FPs CME credit for participating in QI projects addressing health problems identified by the state's public health department. One of those areas is diabetes -- a perfect fit with one of the two SAMs currently offered by the ABFP.
Here's how the SAM study groups will work.
Group members go online and work through their SAM. If they encounter problems, they bring them back to the group for discussion. "Everyone will be working through their SAM, and everyone will have a chance to bring to the group things they found interesting or things they found difficult," Keenan explained.
FPs in the SAM study groups can earn CME credit for the activity, he said. The group offers a platform for resolution of clinical questions and enhances the overall learning experience.
After all, Keenan noted, "The ABFP SAMs are not about passing the test; they're about a way of learning that the ABFP is hoping to promote as a standard."
"Our job is to be smart and nice"
Joane Baumer, M.D., of Fort Worth, Texas, is principal investigator for the Quality Circle project, a joint effort of the Texas AFP and Procter & Gamble Co. The project, initiated in March, bears a strong likeness to the quality improvement in practice component of MC-FP's Part IV.
Each quality circle comprises 10 physicians from the same community. The circle determines a health issue to evaluate, and then each physician gathers relevant patient data from his or her practice to feed to the group. The group discusses the pooled data, swaps best practices and then starts the whole process again.
"We want to see if anything we've done in terms of sharing with each other, getting this information and looking at each other's data is going to change what we do as a group," said Baumer. "That to me is exciting. There's lively discussion and -- probably most important -- some discovery going on."
It's no picnic leaving your comfort zone. "This is invading our space and our minds and challenging us to think," Baumer said. "As a practicing physician for 20 years, I know you don't have time to do a lot of research, but you can get together with a few of your friends occasionally and say, 'How are you doing this?' or 'How are you doing that?' We can look at what's expected of us and then at what we're really doing."
For a reality check on what's expected, turn to your patients, Baumer advised. She described an encounter with one of her patients -- a 5-year-old -- who informed her in no uncertain terms that good doctors are smart and nice.
"So our job is to be smart and nice," Baumer said. "We're developing all these tools for professionalism -- self-reflection, introspection, self-regulation, altruism. Those are the 'nice' skills, the adaptive-emotive skills.
"On the other side, you've got the 'smart' skills, the cognitive-analytic skills. Those are the things that we're just beginning to develop the tools to measure. Now the board comes to us and says, 'We want you do this and this and this,' and what I think they're really trying to get at is: Are we smart and nice?"
To reach writer Cindy Borgmeyer, e-mail cborgmey@aafp.org.
The AAFP welcomed Department of Veterans Affairs Secretary Anthony Principi's decisions March 30 on the scope of chiropractic care in Veterans Health Administration settings.
Principi was responding to a Nov. 3, 2003, list of 38 recommendations sent to him from the department's 11-member Chiropractic Advisory Committee. The committee is made up of six chiropractors, a physical therapist, a member of a veterans service group, and three physicians including AAFP Past President Warren Jones, M.D., of Ridgeland, Miss.
The decisions are "entirely consistent with Academy policy that nonphysician providers of care must engage the patient's family physician in the important decision to provide necessary health care services," said AAFP Executive Vice President Douglas Henley, M.D.
The following approved recommendations are likely to be of particular note for family physicians:
During the committee's deliberations, Jones reiterated the Academy's position that chiropractors should not be viewed as primary care providers. In 2001, when Congress was considering a legislative proposal to designate chiropractors as primary care providers in VHA settings, letters and e-mails to Congress from nearly 7,800 AAFP members helped derail that provision.
The Academy also led a coalition of the American Osteopathic Association, the American Medical Association and the Vietnam Veterans of America to oppose the bill. When the bill emerged from conference committee, the language granting new privileges for chiropractors was deleted, and the VA's Chiropractic Advisory Committee was created to examine scope-of-practice issues.
"This is an example of the Academy representing the best interests of our members and their patients by working to prevent proposed bad legislation from happening," Henley said. "It is important that our members understand this type of 'success' as much as when we achieve the passage of positive legislation -- both are very important."
To read the background on the issue, go to http://www.aafp.org/fpr/20011200/4.html and http://www.aafp.org/fpr/20020200/9.html.
To reach writer J. Michael Brodie, e-mail mbrodie@aafp.org.
Have you ever tallied up the time you spend filling out different credentialing applications for the health care organizations you work with?
Would you like to submit one application for all groups using a given database?
Well, start the celebration -- the AAFP Board of Directors recently voted to endorse the Universal Credentialing DataSource, operated by the Council for Affordable Quality Healthcare. The Academy is the first medical professional organization to support this secure, national provider credentialing database system.
