Citations

Introduction/Objective Opportunistic salpingectomy (OS) has been shown to reduce high-grade serous ovarian cancer (HGSOC) by 42-80%, yet awareness of this strategy outside of obstetrics and gynecology remains limited. The objective of this study was to assess awareness and counseling practices regarding OS for HGSOC prevention among primary care providers (PCPs). Methods We conducted a cross-sectional survey study using a 6-item electronic survey evaluating PCP knowledge and counseling practices related to HGSOC prevention through OS. The study was conducted at a single tertiary care center with gynecologic oncology services. Survey items assessed awareness of HGSOC origin, awareness of OS as a preventative strategy, counseling frequency in the setting of abdominal or pelvic surgery, counseling comfort, and resources needed to increase confidence in recommending OS. Response formats included Likert scales and Yes/No/Unsure options. The survey was distributed by email to attending physicians and advanced practice providers (APPs) in the Department of Family Medicine (FM) and Internal Medicine (IM). Results Of 398 providers surveyed, 136 responded (34% overall response rate; FM 44%, IM 28%), including 96 attending physicians and 40 APPs. Most PCPs were unaware that HGSOC originates in the fallopian tubes (60%) and were unaware of OS as a preventive strategy (71%). Counseling was uncommon: 11% had ever counseled on OS, while 74% had not and 15% reported it was outside their scope. Most respondents (63%) reported being not at all comfortable counseling patients about OS. Providers identified clinical guidelines (60%), CME or training modules (50%), eligibility criteria (48%), gynecology collaboration pathways (48%), and patient-friendly materials (44%) as key supports to improve counseling confidence. Conclusion PCP awareness and counseling regarding OS are limited. Given that guideline support for OS has solidified only in recent years, these gaps are not surprising—and they represent a clear, actionable opportunity. PCPs are well-positioned to lead the expansion of ovarian cancer prevention beyond specialty care with the right tools and support.

Introduction Video visits in primary care have decreased significantly since their surge early in the COVID-19 pandemic. Methods Clinicians including physicians, nurse practitioners, and physician assistants in the Mayo Clinic Department of Family Medicine were invited to dedicate one to two half-days per month exclusively to video visits. Schedules for these half-day sessions remained restricted to video appointments until the day prior. If at least 80% of slots were not filled by then, remaining openings were converted to in-person visits. If the half-day sessions were at least 80% full with video visits, clinicians had the option of performing these sessions remotely. Results Of 155 eligible clinicians, 34 (22%) participated voluntarily in this scheduling intervention. For the participating clinicians, the average video visit rate increased from 6.3% per month preintervention to 11.5% postintervention ( p < 0.001). On a departmental level, the trend line for the percent of outpatient visits via video visit was decreasing by −0.1% per month preintervention. The postintervention slope of the trend line was 0.3% per month ( p < 0.001). The majority (65%) of the time the half-day video visit schedules filled at least 80% and did not require conversion to allow in-person visits allowing clinicians to work remotely if they chose. Conclusion Allowing family medicine clinicians to perform 1–2 half-day schedules dedicated to only video visits increases the percentage of video visit performed per month both for individual clinicians and on a departmental level.

Introduction: Team-based care has become an essential part of modern medical practice. Patient-centered medical homes often struggle to balance the dual competing goals of acute access and continuity of care. Multimorbidity patients may value continuity more than healthy patients, and thus may prefer to wait to see their primary care physician (PCP). Methods: A total of 1700 randomly selected healthy adults and multimorbidity patients were asked to rate satisfaction with care and presented with 4 acute and 4 chronic scenarios to choose an access and continuity preference in an anonymous mailed survey. Results: In all, 770 responses were obtained. All respondents preferred to be seen 2.5 days sooner for acute appointments. Multimorbidity patients preferred to wait 0.28 days longer for acute issues to see their PCP. Patients who were not satisfied with their care team preferred to wait 0.75 days to see their PCP. Those not satisfied with their PCP choose to be seen 0.38 days sooner by their care team or any physician. Conclusions: All patients prefer continuity of care with their PCP for chronic disease management and value quick access to care for acute problems. For acute visits, multimorbidity patients prefer to wait longer to see their PCP than healthy adults. Satisfaction also plays an important role in patients’ willingness to wait for an appointment with their PCP.