Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Abstracts In Press
    • Archives
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Abstracts In Press
    • Archives
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • The Editing Fellowship
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM on Bluesky
  • JABFM On Facebook
  • JABFM On Twitter
  • JABFM On YouTube
Review ArticleClinical Review

A Narrative Review of Slow Medicine Outcomes

Rani Marx and James G. Kahn
The Journal of the American Board of Family Medicine November 2021, 34 (6) 1249-1264; DOI: https://doi.org/10.3122/jabfm.2021.06.210137
Rani Marx
From Initiative for Slow Medicine, Berkeley, CA (RM, JGK); Institute for Health Policy Studies, University of California, San Francisco (JGK).
PhD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James G. Kahn
From Initiative for Slow Medicine, Berkeley, CA (RM, JGK); Institute for Health Policy Studies, University of California, San Francisco (JGK).
MD, MPH
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • References
  • Info & Metrics
  • PDF
Loading

Appendix References

  1. 1.↵
    1. Osborn R,
    2. Moulds D,
    3. Schneider EC,
    4. Doty MM,
    5. Squires D,
    6. Sarnak DO
    . Primary care physicians in ten countries report challenges caring for patients with complex health needs. Health Aff (Millwood) 2015;34:2104–12. Available from: https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.1018?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed. Accessed April 28, 2021.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    Robert Wood Johnson Foundation. 2011 physicians' daily life report. November 15, 2011. Available from: https://www.issuelab.org/resources/12550/12550.pdf. Accessed January 7, 2021.
  3. 3.↵
    Regina Corso Consulting. 2017 patient survey report for the Physicians Foundation. June 2017. Available from: https://physiciansfoundation.org/wp-content/uploads/2017/12/Physicians_Foundation_2017_Patient_Survey_Report.pdf. Accessed January 11, 2021.
  4. 4.↵
    Merritt Hawkins. 2016 survey of America's physicians: practice patterns and perspectives. The Physicians Foundation; September 2016. Available from: https://physiciansfoundation.org/wp-content/uploads/2017/12/Biennial_Physician_Survey_2016.pdf. Accessed January 11, 2021.
  5. 5.↵
    1. Downing NL,
    2. Bates DW,
    3. Longhurst CA
    . Physician burnout in the electronic health record era: are we ignoring the real cause? Ann Intern Med 2018;169:50–1. Available from: https://annals.org/aim/article-abstract/2680726/physician-burnout-electronic-health-record-era-we-ignoring-real-cause. Accessed January 7, 2021.
    OpenUrlAbstract
  6. 6.↵
    1. Hunt LM,
    2. Bell HS,
    3. Baker AM,
    4. Howard HA
    . Electronic health records and the disappearing patient. Med Anthropol Q 2017;31:403–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104392/. Accessed February 1, 2021.
    OpenUrlCrossRefPubMedWeb of Science
  7. 7.↵
    1. Irving G,
    2. Neves AL,
    3. Dambha-Miller H,
    4. et al
    . International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open 2017;7:e017902. Available from: https://bmjopen.bmj.com/content/bmjopen/7/10/e017902.full.pdf?with-ds=yes. Accessed January 28, 2021.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Marx R,
    2. Kahn JG
    . Increased U.S. primary care consultation duration due to EHR burden? BMJ Open; June 1, 2018; comment on Irving et al. Available from: https://bmjopen.bmj.com/content/7/10/e017902.responses. Accessed January 11, 2021.
  9. 9.↵
    1. Tai-Seale M,
    2. Olson CW,
    3. Li J,
    4. et al
    . Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine. Health Aff (Millwood) 2017;36:655–62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546411/. Accessed February 9, 2021.
    OpenUrl
  10. 10.↵
    1. Arndt BG,
    2. Beasley JW,
    3. Watkinson MD,
    4. et al
    . Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med 2017;15:419–26. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593724/. Accessed January 6, 2021.
    OpenUrlFREE Full Text
  11. 11.↵
    1. Sinsky C,
    2. Colligan L,
    3. Li L,
    4. et al
    . Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med 2016;165:753–60. Available from: https://www.acpjournals.org/doi/10.7326/M16-0961?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed. Accessed January 6, 2021.
