Paul R Gordon

Interests

Teaching

Full continuum of learners from medical students through residents and attendings.

Research

Women's health; procedures; novel teaching methods

Courses

Scholarly Contributions

Books

• Gordon, P. R. (2007). Road Map: Family Medicine. New York, NY: McGraw-Hill.
• Gordon, P. R. (2005). Crash Course: Medical Interview and Physical Examination. Elsevier.
• Chadwick, J. A., Gordon, P. R., Marlow, R. A., Campos-Outcalt, D., & Scherger, J. E. (1999). Family Medicine Review II. Atlanta, Georgia: The Sattinger Group, Inc..
• Vuturo, A., David, A. K., Gordon, P. R., Eckhert, N. L., Wolff, L. T., & Brunton, S. A. (1994). Family Medicine Review. Sattinger Group, Inc.
• Hale, F. A., & Gordon, P. R. (1992). The Family Practice Residency Community/Migrant Health Center Linkage Manual. AAFP/PHS AdvocacyPHS Advocacy Network.

Chapters

• Gordon, P. R., & Reibe, G. (2016). Tumors of the Female Reproductive System. In Taylor's Family Medicine. Springer.
• Gordon, P. R., Riebe, G., Patel, S. B., Emerson, H. M., & Dickerson, F. (2016). Tumors of the Female Reproductive Organs. In Taylor's Family Medicine. Springer International Publishing. doi:10.1007/978-1-4939-0779-3_112-2
• Gordon, P. R. (2010). Meningitis. In The 5 Minute Consult. Philadelphia: Lea and Febiger.
• Gordon, P. R. (2000). Cervical Cancer. In 20 Common Problems in Preventive Health Care(pp 253-274). New York, NY: McGraw-Hill.
• Ellis, J. L., & Gordon, P. R. (1991). Farm family mental health issues. In Occupational medicine (Philadelphia, Pa.)(pp 493-502).

Journals/Publications

• Gordon, P. R. (2020). A Listening Tour: Conversations about Obamacare across America's Heartland. Journal of the American Board of Family Medicine : JABFM, 30(4), 544-546.
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  During my sabbatical, I rode my bike 3300 miles from Washington, DC, to Seattle, WA, in order to engage in dialog with people along the northern tier of America's heartland. Through informal and candid conversations with >100 people, I gained insights into attitudes and opinions about the Patient Protection and Affordable Care Act (Obamacare). The comments were overwhelmingly negative. In this reflective essay, I share some of the conversations I had and the insights I gained from this remarkable journey across our beautiful country.
• Gordon, P. R., Howe, C. L., & Aldulaimi, S. (2020). Rebound Bilirubin Levels in Neonates with Hyperbilirubinemia. American Family Physician.
• Roussel, D., Gordon, P. R., Wagner, J. M., Bardack, M., Sardesai, M. G., & Colbert-Getz, J. M. (2020). The learning community faculty experience: how longitudinal relationships with learners enhance work meaning. Perspectives on medical education.
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  Work meaning has gained attention as an important contributor to physician job engagement and well-being but little is known about how faculty participation in medical school learning communities might influence this phenomena. Our study goals were to determine how physician faculty members may derive meaning from serving as mentors for longitudinal learning communities of medical students, to understand how that meaning may impact other areas of their work, and relate our findings to existing literature and theoretical frameworks.
• Shapiro, E., & Gordon, P. (2019).

  How Patients' Stories Shape Their Votes: The Role of Health Care in the 2018 U.S. Midterm Elections.

