Original Research
Older Adults Who See the Same Primary Care Physician Have Fewer Preventable Hospitalizations
Background: Continuity of care has been linked with fewer hospitalizations. This study examined whether better continuity is helpful for acute, potentially preventable hospitalizations that might be avoided with regular care. Researchers analyzed data for 54,376 adults aged 45 years and older from the long-term “45 and Up Study” in New South Wales, Australia. Survey responses were linked with Medicare general practitioner claims and hospital admission records from 2007 to 2017. Researchers used a double machine learning approach to separate the effect of continuity of care from the influence of factors such as age, chronic illness, socioeconomic status, and health behaviors.
What This Study Found:
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Over the 11-year period, 27,634 participants (50.8%) had at least one acute potentially preventable hospitalization.
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Higher continuity was associated with fewer acute hospitalizations, and the reduction was larger for acute than for non-acute conditions. Increasing the Continuity of Care Index from the 45th to the 50th percentile was associated with a 9.8% to 23.5% lower probability of an acute preventable hospitalization compared with non-acute preventable hospitalizations, depending on the machine learning model used.
Implications: The findings suggest that strengthening the patient-clinician relationship can help reduce preventable hospital stays.
Anurag Sharma, PhD, et al
School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Original Research
General Practitioners Say Trust in Patients Deepens Over Time
Background: In this study, researchers aimed to understand how general practitioners experience trust in their patients, and how that trust affects patient care. Researchers interviewed 25 general practitioners across Australia.
What This Study Found:
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Interviewees ranged from 28 to 65 years old.
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Three themes described general practitioners’ trust in patients:
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General practitioners’ trust in patients was an assumed starting point. General practitioners expressed a lack of trust in some complex patients’ ability to navigate the health system, but not in the patients themselves.
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Trust in patients deepens and develops over time as part of a mutual trusting therapeutic relationship.
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General practitioners had difficulty trusting patients who were perceived to be manipulating the relationship for secondary gain. Participants attempted to understand their patient’s situation and establish a trusting relationship even when this was the case.
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Implications: Strengthening systems and training that support general practitioners in maintaining trusting relationships, especially with complex or high-needs patients, can improve continuity and quality of care.
General Practitioners’ Trust in Their Patients: A Qualitative Study
Kerry Uebel, PhD, BScMed, MBBS, MFamMed, et al
School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Original Research
Higher Glycemic Index Linked to Higher Lung Cancer Risk
Background: In this study, researchers examined whether people who follow higher-GI or higher-GL diets have different risks of developing lung cancer. They used data from 101,732 adults in the U.S. National Cancer Institute's Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial cohort who filled out a detailed diet questionnaire when they joined the study (1993–2001). These adults were followed for about 12 years to see who developed lung cancer. The researchers then compared people with the highest GI and GL to those with the lowest, accounting for smoking and other factors.
What This Study Found:
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Glycemic index: People who ate diets with the highest glycemic index had a higher chance of lung cancer than those with the lowest glycemic index — about 13% higher overall — including higher risks for both non–small cell and small cell lung cancer.
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Glycemic load: People who ate diets with the highest glycemic load had a lower chance of lung cancer than those with the lowest glycemic load — about 28% lower overall — and the pattern was similar for non–small cell lung cancer. There was no clear link for small cell lung cancer.
Implications: Diets that contain fewer amounts of high glycemic index foods and higher amounts of high-quality carbohydrates, such as vegetables, fruits, and whole grains, may be linked to lower lung cancer risk.
Dietary Glycemic Index, Glycemic Load, and Risk of Lung Cancer: a Population-Based Cohort Study
Kanran Wang, MD, PhD, et al
Radiology Oncology Center, Chongqing University Cancer Hospital, Chongqing, China
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
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Original Research
Clinicians’ Lack of Adoption Knowledge Interferes with Adoptees’ Patient-Clinician Relationship
Background: Researchers examined health care challenges faced by adult adoptees and how being adopted affects relationships with their clinicians. U.S. adult adoptees completed a mixed-methods online survey. A total of 204 participants were included in the final analysis.
