BY CINDY BORGMEYER
Teamwork. It can mean different things to
different clinicians. You'd expect, for example, to find plenty of differences
between teams in a community health center and in a solo family medicine
practice. But what may surprise you is that there are similarities in how
teamwork figures into both settings -- at least in the case of one good-sized
community health center on the east side of Rochester, N.Y., and a tiny,
two-room family medicine practice in Rochester's Brighton area.
FP Report visited both Westside Health Services' Woodward Health Center and the private practice of family physician L. Gordon Moore, M.D., for this final story in the series on the new model of care proposed in the Future of Family Medicine report. You can access the report at http://www.annfammed.org/cgi/content/full/2/suppl_1/s3.
The FFM report frames the teamwork concept in the context of this new model of care: "Patient care in the New Model will be provided through a multidisciplinary team approach and grounded in a thorough understanding of the population served by the practice. In addition to nurses and clerical personnel, staffing will often include physician assistants and nurse practitioners, as well as nutritionists, health educators, behavioral scientists, and other professional and lay partners."
That description fits the Woodward Health Center to a tee. Part of a federally funded community health program, the center sits within a primary care health professional shortage area. The Woodward center, which has 10 family physicians on staff, provides the full range of primary health care services described in the FFM report.
As director of clinical operations at the Woodward center, Michele Hannagan, F.N.P., spearheaded the introduction of clinical teams last year. One of the first steps, Hannagan recalls, was asking the center's health professional staff some basic questions.
"I asked them, 'What would be the advantages? Why would we move to something like this?' -- because it's a big shift," she said. "The number one answer was continuity of care."
Continuity counts
In family medicine, Hannagan says, "We cover everything -- peds, well-child visits, sick visits, chronically ill people, even (aspects of) OB. The idea was to come up with a system whereby the nurses on a given team would be working with a particular group of doctors and would really get to know that patient group.
"So for a smaller patient group of the bigger whole, the nurses would help the physicians and midlevel providers manage those patient groups more efficiently, to help continuity of care."
Granted, some of the gains may seem minor. Before the new system was implemented, for example, if a patient called in needing a medication refill, a member of the medical records staff pulled that patient's chart and placed it on the physician's desk. Now, a nurse intercedes.
"All refill calls actually first come through our pharmacy," said Hannagan. "But if it's something that needs to be rewritten, a nurse gets it first, so that he or she can essentially triage the stuff that's going to get dumped on the provider's desk. If the nurse can handle calling in a refill, getting a form filled out or making a phone call to a visiting nurses service to follow up on something, then the doctor's pile goes from being three feet high to being maybe a foot."
Hannagan admitted she got some initial pushback from the nurses, who saw their workload increasing. She countered by promising them, "You're going to get to manage this practice. You're going to get to know Mary Jones and know she oftentimes forgets to bring her prescriptions in for her appointment. You can call her ahead of that appointment and ask her to bring that stuff in."
Take ownership
 Wide-open communication channels help ensure Judy Zettek, R.N., and FP L. Gordon Moore, M.D., stay in sync while working side by side in Moore's Rochester, N.Y., solo practice. |
"The nurses are really taking ownership," agreed Louise Bennett, M.D., one of the clinic's full-time family physicians. "Their attitude now is, 'These are our patients; this is our practice.'
"All of the nurses now really have a sense of who the patients are and who their families are so they can see things from the patient's perspective. Now we have a staff that's really working as a team and takes on some of the jobs I used to do."
Along with that sense of ownership has come greater empathy and a renewed commitment to making sure patients receive comprehensive, high-quality care, said Bennett. A nutritionist, social worker, podiatrist and several OB-Gyns work part time at the Woodward center, and members of the primary care clinical teams frequently consult with these extended-team members, said Bennett. The center's family physicians oversee provision of prenatal or obstetric services they don't themselves offer and follow patients admitted to nearby hospitals.
