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Walter G, Laddha R, Jetty A, Jabbarpour Y, Huffstetler A. Racial Inequities in Female Family Physicians Providing Women's Health Procedures. J Am Board Fam Med 2024; 37:134-136. [PMID: 38467430 DOI: 10.3122/jabfm.2023.230078r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 03/13/2024] Open
Abstract
Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities in care received by minority women.
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Affiliation(s)
- Grace Walter
- From the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington DC (GW, RL, AJ, YJ, AH); Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA (AH)
| | - Radhika Laddha
- From the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington DC (GW, RL, AJ, YJ, AH); Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA (AH)
| | - Anuradha Jetty
- From the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington DC (GW, RL, AJ, YJ, AH); Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA (AH)
| | - Yalda Jabbarpour
- From the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington DC (GW, RL, AJ, YJ, AH); Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA (AH)
| | - Alison Huffstetler
- From the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington DC (GW, RL, AJ, YJ, AH); Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond, VA (AH)
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Webel B, Villalobos G, Rockwell MS, Huffstetler A, Britz JB, Brooks EM, Krist AH. Considering the Environmental Impact of Practice-Based Research. J Am Board Fam Med 2024; 37:22-24. [PMID: 38448235 PMCID: PMC11044959 DOI: 10.3122/jabfm.2023.230202r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION Practice-based research networks (PBRNs) improve primary care by addressing issues that matter to clinicians. Building trust between researchers and care teams is essential to this process, which often requires visiting practices to cultivate relationships and perform research activities. However, in a recent study using practice facilitation to improve the delivery of a preventive service, the COVID-19 pandemic prompted us to convert all planned facilitation from an in-person to virtual format. This eliminated the need to commute by automobile to and from practices across the state, greatly reducing the carbon footprint of the study. METHODS From practice facilitator field notes that detailed practice locations and number of sessions, we calculated the total number of driving miles averted by virtual facilitation. We then determined metric tons of carbon dioxide we avoided producing using the Environmental Protection Agency Greenhouse Gases Equivalencies Calculator. During post-intervention interviews, we assessed practices' perspectives and experiences with the virtual format. RESULTS Three practice facilitators provided an average of 3.4 sessions for 64 practices. Virtual facilitation averted 32,574.8 drive miles and prevented the release of 12.7 metric tons of carbon dioxide, an offset equivalent to growing 210 trees for 10 years. Practices reported that virtual facilitation fostered greater engagement and allowed more clinicians and staff to attend sessions. DISCUSSION Climate change poses a significant threat to the health of people and communities. Given their commitment to improving population health, it may be time for PBRNs to routinely assess their environmental impact and minimize preventable environmental costs.
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Affiliation(s)
- Ben Webel
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR).
| | - Gabriela Villalobos
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
| | - Michelle S Rockwell
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
| | - Alison Huffstetler
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
| | - Jacqueline B Britz
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
| | - E Marshall Brooks
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
| | - Alex H Krist
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (BW, GV, AH, JBB, EMB, AHK); and Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA (MSR)
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Brooks EM, Huffstetler A, Britz J, Webel B, Lail Kashiri P, Richards A, Sabo R, O'Loughlin K, Cunningham P, Barnes A, Kuzel T, Krist AH. The Distressed State of Primary Care in Virginia Pre-Medicaid Expansion and Pre-Pandemic. J Am Board Fam Med 2021; 34:1189-1202. [PMID: 34772774 PMCID: PMC8620191 DOI: 10.3122/jabfm.2021.06.210046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/07/2021] [Accepted: 07/21/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Primary care is crucial to the health of individuals and communities, but it faces numerous structural and systemic challenges. Our study assessed the state of primary care in Virginia to prepare for Medicaid expansion. It also provides insight into the frontline of health care prior to an unprecedented global COVID-19 pandemic. METHODS We surveyed 1622 primary care practices to understand organizational characteristics, scope of care, capacity, and organizational stress. RESULTS Practices (484) varied in type, ownership, location, and care for medically underserved and diverse patient populations. Most practices accepted uninsured and Medicaid patients. Practices reported a broad scope of care, including offering behavioral health and medication-assisted therapy for opioid addiction. Over half addressed social needs like transportation and unstable housing. One in three practices experienced a significant stress in 2019, prepandemic, and only 18.8% of practices anticipated a stress in 2020. CONCLUSIONS Primary care serves as the foundation of our health care system and is an essential service, but it is severely stressed, under-resourced, and overburdened in the best of times. Primary care needs strategic workforce planning, adequate access to resources, and financial investment to sustain its value and innovation.
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Affiliation(s)
- E Marshall Brooks
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Alison Huffstetler
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Jacqueline Britz
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Benjamin Webel
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Paulette Lail Kashiri
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Alicia Richards
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Roy Sabo
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Kristen O'Loughlin
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Peter Cunningham
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Andrew Barnes
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Tony Kuzel
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO)
| | - Alex H Krist
- From the Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (EMB, AH, JB, BW, PLK, AR, RS, KO, TK, AHK); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (AR, RS); Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA (PC, AB); Department of Psychology, Virginia Commonwealth University, Richmond. VA (KO).
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