Guy Runkle - Academia.edu (original) (raw)

Papers by Guy Runkle

Military Medicine, 2005

Physicians need practical ways to maintain and augment clinical skills after residency training. ... more Physicians need practical ways to maintain and augment clinical skills after residency training. The problem is amplified when a physician encounters a new practice environment that requires retraining in particular skills. With their broad scope of practice, family physicians are especially prone to deterioration of infrequently used skills. The SAGE model for lifelong learning provides a simple solution for today's military family physicians. Scan, assess, gather, and experience are four key steps physicians should take when maintaining or upgrading clinical skills. This approach allows physicians to identify available resources and to develop action plans to improve skills. Supervisors must encourage physicians to be honest in selfassessment of patient care skills and should support the acquisition of improved skills. System-based solutions, in keeping with suggestions from the Institute of Medicine, are introduced.

The Journal of the American Board of Family Medicine, 2008

Background: Hypertension is a common condition, but little is known about its prevalence in the A... more Background: Hypertension is a common condition, but little is known about its prevalence in the Armed Forces. Our purpose was to provide an estimate of the prevalence of hypertension in a large population of US service members. Methods: We reviewed the screening records for service members who completed health risk assessments at Fort Lewis in Tacoma, WA, in 2004. The prevalence of hypertension and prehypertension were estimated from single recorded blood pressure readings and subjects' reported use of blood pressure medications. Study subject characteristics associated with hypertension and prehypertension were examined by 2 tests and multivariate logistic regression. Results: Thirteen percent of the 15,391 subjects met the study definition for hypertension; 62% met the study definition for prehypertension. Increasing age and body mass index, male sex, black race/ ethnicity, and senior rank were associated with hypertension; only body mass index, male sex, and senior rank were associated with prehypertension. Conclusion: Hypertension and prehypertension are more prevalent in the US Armed Forces than has been previously reported, and prehypertension may be more common in the US Armed forces than in the general population. The high prevalence of prehypertension found in this young, fit population suggests a need to better define the risks and benefits associated with the diagnosis and treatment of prehypertension in low-risk populations.

The Journal of the …, 2005

Purpose: Despite the availability of screening tools for postpartum depression (PPD), there is a ... more Purpose: Despite the availability of screening tools for postpartum depression (PPD), there is a general consensus that the condition is underdiagnosed. This study was conducted to determine how frequently family physicians screen for PPD, what methods they use to screen, and what influences their screening frequency. Methods: A survey of members of the Washington Academy of Family Physicians was conducted. Three hundred sixty-two (60.9%) mailed surveys were returned. The 298 physicians who saw postpartum women and children younger than 1 year of age were included in the study. Results: Of the study population, 70.2% always or often screened for PPD at postpartum gynecologic examinations, and 46% always or often screened mothers at well-child visits. Of those who screened, 30.6% reported using a validated screening tool. Of those, only 18% used a tool specifically designed to screen for PPD. Logistic regression modeling showed that female sex [odds ratio (OR) ‫؍‬ 2.2], training in PPD during residency (OR ‫؍‬ 8.1), training in PPD through medical literature (OR ‫؍‬ 2.1), and agreement that postpartum depression is common enough to warrant screening (OR ‫؍‬ 1.9) were all significantly associated with more frequent screening at postpartum gynecologic visits. Agreement that screening takes too much effort was associated with less frequent screening (OR ‫؍‬ 0.8). Conclusions: Although family physicians believe that PPD is serious, identifiable, and treatable; screening is not universal and use of screening tools designed for PPD is uncommon. Training in postpartum depression and female sex are the variables most strongly associated with frequent screening.

Scandinavian Journal of Primary Health Care, 1993

Military medicine, 2005

Physicians need practical ways to maintain and augment clinical skills after residency training. ... more Physicians need practical ways to maintain and augment clinical skills after residency training. The problem is amplified when a physician encounters a new practice environment that requires retraining in particular skills. With their broad scope of practice, family physicians are especially prone to deterioration of infrequently used skills. The SAGE model for lifelong learning provides a simple solution for today's military family physicians. Scan, assess, gather, and experience are four key steps physicians should take when maintaining or upgrading clinical skills. This approach allows physicians to identify available resources and to develop action plans to improve skills. Supervisors must encourage physicians to be honest in self-assessment of patient care skills and should support the acquisition of improved skills. System-based solutions, in keeping with suggestions from the Institute of Medicine, are introduced.