Over her years in practice, Bennett said she's built a stable of subspecialists to whom she refers patients with more complex medical or surgical needs. All members of the primary care team participate in facilitating these referrals and in tracking patients referred for such care.
Bennett's referral begins with an introductory letter summarizing the patient's complaint and work-up to date. But across town, Moore's solo practice takes a more high-tech approach to engaging subspecialists as ad hoc team members.
Redefine teams
When it comes to reducing overhead, L. Gordon Moore, M.D., is way ahead of the curve. His practice, Ideal Health of Brighton, an area of Rochester, takes up only two rooms in a modest one-story building that's primarily home to an eye care clinic. In one room, Moore sees patients. In the other, he and nurse Judy Zettek, R.N., literally work side by side as a team, monitoring and recording preventive, diagnostic, treatment and follow-up services for the practice's 100-some patients and tracking virtually all business aspects of the practice.
Full integration of electronic health records and other health information technologies allows Moore to practice what he calls "world-class" medicine. By utilizing computerized patient registries, Moore can ensure his patients receive all the recommended preventive services. After all, he said, "The goal of primary care is to stop throwing stents around like rice at a wedding and prevent the need for stents in the first place."
When a patient requires referral for a specific problem, however, Moore smooths that transition for the patient through what he calls "facilitated communication." Using widely accepted clinical decision support tools, he can determine which patients require immediate referral and which can be handled less urgently.
The process starts while Moore's still in the exam room with the patient. He can make the phone call to set up an appointment and then send test results or other relevant findings directly from his computer to the subspecialist's fax machine.
"It increases my confidence that I can take care of it right here and now," he said. "If I can say 'Based on the JNC 7 guidelines, I think I have someone you need to see,' I've done my best to give them someone with high probability, and they'll get them in right away."
The flow of information back to Moore has improved, too. Written shared-care agreements outlining respective expectations and responsibilities help cement the collaborative relationship with specialists outside the practice.
Moore's approach has made a big difference to patient Mary Lou Lunt. "The patient is the center of the team," said Lunt. "It's helped me take more responsibility. You feel like you're working with a team and you're part of it."
To reach writer Cindy Borgmeyer, e-mail cborgmey@aafp.org.
When it comes to building a patient care team, these pearls from Woodward Health Center's Michele Hannagan, F.N.P., director of clinical operations, will go far:
Delegate, delegate, delegate. Just be sure everyone on the care team understands and is comfortable with the parameters established. Her advice for family physicians concerned about delegating: "Lay that right out -- what you want the nurses to not handle, what you want to make sure gets put on your desk."
Pair like with like. When forming the team, consider each member's work style and care philosophy. For example, two of the Woodward center's FPs see a lot of Somali refugee patients, adding translation issues to often complex medical and psychosocial needs. Result? "Those appointments are never just 15 minutes," says Hannagan. "They're always longer than that. If that's going to get you uptight as a nurse because you want to keep moving things along, we're not going to pair you with that patient group."
For better or for worse... . If you commit to practicing as a team, then commit to resolving conflicts as a team. At Woodward, Hannagan says, when nurses come to her with concerns, she encourages them to go back to their teams. "The idea is to let them function without being micromanaged by me or by the medical director," she says, "to let them figure out what system works for them."
Just for you: |
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A significant, beneficial change is coming your way. It's a change nearly 90 percent of members supported in the last FP Report reader survey. Today, the AAFP has three separate news publications, including FP Report. Beginning in April, there will be just one -- a brand-new publication -- delivered several ways. It's called AAFP News Now.
The name says it all. Since it's from the AAFP, it will provide News you can't get anywhere else. And you'll access it Now, whenever you want -- because it will be first and foremost an online publication, with news coverage posted continuously. Bookmark this URL -- http://www.aafp.org/news-now -- and, beginning April 4, visit it daily for the latest news.
In addition, you'll get selected stories in a weekly AAFP News Now e-mail if your e-mail address is on file with the Academy. Finally, at month's end, a printed "digest" of the month's key news will be mailed to you.