Go to the CAQH Web site at https://caqh.geoaccess.com/oas/ and click on "Launch Schedule" for a list of participating health plans. If you work with any plan on the list, you should have received a provider ID number in the mail. However, if you need an ID number, call the health plan and ask its staff to submit your name to CAQH immediately. You will receive a postcard with your number from CAQH. For faster service, confirm your name has been submitted.Within a week, call CAQH at (888) 599-1771 and retrieve your ID number over the phone.
Now you're ready to register. With your ID number in hand, go to the CAQH Web site at http://www.caqh.org and click on "Universal Credentialing DataSource," then "Providers Enter Here." It takes about two hours to enroll.You will submit a single application to a central database that is accessible to all of the participating health plans and networks.
Here's more great news: Physicians participate for free.
You can update your information online or by fax at any time. Once each quarter, you must confirm that your information in the database is correct.
The database will be available nationwide by the end of 2004. These states are not yet participating: Massachusetts, New Mexico, Nevada, Oregon, Arkansas and Utah. Michigan will come on board June 1. Medicare and Medicaid are not involved in the initiative.
To reach writer Sheri Porter, e-mail sporter@aafp.org.
If you think there is time for a breather before gearing up for the upcoming flu season, think again. The CDC has already begun issuing flu bulletins for the 2004 - 2005 season, and vaccine distributors have been taking orders since December.
Several changes will affect vaccine-ordering decisions, and FPs should take heed.
In general, vaccine recommendations are becoming more and more complex, and the flu vaccine recommendations are no exception, said Doug Campos-Outcalt, M.D., M.P.A., of Phoenix, a member of the AAFP Commission on Clinical Policies and Research.
The use of an electronic health record or tracking program will help the physician stay on top of the details and not be befuddled by cutoff dates and catch-up vaccinations.
"The devil's in the details on this one," Campos-Outcalt said.
For instance, children younger than 9 years who have never been vaccinated with the flu vaccine will require a booster shot at least a month after the first dose. This may require some coordination on the part of the physician. Some doctors' offices may consider offering "vaccine days," during which the practice invites patients to come in to catch up on immunizations.
Another area ripe for misinterpretation involves the AAFP recommendation for pregnant women, Campos-Outcalt said. It advises giving the flu vaccine to women who will be in the second or third trimester during flu season. The National Immunization Program, as of late March, called for vaccinating all women who would be pregnant during flu season. The AAFP is reviewing its policy and may revise it.
These factors -- coupled with increased awareness of flu risks as a result of the early, harsh onset of the 2003 - 2004 flu season -- will likely increase demand for the vaccine, said Campos-Outcalt.
The three manufacturers are making production decisions based on projections for demand. Total influenza production is expected to be between 90 million and 100 million doses, compared with 86.9 million doses in 2003.
For the latest from the CDC on flu information for clinicians, go to
http://www.cdc.gov/flu/professionals/;
for AAFP immunization recommendations, go to
http://www.aafp.org/x10631.xml.
To reach writer Toni Lapp, e-mail tlapp@aafp.org.
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Your patients now have something new to read while they're waiting for appointments with you. Family Doctor: Your Essential Guide to Health and Wellbeing, provided free to AAFP members' practices, began shipping last month.
Produced by the Academy in partnership with custom publisher Boston Hannah International, the colorful, 242-page publication has nine chapters packed with articles on a wide range of health issues affecting patients and their families.
Each practice should receive a display copy for the waiting room, plus several additional copies. More copies may be purchased for $6.95 each, plus shipping and handling, by going to http://familydoctor.org, clicking on "New Guide to Health and Wellbeing" on the right side, and then clicking on the Web site for placing orders. Supported by advertising, the publication will be updated annually.
If your practice doesn't receive copies, e-mail familydoctorbook@aafp.org.
WEB EXTRA!
It's been a dozen years since the Accreditation Council for Continuing Medical Education issued its Standards for Commercial Support of Continuing Medical Education. They've received occasional tweaks since then, but it wasn't until about two years ago that the ACCME undertook a major review and update of those standards.
That update is now all but complete, lacking only final approval by each of the council's seven member organizations.
The new standards don't differ greatly from the existing ones, said Norman Kahn, M.D., AAFP vice president for science and education and chair of the ACCME task force that revised the standards. They encompass six core principles:
Areas of particular focus during the revision process, said Kahn, included disclosure policies and how conflicts of interest are resolved. One change he noted is that disclosure of relationships between CME planners or faculty and industry will now be required. "No more 'Dr. X refused to disclose.' That will not be acceptable," he said. Failure to disclose means disqualification.
As for how the revised standards might impact one of the Academy's top money-makers, its CME journal American Family Physician: "Our current advertising policies are in total alignment with the ACCME standards, and we're delighted with that," said Michael Springer, AAFP vice president for publishing and communications.
As an accredited CME provider, the Academy has always taken pains to separate educational content from promotional advertising, Springer said, a fact not lost on the ACCME.
