Ewen Alana M, Villarreal-Calderon Rodolfo, Lynch Sara, Schneider Jeffrey I
Data Analyst, Graduate Medical Education, Boston Medical Center.
Resident, Department of Internal Medicine, Boston Medical Center.
J Grad Med Educ. 2020 Dec;12(6):759-763. doi: 10.4300/JGME-D-20-00158.1. Epub 2020 Dec 2.
Trainee well-being is a major concern for institutions and programs, yet many residents report suboptimal access to or contact with primary care for themselves.
To address the health care needs of residents, we developed a mechanism whereby all incoming residents were offered an appointment with a primary care clinician (PCP) during institutional intern orientation.
In April 2019, all incoming residents (17 specialties) were invited to participate. A collaboration involving the GME office and family medicine and internal medicine departments enabled interested residents to attend PCP appointments that were held at predesignated times during orientation and did not conflict with other orientation or learning activities. Residents received appointment details, and insurance billing processes were followed. A survey was administered to all participating PCPs and incoming residents 2 weeks following their scheduled PCP appointment.
Of the 144 incoming residents, 118 (82%) participated. Among the 71 of 144 (49%) residents who responded to the survey, 94% indicated that they desired an appointment, with 90% attending the appointment as scheduled; 52% purposed their visit as an introduction for future appointments, while 15% requested prescription refills. All but one recommended that the initiative be offered again in the future. Seventy-two percent stated that participating in the PCP initiative definitely/probably led to improvements in self-care, and 76% indicated that participating definitely/probably made them more conscious of their health and well-being.
Integrating PCP appointments into orientation is feasible and was highly acceptable in a large academic medical center.
学员的身心健康是院校和项目主要关注的问题，然而许多住院医师表示，他们自己获得初级保健服务或与初级保健医生接触的机会并不理想。
为满足住院医师的医疗保健需求，我们建立了一种机制，在机构实习医师入职培训期间，为所有新入职的住院医师安排与初级保健医生（PCP）的预约。
2019年4月，邀请了所有新入职的住院医师（17个专业）参与。研究生医学教育（GME）办公室与家庭医学和内科部门合作，使感兴趣的住院医师能够参加在入职培训期间预先指定时间举行的初级保健医生预约，且不与其他入职培训或学习活动冲突。住院医师收到预约详情，并遵循保险计费流程。在预定的初级保健医生预约两周后，对所有参与的初级保健医生和新入职的住院医师进行了一项调查。
144名新入职的住院医师中，118名（82%）参与。在144名（49%）回复调查的住院医师中，94%表示希望预约，90%按计划参加了预约；52%将此次就诊作为未来预约的介绍，而15%要求续开处方。除一人外，所有人都建议未来再次开展该活动。72%的人表示参与初级保健医生活动肯定/可能有助于改善自我保健，76%的人表示参与肯定/可能使他们更加关注自己的健康和幸福。
将初级保健医生预约纳入入职培训是可行的，并且在一个大型学术医疗中心中得到了高度认可。
