Issue - Southern Medical Association

Original Article

Self-Report Study of Predictors of Physician Wellness, Burnout, and Quality of Patient Care

Objective: The goal of this self-report study was to examine the relation of work variables, self-rated health and mental health status, and perceived social support to physician wellness, physician burnout, and quality of patient care. Methods: We administered a demographics questionnaire, the Physician Wellness Inventory, the Maslach Burnout Inventory, and…

Original Article

Association Between Energy Prices and US Hospital Patient Outcomes

Objective: To evaluate associations between changing energy prices and US hospital patient outcomes. Methods: Generalized estimating equations were used to analyze relationships between changes in energy prices and subsequent changes in hospital patient outcomes measures for the years 2008 through 2014. Patient outcomes measures included 30-day acute myocardial infarction, heart…

Original Article

Exploration of the Association Between Physical Health and Suicidal Behavior in Psychiatric Outpatients in Rural America

Objective: Evidence reveals a link between poor physical health and suicide. The physical health of rural, adult psychiatric outpatients with a history of suicide was examined. Methods: The medical records of 192 patients seen at a tertiary-level academic medical center were examined for demographics, psychiatric and medical history, and self-reported…

Review Article

Role of Direct Oral Anticoagulants in the Management of Anticoagulation

For decades, vitamin K antagonists (VKAs) have been the oral treatment of choice for many thromboembolic conditions. The limitations of VKAs include the need for monitoring through blood testing, drug interactions, and narrow therapeutic windows. These shortcomings have led to the development of direct oral anticoagulants. These new oral agents…

Original Article

Sleep Duration and C-Reactive Protein in US Adults

Objective: To use gender-stratified logistic regression analysis to examine the associations between elevated C-reactive protein (CRP; >3–10 mg/L) and sleep duration. Methods: The study sample included male (n = 5033) and female (n = 4917) adult (20 years old and older) participants in the 2007–2010 National Health and Nutrition Examination…

Review Article

Improving Mental Health Services Through Physician Assistants: Legislation in Several Southern States

A national effort to provide more expansive mental health care in the United States has been an increasing priority during the last decade. States have enacted laws that allow for the delegation of psychiatric services to physician assistants in an effort to address the shortage and geographic maldistribution of mental…

Invited Commentary

Commentary on “Nurturing Competence and Compassion in Future Physicians”

The article by Sherling and Hennekens in this issue of the Southern Medical Journal powerfully emphasizes the importance of assessing noncognitive factors in the selection for medicine.1 No question – patients demand and deserve compassionate humane care. My experience suggests that medical school personnel involved in selection (faculty, staff, alumni,…

Review Article

Autoimmune Neutropenia Updates: Etiology, Pathology, and Treatment

Autoimmune neutropenia (AIN) is defined as a neutrophil count

Original Article

Family Medicine–Specific Practice-Based Research Network Productivity and Clinical and Translational Sciences Award Program Affiliation

Objective: Practice-based research networks (PBRNs) are groups of practices that work together to conduct research. Little is known about the degree to which PBRNs may be achieving success. This is the first general survey of family medicine–based PBRN directors in the United States and Canada to examine research productivity outcomes…

Review Article

Lynch Syndrome and Endometrial Cancer

In patients with Lynch syndrome, gynecologic cancer often can be the first presenting malignancy. In this review, we summarize the genetics of Lynch syndrome and review the various modalities of identifying patients at risk for this syndrome. The clinical characteristics of Lynch-associated endometrial cancer and screening and risk-reducing strategies also…

Multidisciplinary Clinical Case Study

Aleukemic Myeloid Leukemia Cutis with a Kikuchi Disease–Like Inflammatory Pattern in Myelodysplastic Syndrome

Myeloid leukemia cutis (MLC) is a rare disease characterized by the infiltration of neoplastic myeloid, myelomonocytic, or monocytic precursors into the skin, producing clinically nonspecific-appearing papules, nodules, plaques, or purpura that necessitate biopsy for definitive diagnosis. In general, it is considered an extramedullary manifestation of acute myeloid leukemia (AML) similar…

Perspectives

Nurturing Competence and Compassion in Future Physicians

The stories at the low-income clinic that day were even more gut-wrenching, the usual shocking pathology was perhaps more obscure. Yet, the premedical school student who was translating for the non–Spanish-speaking clinicians seemed unmoved and disinterested. Although he did his job efficiently, he had no questions for the attending physician….

Original Article

Social Support and Health-Related Quality of Life Among Low-Income Women: Findings from Community-Based Participatory Research

Objectives: This study examined the association between social support and health-related quality of life (HRQoL) among low-income women in the southeastern region of the United States. Methods: Analysis was performed on data from a community needs assessment survey that was designed to explore social determinants of health and QoL indicators…

Invited Commentary

Commentary on “Will the ‘Fixes’ Fall Flat? Prospects for Quality Measures and Payment Incentives to Control Healthcare Spending”

In this issue of the Southern Medical Journal, Hauswald and Sklar et al explore the evolution of Medicare payment policies and the challenges faced by the quality-aligned payment incentives.1 After 50 years of various manipulations to a fee-for-service system, the Medicare Access and Children’s Health Insurance Program Reauthorization Act (MACRA)…

Review Article

Will the “Fixes” Fall Flat? Prospects for Quality Measures and Payment Incentives to Control Healthcare Spending

Payment systems in the US healthcare system have rewarded physicians for services and attempted to control healthcare spending, with rewards and penalties based upon projected goals for future spending. The incorporation of quality goals and alternatives to fee-for-service was introduced to replace the previous system of rewards and penalties. We…

Original Article

Inflammation and Healthy Lifestyle Choices Influence Cardiometabolic Risks in African American Women

Objectives: Individuals of African origin in Europe and the Caribbean have a lower prevalence of coronary heart disease (CHD) than do Europeans and European Americans; however, African Americans, especially women, do not possess the same low CHD prevalence as Africans. As such, this study was designed to determine whether highly…