We're already building the online AAFP News Now, to go live April 4. So mark that date -- and join us online at http://www.aafp.org/news-now.
WEB EXTRA!
EHRs simplify patient notification taskBY SHERI PORTER
When Merck & Co. Inc. withdrew rofecoxib, sold as VIOXX, from the market last fall, the announcement stirred up a host of questions about patient notification. FPs volleyed comments back and forth on an AAFP e-mail discussion list.
One physician wrote that the withdrawal raised the question of who was responsible for good care. Another wrote, "It stands to reason that the pharmacies that fill prescriptions are best positioned to pull up who has actually filled Rxs for a drug and notify these people at the current phone number and address."
"Why don't the insurance companies notify everyone? They have every patient's medication purchase history on file anyway," reasoned a third FP. "I'm dragging my feet on printing out a few hundred letters and paying the postage," said a fourth, adding, "Is this our job? Do we really put ourselves in that much legal jeopardy if we do not specifically notify everyone ourselves?"
FP Report set about finding the answers to these questions.
The first call went to the FDA. Crystal Rice, public affairs specialist, said the agency does not regulate physician practice; rather, it makes information available to physicians.
"The FDA approves medicines and monitors their safety profiles. FDA strongly encourages discussion about medicines -- their benefits versus any potential risks -- between physician and patient," she said.
Next contact: the American Pharmacists Association. Susan Winckler, R.Ph., vice president of policy & communications, said pharmacists have a responsibility to notify patients when a drug is recalled or withdrawn.
In the VIOXX withdrawal last fall, Winckler said many pharmacists reviewed their prescription databases to ascertain who had received VIOXX in the past 60 days. "Pharmacists then either generated a letter or a phone call to those patients informing them of the withdrawal and recommending that they talk to their doctor about an alternative."
The patient may hear from both the pharmacist and the physician, said Winckler, "but in this instance, the redundancy is appropriate."
Do insurers have a responsibility to the patient? "Insurance companies commonly play a role in alerting patients and physicians," said Susan Pisano, vice president of communications for America's Health Insurance Plans. That's because insurers are able to identify patients through claims data.
FP Report turned to AAFP Past President Richard Roberts, M.D., J.D., of Madison, Wis., for a medicolegal perspective. He said the underlying legal principles are "reliance" and "loss of a chance."
"Patients rely on us to look out for their health, especially when we were the ones who prescribed the medication in question. We have a duty to notify them, when we can reasonably do so, in order for them to not ‘lose the chance' to avoid injury," said Roberts.
Notifying 600 patients within 24 hours could be considered unreasonable, he continued. "But if a physician has only one patient on a medication that later is found to be dangerous, and the physician could easily notify that patient, then the physician has a duty (ethical obligation) to notify the patient."
To reach writer Sheri Porter, e-mail sporter@aafp.org.
WEB EXTRA! EHRs simplify patient
notification taskAAFP Past President Richard Roberts, M.D., J.D., of Madison, Wis., offered the following suggestions for physicians grappling with patient notification about drug recalls:
WEB EXTRA!
Last fall, some AAFP members wasted no time telling colleagues how easy it was to identify patients on rofecoxib, sold as VIOXX, when the drug was pulled off the market.
Electronic health records saved the day.
"I timed it this morning -- it took us less than 60 seconds to identify every patient who is on VIOXX or who has been on VIOXX so that we can take appropriate action," Thomas Horton, M.D., of Rainsville, Ala., wrote Sept. 30 to an e-mail discussion list.
In a recent follow-up conversation, Horton said he notified 75 patients of the VIOXX withdrawal by mail using letters generated through his electronic health record system. He said he couldn't have pulled off such a task without his EHR. "There would have been no practical way to sort through over 6,000 charts to find the patients on a particular medication," said Horton.
Steve Diamond, M.D., an FP from Rockford, Ill., had similar rave reviews about his EHR. "In a few minutes, I had a list of all my patients taking VIOXX, listed with their birth dates and phone numbers," Diamond said. His staff took the list of 44 patients and -- in about three hours -- notified every patient on the list.