  . Academic medicine : journal of the Association of American Medical Colleges, 94(7), 931-933. doi:10.1097/acm.0000000000002669
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  Reflecting on the 2018 U.S. midterm elections, it is clear that health care coverage once again played an important role. This prompted the authors to look back on their 2016 bike listening tour across the country when they asked people about their views on the Affordable Care Act. Through those conversations, the authors observed that a common thread was the rampant misunderstanding of health insurance coverage and the central role that politicians had in the creation of policy. In this Invited Commentary, the authors explore the results of the 2018 election, particularly in the rural northern areas where they toured in 2016, and the contradictions between what people say they want, what the candidates say they support, and what the facts actually show. They offer suggestions for the role physicians might play with patients in correcting misunderstandings about the health care system and the policies that shape it. Patients do not always make decisions as physicians do. As opposed to evidence and data, they might rely on personal experiences and stories. The authors suggest that physicians might be able to help patients use these stories to inform their decisions, and to help them understand the connection between their personal health care experiences and the votes they cast in elections.
• LaGrandeur, J., Moros, M., Dobrick, J., Rahimian, R., Siyahian, A., Tomlinson, E., & Gordon, P. (2018). TotShots: An Innovative Pediatric Free Clinic Providing High Patient Satisfaction to the Underserved. Family Medicine, 50(10), 779-781. doi:10.22454/fammed.2018.678901
• LaGrandeur, J., Moros, M., Dobrick, J., Rahimian, R., Siyahian, A., Tomlinson, E., & Gordon, P. (2018). TotShots: An Innovative Pediatric Free Clinic Providing High Patient Satisfaction to the Underserved. Family medicine, 50(10), 779-781.
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  The University of Arizona College of Medicine-Tucson TotShots clinic is a student-developed, student-directed free clinic that provides sports physicals and vaccines to uninsured pediatric patients in Tucson, Arizona. TotShots runs under the greater umbrella of the Commitment to Underserved People Program, which aims to teach medical students how socioeconomic and cultural factors impact health and access to health care. Our objective was to study cost savings and patient satisfaction of this clinic.
• Lin, S., Nguyen, C., Walters, E., & Gordon, P. (2018). Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities. Family medicine, 50(3), 204-211.
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  Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?"
• Lin, S., Nguyen, C., Walters, E., & Gordon, P. (2018). Residents’ Perspectives on Careers in Academic Medicine:: Obstacles and Opportunities. Family Medicine, 50(3), 204-211. doi:10.22454/fammed.2018.306625
• Gordon, P. R. (2017). A listening tour: Conversations about Obamacare across America’s heartland. Journal of the American Board of Family Medicine, 30, 544-546.
• Gordon, P. R., Gray, L., Hollingsworth, A., Shapiro, E. C., & Dalen, J. E. (2017). Opposition to Obamacare: A Closer Look. Academic Medicine, 92(9), 1241-1247. doi:10.1097/acm.0000000000001725
• Gordon, P. R., Gray, L., Hollingsworth, A., Shapiro, E. C., & Dalen, J. E. (2017). Opposition to Obamacare: A Closer Look. Academic medicine : journal of the Association of American Medical Colleges.
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  Prior telephone surveys have reported two main reasons for opposition to the Affordable Care Act (ACA): distrust of government and opposition to the universal coverage mandate. The authors set out to elucidate the reasons for this opposition. This article describes how the authors used qualitative methods with semistructured interviewing as a principal investigative method to gather information from people they met while bicycling across the United States from April through July 2016. During this time, the authors conducted open-ended, semistructured conversations with people they met as they rode their bicycles from Washington, DC, to Seattle, Washington. Informants were chosen as a convenience sample. One hundred sixteen individuals participated as informants. The majority of comments were negative toward the ACA. Conversations were categorized into four themes, which included the following: (1) The ACA has increased the cost of health insurance; (2) government should not tell people what to do; (3) responsibility for ACA problems is diffuse; and (4) the ACA should not pay for other people's problems. These face-to-face conversations indicated that opposition to the ACA may be due to the fact that many Americans have experienced an increase in the cost of insurance either through increased premiums or greatly increased deductibles. They blame this increase in cost on the ACA, President Obama, the government or insurance companies, and the inclusion of "others" in insurance plans. The authors discuss how these findings can influence medical education curricula to better prepare future physicians to discuss health policy issues with patients.
• Lin, S., & Gordon, P. (2017). Preparing Residents for Teaching Careers: The Faculty for Tomorrow Resident Workshop. Family medicine, 49(3), 225-229.
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  Progress toward growing the primary care workforce is at risk of being derailed by an emerging crisis: a critical shortage of family medicine faculty. In response to the faculty shortage, the Society of Teachers of Family Medicine (STFM) launched a 2-year initiative called "Faculty for Tomorrow" (F4T). The F4T Task Force created a workshop designed to increase residents' interest in, and prepare them for, careers in academic family medicine. We aimed to evaluate the effectiveness of this workshop.
• Lin, S., & Gordon, P. R. (2017). Preparing residents for teaching careers: The faculty for tomorrow resident workshop. Family Medicine.
• Parikh, T., Czuzak, M., Bui, N., Wildner, C., Koch, B., Leko, E., Rappaport, W., Adhikari, S., Gordon, P., Gura, M., & Ellis, S. (2017). Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy. Journal of Ultrasound in Medicine, 37(3), 709-715. doi:10.1002/jum.14408
• Adhikari, S., Czuzak, M., Ellis, S. C., Gordon, P., Gura, M., Koch, B., Leko, E., Parikh, T., Rappaport, W. D., & Wildner, C. (2016).

