Robert L Phillips
Dados Biográficos
| ID | 271315 |
|---|---|
| NOME | Robert L Phillips |
| PRENOMES | Robert L |
| SOBRENOME | Phillips |
| ASSINATURA | PHILLIPS R L |
| AFILIAÇÕES | American Board of Internal Medicine |
| ORCID | 0000-0002-1591-5145 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 45 |
| TOTAL DE CITAÇÕES | 72 |
| TOTAL COMO AUTOR | 45 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1971 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Demonstrating the Reliability and Structural Validity of Creating Patient-Level and Clinician-Level Scores on the Person Centered Primary Care Measure
BACKGROUND: The Person Centered Primary Care Measure (PCPCM) was developed to assess "aspects that contribute to patient perceptions regarding the integrating, prioritizing, and personalizing functions of primary care." Several psychometric issues remain unresolved. OBJECTIVES: We sought to examine the performance of the existing patient-level model, evaluate measurement bias, assess the impact of item-level missingness on reliability, examine th…
Validating 8 Area-Based Measures of Social Risk for Predicting Health and Mortality
In this cross-sectional study, area-based measures predicted health outcomes better than individual socioeconomic measures, and generally predicted health equitably across subpopulations; thus, their use should be considered in conjunction or instead of using individual-level measures for selected health policy applications
Family and community medicine workforce training and practice in the Americas
Objectives. This study sought to analyze the current state of the training for and practice of family medicine and family and community medicine to identify gaps and opportunities to implement strategic actions to strengthen the health workforce. Methods This paper reports the results of an observational, analytical, cross-sectional study carried out in countries in the World Health Organization’s Region of the Americas in 2024. A 22-item survey …
Was Fichte a Proto-Fascist
In the varied and diffuse reception history of Fichte’s political philosophy, the most widely discussed episode is the appreciation of Fichte in national socialist Germany. In this article, I reassess some aspects of that reception with an eye to determining whether Fichte could be called a proto-fascist. I begin this reassessment by first outlining Fichte’s account of political economy and nationhood. I then discuss the scholarship on fascism an…
Adapted Choice Architecture and Diversity in the National Academy of Medicine
This Viewpoint discusses how the National Academy of Medicine’s adapted choice architecture has led to a more diverse membership and how other mission-based organizations can consider using this strategy
Measuring Primary Care Spending in the US by State
This case series identifies states’ estimates of primary care spending and recommends steps policymakers can take toward standardizing these estimates
Academic Medicine’s Fourth Mission
A 2021 article, “Now is our time to act: Why academic medicine must embrace community collaboration as its fourth mission,” by Association of American Medical Colleges (AAMC) authors, including AAMC president and CEO Dr. David J. Skorton, offers 2 aims that are highly related: community collaboration and health equity. The AAMC’s call to prioritize community collaboration and health equity as pillars of the academic medicine mission echo earlier …
Fichte on sex, marriage, and gender
“I am only what I make myself to be”, Fichte tells us. In this paper, I outline Fichte’s views on sex, marriage and gender, with two aims. Firstly, to elucidate an aspect of his moral theory which has received little attention, and secondly to argue that Fichte’s distinctive stance on selfhood, freedom, and normativity lead to a revisionary account of gender expression and identity, where people can freely carve out their own identity, irrespecti…
The Value of Funding a Primary Care Extension Program in the United States
This Viewpoint discusses the potential of the Primary Care Extension Program to ensure access to high-quality primary care in the US
Measuring Graduate Medical Education Outcomes to Honor the Social Contract
The graduate medical education (GME) system is heavily subsidized by the public in return for producing physicians who meet society’s needs. Under the terms of this implicit social contract, decisions about how this funding is allocated are deferred to the individual training sites. Institutions receiving public funding face potential conflicts of interest, which have at times prioritized institutional purposes and needs over societal needs, high…
Fichte's Moral Philosophy by Owen Ware (Oxford
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Multinational primary health care experiences from the initial wave of the Covid-19 pandemic
OBJECTIVE: To learn from primary health care experts' experiences from the COVID-19 pandemic across countries. METHODS: We applied qualitative thematic analysis to open-text responses from a multinational rapid response survey of primary health care experts assessing response to the initial wave of the COVID-19 pandemic. RESULTS: Respondents' comments focused on three main areas of primary health care response directly influenced by the pandemic:…
Faith without hope is dead
It is well-known that Kant defends a conception of God and the final end of our moral striving, called the highest good. In this article, I outline Kant's argument for why we ought to have faith in God and hope for the highest good, and argue that the Kantian argument can be extended in such a way as to show the unity of the theological virtues. This feature of the Kantian account can then have ramifications in further questions regarding the rel…
