Poulin EA, Swartz AW, O'Grady JS, Kersten MPM, Angstman KB, et al.
Family medicine. Date of publication 2019 Jul 1;volume 51(7):574-577.
1. Fam Med. 2019 Jul;51(7):574-577. doi: 10.22454/FamMed.2019.659478. Epub 2019 May
21.
Essential Office Procedures for Medicare Patients in Primary Care: Comparison
With Family Medicine Residency Training.
Poulin EA(1), Swartz AW(2), O'Grady JS(3), Kersten MPM(4), Angstman KB(5).
Author information:
(1)Department of Family Medicine, Mayo Clinic Health System-Southeast Minnesota,
Zumbrota, MN.
(2)Department of Family Medicine, Emergency Medicine, and Surgery,
Yukon-Kuskokwim Delta Regional Hospital, Bethel, AK.
(3)Department of Family Medicine, Mayo Clinic, Rochester, MN.
(4)Department of Biology, Emory University, Atlanta, GA.
(5)Department of Family Medicine, College of Medicine, Mayo Clinic, Rochester,
MN.
BACKGROUND AND OBJECTIVES: Demographic trends show an increasing older adult
population. Therefore, family medicine training programs may need to reevaluate
how well their residents perform clinic procedures essential to older adults. Our
objective was to compare the rates of the most frequently performed clinic
procedures for Medicare patients in a large multiregional health care system
(MRHCS) with those in a family medicine residency clinic.
METHODS: In this retrospective cohort study, Current Procedural Terminology
coding data were queried from the billing systems of an MRHCS (the control group)
and a family medicine residency clinic (the study group) for a 3-year period. The
primary outcome was the procedural rate ratios per 1,000 office visits for the 10
most common clinic procedures in the MRHCS billed to Medicare.
RESULTS: The study group consisted of 19,099 office visits by Medicare patients
to the residency clinic; the control group consisted of 2,034,188 visits to the
MRHCS. Except for large joint injection, procedural rates were significantly
different for the other nine procedures (destruction of benign skin lesions, nail
care, punch or shave skin biopsy, removal of impacted cerumen, wound debridement
of skin, Unna boot application, excision of skin lesion, paring of corn or
callus, and insertion of bladder catheter). The rate of skin excision was higher
in the residency clinic than in the MRHCS but lower for the other eight
procedures.
CONCLUSIONS: These data suggest that teaching programs may need to adapt to meet
the current and future practice needs of this increasing patient population.
DOI: 10.22454/FamMed.2019.659478
PMID: 31125421