  96 Novel Use of Ultrasound to Teach Reproductive Physical Examination Skills and Pelvic Anatomy

  . Annals of Emergency Medicine, 68(4), S39. doi:10.1016/j.annemergmed.2016.08.107
• Beach, H., & Gordon, P. (2016). Clinical Examination of the Shoulder. New England Journal of Medicine, 375(11), e24. doi:10.1056/nejmvcm1212941
• Beach, H., & Gordon, P. (2016). VIDEOS IN CLINICAL MEDICINE. Clinical Examination of the Shoulder. The New England journal of medicine, 375(11), e24.
• Gordon, P. R. (2016). How Can Physicians Educate Patients About Health Care Policy Issues?. Academic Medicine, 91(10), 1333-1336. doi:10.1097/acm.0000000000001342
• Gordon, P. R. (2016). How Can Physicians Educate Patients About Health Care Policy Issues?. Academic medicine : journal of the Association of American Medical Colleges, 91(10), 1333-1336.
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  Complicated health care policy decisions are generally made by elected officials. The officials making these complicated decisions are elected by the people, and citizens' participation in the voting process is one of the basic tenets of democracy. Voters in the United States, who are also patients in the health care system, receive enormous amounts of information throughout election cycles. This information is generally delivered in sound bites often intended to elicit an emotional reaction rather than simply inform. From April through July 2016, the author-an academic physician-rode a bicycle across the United States and met with people in small rural towns to ask them their understanding of the Affordable Care Act and the impact it has had on their lives. In this Commentary the author shares some of those stories, which are often informed by sound bites and misinformation. The author argues that it is the role of academic physicians to educate not only students and residents but also patients. In addition to providing information about patients' medical problems, physicians can educate them about the health care policy issues that are decided by elected officials.A doctor can help educate patients about these issues to facilitate their making informed decisions in elections. Physicians have a role and responsibility in society as a knowledgeable person to make the health care system be the best it can be for the most people.
• Gordon, P. R., Keim, S. M., Hernandez, N. C., Gordon, P. R., & Amini, R. (2016). Using standardized patients to evaluate medical students' evidence-based medicine skills.. Journal of evidence-based medicine, 9(1), 38-42. doi:10.1111/jebm.12183
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  To analyze the effectiveness of an Evidence Based Medicine Objective Structured Clinical Examination (EBM OSCE) with standardized patients for end of third year medical students at our institution..This was a single-center prospective cross-sectional investigation. As part of the eight-station OSCE exam, the authors developed and implemented a new 25-minute EBM OSCE station with the goal of evaluating evidence based medicine skills necessary for daily clinical encounters. The OSCE case involved a highly educated patient with a history of recurrent debilitating migraines who has brought eight specific questions regarding the use of steroids for migraine headaches. Students were provided computer stations equipped to record a log of the searches performed..One hundred and four third-year medical students participated in this study. The average number of search tools used by the students was 4 (SD = 2). The 104 students performed a total of 896 searches. The two most commonly used websites were uptodate.com and google.com. Sixty-nine percent (95% CI, 60% to 78%) of students were able to find a meta-analysis regarding the use of dexamethasone for the prevention of rebound migraines. Fifty-two percent of students were able to explain that patients who took dexamethasone had a moderate RR (0.68 to 0.78) of having a recurrent migraine, and 71% of students were able to explain to the standardized patient that the NNT for dexamethasone was nine..The EBM OSCE was successfully integrated into the existing eight-station OSCE and was able to assess student EBM skills.
• Aldulaimi, S., Howe, C. L., & Gordon, P. R. (2019). Rebound Bilirubin Levels in Neonates with Hyperbilirubinemia. Journal of Family Practice.
• Amini, R., Hernandez, N. C., Keim, S. M., & Gordon, P. R. (2015). Using standardized patients to evaluate medical students' evidence-based medicine skills. Journal of evidence-based medicine.
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  To analyze the effectiveness of an Evidence Based Medicine Objective Structured Clinical Examination (EBM OSCE) with standardized patients for end of third year medical students at our institution.
• Parikh, T., Czuzak, M., Bui, N., Wildner, C., Koch, B., Leko, E., Rappaport, W., Adhikari, S., Gordon, P., Gura, M., & Ellis, S. (2018). Novel Use of Ultrasound to Teach Reproductive System Physical Examination Skills and Pelvic Anatomy. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 37(3), 709-15.
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  To determine whether integration of ultrasound (US) into a reproductive system examination clinical skills lab can increase confidence in palpating key reproductive structures during testicular and bimanual pelvic examinations, reduce anxiety about conducting testicular and bimanual pelvic examinations, and improve performance on multiple-choice questions based on structure identification using US images.
• Kutob, R. M., Bormanis, J., Crago, M., Senf, J., Gordon, P., & Shisslak, C. M. (2014). Assessing culturally competent diabetes care with unannounced standardized patients. Family medicine, 45(6), 400-8.
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  More effective diabetes care is desperately needed, especially for ethnic minority populations. Provider cultural competence promises to be an important means for reducing disparities in outcomes for patients with diabetes. The objectives of this study were to understand the role of cultural competence in the diabetes office visit.
• Shisslak, C. M., Bormanis, J., Crago, M., Gordon, P., Kutob, R. M., & Senf, J. H. (2013).