Strengthening Primary Care to Improve Health Outcomes in the US—Creating Oversight to Address Invisibility
This Viewpoint discusses how the lack of a comprehensive national primary care approach creates gaps and confusion in federal policy and proposes solutions
Family Practices in Transforming Clinical Practice Initiative Showed No Changes in Medicare Costs or Utilization
BACKGROUND: The Centers for Medicare and Medicaid Services proposed that the Transforming Clinical Practice Initiative (TCPI) would improve health outcomes for patients, reduce utilization of institutional services, and generate significant savings for payers by the end of September 2019. OBJECTIVE: The objective of this study was to investigate whether participation in TCPI's Practice Transformation Networks (PTNs) was associated with improved c…
Increasing Transparency for Medical School Primary Care Rankings—Moving From a Beauty Contest to a Talent Show
The U.S. News & World Report (US News) annually ranks educational institutions on several criteria that affect many readers' views of their institutional reputations. 1 One critic of the US News rankings recently declared the medical school rankings a "beauty contest." 2 We agree and set out several years ago to persuade US News to shift the source of its data and diversify the foci of its medical school rankings to reflect a broader range of soc…
Primary care perspectives on pandemic politics
While the COVID-19 pandemic now affects the entire world, countries have had diverse responses. Some responded faster than others, with considerable variations in strategy. After securing border control, primary health care approaches (public health and primary care) attempt to mitigate spread through public education to reduce person-to-person contact (hygiene and physical distancing measures, lockdown procedures), triaging of cases by severity,…
Rebuilding a US Federal Data Strategy After the End of the “Community Health Status Indicators”
For nearly 2 decades, the Community Health Status Indicators tool reliably supplied communities with standardized, local health data and the capacity for peer-community comparisons. At the same time, it created a large community of users who shared learning in addressing local health needs. The tool survived a transition from the Health Resources and Services Administration to the Centers for Disease Control and Prevention before being shuttered …
Incorporating machine learning and social determinants of health indicators into prospective risk adjustment for health plan payments
ML improved risk adjustment models and the incorporation of SDH indicators reduced underpayment in several vulnerable populations
Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015
Importance: Recent US health care reforms incentivize improved population health outcomes and primary care functions. It remains unclear how much improving primary care physician supply can improve population health, independent of other health care and socioeconomic factors. Objectives: To identify primary care physician supply changes across US counties from 2005-2015 and associations between such changes and population mortality. Design, Setti…
Which Family Physicians Work Routinely With Nurse Practitioners, Physician Assistants or Certified Nurse Midwives
PURPOSE: Facing rising numbers of insured with implementation of the Affordable Care Act, policy makers are interested in building teams of providers that can accommodate a growing demand for primary care services. Nurse Practitioners (NPs), Physician Assistants (PAs), and Certified Nurse Midwives (CNMs) already augment the physician workforce, particularly in rural areas. Our objective was to determine what physician and areal-level characterist…
Effectiveness Over Efficiency
Interest in improving health care outcomes requires increasing the effectiveness of primary care. Focus on effectiveness is leading many innovative health systems to shrink primary care patient panels to strengthen relationships, and to enhance primary care teams to increase comprehensiveness. Such strategies would make primary care shortages worse than predicted, and are compounded by substantial declines in clinicians of all types choosing prim…
Proximity of providers
Integrated behavioral health and primary care is emerging as a superior means by which to address the needs of the whole person, but we know neither the extent nor the distribution of integration. Using the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System (NPPES) Downloadable File, this study reports where colocation exists for (a) primary care providers and any behavioral health provider and (b) primary c…
Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery
OBJECTIVE: To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. DATA SOURCES/STUDY SETTING: Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were …
A Reemerging Political Space for Linking Person and Community Through Primary Health Care
Objectives. We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities. Methods. We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard–defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an e…
Receipt of Preventive Care Among Adults
Objectives. This study ascertained the separate and combined effects of having insurance and a usual source of care on receiving preventive services. Methods. Descriptive and multivariate analyses of 1996 Medical Expenditure Panel Survey data were conducted. Results. Receipt of preventive services was strongly associated with insurance and a usual source of care. Significant differences were found between insured adults with a usual source of car…
Giving Everyone the Health of the Educated
Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum n…
The All-Volunteer Army