One caveat: Some FPs reported that their EHR systems could not extract the data to generate a list for patient notification.
"The bottom line for patient care is that my patients know that I am a responsive FP who contacted them about a timely medical concern rather than waiting for them to call me," said Diamond. His response to the situation was just good patient care, good public relations and good risk management, he said. "I slept better that night than some other docs might have."
BY LESLIE CHAMPLIN
Family physicians want what's best for their patients, but their patients don't necessarily know what's best for their physicians. Case in point: The AAFP Environmental Scan -- an annual "snapshot" of the political and economic environment that affects medicine's legislative efforts -- and national surveys show medical liability reform tops physicians' list of federal legislative priorities, while the public sees the cost of and access to care as most important.
 Source: 2004 AAFP Environmental Scan |
The difference bodes ill for medical liability reform, unless patients better understand the links among medical liability premiums, access to care and the cost of care, say political analysts. FPs have patients on their side, those analysts say. It's simply a matter of helping them understand the problem.
Multiple surveys indicate Americans list health care among the top three domestic issues. In a January survey by the Kaiser Family Foundation and Harvard School of Public Health, 63 percent of respondents said the government's top priority should be lower health care and insurance costs. Medical malpractice jury awards -- the only medical liability-related item that made the list -- ranked 10th out of 12 concerns.
Public focus on cost and access reflects personal experiences with or awareness of medical debt and its impact on working- and middle-class America. A study in the Feb. 2 Health Affairs, "Illness and Injury as Contributors to Bankruptcy," reported medical debt contributed to or caused 54.5 percent of all bankruptcies in 2001. Health insurance didn't necessarily help: 75.7 percent of study subjects had insurance when the bankrupting illness or injury occurred.
Moreover, people realize medical bankruptcy can affect them: 80 percent in the Health Affairs study earned a middle- or working-class income; 55.8 percent had completed some college coursework; and 56.5 percent were homeowners or had recently lost their homes because of their indebtedness. Medical debt drove more than 20 percent to cut back on food; more than 30 percent failed to pay water or electricity bills; and more than 59 percent forfeited needed doctor or dentist visits.
That hits close to home, says J. Toscano, senior vice president of GMMB, a Washington-based political and public relations consulting firm that works with AAFP on various public health initiatives.
"If you ask what's wrong with health care, people think about cost and access, about prescription drugs. Liability reform is very abstract," he says.
Still, patients do recognize the impact of skyrocketing malpractice premiums. Asked specifically about medical liability, respondents to the Kaiser poll supported reform. Seventy-two percent favored independent review of malpractice lawsuits before claims could be filed, and 63 percent favored limited awards for pain and suffering.
"The public isn't pushing hard for malpractice reform but will be happy to have it if the lawyers, doctors, administration and Congress can agree to a plan," says Kaiser President Drew Altman, Ph.D., of the poll results.
At press time, one liability reform bill similar to one that failed last Congress had been introduced in the House and the Senate. Congress probably won't act on it or any of three other bills containing reform language this year, say analysts. By comparison, more than 15 bills addressed costs and access to health care.
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AAFP's Patient's Voice in Washington program, at http://www.aafp.org/patientsvoice.xml, has materials FPs can use to educate patients about federal liability reform and a sample letter to send President Bush on the issue. |
Toscano's advice on resolving this discrepancy: Help patients understand the link between medical liability premiums and access to health care.
"It's critical that doctors do this in a way that's relevant to patients' care and quality of care," says Toscano. "People like their doctors, so doctors need to explain it so that people sympathize with what the doctor is going through."
Whether medical liability reform will see traction in Congress depends on pressure from the White House, said Kevin Burke, director of the AAFP Government Relations Division. "There will be no progress unless the White House pushes the issue," says Burke.
What can you do? Read more about the AAFP Environmental Scan by going to http://www.aafp.org/x30570.xml and clicking on "View the 2004 Environmental Scan now." The link requires a member sign-in. Then participate in the Patient's Voice in Washington program.