What This Study Found:
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Most participants described multiple types of adoption-related bias by clinicians: More than half of the participants reported clinicians made insensitive or inaccurate statements related to adoption (68%), ignored or dismissed adoption-related concerns (60%), or made them feel uncomfortable, unwelcome, or unsupported (56%).
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Participants who frequently experienced these negative interactions were seven times more likely to change physicians or delay care than adoptees who did not experience bias.
Five Themes Emerged From the Qualitative Results:
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Adoptees want clinicians to recognize and address adoption as a lifelong factor with health care implications.
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Many adoptees perceive that limited access to family medical history negatively impacts their care.
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Adoptees with limited family medical history want to gain an understanding of their medical risks through genetic testing.
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Clinicians’ lack of knowledge about adoption harms patients and impairs the adopted patient-physician relationship.
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Adoptees report improved health care experiences and trust with clinicians who recognize adoption knowledge gaps, are receptive to feedback, and seek additional adoption-competent training.
Implications: The findings highlight the need for health care systems and clinicians to recognize adoption as a lifelong experience that can influence health and care access.
Unmet Health Care Needs of Adult Patients Adopted in Childhood: Insights and Recommendations
Julia L. Small, MD, et al
Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts
Department of Internal Medicine-Pediatrics, University of Colorado, Aurora, Colorado
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Original Research
Innovative Strategy Trains Bilingual Clinic Staff as Dual-Role Medical Interpreters to Bridge Language Gaps in Primary Care
Background: This study tested a process to qualify bilingual staff as medical interpreters at a large community health center. Bilingual employees (137 mostly heritage Spanish speaking individuals) completed a survey, self-rated their Spanish ability by taking a formal general Spanish language test and a formal medical interpretation test. Participants then completed a 40-hour online course and then repeated the medical interpretation test. 87 employees completed all steps.
What This Study Found:
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Heritage Spanish speakers had limited ability to predict their general Spanish proficiency.
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After completing the online course, average interpretation scores improved significantly.
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Higher general oral proficiency predicted higher post-course interpreting scores. Those with lower proficiency were more likely to drop out.
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Overall, 72% of participants who completed training achieved qualified interpreter status.
Implications: This study evaluated an innovative approach to address the high need for qualified medical interpreters by leveraging the unique linguistic and cultural strengths of existing heritage-speaking staff.
Medical Interpreting in Primary Care: Design and Validation of a Replicable Training Program
D. Mike Hardin Jr., MD, et al
Waco Family Medicine – Institute, Waco, Texas
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Research Brief
Study Finds Nationwide Decline in Rural Family Physicians
Background: In this study, researchers used the American Medical Association Physician Masterfile to identify family physicians aged 65 years or younger in the U.S. actively practicing outpatient care from 2017 to 2023. Physicians’ office addresses were mapped to the U.S. Department of Agriculture’s Rural-Urban Continuum Codes to identify and describe family physicians in rural communities.
What This Study Found:
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There has been an 11% nationwide decline in rural family physicians from 2017 to 2023.
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The Northeast saw the greatest percentage loss (15.3%), while the West saw the least (3.2%).
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The proportion of female rural family physicians increased from 35.5% in 2017 to 41.8% in 2023.
Implications: Despite decades of programs to develop the rural workforce, the study findings show an ongoing loss of rural practicing family physicians, which further exacerbates existing disparities rural communities face.
Family Physician Workforce Trends: The Toll on Rural Communities
Colleen T. Fogarty, MD, MSc, et al
University of Rochester School of Medicine & Dentistry, University of Rochester Medical Center, Rochester, New York
Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC
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Research Brief
New Public Dataset Maps Medicare Home Health Use
Background: Home Health Focus is a new publicly available data set representing home health use by Medicare beneficiaries at home health agency, county, and state levels from 2016 to 2019. The dataset was created to allow users to examine local and national trends without the costs or time-consuming process of entering into a data use agreement with the Centers for Medicare and Medicaid Services (CMS).