This paper describes the changing recruitin environment during the 15 years since the inception of the All-Volunteer Force. It describes the origins of the 'dual market' strategy, which'segmented the recruiting market, and focuses on the systematic development of one of the most important recruiting policy initiatives in the 1980s-the Army College Fund. The impact of the ACF is estimated, providing empirical evidence of how significant a policy t…
Proximity of providers
Integrated behavioral health and primary care is emerging as a superior means by which to address the needs of the whole person, but we know neither the extent nor the distribution of integration. Using the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System (NPPES) Downloadable File, this study reports where colocation exists for (a) primary care providers and any behavioral health provider and (b) primary c…
A Reemerging Political Space for Linking Person and Community Through Primary Health Care
Objectives. We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities. Methods. We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard–defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an e…
Avertable Deaths Associated With Household Income in Virginia
Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the ref…
An internalist perspective on party consolidation and the Bulgarian Union of Democratic Forces
Scholars have traditionally held political parties to be indispensable to democracy, and recent studies of democratic consolidation have reaffirmed their importance. Yet analysis of the development of political parties in Eastern Europe and elsewhere has tended to understate the role of internal, organizational factors at the expense of external factors, such as the selection effect of electoral markets and presence of societal cleavages. We argu…
Communitarianism, the Vatican, and the New Global Order
Pope John Paul's great vision of communitarianism and a New Global Order has yet to receive the recognition it deserves in furthering the understanding that humanity is built on religious values, without which transformations in totalitarian regimes would have been impossible. The essence of communitarianism, as put forth by the Vatican, consists of seeking middle ground between Marxist collectivism and rigid individualism and capitalism. Phillip…
Are Smart Tankers Better? AFQT and Military A Productivity
In this article the relationship between soldier productivity and individual characteristics is examined. Our measure of output is the score achieved on a live fire tank gunnery test administered to U.S. Army units in West Germany in early 1984. The crew members' characteristics for which we controlled include mental aptitude, educational and racial background, Army experience, and time served in current position. We also controlled for the type …
Job Satisfaction Among Youth in Military and Civilian Work Settings
Jam joint operation
Intuitonism revisited
Brave new world and the liberal concept of freedom
Job Satisfaction Among Youth in Military and Civilian Work Settings
Are Smart Tankers Better? AFQT and Military A Productivity
In this article the relationship between soldier productivity and individual characteristics is examined. Our measure of output is the score achieved on a live fire tank gunnery test administered to U.S. Army units in West Germany in early 1984. The crew members' characteristics for which we controlled include mental aptitude, educational and racial background, Army experience, and time served in current position. We also controlled for the type …
Is There an Ethic to Nato
The Soviet ruling class, thwarted in its expansionist aims and beset by economic ills, sought to enjoy the fruits of Western culture without risking war, by a policy of “Finlandization” or neutralization of Europe. Phillips, writing in 1987, maintains that NATO had as great a moral duty to check this political ambition as it had to check Soviet military aggression. He suggests ways to reaffirm the rule of law and the commitment to social justice …
Nuclear Deterrence and Just War Theory
The just war tradition stands as the moral and prudential alternative to both pacifism and realism. It forms the only reasonable ethical basis for the understanding of state initiated force. As applied to questions of nuclear deterrence, just war theory is incompatible with Mutual Assured Destruction and with the threat of MAD. Just war theory entails a move toward counterforce with discriminate targeting of military capabilities and away from ci…
Inter‐institutional conference on terrorism research
The All-Volunteer Army
This paper describes the changing recruitin environment during the 15 years since the inception of the All-Volunteer Force. It describes the origins of the 'dual market' strategy, which'segmented the recruiting market, and focuses on the systematic development of one of the most important recruiting policy initiatives in the 1980s-the Army College Fund. The impact of the ACF is estimated, providing empirical evidence of how significant a policy t…
Communitarianism, the Vatican, and the New Global Order
Pope John Paul's great vision of communitarianism and a New Global Order has yet to receive the recognition it deserves in furthering the understanding that humanity is built on religious values, without which transformations in totalitarian regimes would have been impossible. The essence of communitarianism, as put forth by the Vatican, consists of seeking middle ground between Marxist collectivism and rigid individualism and capitalism. Phillip…
Shelby Foote
Receipt of Preventive Care Among Adults