  12. 12.↵
    Merritt Hawkins. 2018 survey of America's physicians: practice patterns and perspectives; an examination of the professional morale, practice patterns, career plans, and perspectives of today's physicians, aggregated by age, gender, primary care/specialists and practice owners/employees. The Physicians Foundation; September 2018. Available from: https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf. Accessed February 1, 2021.
  13. 13.↵
    1. Street RL Jr.,
    2. Liu L,
    3. Farber NJ,
    4. et al
    . Keystrokes, mouse clicks, and gazing at the computer: how physician interaction with the EHR affects patient participation. J Gen Intern Med 2018;33:423–8. Available from: https://link.springer.com/article/10.1007/s11606-017-4228-2. Accessed Februrary 2, 2021.
  14. 14.↵
    1. Bodenheimer T
    . Primary care—will it survive? N Engl J Med 2006;355:861–4. Available from: https://www.nejm.org/doi/10.1056/NEJMp068155. Accessed January 11, 2021.
  15. 15.↵
    AAMC 2018. The complexities of physician supply and demand: projections from 2018 to 2033; June 2020. Available from: https://www.aamc.org/media/45976/download. Accessed January 11, 2021.
  16. 16.↵
    1. Sinsky CA,
    2. Dyrbye LN,
    3. West CP,
    4. Satele D,
    5. Tutty M,
    6. Shanafelt TD
    . Professional satisfaction and the career plans of US physicians. Mayo Clin Proc 2017;92:1625–35. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(17)30637-7/fulltext. Accessed January 11, 2021.
  17. 17.↵
    1. Zallman L,
    2. Finnegan K,
    3. Roll D,
    4. Todaro M,
    5. Oneiz R,
    6. Sayah A
    . Impact of medical scribes in primary care on productivity, face-to-face time, and patient comfort. J Am Board Fam Med 2018;31:612–9. Available from: https://www.jabfm.org/content/31/4/612.long. Accessed February 8, 2021.
    OpenUrlAbstract/FREE Full Text
  18. 18.↵
    1. Ghorob A,
    2. Bodenheimer T
    . Share the Care™: building teams in primary care practices. J Am Board Fam Med 2012;25:143–5. Available from: https://www.jabfm.org/content/25/2/143.long. Accessed January 12, 2021.
    OpenUrl
  19. 19.↵
    1. Sinsky CA,
    2. Willard-Grace R,
    3. Schutzbank AM,
    4. Sinsky TA,
    5. Margolius D,
    6. Bodenheimer T
    . In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med 2013;11:272–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659145/. Accessed January 12, 2021.
  20. 20.↵
    1. Sinsky CA,
    2. Bodenheimer T
    . Powering-up primary care teams: advanced team care with in-room support. Ann Fam Med 2019;17:367–71. Available from: https://www.annfammed.org/content/17/4/367. Accessed January 12, 2021.
    OpenUrlCrossRefPubMed
  21. 21.↵
    Hochmann and Cohen's Slow Medicine blog. Available from: https://centerforhealthjournalism.org/blog-category/slow-medicine. Accessed February 15, 2021.
  22. 22.↵
    1. Wolfson D,
    2. Santa J,
    3. Slass L
    . Engaging physicians and consumers in conversations about treatment overuse and waste: a short history of the Choosing Wisely campaign. Acad Med 2014;89:990–5. Available from: https://journals.lww.com/academicmedicine/Fulltext/2014/07000/Engaging_Physicians_and_Consumers_in_Conversations.17.aspx. Accessed January 12, 2021.
    OpenUrlCrossRefPubMed
  23. 23.↵
    1. Welch HG,
    2. Schwartz LM,
    3. Woloshin S
    . Overdiagnosed: making people sick in the pursuit of health. Boston (MA): Beacon Press, 2012.
  24. 24.↵
    1. Welch HG
    . Less medicine, more health; 7 assumptions that drive too much medical care. Boston (MA): Beacon Press, 2015.
  25. 25.↵
    1. Brownlee S
    . Overtreated—why too much Medicine is making us sicker and poorer. New York: Bloomsbury, 2007.
  26. 26.↵
    1. Gawande A
    . Overkill. New Yorker. May 4, 2015. Available from: https://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande. Accessed January 8, 2021.
  27. 27.↵
    1. Kleinert S,
    2. Horton R
    . From universal health coverage to right care for health. Lancet 2017;390:101–2. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32588-0/fulltext. Accessed February 9, 2021.
