BACKGROUND The purpose of this study was to systematically examine the impact of insurance status on access to and utilization of elective specialty hand surgical care. We hypothesized that patients with Medicaid insurance or those without insurance would have greater difficulty accessing care both in obtaining local surgical care and in reaching a tertiary center for appointments. METHODS Th...

Although the physician assistant (PA) profession was created to bolster the primary care workforce, PAs have assumed increasing roles in subspecialties. This paper compares specialty prevalence between physicians and physician assistants, analyzes trends in PAs' specialty choices from 1997 to 2006, and suggests options for influencing these specialty choices in the future. The number of PAs is ...

Concussions make up nearly 10% of all high school athletic injuries. Recent changes in concussion management guidelines and legislation aim to make concussion care more standardized and safe but simultaneously pose a challenge for the primary care and sports medicine physician. Pediatric and adolescent concussions may cause anxiety for the treating physician due to concerns over return-to-play ...

The New Jersey Legislature authorized the licensing of Physician Assistants (PAs) in 1991. These mid-level practitioners have been useful as “physician extenders” in both office and hospital settings. In primary care and surgical specialties, PAs can undertake diagnostic evaluations, manage inpatient care and function as a hospitalist, assist in surgery or invasive procedures and can perform so...

Afew weeks after leaving private practice in 1976 to join the ranks of insurance company medical directors, I was told by my boss, half seriously and half facetiousl~ that if before I left practice I had climbed on top of my office desk or a waiting room table shouting "I just can’t take this anymore," I would have been well on my way to being declared totally disabled from my occupation as a p...

Intervention: Coordinated care consisting of cognitive behavioural therapy (CBT) plus medication or usual care. CBT consisted of six sessions plus six follow up telephone booster sessions and a patient education video and workbook. A behavioural health specialist delivered CBT and was involved in coordinated care by communicating with both primary care physicians and consultant psychiatrists as...

(1) Practices that are physician-owned and practices that use Electronic Health Records (EHRs) have lower nonemergent emergency department (ED) rates and lower emergent-primary care treatable ED rates. (2) Medical practices with more nurse practitioners or physician assistants per physician have higher emergent-primary care treatable ED and higher ambulatory care sensitive (ACS) rates, but thei...

Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply...

BACKGROUND Individuals with somatic preoccupation constitute a substantial number of primary care patients. Somatically preoccupied patients are challenging to primary care physicians for several reasons including patient complaints consuming a great deal of physician time, expense to diagnose and treat and strain on the physician-patient relationship. This paper examines and discusses how disr...