Objectives. This study ascertained the separate and combined effects of having insurance and a usual source of care on receiving preventive services. Methods. Descriptive and multivariate analyses of 1996 Medical Expenditure Panel Survey data were conducted. Results. Receipt of preventive services was strongly associated with insurance and a usual source of care. Significant differences were found between insured adults with a usual source of car…
Splitting the Difference--Patient Preference versus Conservation of Resources
Case Dr. Dan Troy is a well-respected, well-liked family physician in a medium-sized urban community. He has been practicing family medicine for more than 20 years in a multispecialty group practice in a small city and enjoys his work very much
An internalist perspective on party consolidation and the Bulgarian Union of Democratic Forces
Scholars have traditionally held political parties to be indispensable to democracy, and recent studies of democratic consolidation have reaffirmed their importance. Yet analysis of the development of political parties in Eastern Europe and elsewhere has tended to understate the role of internal, organizational factors at the expense of external factors, such as the selection effect of electoral markets and presence of societal cleavages. We argu…
Changes in Age-Adjusted Mortality Rates and Disparities for Rural Physician Shortage Areas Staffed by the National Health Service Corps
OBJECTIVE: This study assesses whether the National Health Service Corps's legislated goals to see health improve and health disparities lessen are being met in rural health professional shortage areas for a key population health indicator: age-adjusted mortality. METHODS: In a descriptive study using a pre-post design with comparison groups, the authors calculated age-adjusted mortality rates at baseline (1981-1983) and follow-up (1996-1998) for…
Four-Year Residency Training for the Next Generation of Family Physicians
Family medicine training is still largely based on a model developed more than 35 years ago, with 3 years of required rotations in multiple areas of medicine, combined with a longitudinal clinic experience in model family practice centers The physician trained in this model has been prepared to practice in a range of settings and with diverse scopes of practice. The outcome is a physician workforce that is distributed across urban and rural Ameri…
National Health Service Corps Staffing and the Growth of the Local Rural Non‐NHSC Primary Care Physician Workforce
Context: Beyond providing temporary staffing, National Health Service Corps (NHSC) clinicians are believed by some observers to contribute to the long‐term growth of the non‐NHSC physician workforce of the communities where they serve; others worry that NHSC clinicians compete with and impede the supply of other local physicians. Purpose: To assess long‐term changes in the non‐NHSC primary care physician workforce of rural underserved counties th…
Giving Everyone the Health of the Educated
Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum n…
Nonemergency Medicine‐Trained Physician Coverage in Rural Emergency Departments
Context: Rural areas have fewer physicians compared to urban areas, and rural emergency departments often rely on community or contracted providers for staffing. The emergency department workforce is composed of a variety of physician specialties and clinicians. Purpose: To determine the distribution of emergency department clinicians and the proportion of care they provide across the rural‐urban continuum. Methods: Cross‐sectional analysis of se…
Avertable Deaths Associated With Household Income in Virginia
Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the ref…
A Reemerging Political Space for Linking Person and Community Through Primary Health Care
Objectives. We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities. Methods. We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard–defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an e…
Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery
OBJECTIVE: To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. DATA SOURCES/STUDY SETTING: Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were …
Which Family Physicians Work Routinely With Nurse Practitioners, Physician Assistants or Certified Nurse Midwives
PURPOSE: Facing rising numbers of insured with implementation of the Affordable Care Act, policy makers are interested in building teams of providers that can accommodate a growing demand for primary care services. Nurse Practitioners (NPs), Physician Assistants (PAs), and Certified Nurse Midwives (CNMs) already augment the physician workforce, particularly in rural areas. Our objective was to determine what physician and areal-level characterist…
Effectiveness Over Efficiency
Interest in improving health care outcomes requires increasing the effectiveness of primary care. Focus on effectiveness is leading many innovative health systems to shrink primary care patient panels to strengthen relationships, and to enhance primary care teams to increase comprehensiveness. Such strategies would make primary care shortages worse than predicted, and are compounded by substantial declines in clinicians of all types choosing prim…
Proximity of providers
Integrated behavioral health and primary care is emerging as a superior means by which to address the needs of the whole person, but we know neither the extent nor the distribution of integration. Using the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System (NPPES) Downloadable File, this study reports where colocation exists for (a) primary care providers and any behavioral health provider and (b) primary c…
Medicine (24 obras) · Political science (20 obras) · Primary Care and Health Outcomes (18 obras) · Family medicine (16 obras) · Health care (13 obras) · Healthcare Policy and Management (13 obras) · Sociology (12 obras) · Environmental health (11 obras) · Law (11 obras) · Nursing (11 obras)