What the Dataset Includes: The dataset includes basic demographics and indicators of patient function and health status. From 2016 to 2019, home health use rose from 6,853,965 stays among 5,023,681 patients to 7,035,893 stays among 5,088,300 beneficiaries. During the same period, the number of active agencies fell from 11,727 to 10,681.
Implications: Home Health Focus lets researchers, policymakers and journalists quickly describe who uses home health, where they live, and how patterns change over time without a CMS data-use agreement.
Lacey Loomer, PhD, et al
Department of Economics and Health Care Management, Labovitz School of Business and Economics, University of Minnesota Duluth, Duluth, Minnesota
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Research Brief
Young European Family Doctors Show Moderate Readiness for Artificial Intelligence But Knowledge Gaps Limit AI Use
Background: In this study, researchers surveyed 134 young family physicians from 20 European countries to understand how ready they are to use AI in primary care. The web survey used the Medical AI Readiness Scale (MAIRS), which rates four areas: cognition (understanding), ability (skills), vision (future value), and ethics. The maximum possible score is 110, with higher scores indicating greater readiness.
What This Study Found:
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Overall readiness was moderate (median 69/110) with wide variation.
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About one-quarter of participants said they never use AI in family medicine, and frequent use was uncommon.
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Participants who reported knowing more about current AI applications and how AI is used in health care scored higher on readiness.
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Age and training level were not linked to readiness in this sample.
Implications: AI tools are advancing quickly but uneven readiness and low day-to-day use suggest a need for training and curricula tailored to primary care.
Artificial Intelligence Readiness Among Young Family Doctors in Europe
Seyma Handan Akyon, MD, Family Medicine Specialist, et al
Sincan Education and Research Hospital, Ankara, Türkiye
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Editorial
Physician Urges Implementing a New Outpatient Traumatic Brain Injury Guideline in Primary Care to Improve Recovery and Long-Term Outcomes
Millions of Americans experience TBI each year, and many recover under the care of their primary care physician. The author highlights a new clinical practice guideline aimed to improve outpatient care for adults with traumatic brain injury (TBI) who were discharged from the hospital or never hospitalized. The guideline provides evidence-based recommendations for primary care physicians on assessment, education, referrals and treatment initiation during the first and subsequent outpatient visits. The author calls the guideline a long-awaited and important step toward standardizing TBI care and improving patient outcomes. Because no single approach works everywhere, multiple complementary strategies are needed. Implementing these guidelines now rather than waiting years can help patients receive timely, coordinated care that improves recovery and long-term outcomes.
A Clinical Practice Guideline for Adults with Concussion/Mild TBI: We Can’t Wait Until 2042
John J. Leddy, MD, FACSM, FACP, FAMSSM
SUNY Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
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Special Report
New Guideline Standardizes Outpatient Care for Adults Recovering from Traumatic Brain Injury
Traumatic brain injury (TBI) affects millions of Americans each year and can result in long-lasting symptoms. Previously, outpatient TBI care lacked standardized guidance that could not apply uniformly to adults with TBI who could care for themselves after hospital discharge or who did not require hospital admission. The National Academies’ 2022 report on TBI identified this gap and called for coordinated follow-up care, leading to the formation of the Action Collaborative on TBI Care. The collaborative’s Clinical Practice Guideline Working Group synthesized and adapted recommendations from 18 existing evidence-based guidelines using a rigorous consensus process. The new guideline outlines evidence-based recommendations on 11 high-priority topics to guide outpatient care for adults with TBI in the first six months after injury. Topics include assessment, education, referrals, and early treatment. Considerations for older adults, survivors of intimate partner violence, athletes, and military service members are also provided.