    OpenUrlAbstract/FREE Full Text
  28. 28.↵
    1. Zaharias G
    . What is narrative-based medicine? Narrative-based medicine 1. Can Fam Physician 2018;64:176–80. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851389/. Accessed January 12, 2021.
    OpenUrlAbstract/FREE Full Text
  29. 29.↵
    1. Halpern J
    . From detached concern to empathy: humanizing medical practice. New York: Oxford University Press 2001.
  30. 30.↵
    1. Leppin AL,
    2. Montori VM,
    3. Gionfriddo MR
    . Minimally disruptive medicine: a pragmatically comprehensive model for delivering care to patients with multiple chronic conditions. Healthcare (Basel) 2015;3:50–63. Available from: https://www.mdpi.com/2227-9032/3/1/50/htm. Accessed January 12, 2021.
    OpenUrl
  31. 31.↵
    1. Wen LS,
    2. Kosowsky JM
    . When doctors don't listen: how to avoid misdiagnoses and unnecessary tests. New York: Thomas Dunne Books/St. Martin's Press, 2013.
  32. 32.
    1. Montori V
    . Why we revolt: a patient revolution for careful and kind care. Rochester, MN: Mayo Clinic Press, 2020.
  33. 33.
    1. Zulman DM,
    2. Haverfield MC,
    3. Shaw JG,
    4. et al
    . Practices to foster physician presence and connection with patients in the clinical encounter. JAMA 2020;323:70–81. Available from: https://jamanetwork.com/journals/jama/article-abstract/2758456?guestAccessKey=391616d7-b6ad-4648-a08d-4381e92868a8&utm_source=For_The_Media. Accessed January 12, 2021.
    OpenUrlAbstract/FREE Full Text
  34. 34.
    1. Costanzo C,
    2. Verghese A
    . The physical examination as ritual: social sciences and embodiment in the context of the physical examination. Med Clin North Am 2018;102:425–31. PMID: 29650064. Available from: https://pubmed.ncbi.nlm.nih.gov/29650064/. Accessed February 2, 2021.
    OpenUrl
  35. 35.
    1. Verghese A
    . The importance of being. Health Aff (Millwood) 2016;35:1924–7.Oct 1. Available from: https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0837?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed. Accessed February 2, 2021.
    OpenUrlAbstract/FREE Full Text
  36. 36.
    1. Shanafelt TD,
    2. Dyrbye LN,
    3. West CP
    . Addressing physician burnout: the way forward. JAMA 2017;317:901–2. Available from: https://jamanetwork.com/journals/jama/article-abstract/2603408. Accessed February 9, 2021.
  37. 37.
    1. Panagioti M,
    2. Panagopoulou E,
    3. Bower P,
    4. et al
    . Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med 2017;177:195–205. Available from: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2588814. Accessed February 9, 2021.
  38. 38.
    1. Sweet V
    . God's hotel: a doctor, a hospital and a pilgrimage to the heart of medicine. New York: Riverhead Books, 2012.
  39. 39.
    1. Lown B
    . The lost art of healing: practicing compassion in medicine. New York: Houghton Mifflin, 1996.
  40. 40.
    1. Sweet V
    . Slow medicine: the way to healing. New York: Riverhead Books, 2017.
  41. 41.
    1. McCullough D
    . My mother, your mother: embracing “slow medicine,” the compassionate approach to caring for your aging loved ones. New York: HarperCollins, 2008.
  42. 42.
    1. Butler KA
    . Knocking on heaven's door: the path to a better way of death. New York: Scribner, 2013.
  43. 43.
    1. Aronson LE
    . Redefining aging, transforming medicine, reimagining life. New York: Bloomsbury Publishing, 2019.
  44. 44.
    1. Gawande A
    . Being mortal: medicine and what matters in the end. New York: Metropolitan Books, 2014.
  45. 45.
    1. Meltzer D,
    2. Cursio J,
    3. Flores A,
    4. et al
    . Effects of a comprehensive care physician (ccp) program on patient satisfaction, health status, and hospital admissions in Medicare patients at increased risk of hospitalization: initial findings of a randomized trial. Abstract. Academy Health Annual Research Meeting. June 24-26, 2018. Seattle, WA. Available from: https://academyhealth.confex.com/academyhealth/2018arm/meetingapp.cgi/Paper/23609. Accessed January 18, 2021.
