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Departments of Family Medicine (DFMs) in the United States consistently received around 0.2% of total research funding dollars and 0.3% of all awards awarded by the National Institutes of Health (NIH) across the years 2002 to 2014. We used the NIH Reporter tool to quantify the amount of funding and the number of grants received by DFMs from the NIH from 2002 to 2014, using criteria similar to those applied by previous researchers. NIH funding to DFMs as remained fairly consistent across the time period, at roughly 0.2% of total NIH funding and 0.3% of total grants awarded. Changing these proportions will likely require considerable effort to build research capacity within DFMs and their frontline practice research networks, and to shift policymaker and funder perceptions of the value of the FM research enterprise.

Introduction: US primary care physicians and their office staff have experienced large increases in time-consuming requirements for prior authorization (PA) of tests, medications, and other clinical services in recent years. This report presents results of 2 similar studies in which physicians and office staff self observed and reported the amount of time spent on PA activities. Methods: Physicians and office staff from 12 primary care offices in northeastern United States recorded request type, reporter role, and time spent for each PA event at the time of the PA activity. Costs were estimated using salary data from the US Bureau of Labor Statistics (study 1) and from Salary.com (study 2). Time and costs were estimated for the practices in each study. Results: The mean annual projected cost per full-time equivalent physician for PA activities ranged from $2,161 (study 1) to $3,430 (study 2). Using self-reporting at the time of the event, we found that preauthorization is a measurable burden on physician and staff time. Conclusions: Further studies that include cost-benefit analyses, estimates of opportunity costs and costs of delayed testing and treatment, as well as the “hassle factor” for patients and physicians, are warranted.

Physicians who work in challenging contexts such as remote rural locations or with special populations may need support in persevering in their positions and also may suffer vicarious trauma through their work. Academic health centers may be in a position to provide much needed support to these physicians through focused continuing medical education, faculty development, practice-based research networks, and other means.

Purpose: In a number of small studies focused on one or two sports, exercise and competitive level has been observed to favor attainment of higher bone mineral density (BMD) in otherwise healthy athletes. We analyzed merged data from 10 studies to determine the effects of competitive level on upper extremity BMD in female athletes across multiple sports. Methods: This study is a meta-analysis of 10 articles reporting results of similar case-control and cross-sectional studies of BMD in female athletes and nonathletes reporting an effect of athletic participation level. Upper extremity BMD was modeled as an outcome of the level of athleticism using a categorical weighted least squares model and controlling for upper-body impact, age, and body mass index. Results: Upper extremity BMD significantly increased for each level of participation ( 0.140; 95% CI, 0.047‐0.234), Age and body mass index approached significance but the level of upper extremity impact was not significant in the final model. Conclusions: Clinicians may see iteratively greater BMD in female patients who compete at increasingly intense athletic levels, with elite athletes having much higher BMD than other patients who are either active or not. Further research is needed to identify direction and causality of the relationship between competitive level and BMD. (J Am Board Fam Med 2011;24:728‐734.)