To reach writer Leslie Champlin, e-mail lchampli@aafp.org.
BY JANE STOEVER
You can rescue rural America from its shortage of health care professionals, two speakers -- one a family physician -- told congressional aides and others at a Capitol Hill forum recently. The message is one the Academy hopes many FPs will take to their lawmakers, targeting Title VII, Section 747, of the Public Health Service Act.
 Rural areas have had health professional shortages for 100 years, but the problem could be fixed in 10 years, Howard Rabinowitz, M.D., tells Janet Corrigan, Ph.D., after their Capitol Hill forum presentation. |
 About 30 aides to the House and Senate rural health caucuses and other health-related committees joined 50 other participants in the Capitol Hill rural health forum. |
Research indicates rural populations are sicker, older, poorer and more likely to be uninsured than urban and suburban residents. Twenty percent of Americans live in rural communities, but only 9 percent of the nation's physicians work there. To make matters worse, the average stay of a rural primary care physician is only seven years.
"There are two major challenges," FP Howard Rabinowitz, M.D., said at the forum. "First, train people and get them to go to rural areas. Second, keep them there. It's pretty simple."
He heads the Physician Shortage Area Program at Thomas Jefferson University, Philadelphia. The PSAP graduates about 14 medical students a year who enter rural family medicine, 6 percent of a class of 223. And those 14 have staying power. For PSAP alumni 11 to 16 years after beginning rural practice, 68 percent are in the same area, and another 11 percent have moved to a different rural area.
PSAP's recipe for success: Select rural applicants committed to practicing family medicine and returning to a rural area; give them rural mentors throughout medical school; and place them in rural clerkships.
The other forum speaker, Janet Corrigan, Ph.D., study director for the Institute of Medicine report Quality Through Collaboration: The Future of Rural Health, issued last fall, shared IOM's perspective on rural FPs.
Our (IOM) committee felt there was a strong sense that family practice prepares physicians better for the rural practice setting and therefore they're more likely to practice in rural areas -- they have a broader scope of practice," she said. "We'd also like to increase the supply of pediatricians and internists. And physician assistants are really critical; nurses, emergency care providers -- all those other members of the health care team."
So what should Congress do?
"Increase the funding streams that already exist," Rabinowitz told the forum's 80 participants, including 30 legislative aides. He and others at the forum specified Titles VII and VIII of the Public Health Service Act, as well as funding for area health education centers and graduate medical education.
The Jan. 25 forum was sponsored by AAFP's Robert Graham Center in partnership with the IOM, Society of Primary Care Policy Fellows and Academic Family Medicine Advocacy Alliance.
On Feb. 7, President Bush proposed a 2006 fiscal year budget with no funds for Title VII, Section 747 -- even though the section's training grants for health professionals including family physicians have proved vital to improved rural health care. The proposed budget, however, does call for increasing the number of community health centers, especially in rural America. That's further cause for substantial Section 747 funds: More rural community health centers will require more rural FPs.
To e-mail your lawmakers and request support for Section 747 funding, go to http://capitol.aafp.org. For an article on research demonstrating the value of the funding, go to http://www.aafp.org/x32458.xml.
WEB EXTRA!
BY CINDY BORGMEYER
The AAFP Board of Directors voted in January in favor of extending the national moratorium on specialty hospitals. The recommendation clearly reflects the Academy's stance as an evidence-based organization. Yet the Academy's cautious approach to specialty hospitals puts it at odds with the AMA.
At issue is a congressionally mandated moratorium on new specialty hospitals or expansion of existing specialty hospitals, many of them wholly or partly physician-owned. Originally considered exempt from Stark II prohibitions of physician self-referrals under the "whole-hospital exception," about 100 specialty hospitals have sprung up nationwide since the early 1990s. Then Congress called the halt in December 2003.
