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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Related Experiment Video

Updated: Sep 19, 2025

Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
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Differences in Ambulatory Care Outcomes Between Trainees and Faculty: A Multi-center Study.

Kelly L Graham1, Maelys Amat2, Elizabeth Norian2

  • 1Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. kgraham@bidmc.harvard.edu.

Journal of General Internal Medicine
|June 3, 2025
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Summary

Residents in academic medical centers show lower performance in ambulatory care quality measures compared to faculty. Disparities in cancer screening and chronic disease management may stem from disagreements on high-functioning primary care components.

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Area of Science:

  • Health Services Research
  • Medical Education
  • Primary Care Medicine

Background:

  • Academic medical centers (AMCs) deliver complex care, with prior studies showing no inpatient performance differences between residents and faculty.
  • However, single-center analyses indicated lower performance in ambulatory care outcomes among residents compared to faculty.

Purpose of the Study:

  • To determine if resident-faculty performance disparities in ambulatory care are a national issue within AMCs.
  • To identify contributing factors to these disparities in AMC primary care settings.

Main Methods:

  • A retrospective cohort study of 146,961 patients receiving primary care in five AMCs during 2019.
  • Compared outcomes between resident-supervised and faculty-only primary care cohorts.
  • Assessed cancer screening rates, chronic disease control (diabetes, hypertension), and agreement with high-functioning primary care components via surveys with clinic leadership.

Main Results:

  • After adjusting for social complexity, resident-faculty disparities were observed across all five sites for all measured outcomes.
  • Lower performance was noted for breast and colorectal cancer screening, and control of type 2 diabetes mellitus and hypertension.
  • The magnitude of these disparities correlated with disagreement on essential components of high-functioning primary care.

Conclusions:

  • Residents consistently underperformed faculty on routine ambulatory quality measures.
  • Disagreements regarding high-functioning primary care components appear linked to the extent and number of performance disparities.
  • Findings underscore the need for enhanced infrastructural support in primary care settings within AMCs to improve patient care quality.