  46. 46.
    1. Edwards ST,
    2. Peterson K,
    3. Chan B,
    4. Anderson J,
    5. Helfand M
    . Effectiveness of intensive primary care interventions: a systematic review. J Gen Intern Med 2017;32:1377–86. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698228/. Accessed January 18, 2021.
    OpenUrlCrossRefPubMedWeb of Science
  47. 47.
    1. Chase D
    . On retainer: direct primary care practices bypass insurance. California HealthCare Foundation; April 2013. Available from: https://www.chcf.org/wp-content/uploads/2017/12/PDF-OnRetainerDirectPrimaryCare.pdf. Accessed January 20, 2021.
  48. 48.
    1. Huff C
    . Direct primary care: concierge care for the masses. Health Aff (Millwood) 2015;34:2016–9. Available from: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1281. Accessed January 22, 2021.
  49. 49.
    1. Rowe K,
    2. Rowe W,
    3. Umbehr J,
    4. Dong F,
    5. Ablah E
    . Direct primary care in 2015: a survey with selected comparisons to 2005 survey data. Kans J Med 2017;10:3–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733409/. Accessed January 20, 2021.
  50. 50.
    DPC Frontier. Available from: https://mapper.dpcfrontier.com/. Accessed January 20, 2021.
  51. 51.
    1. Eskew PM,
    2. Klink K
    . Direct primary care: practice distribution and cost across the nation. J Am Board Fam Med 2015;28:793–801. Available from: https://www.jabfm.org/content/28/6/793.long. Accessed January 20, 2021.
  52. 52.
    1. Edwards A
    . Direct primary care: a snapshot. American Academy of Family Physicians Foundation; August 20, 2019. Available from: https://www.aafp.org/news/blogs/freshperspectives/entry/20190820fp-dpcsnapshot.html. Accessed January 20, 2021.
  53. 53.
    1. Eskew P
    . In defense of direct primary care. Fam Pract Manag 2016;23:12–4. Available from: https://www.aafp.org/fpm/2016/0900/p12.html. Accessed January 20, 2021.
    OpenUrlCrossRefPubMed
  54. 54.
    1. Al-Agba N
    . Is the direct primary care model dead? The Health Care Blog; June 16, 2016. Available from: http://thehealthcareblog.com/blog/2017/06/06/is-the-direct-primary-care-model-dead/. Accessed January 20, 2021.
  55. 55.
    1. Krivic RS
    . Is the DPC movement at risk of failing? Medical Economics May 21, 2017. Available from: https://www.medicaleconomics.com/view/dpc-movement-risk-failing. Accessed January 20, 2021.
  56. 56.
    1. Pflanzer LR
    . A new kind of doctor's office that doesn't take insurance and charges a monthly fee is “popping up everywhere”—and that could change how we think about healthcare. Business Insider March 19, 2017. Available from: https://www.businessinsider.com/direct-primary-care-a-no-insurance-healthcare-model-2017-3. Accessed January 20, 2021.
  57. 57.
    1. Irving G,
    2. Neves AL,
    3. Dambha-Miller H,
    4. et al
    . International variations in primary care physician consultation time: a systematic review of 67 countries. BMJ Open 2017;7:e017902. Available from: http://bmjopen.bmj.com/content/7/10/e017902.long. Accessed January 11, 2021.
    OpenUrl
  58. 58.
    1. Wilson AD,
    2. Childs S,
    3. Gonçalves-Bradley DC,
    4. Irving GJ
    , Cochrane Effective Practice and Organisation of Care Group. Interventions to increase or decrease the length of primary care physicians' consultation. Cochrane Database Syst Rev 2016;8:CD003540. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003540.pub3/epdf/full. Accessed 29 January 2021.
  59. 59.
    1. Wilson A,
    2. Childs S
    . The effect of interventions to alter the consultation length of family physicians: a systematic review. Br J Gen Pract 2006;56:876–82. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1927097/. Accessed January 28, 2021.
    OpenUrlAbstract/FREE Full Text
  60. 60.
    1. Wilson A,
    2. Childs S
    . The relationship between consultation length, process and outcomes in general practice: a systematic review. Br J Gen Pract 2002;52:1012–20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1314474/pdf/12528590.pdf. Accessed January 28, 2021.
