Less Is More

Simpler & Better Medicine

Clinical Intuition as a Risk Stratification Method for Provision of Care Management Services. — May 22, 2018

Clinical Intuition as a Risk Stratification Method for Provision of Care Management Services.

Summary: For primary care practices seeking to enroll high-risk patients in care management, use of clinical intuition to identify high-risk patients may be associated with a higher proportion of patients being enrolled in care management compared to use of an algorithm, insurance claims, or electronic health record (EHR) based tools.

https://www.ncbi.nlm.nih.gov/m/pubmed/28893815/

Strength of Recommendation = B

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Sitting at patients’ bedsides may improve patients’ perceptions of physician communication skills. — May 8, 2018

Sitting at patients’ bedsides may improve patients’ perceptions of physician communication skills.

Summary: For inpatient hospital visits, if the rounding physician sits the patient is more likely to feel that the physician explained things clearly and listened carefully without the visit taking any longer than if the physician remains standing for the visit.

https://www.ncbi.nlm.nih.gov/m/pubmed/27378679/

Strength of Recommendation = B

Clinician attire and credibility of treatment. — January 23, 2018

Clinician attire and credibility of treatment.

Summary: For primary care clinicians caring for patients with low back pain (and presumably other conditions as well?), wearing casual attire appears to result in the same “perceived treatment credibility” as wearing formal attire, while casual attire is presumably more comfortable for the clinician.

https://www.ncbi.nlm.nih.gov/m/pubmed/27522250/

Strength of Recommendation = B

End-of-Life Care in Older Patients After Serious or Severe Traumatic Brain Injury. — October 17, 2017

End-of-Life Care in Older Patients After Serious or Severe Traumatic Brain Injury.

Summary: For patients over 65 who suffer severe traumatic brain injury (TBI), an approach of providing hospice or palliative care may be associated with a lower likelihood of in-hospital mortality than an approach of providing high-intensity treatments (including gastrostomy and tracheostomy).

https://www.ncbi.nlm.nih.gov/m/pubmed/28975244/

Strength of Recommendation = B

Sitting vs. standing and perception of clinician time at the hospital bedside — April 26, 2017

Sitting vs. standing and perception of clinician time at the hospital bedside

Summary: For patients being seen in hospital, if the physician sits while seeing the patient during hospital rounds, this may lead to the patient perceiving the visit to have been longer than if the physician stands; physician sitting rather than standing may also lead to patients reporting a more positive interaction and a better understanding of their condition.

https://www.ncbi.nlm.nih.gov/m/pubmed/21719234/

Strength of Recommendation = B

Does Electronic Messaging Reduce Incoming Telephone Calls? — October 4, 2016

Does Electronic Messaging Reduce Incoming Telephone Calls?

Summary: A practice of NOT using an internet patient communication portal might actually be associated with lower rates of telephone calls, compared to a practice of implementing an internet patient communication portal in an effort to reduce phone calls. (In other words, implementation of an internet portal may be associated with increased phone call volume)

http://www.ncbi.nlm.nih.gov/m/pubmed/27613794/

Strength of Recommendation = C

Medicare costs in urban areas and the supply of primary care physicians. — September 11, 2015
In California, Primary Care Continuity Was Associated With Reduced Emergency Department Use And Fewer Hospitalizations. — August 24, 2015
Primary care physicians and specialists as personal physicians. Health care expenditures and mortality experience. — July 10, 2015

Primary care physicians and specialists as personal physicians. Health care expenditures and mortality experience.

Summary: Having a primary care physician as one’s personal doctor may be associated with up to 33% lower annual health care expenditures and a lower adjusted rate of mortality, compared to having a specialist as one’s personal physician.

http://www.ncbi.nlm.nih.gov/m/pubmed/9722797/

Strength of Recommendation = B

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