The Board recommendation -- developed by the Commission on Health Care Services in consultation with the commissions on Education and on Legislation and Governmental Affairs -- supports extending the moratorium on specialty hospitals beyond its scheduled June 30 expiration. The Board said it would support continuing the freeze on the hospitals until "the AAFP is convinced by evidence of their benefit on the health and well-being of our communities."
The AMA House of Delegates, on the other hand, voted at its December interim meeting to adopt several measures related to physicians' interests in so-called specialty hospitals -- including calling for an immediate end to the moratorium. Visit http://www.aafp.org/fpr/20050100/6.html for news coverage of that meeting.
A tricky issue
According to AAFP Board Chair Michael Fleming, M.D., of Shreveport, La., the issue is far from clear-cut.
"We all have opinions about the appropriateness of this issue and whether it's hurting private hospitals -- particularly the safety net hospitals -- to 'cherry-pick,'" said Fleming. "Some of these specialty hospitals are actually providing excellent, very high-quality care. Some are even owned by the very hospitals that are complaining about them. So it's not a simple issue."
The Government Accountability Office defines specialty hospitals as facilities in which the diagnoses of two-thirds of Medicare patients fall into no more than two major diagnosis-related group classifications or in which at least two-thirds of Medicare patients are classified into surgical DRGs. In making its decision, the Board focused on several key points. Among them:
No final word yet
Results of those studies will be key in determining the AAFP's final policy on specialty hospitals, Fleming explained.
"We want to wait to see what these studies show," he said. "The whole moratorium was produced to allow these quality studies to proceed, and I can't think of anything more appropriate. So to do something before that moratorium is over just doesn't make a lot of sense."
In the meantime, physicians interested in reviewing current federal statutes on referral to facilities with which they have financial relationships can go to http://www.cms.hhs.gov/medlearn/refphys.asp. Click on "Specialty Hospital Issues" for resources devoted to this topic.
To reach writer Cindy Borgmeyer, e-mail cborgmey@aafp.org.
WEB EXTRA!
HHS has released the final regulations implementing the new Medicare prescription drug benefit and other provisions of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 scheduled to take effect next year. To download PDF versions of fact sheets that review the provisions and explain key changes between the proposed and final rules, go to http://www.cms.hhs.gov/medicarereform/pdbma/general.asp and click under "Technical Fact Sheets." The HHS press release and other related materials may also be accessed at the site.
Also available from HHS are proposed regulations implementing the new electronic prescribing standards called for under the Medicare act. The e-prescribing regulations are available for public comment at http://www.regulations.gov/freddocs/05-01773.htm. Drug plans will be required to support e-prescribing; physician and pharmacy participation will be voluntary.
As reports of health care disparities continue to make headlines
across America, the AAFP is helping to address the issue. Consider making this
new resource available to your black patients: a video and accompanying
guidebook titled "Caring for Your Family's Health: A Guide for African
Americans."
Produced by Conrad Productions in partnership with the Academy, Kaiser Permanente and the Institute of Church Administration and Management, the video and guidebook are available to members just in time for April, National Minority Health Month.
The guidebook gives tips on how black families can maintain their health through proper diet and an active lifestyle. Materials include recipes and charts for recording health information and individual family members' goals.
The video portion of this project aired in five major television markets in mid-February: ABC affiliates in Washington, D.C., and Baltimore; the NBC affiliate station in Cleveland; and CBS affiliates in Atlanta and San Francisco.
You'll want to share this resource with your patients; the materials are free, with only a $3.95 shipping/handling charge. Contact the AAFP order department at (800) 944-0000 or online at https://secure.aafp.org/catalog/viewProduct.do?productId=799&categoryId=4. Hurry. The Academy has a limited supply of 5,000 booklets to accompany 1,000 VHS tapes (item #25) and 4,000 DVDs (#26).
 The New Jersey AFP announces the candidacy of Robert "Butch" Pallay, M.D., of Hillsborough for AAFP Director. |
 The Uniformed Services AFP announces the candidacy of Lori Heim, M.D., of Lakewood, Wash., for AAFP Director. |
 The Wisconsin AFP announces the candidacy of Bradley Fedderly, M.D., of Milwaukee for AAFP Director. |
WEB EXTRA!