Military Medicine, 2005

Physicians need practical ways to maintain and augment clinical skills after residency training. ... more Physicians need practical ways to maintain and augment clinical skills after residency training. The problem is amplified when a physician encounters a new practice environment that requires retraining in particular skills. With their broad scope of practice, family physicians are especially prone to deterioration of infrequently used skills. The SAGE model for lifelong learning provides a simple solution for today's military family physicians. Scan, assess, gather, and experience are four key steps physicians should take when maintaining or upgrading clinical skills. This approach allows physicians to identify available resources and to develop action plans to improve skills. Supervisors must encourage physicians to be honest in selfassessment of patient care skills and should support the acquisition of improved skills. System-based solutions, in keeping with suggestions from the Institute of Medicine, are introduced.

The Journal of the American Board of Family Medicine, 2008

Background: Hypertension is a common condition, but little is known about its prevalence in the A... more Background: Hypertension is a common condition, but little is known about its prevalence in the Armed Forces. Our purpose was to provide an estimate of the prevalence of hypertension in a large population of US service members. Methods: We reviewed the screening records for service members who completed health risk assessments at Fort Lewis in Tacoma, WA, in 2004. The prevalence of hypertension and prehypertension were estimated from single recorded blood pressure readings and subjects' reported use of blood pressure medications. Study subject characteristics associated with hypertension and prehypertension were examined by 2 tests and multivariate logistic regression. Results: Thirteen percent of the 15,391 subjects met the study definition for hypertension; 62% met the study definition for prehypertension. Increasing age and body mass index, male sex, black race/ ethnicity, and senior rank were associated with hypertension; only body mass index, male sex, and senior rank were associated with prehypertension. Conclusion: Hypertension and prehypertension are more prevalent in the US Armed Forces than has been previously reported, and prehypertension may be more common in the US Armed forces than in the general population. The high prevalence of prehypertension found in this young, fit population suggests a need to better define the risks and benefits associated with the diagnosis and treatment of prehypertension in low-risk populations.

The Journal of the …, 2005

Purpose: Despite the availability of screening tools for postpartum depression (PPD), there is a ... more Purpose: Despite the availability of screening tools for postpartum depression (PPD), there is a general consensus that the condition is underdiagnosed. This study was conducted to determine how frequently family physicians screen for PPD, what methods they use to screen, and what influences their screening frequency. Methods: A survey of members of the Washington Academy of Family Physicians was conducted. Three hundred sixty-two (60.9%) mailed surveys were returned. The 298 physicians who saw postpartum women and children younger than 1 year of age were included in the study. Results: Of the study population, 70.2% always or often screened for PPD at postpartum gynecologic examinations, and 46% always or often screened mothers at well-child visits. Of those who screened, 30.6% reported using a validated screening tool. Of those, only 18% used a tool specifically designed to screen for PPD. Logistic regression modeling showed that female sex [odds ratio (OR) ‫؍‬ 2.2], training in PPD during residency (OR ‫؍‬ 8.1), training in PPD through medical literature (OR ‫؍‬ 2.1), and agreement that postpartum depression is common enough to warrant screening (OR ‫؍‬ 1.9) were all significantly associated with more frequent screening at postpartum gynecologic visits. Agreement that screening takes too much effort was associated with less frequent screening (OR ‫؍‬ 0.8). Conclusions: Although family physicians believe that PPD is serious, identifiable, and treatable; screening is not universal and use of screening tools designed for PPD is uncommon. Training in postpartum depression and female sex are the variables most strongly associated with frequent screening.

Scandinavian Journal of Primary Health Care, 1993

Military medicine, 2005

Physicians need practical ways to maintain and augment clinical skills after residency training. ... more Physicians need practical ways to maintain and augment clinical skills after residency training. The problem is amplified when a physician encounters a new practice environment that requires retraining in particular skills. With their broad scope of practice, family physicians are especially prone to deterioration of infrequently used skills. The SAGE model for lifelong learning provides a simple solution for today's military family physicians. Scan, assess, gather, and experience are four key steps physicians should take when maintaining or upgrading clinical skills. This approach allows physicians to identify available resources and to develop action plans to improve skills. Supervisors must encourage physicians to be honest in self-assessment of patient care skills and should support the acquisition of improved skills. System-based solutions, in keeping with suggestions from the Institute of Medicine, are introduced.