Medicine and Health Sciences Commons^™

Allyship For The Rural Health Care Workforce, Nancy D. Spector, Barbara Overholser

Marshall Journal of Medicine

The COVID-19 pandemic revealed a lot about the American impressive yet fragile and overtaxed health care system. Our support systems – both institutional and human- were taxed. Building our network through a variety of methods can help to strengthen our support system while also helping to dismantle the structural inequities that have negative consequences for our workforce and for patient care. Seeking allies in medicine has become an integral component of building one’s network and becoming an ally for those communities that are isolated or under resourced and for those who are underrepresented in medicine has become an important way …

Utility And Yield Of Genetic Testing Leading To A Definitive Neuromuscular Or Neuropathic Diagnosis At A Rural Outpatient Neurology Clinic Affiliated With A University Health Center In West Virginia Over 4 Years., Holly Farkosh, Dominika Lozowska

Marshall Journal of Medicine

Introduction

Clinicians are increasingly relying on genetic testing to pinpoint definite diagnoses. A more general diagnosis of neuropathy or neuromuscular disease like myopathy can be narrowed down substantially using genetic testing. Because carrier status is of utmost importance in reproductive matters, pathogenic results can prognosticate the future course of the illness and help plan ahead for treatment and social supports. Given the expense of genetic testing, it is important to assess the cost-benefit ratio to determine whether it is worthwhile to collect genetic samples. The purpose of the study was to determine the likelihood of obtaining a conclusive confirmatory diagnosis …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Reflections On West Virginia's Early Covid-19 Experience, Stephen M. Petrany, Deb Koester, Robert Walker

Marshall Journal of Medicine

No abstract provided.

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia, Jordan Elliott Miller, Chris Haddox

Marshall Journal of Medicine

The purpose of this research is to better understand the physical and environmental features of outpatient healthcare facilities that act as barriers to healthcare access in rural West Virginia and factors that contribute to non-compliance with the ADA. The research aims to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like year of construction and original purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using the Outpatient Health Care Usability Profile to measure essential features for a facility to be considered ‘usable’. …

Availability Of Long Acting Reversible Contraceptives For Adolescents In Urban Vs Rural West Virginia Counties, Brooke Andrews, Cameron Ross, Jennie L. Yoost

Marshall Journal of Medicine

The study objective was to evaluate long acting reversible contraceptive (LARC) method availability and access for adolescents in rural and urban counties in West Virginia (WV). A cross-sectional survey of Title X family planning providers throughout WV was conducted from January 2016-July 2017. This survey was sent to 226 family planning providers in WV to assess patterns of LARC availability. The survey assessed provider training level, LARC services provided and frequency, clinical practice, referral patterns, and comfort level providing adolescent LARC services. Survey results were analyzed by providers’ rural vs urban status, based on US census county codes. Survey responses …

Perceptions Of Specialties And Primary Care Careers: Findings From West Virginia Medical Student And Resident Focus Groups, April L. Vestal, Laura Boone, Robert Walker, A. Brianna Sheppard, Dakota Morris, Ashley J. Noland

Marshall Journal of Medicine

The purpose of this study was to improve the understanding of how perceptions of practicing specific medical specialties contribute to career decisions. Participants included medical students and residents from training programs in West Virginia. Focus groups were conducted between September 2013 and February 2015. Thematic content analysis of focus group interviews was used to identify phrases indicating perceptions of person- versus technique-oriented personality medical specialties.

“Self-focused” and “other-focused” themes emerged within person-oriented comments. Factors affecting “self”, including work/life balance and salary and practice environment, made certain specialties more appealing. Technique-oriented comments included working in a hospital setting, performing technical procedures, …

A Chart Review Of Acute Care Inter-Hospital Transfers From Rural Wv Hospitals, Dilip Nair, Freddie Vaughan, Katherine Bennett

Marshall Journal of Medicine

Abstract

Objective: To document the characteristics of acute care patient transfers from rural West Virginia hospitals.

Data Sources/Study Setting: Hospital patient charts in rural West Virginia hospitals

Design: We examined 40 acute care patient transfers from rural West Virginia hospitals for patients’ age, gender, race and primary health insurance, the diagnosis and desired specialty service. We compared patients who were not transferred. For each transfer we collected data on the reason for transfer, the availability of beds of the appropriate acuity level as well as the availability of the relevant specialty at the time of transfer.

Principal Findings: Transferred patients …

Generational Differences In Practice Site Selection Criteria Amongst Primary Care Physicians., Christopher Duffrin Phd, Mches, Molly Cashion Mph, Doyle M. Cummings Pharmd, Lauren Whetstone Phd, Jonathon Firnhaber Md, Gary Levine Md, Ricky Watson Md, Msph, Aaron Lambert Md

Marshall Journal of Medicine

ABSTRACT

Background and Objectives: Generational differences are often viewed as shaping the overall attitudes and actions of different age cohorts. It is essential to understand the motivations and generational differences in primary care physicians for efforts to recruit, retain, and educate the future physician workforce. Determining what factors most influence different generations of primary care physicians when choosing a practice site is essential to build our future primary care system. This study examined generational differences in the factors that attracted primary care physicians to their current practice.

Methods: A survey instrument was mailed to all active members of the North …

Keeping Rural Medical Students Connected To Their Roots: A “Home For The Holidays” Immersion Experience, William J. Crump Md, R. Steve Fricker Mpa

Marshall Journal of Medicine

Keeping Rural Medical Students Connected to their Roots: A “Home for the Holidays” Immersion Experience

Abstract

Introduction

Preclinical medical students with an initial affinity for rural practice often experience urban disruption during training. Longer summer rural immersion experiences have been shown to be somewhat effective in keeping rural students connected to their rural roots. Some students cannot adapt their schedules to these longer experiences. In response, a brief practice experience near home during the winter break of the academic year was established.

Methods

Nineteen detailed rural practice assessments were completed by preclinical medical students during school years 2009-2014 and essays …

Velamentous Cord: A Dangerous Case Complicated By A Rural Population, Adam Franks, Md, Carolyn Curtis, Md, Shawndra Barker, Md

Marshall Journal of Medicine

A velamentous cord insertion occurs when the umbilical cord’s Wharton jelly fails to reach the placenta, due to early placental atrophy around the insertion site, leaving a segment of unprotected vessels running through the thin membranes of the amniotic sac. This area of weakness exposes a threat to the well-being of the fetus through acute hemorrhage and both acute and chronic restriction of nutrition. With advances in technology, resolution capabilities of ultrasounds allow for antenatal diagnosis, when previously this was impossible. With this knowledge, considerations for screening and management of this pathology are essential when dealing with a rural population …