  Assessing culturally competent diabetes care with unannounced standardized patients.

  . Family medicine, 45(6), 400-8.
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  More effective diabetes care is desperately needed, especially for ethnic minority populations. Provider cultural competence promises to be an important means for reducing disparities in outcomes for patients with diabetes. The objectives of this study were to understand the role of cultural competence in the diabetes office visit..Unannounced standardized patients (SPs) were sent to the offices of 29 family and internal medicine residents and practicing physicians. The SPs portrayed a Mexican American woman newly diagnosed with type 2 diabetes. Using a checklist developed with the input of experts in Hispanic/Latino health care and cultural competence, the SPs evaluated physicians' cultural competence, diabetes care, and general communications skills..The average total SP Checklist score was 70.7-11.0%, with a range of 43.9% to 90.2%. Physicians scored highly on items that measured general communication skills (95.9%) but were less likely to ask about social history (ie, family and community support issues, 51.9% and 48.1%, respectively). Sixty-seven percent of physicians ordered a hemoglobin A1c, 44% referred to ophthalmology, and 15% performed a monofilament exam. Physicians' inquiry into SPs explanatory model of disease (ie, asking about the SPs' views regarding their disease and its treatment) correlated with the performance of several diabetes treatment-related behaviors, Spearman's rho=.466..The findings provide support for a relationship between inquiry into patients' explanatory models of disease and effective diabetes care. Social history and explanatory model elicitation skills are vital parts of cultural competence training programs and potentially valuable tools for mitigating health disparities.
• Cagno, C. K., & Gordon, P. R. (2012). Videos in clinical medicine. Neonatal circumcision. The New England journal of medicine, 367(2), e3.
• Gordon, P. R., & Cagno, C. K. (2012). Neonatal Circumcision. New England Journal of Medicine, 367(2), e3. doi:10.1056/nejmvcm0810449
• Kutob, R. M., Bormanis, J., Crago, M., Gordon, P., & Shisslak, C. M. (2012). Using standardized patients to teach cross-cultural communication skills. Medical teacher, 34(7), 594.
• Gordon, P. R. (2011). Achieving excellence in medical education. JAMA, 306(14), 1601.
• Gordon, P. R. (2011). Book Review: Achieving Excellence in Medical Education By Richard B. Gunderman. JAMA, 306(14), 1601.
• Gordon, P. R. (2010). Book Review: Diabetes Rising: How a rare disease became a modern pandemic, and what to do about it By Dan Hurley. JAMA, 304(22), 2539.
• Gordon, P. R. (2010). Book review: The essential guide to primary care procedures By: E.J. Mayeaux Jr. JAMA, 303(24), 2529.
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  Book review
• Gordon, P. R. (2010). Diabetes Rising: How a rare disease became a modern pandemic and what to do about it. JAMA, 304(22), 2539.
• Gordon, P. R. (2010). The essential guide to primary care procedures. JAMA, 203(24), 2529.
• Moynahan, K. F., & Gordon, P. R. (2010). Societies Program at the University of Arizona College of Medicine Design, Implementation and Lessons Learned. Journal of the International Association of Medical Science Educators, 20(2), 124-142.
• Gordon, P. (2009). Videos in clinical medicine. Endometrial biopsy. The New England journal of medicine, 361(26), e61.
• Loprinzi, C. L., Sloan, J., Stearns, V., Slack, R., Iyengar, M., Diekmann, B., Kimmick, G., Lovato, J., Gordon, P., Pandya, K., Guttuso, T., Barton, D., & Novotny, P. (2009). Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 27(17), 2831-7.
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  Nonhormonal treatment options have been investigated as treatments for hot flashes, a major clinical problem in many women. Starting in 2000, a series of 10 individual double-blind placebo-controlled studies has evaluated newer antidepressants and gabapentin for treating hot flashes. This current project was developed to conduct an individual patient pooled analysis of the data from these published clinical trials.
• Harris, J. M., Fulginiti, J. V., Gordon, P. R., Elliott, T. E., Davis, B. E., Chabal, C., & Kutob, R. M. (2008). KnowPain-50: a tool for assessing physician pain management education. Pain medicine (Malden, Mass.), 9(5), 542-54.
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  Despite a need for better physician pain management education, there are no widely accepted assessment or outcome measures to support this work.
• Kerwin, J. P., Gordon, P. R., & Senf, J. H. (2007). The variable response of women with menopausal hot flashes when treated with sertraline. Menopause (New York, N.Y.), 14(5), 841-5.
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  To evaluate the variable response of women when treated with a selective serotonin reuptake inhibitor (sertraline) to decrease hot flashes.
• Gordon, P. R. (2006). Thoughts on communication. Annals of family medicine, 4(3), 263-4.
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  Living without the ability to communicate is humbling. Time spent on a sabbatical in Florence, Italy, taught me that my outgoing manner, my interactional skills, and my ability to establish rapport, all personality traits and skills that I thought would overcome my inadequacies as a communicator in Italian are not immutable. I gained some understanding of what our nonnative English-speaking patients might feel. I learned the following lessons: (1) be cautious-what appears to be a lack of interest may be a lack of understanding; (2) our perceptions of aptitude may be mistaken if based on patients' facial expressions and body language; (3) we should not adjust our words and speed of speech just because we think a patient cannot understand what we are saying; and (4) language is an amazingly powerful tool-the inability to communicate transforms us.
