Osteopathic Family Physician RSS feed: Current Issue. Osteopathic Family Physician , the official journal of the American College of Osteopathic Family Physicians, is a peer-reviewed publication whose purpose to deliver information that helps osteopathic family physicians care for their patients, improve their practices, and better understand the activities ACOFP is taking on their behalf. The content areas of the journal reflect the interests of Association members and other health professionals. These areas include such diverse topics as preventive medicine, managed care, osteopathic principles and practices, pain management, public health, medical education, and practice management. The journal?s particular emphases include an active forum for the presentation of family medicine research in diverse settings, involving medical students, residents, fellows, and practicing professionals. Osteopathic Family Physician provides a forum for careful systematic reviews of primary care. As the official journal of the American College of Osteopathic Family Physicians, Osteopathic Family Physician publishes policy statements, communications from the Board of Governors, and notices of important Committee and Special Interest Group projects.http://www.osteopathicfamilyphysician.org/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Osteopathic Family Physician1877-573X24July 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000742/abstract?rss=yesThe term patient-centered medical home is commonplace but its meaning and significance are less well understood. Wikipedia defines the medical home, also known as a patient-centered medical home (PCMH), as an “an approach to providing comprehensive primary care … that facilitates partnerships between individual patients, and their personal Providers, and when appropriate, the patient's family.” The provision of medical homes may allow better access to health care, increase satisfaction with care, and improve health.The medical home issueJay H. Shubrook10.1016/j.osfp.2010.05.001Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Editor's Message8788http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000614/abstract?rss=yesAs much as 6% of the aging population is severely disabled. A significant portion of Medicare spending is attributable to this population, who frequently use acute services and are prone to acute hospitalizations, hospital readmissions, and futile care. For this high-risk, frail, elderly population, data suggest that many of these episodes of care are compounded by suboptimal postdischarge continuity, and by ongoing gaps in access and continuity. An old model of care is emerging as a reinvention of the traditional house call, using the services of clinicians providing care in the home. This paper discusses the evolution of this practice model into a set of competencies and skills defined as residentialist care. Residentialists offer significant potential to create a disruptive innovation in care delivery, close gaps in care, and improve efficiency and continuity of health care to the high-risk, homebound, frail elderly.Enhancing continuity of care and reducing unnecessary utilization in high-risk and homebound patients: the emerging role of the residentialist in the health care delivery systemNorman E. Vinn10.1016/j.osfp.2010.04.002Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Public Health Policy8995http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000249/abstract?rss=yesBackground: Many articles exist outlining the possible benefits of the medical home model on enhanced patient care and reduced over-utilization of the medical system. So far, these articles have focused mainly on the viewpoint of physicians and their perceptions of what patients prefer, with relatively few addressing solely the patient perspectives. Some articles have addressed patient perspectives as a component of a larger study. This study attempts to put into words and data actual patient preferences for a medical home model. In addition, the study aimed to determine whether patients understand their health conditions, what they thought about having multiple doctors, whether they want their primary physician to complete an initial workup before referral to a specialist, and other issues important to patient satisfaction and perceptions of their care.Methods: Fifty-six nonhospitalized English-speaking adults between 18 and 85 years of age and of any ethnic background were surveyed. They responded to a 10-question survey and were asked to rank items—their understanding of their medical problems; the explanation of their problems by their primary care physician (PCP) vs. their specialists; the importance of having their medical information in one place, of obtaining tests before being referred, of seeing a specialist when they had multiple medical conditions, of the PCP's role as a gatekeeper, and of understanding compliance; as well as the necessity of having their PCP clarify treatment plans developed by their specialist—from 1 to 5 based on preference. Results were tabulated and graphed. The study was reviewed by Nova Southeastern University College of Osteopathic Medicine Institutional Review Board.Results: The majority of patients admitted to having good to very good understanding of their medical conditions. In their opinion, this understanding is attributable more so to their PCP than to their specialist. Fifty-three percent of patients stated that they need further clarification of plans developed by their specialist. Of the patients surveyed, 57% preferred one doctor, as opposed to 39% who preferred more than one doctor, and 4% who had no preference. In addition, patients also had a strong preference for having initial tests done before being sent to a specialist. However, they did want to be sent to specialists if needed. Patients acknowledged that compliance with treatment plans is linked to a thorough understanding of their medical problems.Interpretation and conclusion: The data show that the medical home is of benefit to not only the patients, as evidenced by their preferences, but also to the physician because of better understanding of medical conditions leading to better compliance with treatment plans.The utility of the medical home: a survey on patient perspectivesTasleyma Sattar, Hema Jadoonanan, Susan Ledbetter10.1016/j.osfp.2009.12.004Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Original Research96101http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000237/abstract?rss=yesSummary: There is a quality chasm in American health care. The increasing prevalence of chronic disease (including obesity) among members of the US population is by itself sufficient motivation to change the structure of the nation's current health care system. Studies that have tracked the quality of health care services reflect—across the board—a lack of efficiency. The consensus among researchers is that care delivered by physicians working within a