"I think this (revised document) represents a good-faith effort by ACCME to tighten up the amount of self-regulation we do," said Springer. "And self-regulation is the key here. We need to be responsible for our own educational activities and to make sure that they are as appropriate and as free from commercial bias as they can be."
Go to http://www.accme.org/whatsnew/sec_new_nw1_251.asp to access the revised ACCME document, "Standards for Commercial Support: Standards to Ensure the Independence of CME Activities." Help using PDF files is at http://www.aafp.org/pdf.xml.
ACCME member organizations have until Sept. 28 to review and approve the new standards. Only then do they go into effect. At that time, the ACCME will disseminate information on how the standards are to be implemented.
To reach writer Cindy Borgmeyer, e-mail cborgmey@aafp.org.
BY J. MICHAEL BRODIE
WEB EXTRA!
A new study of malpractice claims takes a major step toward determining where errors by primary care physicians actually happen.
Researchers from the Robert Graham Center in Washington studied primary care malpractice claims settled between 1985 and 2000 in the United States and the United Kingdom, using the Physician Insurers Association of America malpractice claims database.
Of the nearly 50,000 claims against primary care physicians, the study focused on 5,921 claims that peer physicians determined involved medical negligence. Of that group, 68 percent involved negligent events in outpatient settings and resulted in more than 1,200 deaths.
So many claims from errors in outpatient settings surprised the researchers, said Robert Phillips, M.D., assistant director of the Graham Center and lead author of the study. Its results were published in the article "Learning From Malpractice Claims About Negligent, Adverse Events in Primary Care in the United States" in the April edition of Quality and Safety in Health Care.
More findings concerning the 5,921 claims:
"The category of diagnostic error doesn't give us enough information to fix the problems," explained Phillips. "For example, it doesn't tell us whether the wrong diagnosis resulted from a lab report that did not reach the physician or if a piece of information was placed in the wrong medical file or if the physician made an erroneous decision that could have been avoided with better training."
Phillips was quick to note that the study did not conclude that primary care physicians working in hospitals are any more prone to errors than other specialists. He did suggest that hospitals should make sure primary care physicians are included in efforts to improve inpatient care safety and the safety of patient transitions into and out of hospitals.
Phillips also suggested ways to improve malpractice data -- more peer review of cases and more collection of contributing factors -- changes that could bolster the effort to improve patient safety. In addition, he made a case for implementing electronic health records.
"The hundreds of people harmed, maimed or killed by errors for which 'problems with records' or 'communication between providers' contributed might have survived unscathed if an EHR was used," he said.
The study is just the start of a conversation about helping physicians avoid tragic outcomes. "We want to help physicians understand that if they have concerns that a patient may be exhibiting symptoms of these particular error- or suit-prone diseases, they need to be extra cautious," said Phillips. "We should also work with malpractice companies to collect data about system factors that contribute to error-related suits so that we can design more effective and safe systems."
To reach writer J. Michael Brodie, e-mail mbrodie@aafp.org.
WEB EXTRA!
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A free patient education resource targeting older drivers is available for your patients. Decisions About Driving: A Toolkit for Older Drivers and Their Families has five handouts that include tips on how to survive after turning in the car keys and checklists to help families assess their loved ones' driving skills. The kit was developed through a cooperative agreement with the National Highway Traffic Safety Administration. Kits come in packets of 10. Order through the order department (#978) or online at http://www.aafp.org/shop/978. |
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Here's a chance to improve patient care with the latest in a series of self-assessment modules: The Family Physicians -- Improving Quality module "Stroke Prevention for the Primary Care Clinician." Objectives for the FP-IQ module include improving physicians' ability to identify patients at risk for stroke and learning how to encourage patients to modify their behavior and reduce their risk. This module is a cooperative venture with the American Academy of Neurology. AAFP Prescribed credit is available. For information on ordering the module ($75), e-mail fpiq@aafp.org or call (800) 274-2237, Ext. 3747. |
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Proven value: Help your patients learn about health topics important to them. Make AAFP patient education brochures available in your office. The handouts are written at a seventh-grade reading level and have been reviewed by physicians, patients and the AAFP Foundation Health Education Program. Each package costs $12.50 and contains 50 copies of a single title. Dozens of topics are available through easy online ordering. Give these brochures a try: "Cholesterol" at http://www.aafp.org/shop/1503, "Osteoporosis in Women" at http://www.aafp.org/shop/1510, "Arthritis" at http://www.aafp.org/shop/1511 and "High Blood Pressure" at http://www.aafp.org/shop/1541. |
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A shipping fee may apply; Kansas residents pay a 7.525 percent tax. |
WEB EXTRA!
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FP Report is published by the
AAFP News Department.
Copyright © 2004 by
American Academy of Family Physicians.