• Gordon, P. R., Kerwin, J. P., Boesen, K. G., & Senf, J. (2006). Sertraline to treat hot flashes: a randomized controlled, double-blind, crossover trial in a general population. Menopause (New York, N.Y.), 13(4), 568-75.
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  To evaluate the effectiveness of a selective serotonin reuptake inhibitor (SSRI) (sertraline) in decreasing hot flashes in a general population of women.
• Gordon, P. (2005). The complex web of diabetes research: family physicians adding their expertise. Family medicine, 37(2), 139-40.
• Gordon, P., Tomasa, L., & Kerwin, J. (2004). ACGME Outcomes Project: selling our expertise. Family medicine, 36(3), 164-7.
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  The Accreditation Council for Graduate Medical Education (ACGME) Outcomes Project emphasizes competency outcome assessment by residency programs. Many residency programs are unprepared to undertake valid competency assessments. Family medicine educators, however, often have substantial experience in competency-based evaluation. We developed a program, with more than 240,000 US dollars of funding from our dean's office, through which our family medicine educational unit provided support to more than 60 residency programs in various specialties. This program assisted directors of these 60 programs to understand the ACGME competency domains, develop measurable competencies for their discipline, and develop evaluation tools to assess those competencies. We were thus able to "sell" our expertise to other programs and generate income for our department.
• Taren, D. L., Thomson, C. A., Koff, N. A., Gordon, P. R., Marian, M. J., Bassford, T. L., Fulginiti, J. V., & Ritenbaugh, C. K. (2001). Effect of an integrated nutrition curriculum on medical education, student clinical performance, and student perception of medical-nutrition training. The American journal of clinical nutrition, 73(6), 1107-12.
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  Ninety-eight percent of medical schools report nutrition as a component of medical education. However, most schools do not have an identifiable nutrition curriculum. Medical schools that do include nutrition have not evaluated its effect on clinical skills.
• Gordon, P. (2000). Birth and death through a child's eyes.. The Journal of the American Board of Family Practice, 13(1), 86. doi:10.3122/jabfm.13.1.86d
• Campos-Outcalt, D., Watkins, A., Fulginiti, J., Kutob, R., & Gordon, P. (1999). Correlations of family medicine clerkship evaluations and Objective Structured Clinical Examination scores and residency directors' ratings. Family medicine, 31(2), 90-4.
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  This study validated the evaluation methods used in a family medicine clerkship by comparing students' scores to how students are rated in their first year of residency by residency directors. The clerkship evaluations consisted of three components: problem solving in small groups, clinical evaluations, and a final examination. These components were combined to form a composite clerkship score. Residency director ratings consisted of 20 individual scores and an overall average.
• Gordon, P. R., & Allen, S. A. (1999). Atypical infective endocarditis. The Journal of the American Board of Family Practice / American Board of Family Practice, 12(5), 391-4.
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  Although infective endocarditis has changed in the recent past as a result of microbiologic and risk factors, it continues to be clinically challenging. The disease is characterized by the formation of septic masses of platelets on the surfaces of heart valves. Several mechanisms can cause or contribute to the development of endocarditis. Although risk factors for infective endocarditis are well known, patients with atypical signs and symptoms continue to challenge us.
• Gordon, P. R., & Senf, J. (1999). Is the annual complete physical examination necessary?. Archives of internal medicine, 159(9), 909-10.
• Murrain, V. E., Gordon, P., & Senf, J. (1999). Number of deliveries performed during family practice residency training. Family medicine, 31(9), 631-4.
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  We conducted a study of family practice residency programs to investigate the number of deliveries performed by residents during training.
• Gordon, P. R., & McClure, C. L. (1998). Cochairs: a new model for departmental leadership. Family medicine, 30(10), 740-3.
• Fass, R., Hixson, L. J., Ciccolo, M. L., Gordon, P., Hunter, G., & Rappaport, W. (1997). Contemporary medical therapy for gastroesophageal reflux disease. American family physician, 55(1), 205-12, 217-8.
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  Gastroesophageal reflux disease is a chronic disorder that requires long-term therapy in most patients. The appropriate medical therapy should be individualized to the severity of symptoms, the degree of esophagitis and the presence of other acid-reflux complications. Lifestyle changes should form the basis of any therapeutic approach. In patients with mild to moderate disease, initial therapy with histamine H2-receptor antagonists in conventional dosages is suggested. Prokinetic agents are potentially useful in patients with impaired esophageal or gastric motor function, but their efficacy as single agents does not appear to surpass that of standard doses of H2 blockers. Sucralfate, a cytoprotective agent, is an additional therapeutic option. For patients with more severe disease, omeprazole and lansoprazole provide unequaled healing rates and accelerated symptom relief. In most patients, maintenance therapy is vital. Surgery is indicated in patients whose disease is refractory to medical therapy and in those who develop complications not amenable to medical therapy.