    OpenUrl
  61. 61.
    1. Morrell DC,
    2. Evans ME,
    3. Morris RW,
    4. Roland MO
    . The “five minute” consultation: effect of time constraint on clinical content and patient satisfaction. Br Med J (Clin Res Ed) 1986;292:870–3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1339979/pdf/bmjcred00227-0028.pdf. Accessed January 28, 2021.
    OpenUrlPubMed
  62. 62.
    1. Ridsdale L,
    2. Carruthers M,
    3. Morris R,
    4. Ridsdale J
    . Study of the effect of time availability on the consultation. J R Coll Gen Pract 1989;39:488–91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1712205/. Accessed January 28, 2021.
    OpenUrlPubMed
  63. 63.
    1. Thomas KB
    . Time and the consultation in general practice. Br Med J 1978;2:1000. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1607875/. Accessed January 28, 2021.
  64. 64.
    1. Wilson A,
    2. McDonald P,
    3. Hayes L,
    4. Cooney J
    . Health promotion in the general practice consultation: a minute makes a difference. BMJ 1992;304:227–30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1881485/pdf/bmj00057-0037.pdf. Accessed January 28, 2021.
    OpenUrl
  65. 65.
    1. Campbell SM,
    2. Hann M,
    3. Hacker J,
    4. et al
    . Identifying predictors of high quality care in English general practice: observational study. BMJ 2001;323:784–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC57358/. Accessed January 28, 2021.
  66. 66.
    1. Howie JG,
    2. Porter AM,
    3. Heaney DJ,
    4. Hopton JL
    . Long to short consultation ratio: a proxy measure of quality of care for general practice. Br J Gen Pract 1991;41:48–54. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371550/pdf/brjgenprac00071-0006.pdf. Accessed January 28, 2021.
  67. 67.
    1. Hughes D
    . Consultation length and outcome in two group general practices. J R Coll Gen Pract 1983;33:143–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1972718/pdf/jroyalcgprac00075-0017.pdf. Accessed January 28, 2021.
  68. 68.
    1. Davidson W,
    2. Molloy DW,
    3. Somers G,
    4. Bédard M
    . Relation between physician characteristics and prescribing for elderly people in New Brunswick. CMAJ 1994;150:917–21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1486694/pdf/cmaj00286-0113.pdf. Accessed January 28, 2021.
    OpenUrlAbstract/FREE Full Text
  69. 69.
    1. Tamblyn R,
    2. Berkson L,
    3. Dauphinee WD,
    4. et al
    . Unnecessary prescribing of NSAIDs and the management of NSAID-related gastropathy in medical practice. Ann Intern Med 1997;127:429–38. Available from: https://www.acpjournals.org/doi/10.7326/0003-4819-127-6-199709150-00003?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed. Accessed January 28, 2021.
    OpenUrl
  70. 70.
    1. Mercer SW,
    2. Fitzpatrick B,
    3. Guthrie B,
    4. et al
    . The CARE Plus study—a whole-system intervention to improve quality of life of primary care patients with multimorbidity in areas of high socioeconomic deprivation: exploratory cluster randomised controlled trial and cost-utility analysis. BMC Med 2016;14:88. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916534/. Accessed January 28, 2021.
  71. 71.
    1. Klemes A,
    2. Seligmann RE,
    3. Allen L,
    4. Kubica MA,
    5. Warth K,
    6. Kaminetsky B
    . Personalized preventive care leads to significant reductions in hospital utilization. Am J Manag Care 2012;18:e453–60. Available from: https://www.ajmc.com/view/personalized-preventive-care-leads-to-significant-reductions-in-hospital-utilization. Accessed January 20, 2021.
    OpenUrl
  72. 72.
    1. Musich S,
    2. Wang S,
    3. Hawkins K,
    4. Klemes A
    . The Impact of Personalized Preventive Care on Health Care Quality, Utilization, and Expenditures. Popul Health Manag 2016;19:389–97.Dec. Epub 2016 Feb 12. PMID: 26871762; PMCID: PMC5296930. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/. Accessed January 22, 2021.
    OpenUrl
  73. 73.
