Background-Little is known about patient preference regarding the physical exam in nonurgent primary care settings.Objective-To determine the differences between a patient's expectations of the physical exam and the actual components of the physical examination performed during a non-urgent visit.Design-452 surveys administered in the waiting room of a VA primary care clinic in West Haven, CT.Key Results-The response rate was 91.6% (n = 414). For 15 of 16 maneuvers on the survey, more respondents believed a reasonable provider should conduct it than received it at their annual physical exam; for 7 of them (breast, axillary, rectal, pelvic, total body skin exam, electrocardiogram, and stress test), over twice as many respondents believed they should be done than received them. There was an association between a patient's perception of their primary care provider and the number of maneuvers recalled at their annual exam (P <0.001), and a gap in the number of maneuvers expected from a reasonable provider by non-white and white patients (P <0.001).Limitations-Convenience sample, response bias (healthy patients are more likely to respond) and recall bias.Conclusion-Patient perception of their primary care provider is strongly associated with the number of maneuvers recalled during an annual physical. Furthermore, the number of maneuvers expected by a patient is influenced by race, with non-white patients desiring more. This suggests the need for further research on the role of race in expectations of healthcare providers.
A 6-month-old girl presented with an irregular nodule on the right lateral neck. The lesion, which superficially resembled a lymphangioma or mastocytoma, had been present since birth but had recently been growing. The patient was referred for surgical resection. Microscopic findings were compatible with a recently described rare hamartoma termed "panfollicular nevus," which is a well-circumscribed lesion containing aberrantly differentiated, clustered hair follicles in high density.
This paper summarized the basic concepts and key technical components of Metaverse, explored its application and technical maturity, and by analyzing the impact of multiple variables on Metaverse digital economy, put forward a composite model of multivariable linear and coupling overlay to evaluate the level of development of digital economy, and conducted numerical calculation and analysis, which is of great significance to the study of digital economy in the context of the Metaverse. The direction and suggestions for further research are also put forward.
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