• Gordon, P. R., Campos-Outcalt, D., Steele, L., & Gonzales, C. (1994). Mammography and Pap smear screening of Yaqui Indian women. Public health reports (Washington, D.C. : 1974), 109(1), 99-103.
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  The Pascua-Yaqui Tribe of Arizona receives its health care services at a local neighborhood health center in Tucson and a satellite clinic located on the reservation. Using a computerized data base from the health center, the authors determined the use rates by Pascua-Yaqui women ages 35-65 of the Papanicolaou smear and mammography screening. Among active users of the health center, 31-36 percent had received a Papanicolaou smear, according to the yearly data bases examined from 1986 to 1990, while 65 percent of the women had received at least one smear test over the entire 5-year period. Regarding mammography screening, 41-43 percent of the women ages 50-65 had received a mammogram in the years studied, and 51-58 percent of the women ages 40-49 had been screened. In all, 67 percent had received at least one mammogram during the 1988-90 period when the center offered mammography. This population of 35-65-year-old American Indian women, for whom financial access is not a barrier, were receiving Papanicolaou smears and mammograms at rates comparable with other segments of the U.S. population but at lower rates than those recommended by the American Cancer Society and National Cancer Institute. The challenge for the health center is to reach those women who are eligible for services but do not use them and to address the nonfinancial barriers to care such as language, transportation, and gender-specific issues.
• Rappaport, W. D., Gordon, P., Warneke, J. A., Neal, D., & Hunter, G. C. (1994). Contraindications and complications of laparoscopic cholecystectomy. American family physician, 50(8), 1707-11, 1714.
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  Laparoscopic cholecystectomy is a commonly performed procedure for the removal of symptomatic gallstones. Compared with open cholecystectomy, laparoscopic cholecystectomy is associated with less postoperative pain, earlier discharge from the hospital and a more rapid recovery. However, there are specific contraindications to the procedure, including empyema of the gallbladder, gangrenous cholecystitis, coagulopathy, portal hypertension and peritonitis. Complications from laparoscopic cholecystectomy include common duct injury, bleeding, bile leakage and wound infection. An understanding of these issues allows the family physician to more appropriately select patients for laparoscopic removal of the gallbladder.
• Gordon, P. R., & Hale, F. (1993). The service-education linkage: implications for family practice residency programs and community and migrant health centers. Family medicine, 25(5), 316-21.
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  Access to quality primary health care for our country's underserved populations is a challenge for both the government and physicians. The Division of Medicine, through funding priorities and other initiatives, is encouraging family practice educators to train residents and students for work in community and migrant health centers (C/MHCs) in underserved areas. The objective of this research was to study linkages between family practice residency programs and C/MHCs and determine the reasons for affiliation, disadvantages and advantages, predictors of successful linkages, and common errors in the linkage agreement.
• Gordon, P. (1991). Colposcopy training in family practice residency programs. Family medicine, 23(4), 310-2.
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  This study investigated colposcopy training in family practice residency programs, using a national survey of all 376 residency program directors. Responses were received from 75% of the directors; 59% provided colposcopy training, and 40% of the programs not providing the training were in the process of developing a training experience. There was a regional difference in programs providing training; those in the northeast were least likely to provide training and were also least likely to be actively integrating training into their curricula. The three most common barriers to colposcopy training were lack of trained faculty, equipment costs, and inadequate patient volume.
• Gordon, P. (1992). Colposcopy training. The Journal of the American Board of Family Practice / American Board of Family Practice, 5(4), 450-1.
• Gordon, P., & Hatch, K. (1992). Survey of colposcopy practices by obstetrician/gynecologists. The Journal of reproductive medicine, 37(10), 861-3.
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  A statewide survey to characterize the colposcopy patterns of practicing obstetrician/gynecologists was undertaken. There was a 66.1% response rate, with 98.2% of respondents performing colposcopy. Of those performing colposcopy, nearly all perform biopsies, cryosurgery and conizations; 73.4% perform laser vaporization, 66.7% perform laser cone biopsy and 11% perform laser cone biopsies in their offices. The mean number of colposcopies performed by respondents in a six-month period was 55. Twenty percent performed less than one examination per week and an additional 60% performed two to three examinations per week. Further studies to assess the diagnostic accuracy of those performing greater and lesser numbers of examinations are needed.
• Weiss, B. D., & Gordon, P. (1992).