    1. Wu WN,
    2. Bliss G,
    3. Bliss EB,
    4. Green LA
    . Practice profile. A direct primary care medical home: the Qliance experience. Health Aff (Millwood) 2010;29:959–62. Available from: https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010.0047?cited-by=yes&;. Accessed January 22, 2021.
    OpenUrl
  74. 74.
    Qliance Medical Group. Online table; 2010. Available from: https://b-i.forbesimg.com/davechase/files/2013/07/DPC-Qliance-reduction-in-downstream-care.jpg. Accessed January 22, 2021.
  75. 75.
    Qliance. New primary care model delivers 20 percent lower overall healthcare costs, increases patient satisfaction and delivers better care; January 15, 2015. Available from: http://www.prnewswire.com/news-releases/new-primary-care-model-delivers-20-percent-lower-overall-healthcare-costs-increases-patient-satisfaction-and-delivers-better-care-300021116.html. Accessed January 22, 2021.
  76. 76.
    1. Govindarajan V,
    2. Ramamurti R
    . Transforming health care from the ground up. Harvard Business Review Magazine July-Aug 2018. Available from: https://hbr.org/2018/07/transforming-health-care-from-the-ground-up. Accessed January 22, 2021.
  77. 77.
    1. Shemkus S
    . Iora Health's promise: patients come first. Boston Globe May 4, 2015. Available from: https://www.bostonglobe.com/business/2015/05/03/iora-health-pioneers-new-primary-care-model/kc7V4W5V8OJ0gxFqY4zBrK/story.html. Accessed January 22, 2021.
  78. 78.
    1. Schiff J
    . Best practices: from the bottom up, Iora Health helps providers build ACO framework. Modern Healthcare June 18, 2016. Available from: https://www.modernhealthcare.com/article/20160618/MAGAZINE/306189997/iora-health-helping-providers-invert-aco-models. Accessed January 22, 2021.
  79. 79.
    1. Brubaker H
    . This Elkins Park Company has a plan to reduce employees' health-care costs. Philadelphia Inquirer January 28, 2019. Available from: https://www.philly.com/business/direct-primary-care-r-health-pareto-captive-philadelphia-new-jersey-20190128.html. Accessed January 22, 2021.
  80. 80.
    1. Tanio C,
    2. Chen C
    . Innovations at Miami practice show promise for treating high-risk Medicare patients. Health Aff (Millwood) 2013;32:1078–82. Available from: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2012.0201. Accessed January 22, 2021.
  81. 81.
    1. Ghany R,
    2. Tamariz L,
    3. Chen G,
    4. et al
    . High-touch care leads to better outcomes and lower costs in a senior population. Am J Manag Care 2018;Sep 124:e300–e304. Available from: https://www.ajmc.com/view/hightouch-care-leads-to-better-outcomes-and-lower-costs-in-a-senior-population. Accessed January 22, 2021.
  82. 82.
    1. Chen C
    . How concierge care for low-income seniors can improve outcomes and reduce costs. Am J Manag Care; September 25, 2017. Available from: https://www.ajmc.com/view/how-concierge-care-for-low-income-seniors-can-improve-outcomes-and-reduce-costs. Accessed April 28, 2021.
  83. 83.
    1. Phillips RL Jr.,
    2. Bronnikov S,
    3. Petterson S,
    4. et al
    . Case study of a primary care-based accountable care system approach to medical home transformation. J Ambul Care Manage 2011;34:67–77. Available from: https://journals.lww.com/ambulatorycaremanagement/Abstract/2011/01000/Case_Study_of_a_Primary_Care_Based_Accountable.9.aspx. Accessed January 22, 2021.
    OpenUrlAbstract/FREE Full Text
  84. 84.
    Institute for Healthcare Improvement. Signature Healthcare: a triple aim improvement story. Cambridge, MA: Institute for Healthcare Improvement; October 2015. Available from: http://www.ihi.org/resources/Pages/Publications/SignatureHealthcareTripleAim.aspx. Accessed January 22, 2021.
  85. 85.
    1. Whittington JW,
    2. Nolan K,
    3. Lewis N,
    4. Torres T
    . Pursuing the triple aim: the first 7 years. Milbank Q 2015;93:263–300. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462878/. Accessed January 22, 2021.
  86. 86.