Primary Care Medical Home (PCMH) model consistently leads to better outcomes for patients with chronic diseases. Change, it would seem, is required.Utilizing medical homes to manage chronic conditionsSteven Kamajian10.1016/j.osfp.2010.01.002Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Review Articles102107http://www.osteopathicfamilyphysician.org/article/PIIS1877573X1000064X/abstract?rss=yesResearch consistently suggests that electronic medical records (EMRs) provide many clinical and economic benefits associated with their adoption. Improved coordination of patient care, reduced medication errors, and improved preventive screening rates are just a few of the clinical benefits. The federal government has placed considerable emphasis on interoperability in the hopes that providers at different facilities will be able to exchange health data to maximize the quality and speed of care. The administrative benefits of EMRs include reduced transcription costs, more accurate coding, and increased efficiency of claims submission. Because of their potential, the federal government has progressively increased its efforts to facilitate the widespread adoption of interoperable EMR systems. This article discusses the government's health information technology incentive programs for Medicare and Medicaid providers, and reviews the overall “meaningful use” edibility criteria. Electronic prescribing bonuses are also discussed. This article hopes to demonstrate that because EMRs are likely to become mandatory in the near future, it is important for physicians to consider EMR implementation now while they can receive the maximum amount of reimbursement for their investments under the current incentives.The case for electronic medical records—why the time to act is nowThomas G. Zimmerman10.1016/j.osfp.2010.03.003Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Review Articles108113http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000766/abstract?rss=yesPrimary care continues to suffer a loss of interest among graduates of medical school. The patient-centered medical home (PCMH) provides a potential vehicle to redefine primary care as chronic disease increases in prevalence in the United States. The model, as developed by the American Osteopathic Association, American Academy of Family Physicians, American Academy of Pediatrics, and American College of Physicians provides a organized team focused on engaging and collaborating with patients and family using evidenced-based, goal-directed therapy. Challenges for primary care include practice expansion in terms of information technology and human resources to meet the needs of patents in terms of primary and secondary prevention as well as care coordination. Payment methods to fund these changes are being explored by several states through pilot projects. Although the PCMH has shown early evidence in its ability to improve both physicians' satisfaction with practice and patients outcomes, broad implementation will not occur without payers and employers realizing the value of the PCMH and providing resources for funding the transition of primary care practices.The patient centered medical home: moving from dialogue to implementationRichard Snow10.1016/j.osfp.2010.04.007Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Public Health Policy114117http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000754/abstract?rss=yesDuring its April 1 meeting, the Medicare Payment Advisory Commission (MedPAC) considered recommendations on graduate medical education (GME) payment for inclusion in its June report to Congress. In making these recommendations, the Commission determined that at least a portion of Medicare GME payment should be used as a “lever for change.” Because MedPAC staff long has contended that indirect medical education payment is higher than empirically justified, the Commission recommended redirecting these funds to achieve certain objectives, including increasing payment system accountability and transparency. Subject to final modifications, the recommendations include:Washington, D.C. updateKeith Studdard, Marcelino Oliva10.1016/j.osfp.2010.05.002Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Washington, D.C. Update118120http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000729/abstract?rss=yesAfter reading the article on Management of Chronic Rhinosinusitis by Adarsh Gupta, DO, MS, and Ashmit Gupta, MD, MPH, in the January/February 2010 issue of Osteopathic Family Physician, I am disappointed that there is no mention of utilizing OMM in the management of this common complaint. The authors state in the “Managing chronic rhinosinusitis” section: “The goal of medical management is to … promote drainage and a more normal nasal environment.”Encouraging OFP editorial staff to present information and articles on the use of Osteopathic manipulative careGeraldine N. Urse10.1016/j.osfp.2010.03.005Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Letters to the Editor121121http://www.osteopathicfamilyphysician.org/article/PIIS1877573X1000078X/abstract?rss=yesI would like to thank Dr. Urse for her Letter to the Editor. We welcome the sentiment of this letter and agree whole-heartedly that we have a great opportunity to highlight osteopathic principles and osteopathic manipulation with our article selections for this journal. Although we do not control what content is submitted to the journal, we certainly can consider inclusion of osteopathic principles and OMT as part of a final manuscript review. I think this can be even more important with medical topics that are not primarily musculoskeletal and where OMT can be beneficial. As a counterpoint, we will expect that OMT-focused articles/research have the same supporting evidence as other treatments. We challenge osteopathic family physicians to continue to contribute to the collective database of evidence that supports the use of OMT. In the end, patients will benefit from the most comprehensive treatment plan.Letter to the Editor Response: OMM InclusionJay H. Shubrook10.1016/j.osfp.2010.04.008Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1Letters to the Editor121121http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000869/abstract?rss=yesCalendar of Events10.1016/S1877-573X(10)00086-9Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1122122http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000821/abstract?rss=yesGuide for readers10.1016/S1877-573X(10)00082-1Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1FrontmatterA1A1http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000833/abstract?rss=yesEditorial Board10.1016/S1877-573X(10)00083-3Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1FrontmatterA2A2http://www.osteopathicfamilyphysician.org/article/PIIS1877573X10000845/abstract?rss=yesTable of contents10.1016/S1877-573X(10)00084-5Osteopathic Family Physician 2, 4 (2010)2010-07-01Osteopathic Family Physician2010-07-0124S1877-573X(10)X0004-1FrontmatterA3A3