  Family physicians' colposcopy practices.

  . Journal of The American Board of Family Practice, 5(1), 27-30. doi:10.3122/jabfm.5.1.27
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  Background: The objectives of this study were to determine (1) the extent to which family physicians are performing colposcopy, (2) which colposcopic procedures are performed by these family physicians, (3) demographic characteristics of physics who perform colposcopy, and (4) whether physicians who do not perform colposcopy plan to do so in the future. Methods: A questionnaire was mailed to all 757 self-identified family practice physicians in Arizona. Results: The return rate was 72 percent, and the response rate was 55.5 percent. Results indicated that 19.3 percent of respondents were trained to perform colposcopy, and 9.5 percent actually have performed it. For those performing colposcopy, the mean number of procedures performed during the previous 6 months was 25 (range 2–100). Conclusions: Certain barriers to performing colposcopy were identified: (1) lack of available training, (2) interspecialty “turf battles,” (3) quality assurance, and (4) the cost of malpractice liability insurance. Nevertheless, there were no insurmountable reasons why family physicians could not perform colposcopy.
• Gordon, P. (1991). Serious bacterial infections in children. When can outpatient treatment be used?. Postgraduate medicine, 90(1), 87-90.
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  Several studies now support outpatient treatment of many serious bacterial infections in children, such as periorbital or buccal cellulitis, urinary tract infection, pneumonia, and abscess. However, an appropriate agent, that is, a third-generation cephalosporin with a long half-life, must be available and its effectiveness properly researched. In addition, children must be free of other illnesses and able to ingest fluids and maintain hydration, and their parents must be willing and able to cooperate with an outpatient treatment regimen. Family physicians can maintain the close patient and family contact needed to facilitate this form of therapy.
• Gordon, P. R., Bassford, T. L., & Lippman, S. M. (1991). Cancer risk reduction counseling: a computer-assisted curriculum. American journal of preventive medicine, 7(4), 244-7.
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  Significant progress has been made in the identification of factors associated with an increased risk of developing cancer. Cancer is increasingly viewed as a preventable disease. Its prevention involves risk reduction counseling. This counseling is an important skill for the family physician but can be difficult to learn and to teach. We used a prototype, computer-assisted cancer risk reduction counseling curriculum with first-year medical students. We found a statistically significant change in both knowledge-based and attitudinal questions and answers after the use of this curriculum.
• Ventres, W., & Gordon, P. (1990). Communication strategies in caring for the underserved. Journal of health care for the poor and underserved, 1(3), 305-14.
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  Physicians face numerous challenges in caring for underserved patients. These include both structural barriers, such as the increasing ranks of the uninsured, and contextual barriers. Contextual problems are embedded within the communication between doctors and patients. Communication between doctors and poor patients fails principally because of inadequately shared information and a power asymmetry in the relationship. This paper addresses specific strategies which practitioners and educators can use to improve communication with poor patients and assist in their empowerment. These strategies include employing attentive patient care, attending to the use of jargon, and using self-empowering language.
• Gordon, P. (1989). Evaluation of an intervention to increase seat belt use. Family medicine, 21(6), 458-60.
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  People continue to travel without wearing seat belts despite their proven safety value. Numerous interventions in primary care physicians' offices to enhance the use of seat belts have met with limited success. In a rural neighborhood health center, an intervention using the language of self-responsibility was evaluated. Of 105 patients receiving the intervention, seat belt use increased from 20% before to 35.2% after the intervention (P less than .001). No change in seat belt use occurred in a control group of patients who did not receive the intervention.