    1. Hulka BS,
    2. Romm FJ,
    3. Parkerson GR Jr.,
    4. Russell IT,
    5. Clapp NE,
    6. Johnson FS
    . Peer review in ambulatory care: use of explicit criteria and implicit judgments. Med Care 1979;17:1–73. Available from: https://www.ncbi.nlm.nih.gov/pubmed/763009. Accessed January 28, 2021.
    OpenUrlCrossRefPubMed
  87. 87.
    1. Hartzema AG,
    2. Christensen DB
    . Nonmedical factors associated with the prescribing volume among family practitioners in an HMO. Med Care 1983;21:990–1000. Available from: https://journals.lww.com/lww-medicalcare/Abstract/1983/10000/Nonmedical_Factors_Associated_With_the_Prescribing.5.aspx. Accessed January 28, 2021.
  88. 88.
    1. Camasso MJ,
    2. Camasso AE
    . Practitioner productivity and the product content of medical care in publicly supported health centers. Soc Sci Med 1994;38:733–48. Available from: https://www.sciencedirect.com/science/article/abs/pii/0277953694904642. Accessed January 28, 2021.
    OpenUrlCrossRefPubMed
  89. 89.
    1. Dugdale DC,
    2. Epstein R,
    3. Pantilat SZ
    . Time and the patient-physician relationship. J Gen Intern Med 1999;14:S34–40. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1496869/. Accessed January 28, 2021.
    OpenUrlCrossRefPubMedWeb of Science
  90. 90.
    1. Wilson A
    . Consultation length in general practice: a review. Br J Gen Pract 1991;41:119–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1371626/. Accessed January 28, 2021.
    OpenUrlPubMedWeb of Science
  91. 91.
    1. Deveugele M,
    2. Derese A,
    3. van den Brink-Muinen A,
    4. Bensing J,
    5. De Maeseneer J
    . Consultation length in general practice: cross sectional study in six European countries. BMJ 2002;325:472. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC119444/. Accessed February 4, 2021.
    OpenUrlCrossRefPubMedWeb of Science
  92. 92.
    1. Konrad TR,
    2. Link CL,
    3. Shackelton RJ,
    4. et al
    . It's about time: physicians' perceptions of time constraints in primary care medical practice in three national healthcare systems. Med Care 2010;48:95–100. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621071/pdf/nihms454710.pdf. Accessed January 28, 2021.
    OpenUrlPubMed
  93. 93.
    1. Sinsky CA,
    2. Privitera MR
    . Creating a “manageable cockpit” for clinicians: a shared responsibility. JAMA Intern Med 2018;178:741–2. Available from: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2674872. Accessed January 28, 2021.
    OpenUrlAbstract/FREE Full Text
  94. 94.
    1. Ashton M
    . Getting rid of stupid stuff. N Engl J Med 2018;379:1789–91. Available from: https://www.nejm.org/doi/full/10.1056/NEJMp1809698. Accessed January 28, 2021.
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family   Medicine: 34 (6)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 6
November/December 2021
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
A Narrative Review of Slow Medicine Outcomes
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 1 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
A Narrative Review of Slow Medicine Outcomes
Rani Marx, James G. Kahn
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1249-1264; DOI: 10.3122/jabfm.2021.06.210137

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
A Narrative Review of Slow Medicine Outcomes
Rani Marx, James G. Kahn
The Journal of the American Board of Family Medicine Nov 2021, 34 (6) 1249-1264; DOI: 10.3122/jabfm.2021.06.210137
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Background
    • Methods
    • Results
    • Discussion
    • Limitations
    • Conclusions
    • Appendix
    • Notes
    • References
  • Figures & Data
  • References
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Does the duration of ambulatory consultations affect the quality of healthcare? A systematic review
  • Research on the Issues Family Physicians Face Today: Controlled Substances, COVID-19, Hypertension, and "Slow Medicine," Among Many More Topics
  • Google Scholar

More in this TOC Section

  • Interpretating Normal Values and Reference Ranges for Laboratory Tests
  • Non-Surgical Management of Urinary Incontinence
  • Screening and Diagnosis of Type 2 Diabetes in Sickle Cell Disease
Show more Clinical Review

Similar Articles

Keywords

  • Consultation
  • Narrative Review
  • Physician–Patient Relations
  • Primary Health Care
  • Slow Medicine

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2025 American Board of Family Medicine

Powered by HighWire