Action Collaborative on Traumatic Brain Injury Care: Adapted Clinical Practice Guideline
Noah D. Silverberg, PhD, et al
University of British Columbia, Vancouver, British Columbia, Canada
Early Access Link (available now but temporary)
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Special Report
New Report Presents Recommendations to Strengthen Primary Care for Latino Patients With Chronic Conditions
Latinos face significant health disparities, especially in chronic conditions such as cardiovascular disease, diabetes, asthma, and cancer. Primary care clinicians play a critical role in managing and preventing these diseases, yet Latinos face multiple barriers to quality care. In April 2024, the Primary Care Latino Equity Research (PRIMER) Center convened the Latino Primary Care Summit on “Chronic Conditions in Latinos: Trends, Innovations and Care for the Future.” This special report summarizes the discussions at the summit and outlines key research areas and the advances needed to answer questions crucial to Latino primary care, outlining seven recommendations. The report urges pairing research with policy partners so evidence moves into practice, consistently disaggregating Latino data, and investing in the mentorship and career advancement of Latino scientists and students. It also calls for expediting implementation research in real-world primary care settings that serve Latino communities and for co-designing communication practices and new technologies with those communities. The report recommends using telemedicine and AI equitably and studying multigenerational households and policy eligibility frictions to design trauma-informed interventions that fit Latino family life.
Miguel Marino, PhD, et al
Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
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Essay
Essay by OB-GYN Urges Institutions to Support Physician Retention and Reduce Burnout Risk
An OB-GYN reflects on a challenging year when leadership transitions, the COVID-19 pandemic, and faculty attrition left her feeling unsupported clinically and academically and took away her joy in medicine. The author identifies common themes across physicians’ experiences that can inform policies and benefits, such as small but meaningful shifts in compensation, schedules, and administrative work that can help retain physicians. She notes that interventions should happen early to encourage well-being and retention.
The Year I Lost Joy in Medicine
Huma Farid, MD
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
Pre-Embargo Link (temporary)
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Essay
Researcher Urges Journals to Make It Easier for Patients and Caregivers to Publish Case Studies and Hypothesis Papers
The author, a social science researcher and caregiver for his daughter with several chronic conditions, argues that better mechanisms are needed for sharing patient and caregiver learning with researchers. Patients and caregivers have first-hand access to valuable longitudinal observations that can inform the field’s understanding of complex chronic conditions and how to treat them. The author urges medical journals to make it easier for patients and caregivers to publish case studies and hypothesis papers.
To Ground Research in the Lived Experience of Patients and Caregivers, Give Us a Voice!
Jeffrey Lubell, JD
Independent Researcher
Norwich, Vermont
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Family Medicine Updates
NAPCRG Launches Platform to Extend Year-Round Training, Mentorship, and Collaboration for Primary Care Researchers
Built in response to member demand for programming beyond the annual meeting, NAPCRG+ delivers webinars, fellowships, and multi-session courses through a new learning management system, and adds Mentor Match in NAPCRG Connect to pair researchers across institutions and countries. As NAPCRG+ launches this November, researchers worldwide are invited to explore offerings, participate in upcoming sessions, and help shape the program’s future.
NAPCRG+ Launches to Extend Year-Round Opportunities for Primary Care Researchers
ADFM Announces Progress on the National Family Medicine Strategic Plan for Research
The Association of Departments of Family Medicine (ADFM) announces progress on the National Family Medicine Strategic Plan for Research, including a living US Family Medicine Research Training Database that catalogs 160+ family medicine research tracks. The tracks include medical student programs, MD/PhD joint degree programs, residency programs, and clinical or academic fellowships with a research emphasis. The database helps departments recruit, support, and grow the next generation of family medicine researchers. A four-part Chairs’ Research Curriculum and Learning Series series convenes department chairs to share strategies, specifically around vision, infrastructure, regulation, and funding. The materials available, including webinars, audio, slides, and written guides, allow chairs to engage in a way that best fits their schedules and learning style.
Update on the National Family Medicine Strategic Plan for Research
Journal
The Annals of Family Medicine
Article Title
Tip Sheet Summaries Annals of Family Medicine November/December 2025
Article Publication Date
24-Nov-2025