Presentations

• Gordon, P. R., Sunderman, K. A., Beach, H. N., Beach, H. N., Sunderman, K. A., & Gordon, P. R. (2017, May). Balancing the need for personal wellness and the demands of education and future clinical practice- a longitudinal perspective through clerkship, residency, and fellowship.. Society for Teachers in Family Medicine. San Diego, CA: STFM.
• Sunderman, K. A., & Gordon, P. R. (2016, Spring). Assessing Teaching Techniques for Motivational Interviewing. STFM Conference on Medical Student Education.

Poster Presentations

• Sardesai, M. G., Bardack, M., Roussel, D., Wagner, J., Colbert-Getz, J., & Gordon, P. R. (2019, November). The Multi-Institutional Qualitative Study: Is it a Unicorn or a Real Beast?. AAMC: National Meeting: Learn, Serve Lead. Phoenix, AZ: AAMC.
• Adamas-Rappaport, W., Ellis, S. C., Wildner, C., Gordon, P. R., Leko, E. O., Gura, M., Koch, B., Adhikari, S. R., Czuzak, M. H., & Parikh, T. M. (2017, June). Using standardized patients and ultrasound to enhance reproductive physical exam skills & pelvic anatomy identification. Association of Standardized Patient Educators Annual Conference. Alexandria, VA: ASPE.
• Mora, F., Prichard, G., Aldulaimi, S., Pust, R. E., Moreno, F., Stevenson, A., & Gordon, P. R. (2017, spring). “Global Health at the University of Arizona: The Ecuador Program”. Presented by Mora F at Annual University of Arizona South Campus Graduate Medical Education Scholarly Day.. Annual University of Arizona South Campus Graduate Medical Education Scholarly Day..
• Wildner, C. M., Leko, E. O., Adamas-Rappaport, W., Gordon, P. R., Ellis, S. C., Gura, M., Koch, B. D., Czuzak, M. H., Adhikari, S. R., & Parikh, T. M. (2017, April). "Novel Use of Ultrasound to Aid in Medical Student Reproductive Physical Examination Skills and Pelvic Anatomy". AMES Medical Education Research Day. University of Arizona College of Medicine: AMES.
• Wildner, C. M., Leko, E. O., Adamas-Rappaport, W., Gordon, P. R., Ellis, S. C., Gura, M., Koch, B. D., Czuzak, M. H., Adhikari, S. R., & Parikh, T. M. (2017, June). "Novel Use of Ultrasound to Aid in Medical Student Reproductive Physical Examination Skills and Pelvic Anatomy". Association of Standardized Patient Education. Alexandria, Virginia.

Other Teaching Materials

• Gordon, P. R. (2015. NEJM Knowledge+ Family Medicine. Massachusetts Medical Society.
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