To the editor:
I was pleased to read in the February FP Report ("Rhode Island FP Tackles Access Problem for His Uninsured Patients") that Dr. Michael Fine has not only discovered what I've been screaming about for years -- he has done something about it.
Fine has discovered that so-called health insurance is unreasonably expensive, unfair and irrational. The established practice of charging the uninsured patient more, rather than less, than insurance companies will pay for a service is absurd.
Patients and doctors alike have fallen into the trap of demanding that everything be included in insurance coverage. It's understandable that the insurance industry would welcome this mind-set so long as it can charge enough in premiums to cover the claims. But it is incomprehensible why the public and medical profession cannot see the folly in this.
When a patient has "full coverage," do you spend 15 minutes explaining why an X-ray for a minor injury isn't necessary, or do you just go ahead and order the X-ray? Unnecessary lab and imaging tests and prescriptions result in medical expenses that could easily be dispensed with. Add in administrative costs levied by the doctor's office and by the insurance company, and you are pouring money down a rat hole.
Uninsured patients are receptive to reasonable information that will reduce out-of-pocket expenses. Shame on the AAFP for championing universal coverage instead of analyzing the real problem and working to fix it. Now is not too late!
Frank Leitnaker, M.D.
Miesau Army Depot, Germany
WEB EXTRA!
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Did you know identity theft ranks No. 1 on the list of reported consumer complaints? It's also the fastest-growing white-collar crime in America. AAFP members can get help with the consequences of identity theft by using ID Theft Assist, a new member service program. The program acts as your advocate if your personal identity is stolen and takes important legal steps that will save you time. You'll receive financial and credit support, legal assistance, advice on how to take protective measures to avoid further identity theft occurrences, and access to counselors who can help you deal with the anxiety and trauma caused by identity theft. Visit http://www.aafp.org/idtheftassist.xml for more information about this program. |
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The Academy recently launched its all-Web-based Annual Clinical Focus 2005 Genomics. The first of eight programs to be produced for this year's ACF focuses on how FPs can use a patient's family history to predict and manage health conditions that include a genetic component. Members can earn up to 22 free CME credits by completing the program, which includes a practice-based quality improvement project. Other topics to be covered throughout the year include breast cancer, Alzheimer's disease, colon cancer and bipolar disorder. To get started on this first 2005 ACF program, go to http://www.aafp.org/acfgenomics.xml and click on "Family History Program." Additional information about the 2005 ACF is available at the site |
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Proven value: Are you preparing to sit for the American Board of Family Medicine certification or recertification exam? AAFP's Family Medicine Board Review Courses are a great way to prepare. Choose a city and date that are most convenient for you: Seattle, April 17 - 23; Kansas City, Mo., May 15 - 21; or Greensboro, N.C., June 5 - 11. The six-and-one-half day format gives participants ample time -- in an intense learning environment -- to absorb information in a broadly based review program. Lectures cover these topic areas: internal medicine, geriatrics, surgery, pediatrics, women's health and obstetrics. Choose from a wide variety of breakout sessions including electrocardiogram interpretation, nutrition, common ENT problems and management of chronic pain (a complete list is available online). Online registration is open at http://www.aafp.org/x3298.xml. Board review courses are listed at the top of the page. Note the early-bird discount for each course. |
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Proven value: Patient education brochures are a great way to communicate health information to your patients. Order brochures on lowering cholesterol levels at http://www.aafp.org/shop/1503, on osteoporosis in women at http://www.aafp.org/shop/1510 and on lowering high blood pressure at http://www.aafp.org/shop/1541. Pay $12.50 for a package of 50 brochures of any single title. |
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A shipping fee may apply; Kansas residents pay a 7.525 percent tax. |
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FP Report is published by the
AAFP News Department.
Copyright © 2005 by
American Academy of Family Physicians.
